CFPC exam vs. Royal College exams

[MedSchoolHope101]

Hi everyone! I am an incoming M1 with a lot of free time at the moment, so I have been doing a bit of research to better understand the residency process.

From what I understood, family medicine residents have their own CFPC exam while all other specialties have their specific Royal College exams. Since I saw many people mentioning how grueling it was to study for the Royal College exams in their last year, I was wandering how the CFPC exam compares in terms of difficulty/studying. Is it as horrible and difficult as people describe the Royal College exams? Or would you say that the 2 years in family medicine residency prepare you fairly well for the exam and you do not to have to study every waking hour of the day for a whole year for the CFPC exam?

[medisforme]

There are very few people who would have done both exams, so you probably won't get any answers from personal experience.  I think it is pretty well acknowledged the Royal College exams are much more difficult for a variety of obvious reasons.  For context, I studied about 3 hours/day for 3 months for the combined CFPC oral/written exam and probably could have studied a little less.  My understanding is that a lot of R5+ residents are studying 4-8hrs everyday for a year to prepare for the Royal College exam.

[blah1234]

Royal college exam year was the worst year of my life by far. My friends in FM had much lighter final years even with exam studying.

[chateau22]

4 hours ago, medisforme said:

There are very few people who would have done both exams, so you probably won't get any answers from personal experience.  I think it is pretty well acknowledged the Royal College exams are much more difficult for a variety of obvious reasons.  For context, I studied about 3 hours/day for 3 months for the combined CFPC oral/written exam and probably could have studied a little less.  My understanding is that a lot of R5+ residents are studying 4-8hrs everyday for a year to prepare for the Royal College exam.

Omg this sounds awful

[rmorelan]

1 hour ago, chateau22 said:

Omg this sounds awful

It is, and that estimate timewise is pretty accurate. You basically lose a year of your life. Everything I did during that time was centred on the exam. 

It isn't a competition for whose life sucks the most - but I do think people should be always aware of what they are getting into. Not only does that exam cloud things, but the residency as a whole is has it looming always in the future. 

The problem with PGY5 exams in general is they can ask you anything from any part of the field - which is always a bottomless pit. You have to understand all things fully as you basically operate in this unrealistic framework of not being able to talk to anyone, look anything up, or spend more than ~1-2 minutes looking at the problem. 

[ellorie]

Yeah imagine if you had to study for it twice...oh wait...

[RadHopeful]

30 minutes ago, rmorelan said:

It is, and that estimate timewise is pretty accurate. You basically lose a year of your life. Everything I did during that time was centred on the exam. 

It isn't a competition for whose life sucks the most - but I do think people should be always aware of what they are getting into. Not only does that exam cloud things, but the residency as a whole is has it looming always in the future. 

Incoming radiology resident here! Is there anything you wish you would have done differently during your first years of residency that would have made the 5th year experience go a little more smoothly? 

[rmorelan]

1 hour ago, RadHopeful said:

Incoming radiology resident here! Is there anything you wish you would have done differently during your first years of residency that would have made the 5th year experience go a little more smoothly? 

ha sure - some of this I was told when I started and tried to follow, some of it was stuff I ended up knowing in the end

start studying - really do need to study a couple of hours a night to do this well. There is really little room for catch up. Start with the basic books and go from there. 

depending on your school you will have different rounds formats. My school was extremely rounds heavy - 2 hrs a day. I will let everyone know I hate rounds - I hate being put on the spot, I hate learning radiology by doing things with endless random cases not organized around any theme or pattern, and I hate that I am being asked to learn two things at once - how to "take a case" and the actual radiology - again without grounding in some logical structure I don't find them as useful as doing just say an hour of really focused reading. 

All that is great but it doesn't matter because you have rounds ha - and like it or not that is the way it is taught. So knowing that you need to realize that no one really cares in the first 1-2 years if you get a case right or wrong. It just doesn't matter - no on has any expectations yet (in years 4-5 ok yeah you are going to know if you messed something up). So yes take cases, volunteer if that is an option. Just do it even if you hate it as much as I do - because in the end learning how to take cases is a huge part of doing the exam. Functioning well even if you have no real idea what is going on is the point because I can assure you there WELL be exam questions where you despite all you did you will have no idea what is going on (in fact it appears some questions are there EXACTLY for that purpose). 

So I could go on but it is all about small points to remember ha - study every day for ideally 2 hours no matter how tired, stressed or just annoyed you are (and you will be oh so tired and stressed). Your PGY 5 self with thank you, and take cases - just do it and try even when you suck at it. We have all been there. 

 

[rmorelan]

1 hour ago, ellorie said:

Yeah imagine if you had to study for it twice...oh wait...

yes - and from what I understand study the second time differently as the test is not what it was promised for 5 years. It something else. 

You don't want something else - you want to at the very least KNOW what you are getting into 

 

[ellorie]

2 minutes ago, rmorelan said:

yes - and from what I understand study the second time differently as the test is not what it was promised for 5 years. It something else. 

You don't want something else - you want to at the very least KNOW what you are getting into 

 

Gosh, did they change something? I assumed they were just going to give the same written exam they had prepared for the spring.  Do you know something I don't?

[rmorelan]

1 minute ago, ellorie said:

Gosh, did they change something? I assumed they were just going to give the same written exam they had prepared for the spring.  Do you know something I don't?

Ha no - see now I am freaking people out

I am assuming it is the same. The issue is that normally the written exams are not worth as much as the other parts. For rads we were flat out told how little in comparison it was.  

Now it is suddenly worth more - and in our case the written exam being worth so little we didn't hold them to account as much on its contents/structure etc. It was about the oral - for 5 years - nothing but oral exam prep after oral exam prep. In may case literally 2 hours a day, every single day of work, and in 5th year just a ton of it. Never had a MC exam prep as a part of my residency training (and it was a very good program) - the test was only vaguely dealt with. 

So I wouldn't like this - the game has changed, and it is right at the end. I don't know about you but my first round of exam prep appropriately focused the most on what matter - literally thousands of oral cases in front of a live studio audience. Very different skill set than just doing the MC test. One is about considering all possible answers, and logically managing things - cases NEVER have a single answer because there is nothing to discuss. MC only has one answer. 

Also if they don't change it - again I don't think they are - then there is another issue. In our case the exams are designed to all work together. You don't have the same question on the oral exam as you do on the MC exam or the OSCE exam. So now that means removing pieces entire parts of field X may not be tested, and in effect other parts are enhanced. The MC test as it was was not designed to do all things. Now it has to. 

[RadHopeful]

10 minutes ago, rmorelan said:

ha sure - some of this I was told when I started and tried to follow, some of it was stuff I ended up knowing in the end

start studying - really do need to study a couple of hours a night to do this well. There is really little room for catch up. Start with the basic books and go from there. 

depending on your school you will have different rounds formats. My school was extremely rounds heavy - 2 hrs a day. I will let everyone know I hate rounds - I hate being put on the spot, I hate learning radiology by doing things with endless random cases not organized around any theme or pattern, and I hate that I am being asked to learn two things at once - how to "take a case" and the actual radiology - again without grounding in some logical structure I don't find them as useful as doing just say an hour of really focused reading. 

All that is great but it doesn't matter because you have rounds ha - and like it or not that is the way it is taught. So knowing that you need to realize that no one really cares in the first 1-2 years if you get a case right or wrong. It just doesn't matter - no on has any expectations yet (in years 4-5 ok yeah you are going to know if you messed something up). So yes take cases, volunteer if that is an option. Just do it even if you hate it as much as I do - because in the end learning how to take cases is a huge part of doing the exam. Functioning well even if you have no real idea what is going on is the point because I can assure you there WELL be exam questions where you despite all you did you will have no idea what is going on (in fact it appears some questions are there EXACTLY for that purpose). 

So I could go on but it is all about small points to remember ha - study every day for ideally 2 hours no matter how tired, stressed or just annoyed you are (and you will be oh so tired and stressed). Your PGY 5 self with thank you, and take cases - just do it and try even when you suck at it. We have all been there. 

 

Thank you so much for the tips! From what I've observed during rotations at my program, people rarely volunteer haha. The way you framed it as a learning experience rather than an "evaluation" is a great mindset to have and I'll try to take that advice to heart.

[ellorie]

1 minute ago, rmorelan said:

Ha no - see now I am freaking people out

I am assuming it is the same. The issue is that normally the written exams are not worth as much as the other parts. For rads we were flat out told how little in comparison it was.  

Now it is suddenly worth more - and in our case the written exam being worth so little we didn't hold them to account as much on its contents/structure etc. It was about the oral - for 5 years - nothing but oral exam prep after oral exam prep. In may case literally 2 hours a day, every single day of work, and in 5th year just a ton of it. Never had a MC exam prep as a part of my residency training (and it was a very good program) - the test was only vaguely dealt with. 

So I wouldn't like this - the game has changed, and it is right at the end. I don't know about you but my first round of exam prep appropriately focused the most on what matter - literally thousands of oral cases in front of a live studio audience. Very different skill set than just doing the MC test. One is about considering all possible answers, and logically managing things - cases NEVER have a single answer because there is nothing to discuss. MC only has one answer. 

Also if they don't change it - again I don't think they are - then there is another issue. In our case the exams are designed to all work together. You don't have the same question on the oral exam as you do on the MC exam or the OSCE exam. So now that means removing pieces entire parts of field X may not be tested, and in effect other parts are enhanced. The MC test as it was was not designed to do all things. Now it has to. 

Oh.  Our specialty is different - at least in my program, we typically devote very little time to preparing for the oral and study extensively for the written.  Our oral more than anything is a demonstration of soft skills, based on the prep that we did do and what we were taught within our program to expect.

[rmorelan]

1 minute ago, ellorie said:

Oh.  Our specialty is different - at least in my program, we typically devote very little time to preparing for the oral and study extensively for the written.  Our oral more than anything is a demonstration of soft skills, based on the prep that we did do and what we were taught within our program to expect.

see each group is different - for you it is "better" if you could use just a phrase for this entire mess. May other groups it aligns more towards the oral exam approach. It sucks for all but perhaps sucks less for some. 

[rmorelan]

34 minutes ago, RadHopeful said:

Thank you so much for the tips! From what I've observed during rotations at my program, people rarely volunteer haha. The way you framed it as a learning experience rather than an "evaluation" is a great mindset to have and I'll try to take that advice to heart.

because they are afraid of looking bad, and just hate the overall approach. 

but really no one cares. I really no one in the end. 

Plus honestly the ones that do to it - well I will say this much. The cases I messed up on I know perfectly now. I knew that if one of those showed up on the exam, I would just nail it (one actually did). Those that take a lot of cases are a lot better polished and ready by the end. 

In the end you cannot hide from the oral exam. To paraphrase - Dread it. Run from it. The exam still arrives all the same. 

Edited June 14, 2020 by rmorelan

[RadHopeful]

30 minutes ago, rmorelan said:

because they are afraid of looking bad, and just hate the overall approach. 

 

I'm guessing that the feeling probably depends on the faculty leading the rounds. During clerkship, I've felt safer asking questions and acknowledging my uncertainties with some preceptors more than others. There are also those who were able to "quiz" me on stuff without making me feel bad about not knowing the answer. I've learned so much thanks to them.

Unfortunately, being able to gauge whether or not a preceptor fostered that kind of safe learning environment was instrumental to me doing well during clerkship. It's an art to know when to shut up and when to put yourself out there and be vulnerable without fearing consequences to your rotation eval. 

But I get your point, I'll try my best to lower my guards and put myself out there for the sake of learning and for the oral exam. I can totally see how my co-residents wouldn't care (as much as I wouldn't) but I hope faculty will also be receptive!

[rmorelan]

5 minutes ago, RadHopeful said:

I'm guessing that the feeling probably depends on the faculty leading the rounds. During clerkship, I've felt safer asking questions and acknowledging my uncertainties with some preceptors more than others. There are also those who were able to "quiz" me on stuff without making me feel bad about not knowing the answer. I've learned so much thanks to them.

Unfortunately, being able to gauge whether or not a preceptor fostered that kind of safe learning environment was instrumental to me doing well during clerkship. It's an art to know when to shut up and when to put yourself out there and be vulnerable without fearing consequences to your rotation eval. 

sure! but in clerkship is similar to say years 1-2 in residency. Our expectations are usually lower, we aim to be supportive and we don't super care if you mess up (we will teach you). When you are in residency - you are in a room full of your peers in the field you have 100% committed to, and often with staff that can significantly boost or limit your career it can be different (not that clerks aren't under pressure for those LORs mind you). Doesn't even matter that much about how others are judging you - you are judging yourself (and many are harsh judges). 

and for the rounds as bad as this sounds they often aren't trying to foster a stress free experience - the oral exam is not stress free and learning how to actually perform on one of the most stressful days of your life is the objective. We used the expression your can sweat now or bleed later (a saying we stole of course ) and there is truth in that.  That is actually part of the problem with oral exams (what are you testing? the material? or the presentation?). Unfortunately we haven't found a way to teach people to perform under stress well other than continuously putting them under stress until the are immune to it. It is a dated system - and one that we are working on changing. 

[RadHopeful]

3 minutes ago, rmorelan said:

you can sweat now or bleed later

Hahahaha oh man what did I sign up for? All right I will heed that warning! Good night to you and thanks again 

[rmorelan]

5 minutes ago, RadHopeful said:

Hahahaha oh man what did I sign up for? All right I will heed that warning! Good night to you and thanks again 

ha - well hopefully competency based training will also help with this as you go along

good luck! 

[polarbear89]

It's interesting. Lots of my friends in family medicine studied for their certifying exam in the couple months leading up to it but it didn't seem to take over anyone's life and no one seemed overly stressed about it in comparison with my friends writing their royal colleges. Going into that year for myself now is really stressful and I have no idea how I will sustain that kind of stamina but yet feel like I know nothing...

[blah1234]

1 hour ago, polarbear89 said:

It's interesting. Lots of my friends in family medicine studied for their certifying exam in the couple months leading up to it but it didn't seem to take over anyone's life and no one seemed overly stressed about it in comparison with my friends writing their royal colleges. Going into that year for myself now is really stressful and I have no idea how I will sustain that kind of stamina but yet feel like I know nothing...

Yea, my friends in FM had much more normal studying schedules. I'm glad I'm on the other side now but I honestly think we don't do enough to tell students how awful the exam year can be. I still don't understand how people did it while taking care of their kids.

[LostLamb]

On 6/13/2020 at 7:47 PM, ellorie said:

Oh.  Our specialty is different - at least in my program, we typically devote very little time to preparing for the oral and study extensively for the written.  Our oral more than anything is a demonstration of soft skills, based on the prep that we did do and what we were taught within our program to expect.

This is interesting to hear, because while the oral examination/PDM/OSCE for psychiatry is about showing your approach (as I assume it is in all specialties...as it is in all of medical training really), it is not just a demonstration of soft skills. I think a lack of soft skills would be extremely detrimental, but you need the textbook knowledge to be successful in the examination.

However, this doesn't apply this year since it will be all MCQ so the textbook knowledge and other preparations will suffice

Don't stress on re-studying. Just review and ramp up to be sharp by end of summer. Best of luck!!

LL

[ellorie]

4 minutes ago, LostLamb said:

This is interesting to hear, because while the oral examination/PDM/OSCE for psychiatry is about showing your approach (as I assume it is in all specialties...as it is in all of medical training really), it is not just a demonstration of soft skills. I think a lack of soft skills would be extremely detrimental, but you need the textbook knowledge to be successful in the examination.

However, this doesn't apply this year since it will be all MCQ so the textbook knowledge and other preparations will suffice

Don't stress on re-studying. Just review and ramp up to be sharp by end of summer. Best of luck!!

LL

Having not actually taken it, I can't comment - but the message from our program and from upper years I spoke to was really not to worry about the oral exam and to study for it minimally.

Just hard to figure out how to re-do 8 months of studying in 8 weeks

[LostLamb]

2 hours ago, ellorie said:

Having not actually taken it, I can't comment - but the message from our program and from upper years I spoke to was really not to worry about the oral exam and to study for it minimally.

Just hard to figure out how to re-do 8 months of studying in 8 weeks

Having sat the oral and written last year I don’t agree but I guess different philosophies at each school. I did not do a ton of pre-exam oral practise but I still prepared, but the real prep was the MCQ prep. 
 

You don’t need to redo 8 months of study at this point. The next 8 weeks should be review. If you were ready for March then you’ll be fine. Don’t stress out—easier said than done.