The SAQ paper consists of 12 questions to be answered in 3 hours, 6 based on topics from each of the 6 mandatory units of training and six from the general duties, optional and advanced science modules. Only one question is based on the optional modules.
-Mandatory units: anaesthetic practice relevant to neurosurgery, neuroradiology and neurocritical care, cardiothoracic surgery, intensive care medicine, obstetrics, paediatrics and pain medicine.
-General duties: airway management, day surgery, critical incidents, general/urology/gynaecology surgery, ENT/maxillofacial/dental surgery, management of respiratory and cardiac arrest, non-theatre duties, orthopaedic surgery, regional anesthesia, sedation practice, transfer medicine, trauma and stabilization practice.
-Optional modules: anaesthetic practice relevant to ophthalmic surgery, plastics & burns surgery, vascular surgery
-Advanced sciences: anatomy, applied clinical pharmacology, applied physiology/biochemistry, physics/clinical measurement and statistical basis of clinical trial management.
All SAQ questions are mapped to a specific section of the basic or intermediate curriculum. To facilitate an objective and reproducible marking process, a model answer template is provided for each question. Key facts in this template are bullet pointed and assigned marks. The number of marks available for each section of the answer is shown in the question. All questions are subjected to an exhaustive editing and peer review process before use in an examination.
The SAQ paper is written to contain questions with varying levels of difficulty:
-2 questions adjudged to be difficult (pass mark 10-11/20)
- 8 questions adjudged to be moderately difficult (pass mark 12-13/20)
- 2 questions adjudged to be easy (pass mark 14/20 or more)
The level of difficulty and the pass mark are finalised using a process called Angoff referencing, which takes place during the Paper Checking and Standard Setting meetings of the Final examiners. Angoff referencing uses the experience of the examiners to set a pass mark for each question such that a “typical” trainee, with adequate preparation, knowledge and experience, will perform satisfactorily and achieve a pass for the whole exam.
- Short answer questions (SAQs) are submitted throughout the year, principally by members of SAQ core group of Examiners. This is done in order to develop a database of questions for use in future papers and Final FRCA revision resources. New SAQs are based on areas of syllabus thus far not well covered as well as recent advances and current trends in anaesthesia. The questions are designed to be answered in 12ish minutes (with 2-3 minutes preparation time). The questions are drawn from the Intermediate Curriculum.
- Shortlist of 15 questions suitable for next paper. Preference may be given to questions that are ‘new’, have not been asked before, and are exam-ready. November
- SAQ core group meeting: SAQ group meet to discuss shortlisted questions and choose the final 12. All questions scrutinised and modified.
- Paper checking: six teams of examiners examine two questions and their model answer templates for accuracy and clarity. They assign a provisional passmark. This team of examiners will be the same individuals that mark these answers in the paper to ensure consistent standards.
- Standard setting day: The examiners re-assemble and mark 4 anonymised SAQ answer books containing the 2 questions they had looked at on paper checking day. The four sets of booklets are chosen on the basis of MCQ scores so as to represent the spectrum of ability within the candidate cohort. Subsequent discussions focus on ensuring the scripts are awarded every mark allowed by answer template and a consistent template is applied against all four candidates. At the end of the day, a finalised Angoff reference pass mark is confirmed.
- Paper marking: The candidate answer booklets are then divided amongst the team and taken away for marking. This process results in each of a candidates answer booklets being marked by a different examiner to eliminate risk of bias.
The marking system for Final Written exam
The pass mark is the sum of the percentage pass marks of the MCQ and SAQ papers.
The pass mark for each paper will be calculated as a percentage and rounded down to two decimal places.
The resultant pass mark for each paper is added together and the combined percentage score rounded down to one decimal place.
One mark will be awarded for each correct answer in the MTF section. Four marks will be awarded for each correct question in the SBA section.
With 60 MTF and 30 SBA the maximum mark obtainable for the MCQ paper is 420 marks.
The Pass mark is set by the Examiners using Angoff Referencing. To allow for the exam reliability this mark is then reduced by 1 x SEM to give the pass mark. Negative marking is not used. See above re combined pass mark.
All 12 questions must be attempted; candidates will fail if one or more questions are not attempted. Questions in the wrong answer book will not normally be marked. Each question is marked out of 20. The pass mark for each question is determined by the examiners collectively using an Angoff Reference method. The pass marks for the 12 questions are summed to give a total mark for the paper. To allow for the exam reliability this is then reduced by 1 x SEM to give the pass mark. See above concerning combined pass mark.