The overall pass rate for this paper was 62.65% This compares with recent SAQ papers
  • - September 2015, 49.50%
  • - March 2015, 45.30%
  • - September 2014, 30.32%


The pass rate for this exam was greater than at the last 3 sittings, which is very encouraging.


However, candidates continue to disadvantage themselves in a number of familiar ways:


  • Failure to answer the question asked
    It is very important, even when pressed for time, to read the question carefully and answer what is asked. For example, in question 4 of this exam about carotid endarterectomy, part (c) asked for factors that would reduce the risk of perioperative cerebrovascular accident, and part (d) asked candidates to identify other specific postoperative complications. Unfortunately some candidates mentioned the different forms of cerebrovascular accident that may occur postoperatively in their answer to part (d), so could not be given marks, and wasted valuable time. In question 12, on the subject of accidental awareness under general anaesthesia, a number of candidates discussed the management of awareness in their answer to part (c) despite the fact that this was not asked for.

    The examiners will often underline parts of the question so as to draw your attention to them. In this paper this was done in part (a) of question 3 about intrathecal opioids – What are the site of action and intra and extracellular mechanisms of analgesic effect within the spinal cord following the administration of intrathecal (IT) opioids? Despite this some candidates wrote about the mechanism of action of local anaesthetics.


  • Poor weighting of answers
    Make sure you note how many marks are allocated to each part of the question. Writing extensively on the low scoring sections of the question, to the detriment of other sections, will reduce your overall score.



  • Illegible handwriting
    Examiners take great care to extract answers from a candidate’s script, but only material that can be read will achieve a mark. Candidates are encouraged to set out their answers in a bullet point or table format where possible. This aids both legibility and time management.


  • Candidates, trainers and examiners will be pleased to see that the pass rate for this sitting of the SAQ paper has increased when compared to the last three.
    It is encouraging that of the questions on mandatory units of training, 3 had amongst the highest pass rates in the paper
    , but it is disappointing that the questions on pain, paediatric anaesthesia and cardiothoracic anaesthesia were not answered well. Again we would emphasize the importance of gaining some clinical exposure in these specialist areas prior to sitting the Final FRCA exam.
  • Knowledge of advanced science seemed particularly poor in this exam. We remind candidates that this is an important part of the intermediate syllabus which can come into several questions in a single paper, reflecting the way in which applied science forms part of our daily clinical practice.

The overall pass rate for this paper was 49.5% This compares with recent SAQ papers
  • - March 2015 45.30%
  • -  September 2014 30.32%



  • The pass rate for this exam was greater than at the last 2 sittings which is very encouraging. However, candidates continue to disadvantage themselves in a number of familiar ways:


  • Failure to answer the question asked
    It is very important, even when pressed for time, to read the question carefully and answer what is asked. For example, in question 1 of this exam about CSF, part (d) asked for factors predisposing to the development of a post-dural puncture headache after lumbar puncture. Unfortunately, many candidates talked about the factors that increase the risk of accidental dural puncture and, whilst the information they gave on that topic was correct, it was not what was asked for so they could not be given any marks.
    The examiners will often anticipate confusion and will underline parts of the question so as to draw your attention to them. In this paper this was done in parts (b) and (c) of question 3 about severe pre-eclampsia. In part (c) the question was written as follows: What changes would you make to your usual general anaesthetic technique for a pregnant woman, if this woman needed a general anaesthetic for caesarean section? The answer that was expected was the changes you would make to your general anaesthetic technique in the presence of severe pre-eclampsia. However, some candidates simply wrote about how to give a general anaesthetic to any pregnant woman so scored very few marks despite having written a great deal.



  • Poor weighting of answers
    Make sure you note how many marks are allocated to each part of the question. Writing extensively on the low scoring sections of the question, to the detriment of other sections, will reduce your overall score.



  • Illegible handwriting
    Examiners take great care to extract answers from a candidate’s script, but only material that can be read will achieve a mark. Candidates are encouraged to set out their answers in a bullet point or table format where possible. This aids both legibility and time management.



It is encouraging to see that the pass rate for this sitting of the SAQ paper has increased when compared to the last two. Of particular note is the fact that 4 of the questions on mandatory units of training had amongst the highest pass rates. This has not been the case in recent exams and suggests that candidates have taken the advice contained in previous reports to delay sitting the final FRCA exam until they have some clinical experience in these subject areas. However, it is worrying that the obstetric questions continue to be poorly answered particularly as pre-fellowship trainees will often be working with distant supervision when on call for obstetrics.

The overall pass rate for this paper was 45.3% This compares with recent SAQ papers:



September 2014 30.32%
March 2014 60.32%
September 2013 78.14%
March 2013 67.36%


Analysis of Results

Candidates who failed the SAQ paper tended to produce at least 3 answers which were deemed to be poor fails, and a surprising number generated 8-10 such scores. Inexperience and/or poor preparation must explain these data.
Additionally, candidates continued to disadvantage themselves in a number of familiar ways;

Failing to answer the question asked.
For example, in the opening stem of question 2 Autistic Spectrum Disorder was fully defined as ASD, an NHS approved abbreviation. But many candidates chose to answer a question on Atrial Septal Defect, which was not defined and scored no marks.

Poor weighting of answers
The marks allocated to each section of the question are clearly indicated. Writing extensively on the low scoring sections of the question to the detriment of sections where more marks are available limits the maximum score attainable. This probably reflects poor detailed knowledge of the subject.

Giving general and superficial answers to specific questions – e.g. “give oxygen” instead of dealing with specific details of management.

Illegible handwriting – Examiners take great care to extract answers from a candidate’s script, but it remains true that only material that can be read will achieve a score. Candidates are encouraged to set out their answers in a “bullet point” or “table” format which will aid legibility and time management, and also serve as an aide memoir to the number of key points required for each section. See the answer templates given as examples in the SAQ Chair’s report for the September 2014 SAQ paper.




Although the pass rate has improved from the September 2014 sitting, the results are still disappointing. The Angoff process for determining the pass and poor fail thresholds has proved robust in years past and there is no reason to assume the validity of this methodology has changed. The high overall rate of poor fails suggests a deficiency in core knowledge and clinical experience as has been commented upon in previous SAQ Chair’s reports.
Four questions from the six mandatory subjects returned high poor fail rates. It seems likely that candidates attending for the Final FRCA examination have not always rotated through these sub-specialities and may have given insufficient weight to revising the topics. It is worth repeating the advice given in previous SAQ Chair’s reports that candidates should arrange short “taster” sessions in the mandatory units of training if their direct experience of the subject is limited.
However the inclusion of the six mandatory questions cannot be the whole explanation for the low pass rate, as evidenced by the poor fail rates for non-specialist questions such as hip revision (Q7), liver disease (Q10) and anaesthesia for ECT (Q12). The ability to apply knowledge effectively and safely in clinical practice is vitally important and it is the responsibility of Schools of Anaesthesia to fill the gaps in knowledge exposed by the examination process.
The breadth of the Final FRCA syllabus is wide and the content of the SAQ paper will reflect this diversity of subject matter. It seems likely that the sheer weight of material may lead some candidates to consider individual topics of the syllabus at too superficial a level, particularly where they have no direct experience of the subject. This leaves them unable to provide the detail required to attain a comfortable pass.
A recurrent opinion expressed by the Examiners was that many of the candidates in this cohort seemed significantly short of practical clinical experience as judged by the lack of detail, and the weighting and emphasis of their answers. It is recommended that candidates discuss their examination preparedness with their educational supervisor and/or college tutor. Candidates need to ensure that their experience to date allows them a realistic chance of passing the Final examination.
The overall pass rate for this paper was 30.32% This compares with recent SAQ papers
• March 2014 – 60.32%
• September 2013 – 78.14%
• March 2013 – 67.36%

Analysis of Results

Candidates continue to disadvantage themselves in a number of familiar ways;

Failing to answer the question asked – whether this is because of poor knowledge and preparation, or from rushing the answer due to time constraints, only material relevant to the question asked can score. For example, if the question asks for specific factors or draws attention to the fetus there is no point in writing about unrelated general features in the answer.

Poor weighting of answers – writing extensively on the low scoring sections of the question to the detriment of other sections where more marks are available. This approach limits the maximum score attainable but might reflect poor knowledge of the subject.

Illegible handwriting – examiners take great care to extract answers from a candidate’s script, but it remains true that only material that can be read will achieve a score. Candidates are encouraged to set out their answers in a “bullet point” or “table” format which will aid legibility and time management, and also serve as an aide memoir to the number of key points required for each section.

Examiners comment in feedback that many candidates seem unaware of the breadth and depth of information required for a “pass” answer in the SAQ paper, offering only a superficial treatment of the questions. To help candidates with future preparation, two of the answer templates for the September 2014 paper will be included in this report (see below). These questions will now be removed from the SAQ database.
The overall pass rate was 60.32%.

This compares with recent SAQ papers:
September 2013 – 78.14%
March 2013 – 67.36%

Analysis of Results

Overall

Candidates continued to disadvantage themselves in a number of familiar ways;

Failing to answer the question asked – whether this was because of poor knowledge and preparation, or from rushing the answer due to time constraints, only material relevant to the question asked can score.

Poor weighting of answers – candidates must appreciate that if any section of a question is considered to be worth 50% of the 20 possible marks, it is likely that there are 10 key pieces of information required to maximize their score. Writing extensively on the section worth 10% of the marks will not compensate for a lack of information elsewhere. From September 2014 these percentages will be replaced with marks out of the total 20 to make it easier for candidates to allocate appropriate weighting and time to each section of the question.

Illegible handwriting – Examiners take great care to extract answers from a candidate’s script, however only the material that can be read will achieve a score. Candidates are encouraged to set out their answers in a “bullet point” or “table” format which will aid legibility and time management, and also serve as an aide memoir to the number of key points required for each section.

It is disheartening that the pass rate for the March 2014 SAQ has declined when referenced to the most recent past papers. The Court of Examiners take particular effort to consider the level of difficulty of each question and to give the benefit of the doubt to candidates who may have misinterpreted some of the questions asked.

It is clear from the overall results of the cohort for this paper that many candidates continue to give insufficient weight to the six mandatory subject areas in their preparation for the examination; there is simply no substitute for knowing the material. It has been recommended previously that candidates should arrange 1-2 day “taster” sessions in the mandatory units of practice if they have not experienced these as part of the usual training carousel; this advice remains pertinent.

As with previous papers, some areas of knowledge deficit have been highlighted which are spread evenly throughout the candidate cohort. Where this ignorance encompasses fundamental basics of practice, it is the responsibility of Schools of Anaesthesia to fill these gaps.
The overall pass rate was higher than is usual at 78.14% This compares with recent SAQ papers
March 2013 - 67.36%
September 2012 - 51.9%
March 2012 - 66.51%

It is heartening that the pass rate for the September 2013 SAQ was higher than recent sittings. The Board of Examiners have made particular effort to take into consideration the level of difficulty of each question and give the benefit of the doubt in the way candidates may have interpreted several of the questions asked.
Each paper exposes areas of knowledge deficit and apparent inexperience in some areas, some very basic. In preparation for this exam it might be prudent to arrange 1-2 day “taster” sessions in some of the mandatory units of training, particularly anaesthesia for neuroanaesthesia and cardiothoracic surgery covered in the SAQ.

One area of concern in a small minority of candidates was the standard of handwriting. If a script cannot be read, it is difficult to award marks. If you think your handwriting is “bad” please make an attempt to improve the legibility. I have to reiterate that candidates should read the question carefully and only answer the question that is asked!


The overall pass rate was 67.36%.

This compares with recent SAQ papers
September 2012 - 51.9%
March 2012 - 66.51%

It is heartening that the pass rate for the March 2012 SAQ was higher than recent sittings. The Board of Examiners have made particular effort to take into consideration the level of difficulty of each question and give the benefit of the doubt in the way candidates may have interpreted some of the questions asked.

Each paper exposes some areas of knowledge deficit and apparent inexperience in some areas, some very basic. In preparation for this exam it might be prudent to arrange 1-2 day “taster” sessions in some of the mandatory units of training, particularly anaesthesia for cardiothoracic and endocrine surgery covered in the SAQ.

One area of concern in a small minority of candidates was the standard of handwriting. If a script cannot be read, it is difficult to award marks. If you think your handwriting is “bad” please make an attempt to improve the legibility.