Ask any cyclist what their ‘routine’ is in the run up to a race and you’ll likely be there a while as they carefully recount the day-by-day, minute-to-minute strategy to ensure they’re set up for the best possible performance on the day. Nothing gets forgotten, be it training, food, sleep, clothing – you name it, a cyclist has tweaked it to beyond-neurotic perfection. While they don’t usually require figure-hugging lycra and obnoxiously fluoro sock choices, I strongly believe that a lot of the same principles seen in bike racing can be applied to examinations, as they are essentially the equivalent of a bike race for your brain. So here is my 6 part breakdown on how to prepare for that all important event, and get the most out of that spongy brain-muscle between your studious ears…
Train how you race
There’s no point doing lots of long, gentle mountain riding if the race involves a short, high intensity blast around a velodrome; you have to ensure you’re training your body for the physical requirements on the day. Likewise, if your examination is going to be a series of multiple choice questions, you should practice doing questions rather than just reading through blocks of material in prose format. Of course you’ll need to read and learn the relevant information, but if you use MCQs as a reference, you’ll see the sort of patterns that pop up, and learn to process the information in a way that anticipates the questions that might be asked of you on the day. If your exam is an essay paper, practice writing essays under timed conditions, in the same format, with the same pen, long in advance of the exam. You’ll be surprised how tired your hands get if you’ve not written a complete essay all year and suddenly you try and do three in an hour on the day.
Don’t overdo it
My guess would be that almost every cyclist at some point has fallen into the trap of overtraining. The sport is enjoyable, addictive and it’s very easy to assume that more training means more improvement. However the gains in your performance happen when you’re resting, allowing your muscles to rebuild and strengthen. Ideally you’d be sleeping all the time you’re not riding or eating…
The same principles apply to revision. Your brain uses its down time, particularly when asleep, to subconsciously sift through the material covered during the day and consolidate the useful information into its long term memory. To make your revision worthwhile, you’ll need to ensure you’re getting enough sleep to reap what you sow, so it may be a good idea to put the pen down a little earlier and get some well earned kip. This is doubly important if you’re doing exercise as well, which you should be!
Get your food right
If you put sludge in your car, it’s not going to run very well. If you try and win a bike race on KFC and doughnuts you’ll be sorely disappointed, and probably rather ill at the end of it. Equally, if you try and work your brain overtime in the weeks before the big day, and don’t give it good fuel to use, it will burn out very quickly. Having a tub of chocolate mini-bites next to you while you work may give you a little ‘lift’ every time you have one, but it is doing your concentration, memory and general health no favours in the long run. Fill up on good quality veg, oily fats and really complex carbohydrates and your concentration, endurance and performance will all speak for themselves. You may feel that you don’t have time to cook a ‘proper’ meal, but I promise you – you do. Not only will the break from revising give you a motivation boost, but concentrating on your food will make you feel fuller and stop you snacking between meals.
Coffee – this was almost worth a post in its own right. Caffeine has proven to be a powerful performance enhancer both physically and mentally, and is thought to have numerous health benefits that I won’t delve into here. Essentially, the best thing to do is work out just how much is right for you; be it none, a little or a lot, and keep it there. Don’t go overboard in exam term. If you think you’re over-tired and the coffee is no longer enough, it means you need more sleep, not more caffeine. On the day, have the same amount as normal – it’s what your brain is used to, and the smell of the coffee will trigger memories on a subconscious level too (Google ‘state dependent learning’ for more info).
In the weeks running up to a big event, different cyclists will do their own things, but in general the weeks immediately prior involve a lower volume of training to allow the body to be as fresh as possible on the day when it matters. That definitely doesn’t mean doing nothing at all in the week before, rather just doing enough to tick things over and stop them going stale. The same goes for revision – you don’t want to be cramming until five in the morning and then turning up to sit the paper exhausted and demoralised. I usually work fairly solidly up until two days to go, then on the day before I take it easy. I’ll do some solid exercise, and a bit of light reading, but generally let my brain rest before the event. I’m always tempted to sit and cram, especially when I see other students working, but when I’m sat in the exam room, I’m always more grateful for the rest than the extra information on the day before.
It’s hard to stay motivated when revising, especially for medical exams with their seemingly endless quantities of information and undefined syllabus. But keeping up your motivation is key to productive work – you will process the information more effectively and it’ll stick in your memory for longer. When I feel my own motivation slipping, I like to write down as many reasons why I’m sitting that exam as I can think of. Usually it’s enough to get me back on track and keen to work, but if it doesn’t, there are always fantastic motivational videos on YouTube to get you in a productive mood!
On the day
It’s show time. Exam day routine is a personal affair that everyone does differently. Some rise at the crack of dawn to cram last minute information that may be of use into their short term memory, while others saunter into the exam room at the last minute having just woken up. Find what works for you, and commit to it. Personally I don’t like to do any extra work on exam day, to leave my brain as fresh as possible for the task ahead. I have a big breakfast, a couple of coffees and then try to relax as much as possible before the inevitable onslaught begins. After the exam, forget about it, if you can. It’s easier said than done, but it doesn’t help anyone to sit there dissecting what happens; partly because it serves only to stress people out, but also because you’re likely to misremember questions or answers that you gave, even if only slightly, that can lead you to thinking you got things wrong when you didn’t. So chill out, and enjoy a well-deserved rest!
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What to do when taking a call about a patient on the ward…
Who, what and where are they?
What’s the patient’s name, hospital number and which ward are they on? What is the reason that they’ve come into hospital and why is the person calling about them?
What are their obs?
This tells you whether they’re decompensating and need to be seen immediately. What’s their NEWS score, and what’s the trend? If they’ve been sat at NEWS 5 for three days and now are NEWS 4, that’s a lot less worrying than jumping from 0 to 3 in the last two hours. If they’re clearly very unwell then ask the ward to bleep your senior as well.
Are you worried about them?
Asking the caller how the patient is clinically, and whether they as a healthcare professional are concerned about the patient is a good guide as to the urgency of the situation. Trust the nurse’s instinct…
Is there a time limit?
When does this job need doing by? Can it wait for you do do a few of your other jobs first? Prescribing insulin that is going to run out in 2hrs can wait until after you’ve reviewed the ECG for the other patient that has chest pain.
What’s your name and number?
Know who you talked to and how to call them back if you need further information.
While I’m on the way…
Ask for a repeat set of obs/ECG/urine dip, while you’re headed to the ward. This will speed everything up and help you get your head clear on the way over.