Oral exam questions

On average you will spend 5 minutes on each oral viva topic. Should a question have a somewhat limited scope or your knowledge is poor you will spend a little less time on it, but consistency demands that the examiners divide the time more or less equally. The oral vivas are structured so that the examiners have no choice of questions. In the past the oral viva consisted of as many questions as the examiner wanted to ask the candidate. The oral viva could include upwards of 15 topics with a spot diagnosis and very brief discussion of management of the condition shown.

Previously examiners in the hands oral were all hand surgeons and likewise in the children’s oral all examiners were paediatric orthopaedic surgeons. It is now highly unlikely an examiner is able to examine you in their chosen subspecialty. The aim is to avoid them asking you excessive depth in an area of special interest or area of expertise. The aim of the exam is to test your knowledge to the level of a day one orthopaedic consultant in a District General Hospital and not to the chosen expert subspecialty level of the examiner. Thus a hip surgeon may have to ask you about hand topics or a shoulder surgeon about paediatric orthopaedic topics. The examiners may not necessarily be ignorant on these subjects but it is fair to say your own clinical experience may well be more recent and well informed than theirs. This should give you some confidence to speak with experience but don’t overdo it and rub up the examiners the wrong way.

It has been suggested that the structured nature of the exam reduces the likelihood of an examiner being able to question you in excessive depth about a subject. This is especially so as the examiner is only likely to have general rather than subspecialty interest in the subject. We would counter this with saying that it is surprising how much ground one can cover in 5 minutes. In addition it is surprising how much an examiner will know outside their area of interest. The vast majority of examiners are conscientious and keep themselves up to date with orthopaedics. Also, examiners would definitely want to avoid the potential embarrassment of a candidate being more informed on a topic than they are.

It is better not to argue with the examiners but if your answer reflects current thinking on a subject and is at odds with the examiner explain the evidence and up-to-date thinking. You may get the sense that the examiner is unhappy with your answer mainly because it does not match with what is written on the sheet so have the confidence to explain the new thinking. Offer your considered reasoning of the issue without being patronizing or causing embarrassment to the examiner.

The other concern with the format of the structured oral is that it may lack fluency and spontaneity. Some examiners may simply introduce the question before initiating a discussion with only occasional reference to the answer sheet. This is usually because they are experienced, are familiar with the material and have the self-assurance to allow the oral to run a more spontaneous course. They are confident enough in their own ability to access the answers. An examiner who is less certain of an answer, less comfortable with the topic and who is less certain of the criteria against which the answers are to be judged is likely to spend more time referring to the answer sheet. Then again the examiner may be particularly pedantic in their interpretation of how a structured viva should be conducted or be paranoid that the examiner assessor will pull them in and reprimand them for straying too far from the structured oral examining process. You may be able to detect clues as to what type of examiner you have by how he/she phrases the question. If the examiner looks down onto a sheet and reads the question from it without looking up at you and making eye contact they are in the second category. These examiners want facts, and ideally the facts that are listed on the answer paper.

You can refine your answering technique to improve your performance and the overall impression that you create. Some candidates may need a lot of prompting whilst others can get into a rhythm and quickly impress examiners with their knowledge. Examiners like a candidate who can take control and make life easy for them.

Most candidates usually require a bit of help from the examiner. If you have a reasonable knowledge of a subject then with oral examination practice you can train yourself to deliver the information with more facility and polish.

Do not worry about the pace of the oral exam. It is the responsibility of the examiners to ensure that the requisite points are covered, and the guided answer sheets from which they are working contain more information than all but the most talented candidates will cover. That said, do not stall the oral exam hoping the examiners will run out of time and only be able to ask you a few questions at the beginning rather than the more difficult ones at the end. This tactic is obvious to examiners and it annoys them immensely so that they will downgrade your mark.

The examiners’ answer sheet also contains a list of prompts to guide the candidate back onto the subject if they stray too far and go off at a tangent from the question.

Every second an examiner talks provides less time for a candidate to show if he or she is competent. Therefore examiners are encouraged to allow candidates the maximum time to talk as much as possible. This process is helped by clear explicit questions. This contrasts to the old days when examiners would go off at tangents and tell you stories or anecdotes, although in all fairness you had usually passed the viva exam by that stage!

Examiners are now strongly encouraged to stop hammering on if a candidate can’t answer a question, and just move on to another question. This is very different from the early millennium when many candidates frequently complained that some examiners would just keep at it in the vivas looking for the magical word to unlock the door.

Oral exam questions are prepared so as to be crystal clear and explicit with default questions if candidates are unable to answer. Tutorials are avoided, although again in the old days you had usually failed by the tutorial stage. It was not unheard of for examiners to stop formally examining candidates and give them an anatomy tutorial if they had messed up the anatomy section and failed outright.

Examiners may use props such as slides, radiographs, pictures and charts or surgical implants (e.g. screws, plates, femoral stem, worn polyethylene) but are advised to make sure they are clear and unambiguous to the candidates. Laminated photographs are generally preferred to laptops.