SAQ Introduction

Dr James Shorthouse MBBS BSc (Hons) FRCA
Final FRCA Resource Editor

- A three hour paper, consisting of twelve Short Answer Questions. All questions carry equal marking i.e. out of 20, but pass marks may vary from question to question, and are decided by the examiners committee during paper-setting sessions using modified Angoff referencing. The pass marks for the 12 questions are summed to give a total mark for the whole paper.

- The candidate is provided with a question sheet containing all twelve questions (including mark allocation percentages), scrap paper for notes/planning, and six different coloured booklets to answer their questions in:

- Questions 1 & 2 in the Blue Book A
- Questions 3 & 4 in the Pink Book B
- Questions 5 & 6 in the Green Book C
- Questions 7 & 8 in the Yellow Book D
- Questions 9 & 10 in the Orange Book E
- Questions 11 & 12 in the Grey Book F

- In these booklets, one question will be printed on the first page, and the second question will be printed half-way through the book.

- It is imperative that the candidate understands that they must answer all twelve questions. The written section will be failed if questions are omitted accidently, on purpose, or answered in the wrong booklet.

- Answers for anatomy/regional block questions should also contain accompanying simple line diagrams. Whilst every candidate has different learning styles and methods, the use of schematics, graphs, and line diagrams is the ideal way to learn concepts, especially in anatomy and regional techniques. This is the best way to pick up valuable marks both in the SAQ paper, and indeed also the Structured Oral Examination, in the quickest way possible.

- More recently, the Royal College of Anaesthetists has placed greater emphasis on testing the candidate’s knowledge of topical issues, recent guidelines, and public interest subjects relevant to Anaesthesia, Critical Care, and Pain medicine within the written paper. These are often not subjects which may have been thought about by the candidate e.g. a recent question of the relevance of child abuse to anaesthesia. A list of online resources to locate these topical issues and guidelines is included after this introduction.

- Candidates often fail this section of the written paper not through lack of knowledge, but due to lack of organisation in both revision pre-exam, and structure whilst attempting the SAQ paper. This written paper is unlike any other the candidate has attempted previously; it is extremely time-pressured, mentally exhausting, and requires concise and relevant answers in a structured and legible manner. Thus, it is vital that the candidate develops a technique to suit his/her writing style so that the whole SAQ paper may be completed successfully within the allotted time limit. The only way to achieve this is by practicing past SAQ examinations repeatedly. Not only will this allow the candidate to build up the stamina required to concentrate for three hours and answer all the questions, it will also allow the practice of planning for the questions, drawing simple quick line diagrams, and structuring the question clearly and legibly

- The technique of answering questions will vary between candidates. No more than fifteen minutes should be spent on each question despite the temptation to run-over on strong topics and leave weak topics to the end with less answering time. This is usually divided into two-three minutes planning and twelve-thirteen minutes writing/drawing. Suggested methods of time-allocation include:
- Spending approximately thirty-five minutes at the beginning reading the question carefully and producing a short plan / spider-diagram for each question. Once all plans are completed, this leaves two hours & twenty five minutes to produce answers for the twelve questions, or twelve minutes per question.
- Spending a minute reading through the paper and deciding what order to answer the questions (take great care with answering the right question in the right booklet if altering the natural order of the paper!), then making a plan, followed by answering the question for that plan.

- Although planning the question is recommended, some (lucky) candidates have the ability to do this in their head, and therefore will be able to allocate fifteen minutes per question for writing/drawing.
General hints
- Remember that the question allocations add up to 90%. 10% of the marks are given for layout, structure, organisation, relevance, & legibility of the answer produced.
- Make it easy for the examiner who has to mark hundreds of versions of the same question over a few nights; ensure you practice nice handwriting & appropriate spelling.
- Use bullet points rather than large chunks of prose text.
- Try to incorporate diagrams/graphs/schematics rather than text. Many more marks will be picked up with a well labelled, simple line diagram of the nerves of the ankle to be blocked, rather than writing about them, for example.

- Make sure that answers are relevant. Do not waste valuable time producing facts which do not answer the question. For instance, when answering a question on the intravenous fluid management of a dehydrated child, listing the methods of assessing dehydration in a child is not relevant unless specifically asked for in a question stem, and will not gain any marks.

Resources

- The CEACCP articles (BJA publication)
- BJA Review Articles
- Anaesthesia Review Articles
- NICE guidelines
- NPSA guidelines
- NCEPOD Reports
- RCOA publications
- Association of Anaesthetists guidelines
- British Pain Society guidelines
- Association of Paediatric Anaesthetists guidelines
- Update in Anaesthesia
- Instant Anatomy
- New York School of Regional Anaesthesia