Preparing for something as mammoth as radiology fellowship exams is no easy task. It takes months, and sometimes years, of dedicated work and planning to be able to get the content covered and understood in a way that not only allows us to pass, but to emerge as a skilled radiologist at the end.
Preparation styles are as many an varied as the training radiologists themselves, but the style (or styles) you chose needs to have a few characteristics to be successful. They should be sustainable, flexible, thorough and relevant, although remember that there is no 'on size fits all' or blueprint for getting through. You will need to engage in many different learning environments and types of resources (including teaching sessions, formal lectures, case books and textbooks) to develop the significant depth of understanding the topics to be successful.
Sustainable study styles allow you to get into a rhythm and build a body of retained knowledge. If you start learning a topic, whether it be an entire syllabus or even just a single section within it, you ideally want to be able to see it through to the end. In my preparation, my large long term project was organising past questions by the syllabus - writing notes and adding additional syllabus notes to the areas I hadn't covered. The problem with this was that it was often boring, and as I was writing notes it didn't leave much room for me to add (or test myself with) diagnostic images. So while I kept on with this, I implemented other study styles within it.
This is where the flexibility comes in. No one type of learning is going to get you through the entire preparation - and nor should it. Engaging in different methods of learning can help information retention, and keep you engaged in the task at hand. During written exam preparation, I was getting bogged down in note writing and having trouble retaining obstetric content. So mix it up, for studying early pregnancy ultrasound I created a PowerPoint based on the syllabus content and the courses I had attended. Even though this was a smaller project that took a week or two (between other study), I was left with a great learning tool which allowed revision and self assessment. I actually ended up trying to continue this through the entire obstetrics and gynaecology subject, but ended up losing interest after a while and moving on to something else.
When you are employing a primary learning style, be it reading, annotating or writing your own notes, it needs to be thorough. Ideally, you want to cover as much of the syllabus as possible - especially the topics which are high yield and/or examined often. In radiology, most of us will have a topic that they favour and find learning about it more interesting and engaging. We will often also have a system we find a total grind and very difficult to get into, leaving it a vulnerable weak spot. Your study strategy should make provisions for this so that time and effort can be divided as needed.
Designing a strategy which allows you to preference knowledge which is high yield and relevant is also very important to a successful preparation. Ensure that resources - especially if they are large textbooks - give sufficiently up to date information which is relevant for the geographical setting and the modality. I started my preparation reading Brant & Helms (big for me because I am not usually a textbook reader), but it became apparent that the level of knowledge was not going to be enough to get me through the final hurdles. What this early experience did give me, however, was a base coat on which I could build. This included specific textbook chapters (for example pulmonary nodules in Webb & Ellicker HRCT - highly recommend), Radiographics or other review articles, and articles on StatDx or Radiopaedia.org.
Finding your own style
Before we launch into personal learning styles (which is really about covering and consolidating content) remember that for radiology exams a lot of the learning has to come from doing. You should be reporting as much as possible and taking every possible opportunity to present cases. By showing up and taking an interest, you will learn a lot and be privy to excellent guidance and feedback from your senior colleagues.
So let's consider how we can formulate a plan to learn on our own.
Remember that when you are preparing for a big exam that you have real-life experience to draw from. By the time are ready for fellowship we have sat Year 12 school exams (which required a sustained study effort of over a year for many of us), countless medical school exams (including large barriers at the end) and the RANZCR Part I exam. Granted, we probably haven't sat anything quite like the RANZCR Part II before, but we have had the experience of road-testing different study methods and ways of learning certain types of content.
I know that I am a writer. For my Year 12 HSC (as we call it in NSW), I wrote lots of notes and did a lot of practice exams. I also had colour coded highlighters and notes. In a moment that I would like to forget, my poor father had to drive me out one afternoon in search of a specific brand and coloured pink highlighter which had mysteriously gone missing. But that was just how I learned.
Even within writing there is variability. I mixed typing with handwriting - often then scribbling on my typed notes. Others work electronically, which is admittedly much better for the environment. The writing element was interspersed with reading - particularly case books as I found the information a good balance between high-yield and engaging.
My husband on the other hand, is a reader. He can read a whole book front to back and manages to not only retain the knowledge but process and apply it.
In tutorials or formal lectures, there are also different ways of interacting with the content. I am a note taker, which I have found helps me to think through the problems and retain information. Others are listeners, and find better retention from concentrating wholeheartedly. There is no right answer. If you are unsure, think back to other times you have learned in a lecture or tutorial environment and ask - did you get more by listening or note taking? It is also true that your interaction may also depend on your mood and yield of the topic. For some opportunities listeners may chose to take brief notes and the opposite may be true where a writer would much prefer to immerse themselves, and just sit and listen.
Some final thoughts...
Often, a study style is something which evolves organically and not something that you have to consciously create and adhere too. For some, however, taking a moment to reflect on what has worked well in the past may help them to bring some more structure and focus to their learning.
Long term exam preparation, however, should maintain a degree of fluidity and be open to change over time depending on how your knowledge and understanding grows and changes. Do not lock yourself into a structure which isn't working. If you are feeling unproductive, give yourself permission to shift to another way of learning to maintain productivity. Remember that even if a set of notes is half written, it is not lost time. You have taken the time to consolidate the first half of the content, and now have the freedom to find a different way to learn the rest. Don't let perfect be the enemy of good.
Lastly, the focus from book work and pure knowledge should shift between the radiology written and viva exams. Vivas are more technique and problem solving driven which is primarily a product of rehearsal and experience. Reading a chest radiology textbook cover to cover isn't going to simulate the experience of presenting cases to an examiner.
Good luck and happy learning!
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