How to use your preparation time

Now that we have covered two question approaches, let’s look at how to use your preparation time and organise your notes.

This is the page layout that worked for me. Treat it as a starting point—as you practise, you will discover what helps you think clearly and deliver a structured answer.

1. Choose your approach

When you read the stem, first ask yourself:

“Does this patient need immediate assessment and resuscitation using A–E, or are they stable enough for a history and examination approach?”

This decision determines how you organise your page and prioritise your answer.

2. Set out your page

For a patient suited to a history and examination approach, I would use the following layout:

You will notice that it closely follows the GP and low-acuity ED assessment structure we discussed earlier:

Opening → Concerns and considerations → Differentials → Preparation → History → Examination → Investigations

An opening question will often ask how you would assess the patient. Organising your notes this way gives you a framework for answering it.

Use brief headings and case-specific prompts, rather than writing full sentences. Your notes should help you recall your priorities without becoming a script you have to read. In the end I didn’t actually write any headings in the boxes. I knew which boxes were for what and wrote key words in each as memory prompts as you do not get a lot of prep time.

3. Prepare for the follow-up questions

You will also see a management section containing an acronym. We will cover this in the management section of this guide. I found that writing it down early helped me remember the key elements when the discussion moved on to treatment.

Leave some space for questions two and three, including any new information the examiner provides. Under pressure, it is easy to lose track of a detail—having somewhere to record it helps you adapt your answer as the case develops.

4. Put it into practice

Pause here and try a few of the basic practice cases. Use your preparation time to identify the appropriate approach, set out your page and note your main priorities. Then practise answering aloud using those notes.

At this stage, focus on building a reliable structure and becoming comfortable with your page layout. You can refine both as you gain experience.

Setting out your page for an A–E approach

If the patient requires immediate assessment and resuscitation, I would organise my page like this:

Notice how closely the layout follows the emergency structure we discussed earlier. It prompts you to recognise the emergency, outline your immediate priorities using the sandwich technique, and then work through A–E, reassessment and ongoing care. The arrow from circulation to investigations is because circulation is where I inserted 2 large bore IVs and pulled off my bloods. This led nicely into quickly discussing urgent investigations.

GP and low-acuity ED assessment questions, together with emergency questions, should be a major focus of your practice. Become familiar with both layouts so you can choose the appropriate approach quickly and use your preparation time effectively.

Later in the course, we will explore each section in more detail, including my tips for refining your answers. For now, focus on building a clear structure and practising until it feels natural.