If you’re preparing to sit the essay exam, I’ve put together a few tips below which might be helpful.
Imagine that the exam is a dinner party and you want to deliver a meal (essay) that will impress the examiners. You’ll be cooking in your own kitchen, with your own ingredients. But they will tell you on the day what they want you to cook. And you’ll only have a limited amount of time to make the meal.
How would you go about preparing:
1) You don’t have to be a Cordon Bleu chef to satisfy the examiners, but you do need to be a competent cook. Read practice essays from people who have passed to get a sense of the standard required. Talk to consultants who have been examiners about what they were looking for and common pitfalls. Rob Seltzer’s article is a great place to start.
2) Learn by doing! You’re never going to become a capable cook just by watching MasterChef. Reading recipe books, watching cooking shows, and hanging around in the kitchen while other people cook are all fun, and you will pick up some ideas by watching others. But to learn the skills you need to give it a go, make lots of mistakes, and practice the parts that didn’t go so well last time. Watch other chefs / essay writers by all means. But don’t expect to gain the skills you need by being a bystander.
3) Have a well stocked pantry of ideas. Focus on the basics and build from there. For a meal, the basics might get butter, eggs, and flour. For the essay exam, the basics might be Beauchamp and Childress’s four ethical principles, the biopsychosocial model of health, and the CHIME recovery principles. On their own they won’t make a complete essay, but you will need them to make something great. Once you’ve got the basics, you can start adding to your pantry of ideas. So for the ethics section of your essay, instead of just having the four principles, perhaps you can reach for the big C’s of ethics – confidentiality, cost, consent, conflict of interest. Or perhaps you can add some ideas from the College’s Code of Ethics.
4) Share your efforts with others: Your cake might look great to you but if you’ve used salt instead of sugar it will be a disaster on the day. Share your work with others as early and often as possible to get feedback. I committed to sharing an essay a week which helped immensely with my learning but also kept me accountable. The best way to get honest and constructive feedback is to ask for feedback on a specific element. Ask your essay readers: Can you give me some suggestions on my paragraph structure? Can you help me to correct my spelling or grammar? Which parts of the essay were unclear or difficult to follow? How could I improve my conclusion?
5) On the day, make sure you understand what it is you’re being asked to create. If the examiners want an Italian meal, you’re not going to pass if you give them a traditional South African meal, no matter how delicious boerewors and pap might be. Read the quote carefully and think about what it means and how it could be interpreted … don’t just serve up a pre-prepared dish and hope that no one will notice. The introduction of your essay is a great place to show that you have thought about who wrote the quote, where it was published, when it was written, and to define any ambiguous terms.
6) At the same time, play to your strengths. There are usually multiple ways to interpret a quote while still staying true to the topic. If the topic is Italian you could offer pasta, risotto, or bruschetta and still pass. Just like using herbs from your own garden adds a freshness to your cooking, so does using material from your own culture, life, and experience. Examiners get tired of reading essays. Offer them something fresh from your own culture or clinical experience – but still on topic – to brighten things up.
7) Plan your menu: the College wants to see your ability to approach a topic from different perspectives and to develop a number of lines of argument. I thought about the body of my essay as a three course meal, showcasing three different approaches: traditional / modern / fusion. The first “traditional” section usually looked at the quote through a conservative / medical / paternalistic / hospital-based lens drawing on the history of psychiatry. The second “modern” section typically viewed the quote from a recovery-focused, multidisciplinary, “upstream” public health, multicultural lens drawing on ethical and consumer perspectives. The third “fusion” section offered a balanced and pragmatic perspective, drawing on evidence, guidelines, and my clinical experience. Plus of course a starter / introduction and a finale / conclusion!
8) Get your timing right. 50 minutes is tight. Just as cooking a great meal relies on getting the timing right, so too does the essay exam. Use your reading and planning time well. Practice writing by hand. Know how many words you can write in the time available and how they will fit on the page. Write on alternative lines to give yourself space to come back and make corrections or additions if time allows. And make sure you leave enough time for conclusion – it counts for a lot and is your chance to bring your ideas together and perhaps offer a suggestion for future directions.
9) Double check the recipe to make sure you haven’t left out any essential ingredients. I can’t tell you how many times I’ve made Alison Holst’s blueberry muffins and realised, as I’m putting them in the oven, that the melted butter is still sitting on the bench. You don’t want to give up marks by forgetting to include a domain. It can help to jot down a checklist of domains you want to cover as soon as you come into the exam.
10) Enjoy the process! Writing – like cooking – can feel like drudgery or it can be a joyful way to express yourself and to connect with other people. Use this time – as much as possible – to reflect on our profession and the kind of psychiatrist you want to be. Read great books (I loved Shrinks and Saving Normal), watch TED talks from people with lived experience (Elyn Saks and Eleanor Longden are a good place to start), watch films that portray mental illness in positive and negative ways, and use your writing as a way to spark conversations with friends, family, and colleagues about what it would take to create a world where people can flourish.
I hope that helps! All the very best for your exams.