There’s a big bundle of CTRs (Clinical Topic Review) in my pigeon hole this morning, all freshly printed and pristine ready for marking at the next FCEM exam. I’ve not opened them yet, but since the topic is on my mind it’s time for the second installment on getting your CTR ready for the FCEM.
Ok folks, so I am going to presume that you have decided on a topic for your CTR. You will have considered this with as much care as you would if choosing your first born child’s name. You cherish it, love it, want to spend more time with it and will no doubt be boring everyone else with the story of why it is as it is. Fantastic. If you’re not enthusiastic at this stage then you are stuffed. So, let’s think about how you are actually going to go about getting your CTR together, basically how do we move from idea through to submission.
The first thing is to admit to yourself and others that this is something that you cannot do alone. You are going to need help and support and you will need to bounce ideas off people as you progress. That’s not to say that writing a CTR is a team effort (there are rules about that sort of thing) but rather you will almost certainly get so close to the subject that sometimes you will not be able to write coherently for someone who does not share your passion for the topic. Remember that an examiner is going to have to make sense of your topic, and although all examiners are brilliant (obviously), it never hurts to make it easy for them to give you marks.
We’ve already mentioned the issue of time. There will not be enough time – ever. You need to start early and certainly be giving your CTR topics a lot of though at least a year before the exam…really?? That long?? Well yes, if you look at the flow diagram below you will see that there are a number of loops in here that could really catch you out. In particular the final loop from ‘any good?’ all the way back to ideas is a killer. I’ve had several trainees come to me with a week to go to submission for ‘a quick look at my CTR’, and I’ve had to tell them that I think it’s going to fail (I’m 100% sensitive and specific on this test thus far). They have effectively wasted their time up to that point, plus a load of cash on an exam entrance fee that they have no chance of passing.
So what can we suggest? If you bob back to the flow diagram just try and assign a time period to each of the steps to do it WELL. How long do you think it will realistically take you to get through all the stages, remembering that you should be talking about and discussing your ideas and concerns as you go along with colleagues and your trainer? I reckon about 3-4 months is a minimum time for someone who has not done this sort of work before, may be more if it’s the very first time……and the worst case scenario is that you might have to do this twice if the final test fails. So, believe me that you should start at least a year ahead? It’s true. You want this done in good time so that you can concentrate on other aspects of the exam.