Passing the DOHNS Part 2: Top Ten Tips

Here are my Top Ten Tips towards passing the Diploma in Otolaryngology-Head and Neck Surgery (DOHNS) Part 2 objectively structured clinical examination (OSCE).

Tip 1: Fend off the 'failure mindset'

Try not to worry about failure, it's not worth it - many ​​very successful physicians and surgeons have failed at least one Royal College examination. Failure can contextualise success. The financial aspect is frustrating, but you will earn it back during your medical career.​​ Medics are always talking about medicine, try and change the subject!

Tip 2: Understanding your learning

Know how you learn - some people learn through principles, others like mnemonics - be flexible.​​​

Tip 3: Clinical experience is important

The questions and stations within the DOHNS Part 2 OSCE home in on knowledge and skills acquired during clinical training as a junior ENT doctor. Yes, there are harder questions on pathology or other aspects that you may not have clinically encountered. However, do not discount your real-life experience as a learning opportunity. Speak to your peers and senior colleagues about the DOHNS examination and try and integrate learning into work as much as possible.

Tip 4: Organisation

Plan your exam dates, exam leave, study schedule and travel plans well in advance. This organisation fosters a healthy revision experience.

Tip 5: Work-life balance and non-technical skills

Try and keep a balance in your life - some people isolate themselves during revision. Five stations in the DOHNS OSCE require you to interact with real people (actors). Practicing with a friend, your partner or even a relative (they do not need to be medical) is one of the best revision methods. The DOHNS OSCE is about both non-technical skills and technical knowledge.​

Tip 6: Short answer questions

The DOHNS OSCE written stations are short answer questions. They often require lists of information. Be guided by the amount of space given for a question (i.e. one short line generally means only one or two words are required!). If the question asks for SIX of something, only write six answers. The person marking the examination will only award marks for the first answers that he or she reads. You can practice short answer questions with answers and learning materials within the DO-HNS VLE.

Tip 7: Use the rest stations effectively

Use the time at 'rest' stations to complete any missing answers, make appropriate changes or plan out your consultation before a clinical station. Remember surgery is all about preparation and thinking ahead! ​

Tip 8: Keep your answers simple

Keep answers simple. This mindset helps answer some questions, for example: -

• 'List two management options for this condition': conservative (watch and wait) and surgical (named procedure e.g. tonsillectomy)

• 'List three treatment modalities for this condition': chemotherapy, radiotherapy and surgery ​​

Tip 9: Otolaryngology combines medicine and surgery

Think of otolaryngology as a medical specialty with a surgical adjunct. Detailed knowledge of surgical procedures will not be expected. This is taught during core training and the six years of specialty training with or without a fellowship! Good knowledge of relevant basic sciences, (differential) diagnosis, radiology, data interpretation and medical management will be expected. You must also be familiar with basic instrumentation and equipment used in ear, nose and throat surgery and outpatient practice.

Tip 10: Do not worry about the examiners

You will usually not feel sure about your performance during an OSCE. There will be no positive indicators from the examiners and the actors and artificial situations may have made you feel anxious and uncertain. The written stations will vary from relatively easy to difficult questions. This is normal and required to set the standard of the examination. I can assure you that the DOHNS examiners go to a lot of effort to ensure fairness and high standards of examination practice. Finally, remember a busy on-call shift with multiple unwell patients is mentally, emotionally and physically harder than this examination. You have the skills and knowledge to pass the DOHNS OSCE, even if it takes you more than one attempt.