How to use those 10 minutes

Last updated on 26 Jan 2026

Just ten minutes

This entire post is dedicated to optimising your technique for those fateful ten minutes before the clinical long case in the SOE exam.

There's no getting around the fact that knowledge is rather important for this exam.

The curriculum for the FRCA is enormous, and there is no substitute for having seen and learned as much of the relevant material as possible.

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When it comes to potentially catastrophic decision-making, anaesthetics is the highest-risk specialty in the game.

Of all the specialties in medicine, anaesthesia is unique in its characteristics:

High risk
Low margin for error
Often invisible until things go wrong

Hence the exam is difficult for a reason - they don't want just anyone giving an anaesthetic.

The exam was deliberately made insanely challenging in order to prevent anaesthesia being given by those unfit to manage its complications.

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Anaesthetics requires you to think clearly when overloaded, so that's what the exam does to you.

But it's not just knowledge

The thing that people forget is that this isn't just a knowledge test, it's a test of your judgement, and whether it is fitting for the consultant you're destined to become.

They are asking:

Do I trust this person to manage a sick patient safely at 3am?
Will they escalate appropriately when unsure or understaffed?
Are they safe when things go wrong?

You will be expected to:

Weigh up competing risks
Tolerate uncertainty
Make decisions using incomplete information
Prioritise under pressure
Defend decisions that don’t have a single correct answer

The ambiguity is deliberate, and often deeply uncomfortable for candidates who are used to certainty, because they want you to apply principles to unfamiliar environments, rather than rely on having seen it before.

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They're not expecting you to know all the right answers, they're expecting you to make a sensible, justifiable plan that keeps the patient safe.

Have a method

No doubt by now you'll have your way of doing an epidural, and you'll know when you like to give your long-acting opioids before weaning off the remifentanil.

You should also figure out how you like to organise your thoughts during these crucial ten minutes, which you will only figure out by practising.

Some candidates fold the paper into quarters
Some divide in half with a line
Others draw spider diagrams
Some scatter thoughts seemingly at random across the page (presumably the same people that label their syringes longitudinally)

As long as you're able to retrieve your thoughts in a coherent manner during the exam, it doesn't matter how you throw them down onto the single sheet of A4 they allow you to bring in.

Just have your way of doing, and stick to it.

Start with a headline

It's no secret that examiners will decide within thirty seconds whether or not they think you're going to pass the station.

They are instructed, of course, to be impartial and neutral, and they will continue to assess your responses throughout the station, however everything you say will be framed from a cognitive starting point that will either be in your favour or against you.

If you can start strong, this will earn you the benefit of the doubt later on.

For the clinical long case, the first thing we can guarantee you will be asked is:

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"Please summarise the case."

It is the one question you can be absolutely certain is coming your way, so make sure you have a slick answer ready.

On your first pass reading through the material, you should be thinking 'what is my headline?'

You need to practise this

This is a skill that you need to build confidence in. Go through as many long case examples as you can find, and don't even look at all the questions that follow.

Literally just sit there, read the introductory material, and write your headline.

Use the same structure each time:

Your headline should include: