The article below is an accompaniment to our brand new course, Prescribing Safety Assessment (PSA). The following video is taken from one of the introductory lessons of this course. Click here to learn more about the Prescribing Safety Assessment course.
The PSA is a two hour prescribing exam taken in the final year of medical school. It is comprised of 8 sections totalling 200 marks over 120 minutes.
These sections include:
- Prescription Review
- Planning Management
- Adverse Drug Reactions
- Drug Monitoring
- Data Interpretation
- Communicating Information
- Calculation Skills
You will not be allowed to bring anything into the exam other than a calculator, pencil, pen and the paper version of the BNF. You will have online access to the BNF and NICE guidelines throughout the exam.
The real problem lies with the time constraint of only 2 hours for 200 marks! That allows for 36 seconds per mark. This exam is notoriously difficult for many to finish let alone be able to check their work.
So how do you prepare for such a time-sensitive, information dense exam?
For a downloadable crib sheet to help you practice the kinds of calculations you’ll need to do to pass the PSA exam, click here.
Tips to help you succeed in the PSA
- Don’t lose easy marks! As prescribing counts for a whopping great 40% of the marks don’t lose out on the ample marks available for your signature and the date!
- Know your metrics! milligrams and millilitres, micrograms and nanograms. Know the difference and how to convert between them.
- Get familiar with the BNF. The BNF online is the best option if you are wondering, but it really helps with efficiency if you are already familiar with how to navigate it before sitting the exam.
- You don’t need to know everything, you just need to know how to find it. This is key! There are things you need to know – but you can be smart about learning what can’t be found on the BNF as long as you know how to locate the information you are looking for. For example what to do with a high INR can be found in the BNF.
- Practice makes perfect! There are lots of PSA questions around but the ones that you shouldn’t forget to look at are the questions available from the Prescribing Safety Assessment website. They are in the exact format you will see in the exam so definitely familiarise yourself with those.
- Don’t make it too complicated. Remember, this exam is aimed at final year medical students and Foundation Year 1 doctors so the paper will not ask you to prescribe chemotherapy drugs or other specialist medications so don’t worry about learning those.
- As an F1 you will often be asked to prescribe fluids so memorise the NICE guidelines for maintenance fluid: 25-30mL/kg/day of fluid, 1mmol/kg/day of sodium, potassium and chloride, and 50-100g/day of glucose.
- ‘Ctrl F’ is your friend. The BNF is huge so ‘Ctrl F’ is ideal for finding drug interactions and side effects easily.
- Mnemonics can be super helpful. There are a few things like enzyme inducers and inhibitors that you will need to rote learn and mnemonics can help with that.
- Calculations are an inevitable part of the exam and can be an opportunity to prepare to grab some marks. Download our PSA calculations cheat sheet to get all the notes you need to tackle these questions on one page.