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4. How to Pass the Fellowship of the Hong Kong College of Anaesthesiologists (Final Fellowship Examinations)

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 How to Pass the Fellowship of the Hong Kong College of Anaesthesiologists (Final Fellowship Examinations)
===========================================================================================================

  A practical, section-by-section study plan for the HKCA Final written papers, oral exam, and OSCE.

  [     MDster Editorial Team ](https://mdster.com/about) ·      Mar 15, 2026  ·      7 min read  ·       197

  [     Reviewed by Dr. Ali Ragab, MBBCH, MSc, MCAI ](https://mdster.com/medical-reviewers/dr-ali-ragab) [Editorial Policy](https://mdster.com/editorial-policy) | [Corrections Policy](https://mdster.com/corrections)

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 Most candidates who underperform in the HKCA Final do not lack knowledge; they prepare for it as if it were one exam. It is not. You are sitting a written section with different task types, then a long oral, then an OSCE that rewards structure under pressure. As of March 15, 2026, the March/May sitting is effectively underway, so anyone not already in final taper should now plan deliberately for the August 10-11, 2026 written papers, followed by oral on October 2-3 and OSCE on October 4, with the application closing on June 30, 2026. [\[1\]](#cite-1 "Reference [1]")

Reverse-engineer the exam before you revise
-------------------------------------------

The official HKCA FAQ describes three equally weighted sections: written, oral, and OSCE. You must achieve an aggregate pass in the written papers to be invited to the oral and OSCE. The College also uses a closed marking system with scores from 2 to 8, where 5 is the pass mark, and it explicitly warns that unanswered written questions are very hard to compensate for later. That means your study plan should be built around **complete, pass-level performance across all components**, not brilliance in one area. [\[2\]](#cite-2 "Reference [2]")

- Split your weekly study into **written, oral, and OSCE lanes** from the start.
- Keep a single error log with three columns: **knowledge gap, structure gap, communication gap**.
- Judge every session by one question: **would this score a 5 today?**

Train the written papers as separate skills
-------------------------------------------

Paper I is a speed-and-relevance exam: 12 mandatory questions in 2 hours, with about 10 minutes per question. Recent past papers show a mix of linked clinical scenarios and standalone SAQs. Do not practise by reading model answers. Practise by writing timed answers that start with the issue in front of you, not everything you know about the topic. HKCA specifically notes that irrelevant answers do not score. [\[2\]](#cite-2 "Reference [2]")

Use one repeatable scaffold for most Paper I answers:

1. **Immediate priorities / safety issues**
2. **Focused assessment and key differentials**
3. **Investigations or optimisation needed now**
4. **Anaesthetic plan with monitoring and contingencies**
5. **Postoperative destination and ongoing risks**

Paper II should be treated as three mini-exams: critical appraisal, investigations, and radiology. The published FAQ says you are given an article to read for 30-60 minutes, then answer questions in 10 minutes; investigations and radiology are each 10-minute tasks. Build a weekly routine around that exact format: one timed journal appraisal, one investigations set, and one imaging set every week. For critical appraisal, use a fixed checklist: study question, design, bias, statistics, clinical relevance, and whether the conclusions actually follow from the data. [\[2\]](#cite-2 "Reference [2]")

The same FAQ also describes a separate MCQ paper of 60 true-false and 30 single-best-answer questions over 3 hours. Even if your department teaching naturally drifts toward scenarios and viva practice, protect two short MCQ blocks each week so breadth topics, pharmacology, physiology, pain, ICU, and research methods stay active in memory. Spaced repetition and retrieval practice improve performance in health professions education, so make your revision **question-led**, not note-led. [\[2\]](#cite-2 "Reference [2]")

> **Pro Tip:** In Paper I, stop at 10 minutes even if the answer feels unfinished. Twelve competent answers beat six polished answers and six blanks.

Prepare the oral and OSCE as performance exams
----------------------------------------------

The oral is long: three tables, two examiners per table, 15 minutes each, for a total of 90 minutes. That format punishes rambling. Practise with a strict opening framework: **state assumptions, identify priorities, give your plan, justify your choice, then mention backup options**. Your study partner should interrupt, redirect, and ask, "What would you do now?" because that is closer to the real cognitive load than a friendly discussion. [\[2\]](#cite-2 "Reference [2]")

The OSCE includes 10 stations plus rest stations, and the long clinical case runs for 20 minutes with double weighting. The College lists content such as regional anaesthesia, equipment, crisis management, resuscitation, interpretation of radiology and laboratory results, physical examination, communication, and procedural skills. Do not revise OSCE by just talking through stations. Rehearse what the examiner can actually observe: your introduction, focused examination sequence, equipment check, crisis algorithm, consent language, and perioperative plan summary. [\[2\]](#cite-2 "Reference [2]")

> **Pro Tip:** After every mock OSCE, ask only two questions: **What did I fail to say? What did I fail to do visibly?**

Use resources like an examiner, not like a collector
----------------------------------------------------

Your best resources are the official ones: past papers, the Final Exam FAQ, the curriculum, critical appraisal sample material, and exam-focused HKCA courses. In 2026, the College has continued to run final-exam-targeted activities including a crash course with mock written, mock viva, and mock OSCE components. Use these to benchmark timing and structure, not to accumulate more notes. Add one weekly journal-club-style appraisal session and one small viva group of 3-4 candidates who will actually mark you against structure and prioritisation. [\[1\]](#cite-1 "Reference [1]")

Study Schedule Template
-----------------------

For most readers on March 15, 2026, the realistic target is the **August/October 2026** sitting. Build the next 12 weeks like this. [\[1\]](#cite-1 "Reference [1]")

PhaseWeekly focusNon-negotiable outputWeeks 12-92 timed Paper I sets, 1 critical appraisal, 2 MCQ blocks, 1 vivaOne complete error log review every SundayWeeks 8-51 full written mock, 2 investigation/radiology drills, 2 viva sessions, 1 OSCE circuitRewrite weak answers within 24 hoursWeeks 4-2Alternate full written and full clinical mock weeksAt least one long-case OSCE each weekFinal weekShort targeted drills onlyNo new textbooks; revise templates, errors, and standard phrasing

Common Pitfalls
---------------

- **Writing generic essays instead of answering the scenario.** Fix: your first line should identify the problem in *this* patient.
- **Leaving critical appraisal until the last month.** Fix: one article every week from the start.
- **Doing "nice" vivas.** Fix: insist on interruption, time pressure, and follow-up questions.
- **Treating OSCE as a theory exam.** Fix: practise the physical actions and spoken scripts.
- **Forgetting the carry-forward rule.** If you pass the written but fail oral or OSCE, HKCA allows the written pass to be carried forward for up to four consecutive attempts, so document your clinical weaknesses precisely after any failed sitting. [\[2\]](#cite-2 "Reference [2]")

Key Takeaways
-------------

- This week, decide whether you are in **final taper** or targeting **August 10-11, 2026**. [\[1\]](#cite-1 "Reference [1]")
- Build one answer template for **Paper I**, one checklist for **critical appraisal**, and one opening structure for **viva**.
- Start weekly **OSCE practice** that includes observable behaviour, not just discussion.
- Use **past papers and official HKCA mock activities** as active drills, not passive reading. [\[1\]](#cite-1 "Reference [1]")
- Review your error log every Sunday and convert weak topics into timed questions for the next week.

The HKCA Final becomes more manageable when your preparation mirrors the marking: concise, relevant, timed, and spoken out loud. Train like the exam is delivered, and you will start to look like a candidate ready for Fellowship.

        References  (8)
------------------

 1. 1.  [ www.hkca.edu.hk/anaesthesiology/examinations     ](https://www.hkca.edu.hk/anaesthesiology/examinations/)   [↩](#cite-ref-1-1 "Back to text")
2. 2.  [ www.hkca.edu.hk/wp-content/uploads/2025/09/Exam\_FAQ\_202112\_Final\_Exam.pdf     ](https://www.hkca.edu.hk/wp-content/uploads/2025/09/Exam_FAQ_202112_Final_Exam.pdf)   [↩](#cite-ref-2-1 "Back to text")
3. 3.  Hong Kong College of Anaesthesiologists. Anaesthesia Examinations. Accessed March 15, 2026.
4. 4.  Hong Kong College of Anaesthesiologists. Final Fellowship Examination FAQ (posted December 23, 2021; available on HKCA website). Accessed March 15, 2026.
5. 5.  Hong Kong College of Anaesthesiologists. Vocational Training Guide for trainees starting 1 July 2018. Accessed March 15, 2026.
6. 6.  Hong Kong College of Anaesthesiologists. Courses - Anaesthesiology. Accessed March 15, 2026.
7. 7.  Maye JA, Hurley F. The Effectiveness of Spaced Repetition in Medical Education: A Systematic Review and Meta-Analysis. Clin Teach. 2026;23(2):e70353.
8. 8.  Trumble E, Lodge J, Mandrusiak A, Forbes R. Systematic review of distributed practice and retrieval practice in health professions education. Adv Health Sci Educ Theory Pract. 2024;29(2):689-714.

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