The FCEM Management Viva - The Basics

The Management Viva

Total of 35min

There is a structured marking grid with ideal Answers

The pass mark is 60-65%

The aim is to assess:

• Ability to prioritise and time manage


• Decision making


• Delegation


• Communication Skills


• Medico-legal awareness


• Governance


• Ethics & Probity


• Managing your staff


• Recognising educational opportunities


• Knowledge of complaints and disciplinary procedure

Common Themes

• Complaints


• Doctors with difficulties


• Freedom of information


• Staffing issues


• SUIs /Adverse events


• Policy Declarations from other departments

The In Tray

• 5 minutes Reading time


• 15 minutes viva


• Usually maximum of 9 items


• Consists of your Diary Card, Letters, memos, emails


• The first 5 minutes is the most important make sure you read everything, and sort them in order of priority


• Write post it notes of key bits. You can also write or underline on the exam papers.


• You get marks for talking about everything in the in tray even the fillers


• Diary Card is the most important as it gives details of your department and offers ways to link things in for extra marks


• Keep it in front of you

Starting the Viva

• Check the department first – if it is melt down then everything else waits.


• Do I have a clinic or a ward round?


• Can a middle-grade start it?


• What meetings do I have? When are they? Who will be there?


• Do they tie into anything in my box?

Structure of answers

• Have structure to your answers. The following headings might help.


• Always talk about information gathering and how you going to do that. (Patient’s notes, statement from staff, CCTV, IT records, etc)


• Patient issues – Is the patient safe now? Was the treatment/management appropriate?


• Staffing issues – Are there any staff member affected and how? Don’t forget about the pastoral care.


• Short term solutions – Junior doctor teaching session, removing sharps and putting appropriate sharp bins, etc.


• Long term solutions – Making formal policy or pathway.

Prioritising your In Tray

Three levels of priority:

1. Important and time dependant – You need to sort out now


2. Important but not time dependant – You can sort out later


3. Neither important nor time dependant

Tell the examiners how you have done this.

Marking and Scoring Well

• Remember that it is a fixed scheme with ideal answers, every piece in your in- tray carries marks, but value varies (2-12)


• Spend more time on complicated ones


• Score higher by finding the tie ups to diary and other items in the In-Tray


• Be decisive – don’t sit on the fence


• Mention the links and tie ins


• “I’d like to check on the patient”


• Delegate appropriately


• Secure copies of notes and documents


• Take minutes of important meetings


• Empathise with the situation


• Address the issues


• Use guidelines


• Know the organisations who can help – CQC, NPSA, NCAS etc


• Know the processes at your trust – download and read your policies

The common pitfalls are:

Sounding like you have just learnt off the answer

Not touching on all parts of the in-tray

Not moving on in a timely manner

Arguing with the examiners

The Long Case

• More difficult to predict


• Complex multifaceted case


• Once you look up from reading it they will start quizzing you

On the day of the Vivas

• Dress if going for an interview.


• Lots of hanging about on this day.


• Be calm.


• Time is short, so make good use of it


• Read all the papers and have something to say about each of them


• If the examiners try to move you on then let them


• Don’t look up from the long case until you have read it all


• Don’t get aggressive.


• Be polite

With input from London FCEM Course

The FCEM Management Viva - The Basics