Dr Binula Wickramarachchi & Dr Luke Phillips

Welcome to our Unlocking the ACEM Exams blog posts where we unlock the key study habits, resources and top tips from recent successful exam candidates.  This week we got to sit down with Dr Binula Wickramarachchi who recently completed a successful sitting of the ACEM fellowship OSCE exam (2022.1). Binula outlines some of his key tips to success in the post below.

Dr Binula Wickramarachchi

Dr Binula Wickramarachchi


Binula is an Emergency Advanced Trainee and Education Fellow at the Alfred Hospital. He grew up among the verdant hills of Auckland, New Zealand, obtaining his medical degree and Postgraduate Diploma in Clinical Education at the University of Auckland. He also has a passion for point of care ultrasound, particularly echo and lung ultrasound.

At home, Binula is a devoted parent to his two feline daughters, and is the household co-lead for the acclimatisation to a new human child.

“How did you prepare for the exam?”
  • A frequent, consistent and supportive study group is a must
  • Don’t underestimate the value of repeating stations, especially a day or two following a good learning encounter
  • Identify your deficiencies early and work on these. It can be easy to keep patting yourself on the back for something you’re already good at
  • Practice with a range of FACEM’s, including newer and more experienced ones. It is especially helpful to practice with ones that will be more critical with you, but try to avoid this closer to the exam

“What are your top tips for success?”

  • Be adaptable – many of the cases you will face in the exam, you won’t have seen before, or will be presented in a different context/format. You have to be able to answer the questions that are presented, not necessarily what you have practiced.
  • Practice speaking confidently, concisely and in a structured manner. Appropriate language has a huge effect on how you’re perceived.

“Do you have any pearls about refining your exam technique?”

  • Use the pace of your speech effectively:
    • slow down for empathy,
    • speed up for factual information,
    • use silence appropriately when breaking bad news or giving complex information.
  • Use reading time effectively:
    • actively read the stem and extract all the information you can from it.
    • This can help you to pre-empt where you think the station will go, but be careful to not assume too much, and to adapt if it turns an unexpected corner
  • If props are provided, extract all relevant information from them outside the room. This way, you can focus on answering the questions in the station, rather than spend time interpreting inside the room. For example:
    • Do the blood gas calculations,
    • Interpret the X-rays/ECGs fully.

  • Do as many trial exams as possible – each one will make you that much more comfortable with the exam process.
    • Speak to your DEMT or OSCE exam facilitator about how to get involved in these.

Any resources you would recommend?

  • Comm’s Lab with Dr Hayden Richards (YouTube) – This is a gold mine of reallly useful communication strategies. 
  • End of life discussions 
  • Don Liew’s personal coaching and trial exams – I found the coaching very individualised and helpful in practicing to iron out my weaknesses. As above, the trial exam was great for further practice.
  • Various online question banks available – get your hands on these early and organise them so practice comes easily. Speak to recent exam graduates about how to get ahold of these resources.