I'd read through a guideline, feel like I understood it, tick it off my list, and move on. In the exam, I'd see a question on that guideline and realise I could remember the broad strokes but not the specific step the question was asking about.

The exam tests decision points, not broad knowledge. Knowing a guideline exists is not the same as knowing what to do at each branching point. You need to know the detail — the specific step, the exact threshold, the precise moment the algorithm splits.

Download the actual guideline PDFs — not just summary cards or revision notes. The exam tests nuances that summaries miss. Summary cards are useful for quick review, but they strip out the detail the exam is looking for.

Key guidelines to include:

• ALS special circumstances — Resus Council UK
• Sepsis — NICE NG51
• Head Injury — NICE NG232
• Anaphylaxis — Resus Council UK
• Procedural Sedation — RCEM BPG
• Ketamine Sedation — RCEM BPG
• DKA — JBDS
• Major Haemorrhage Protocol
• C-Spine — NICE NG232/QS74
• Mental Capacity Act
• Mental Health Act

Keep them in one folder — digital or printed, whatever works for you. For the full list of key guidelines with links, visit the useful resources page on frcementor.com.

Don't just read — actively recall. There are several ways to consolidate algorithms, and the more methods you use, the better they stick:

Draw it — sketch the algorithm from memory. Time-consuming but very effective for visual learners. Recite it — talk through each step out loud as if you're explaining to a junior. Act it out — mentally walk through a clinical scenario applying each step. Test others — quiz your colleagues on the algorithm steps. Get tested — ask someone to test you and catch the gaps you didn't know you had.

Focus on the branching points — where the algorithm splits. The exam tests what happens when the standard approach fails: refractory anaphylaxis, cardiac arrest special circumstances, DKA complications. Cover each step and ask yourself: what comes next? If you hesitate, that's the gap.

After learning each algorithm, practise as many SBA questions as you can on that topic. The questions reveal nuances the guideline summary doesn't. Focus on why you got questions wrong, not just the score.

Each question on frcementor.com links to the relevant guideline — so you can check the source immediately. Track which guidelines you're weakest on and revise those more. Supplement with RCEM Learning SBAs for weaker areas.

This is the most underrated revision method. When advising juniors, refer to the actual guideline and read it together. Talk through algorithms with your team. When you see a relevant case, mentally run through the algorithm steps.

After each shift, note which guidelines came up and review any gaps. Teach emergency algorithms to juniors — if you can teach it, you know it. Every clinical conversation is revision if you approach it that way.

The exam tests the specific moments where the algorithm branches. For each guideline, ask yourself: where does the algorithm branch? What determines which path you take?

Examples: When to CT vs observe (head injury). When to intubate vs manage conservatively (sedation). When to give adrenaline IV vs IM (anaphylaxis). When to stop resuscitation. When to transfer vs manage locally. These are consultant-level decisions — and they're exactly what the exam is assessing.

The exam loves testing what happens when the standard approach doesn't work. These are the questions that separate pass from fail:

• Refractory anaphylaxis — IV adrenaline infusion, glucagon in beta-blocker patients
• Cardiac arrest in hypothermia — withhold drugs until core temp >30°C
• Cardiac arrest in pregnancy — perimortem caesarean at 4 minutes
• Ketamine sedation with active URTI — contraindicated
• Collar in ankylosing spondylitis — contraindicated, immobilise in position found
• Normal CT + neurological deficit — MRI (think SCIWORA)
• Anticoagulated patient with head injury — know the different time pathways

Review each guideline on day 1, day 3, day 7, day 14. Each time, try to recall from memory BEFORE looking. Focus more time on the ones you keep forgetting.

In the final 2 weeks, do a daily 10-minute algorithm speed drill. Keep your guideline file accessible — on the bus, on a break, before bed. 5 minutes of active recall beats 30 minutes of passive reading.

• Head injury CT algorithms (adults + children) — NICE NG232
• Sepsis 1-hour bundle — NICE NG51
• Anaphylaxis (including refractory) — Resus Council UK
• Procedural sedation (monitoring, discharge, complications) — RCEM BPG
• Toxicology — paracetamol, toxidromes, antidotes
• Mental Capacity Act / Mental Health Act
• C-spine imaging and clearance — NICE NG232/QS74
• ALS — every sitting. Know the small print, not just the basic algorithm. Special circumstances (hypothermia, poisoning, pregnancy, electrolytes), post-ROSC care, when to stop.
• ATLS — every sitting. The exam goes beyond the primary survey. Know the decision points: when to activate massive transfusion, resuscitative thoracotomy indications, damage control resuscitation.

SLOs 3, 4, 1, and 5 account for 78% of marks — weight your guideline revision accordingly. The exam tests the steps PAST the basic algorithm — the nuances, the exceptions, the consultant-level decisions.