ANZCA Primary study guide
ANZCA Primary · Work through your exam, one topic at a time.
The ANZCA Primary Examination is the first major hurdle on the pathway to fellowship with the Australian and New Zealand College of Anaesthetists, the body responsible for anaesthesia, pain medicine and perioperative medicine training in Australia and New Zealand. It is designed for trainees who have entered the ANZCA anaesthesia training program and need to demonstrate a solid foundation in the sciences underpinning safe specialist practice before progressing through later stages of training. Preparation is built around four broad areas - anaesthesia, pain medicine, perioperative medicine, and the basic sciences relevant to anaesthesia practice - with the basic sciences weighted equally alongside the three clinical domains. That balance matters: candidates who treat physiology, pharmacology and physics as optional extras tend to struggle, because the clinical content is examined through a basic-science lens. The ANZCA Primary study guide has 4 sections and about 967 words.
01Anaesthesia: Core Pharmacology and Physiology Reasoning
Anaesthesia questions reward a mechanistic chain, not a memorised list. For any drug, be able to move from receptor or channel → organ effect → measurable change → clinical consequence.
264 words, about 1 min02Pain Medicine: Mechanisms and Multimodal Logic
Frame pain as nociception → transmission → modulation → perception , then map drugs to each step. Know: peripheral sensitisation (bradykinin, prostaglandins, substance P), central sensitisation and wind-up (NMDA receptor involvement), and descending inhibitory pathways (opioid, noradrenergic, serotonergic).
245 words, about 1 min03Perioperative Medicine: Risk, Optimisation, and Complications
Perioperative medicine is about risk stratification and modification . Know cardiac risk indices (revised cardiac risk index, functional capacity in METs), when to investigate (and when not to), and the logic of perioperative beta-blockade, statins, and antiplatelet management.
247 words, about 1 min04Basic Sciences Relevant to Anaesthesia Practice
Expect integrated physiology, pharmacology, and physics. Key areas: respiratory (compliance, resistance, V/Q mismatch, shunt vs dead space, oxygen cascade, hypoxic pulmonary vasoconstriction), cardiovascular (Frank-Starling, preload/afterload, cardiac output determinants), renal and fluid compartments (Starling forces, osmolality vs tonicity), and acid-base (Henderson-Hasselbalch, anion gap, compensation logic).
211 words, about 1 min