EDAIC common mistakes
EDAIC · Understand the traps and how to avoid them.
Answering a structured oral question with a stream of consciousness list of everything known about the topic, without committing to a diagnosis, dose, or decision, and stopping only when the examiner interrupts.
Candidates prepare by reading review articles and fear omitting a fact, so they dump content rather than reason. In the EDAIC Part II structured oral, marks are awarded for a defensible clinical decision and the reasoning behind it, not for enumerating associations; unstructured answers also invite the examiner to probe areas the candidate has not prepared.
What to do instead
Practise a fixed answer scaffold out loud for every stem: state the problem in one sentence, give the top two or three differentials with the discriminating feature of each, state the single most likely diagnosis, then say what you would do in the next 15 minutes and what you would avoid. Rehearse with a timer so each answer takes 60–90 seconds, and deliberately end with 'that is my plan - would you like me to expand on any part?' so the examiner directs the next question.
Reciting doses, concentrations, and infusion rates as bare numbers, then freezing or guessing when asked to convert them to a patient of a different weight or to a rate in mL/h.
Numbers are memorised as isolated facts tied to the textbook example (usually a 70 kg adult) rather than as a set of relationships, so any change in weight, concentration, or time unit breaks the recall chain. Candidates also confuse mg/kg with mg/kg/h and mcg/kg/min with mcg/min, especially for adrenaline, noradrenaline, and local anaesthetics.
What to do instead
Store drugs as a rule plus a worked example: for each vasoactive drug know the standard concentration, the starting rate in mL/h for a 70 kg adult, and the formula rate (mL/h) = dose (mcg/kg/min) × weight (kg) × 60 / concentration (mcg/mL). For local anaesthetics know the maximum mg/kg for each agent and calculate the volume of the specific percentage that this represents. Write the calculation on the paper provided, showing units at each step, and sanity-check the answer against a familiar value.
Describing a technique or drug without stating the contraindications, the failure mode, and the rescue plan, for example discussing a spinal anaesthetic without mentioning what to do if the block is inadequate or high.
Candidates rehearse the 'how to do it' narrative because that is what textbooks and logbooks emphasise, and they treat complications as a separate topic. Structured oral stations are built around safety-critical decision points, so an answer without a rescue plan reads as unsafe even when the technique described is correct.
What to do instead
For every procedure or drug you prepare, write three lines: absolute and relative contraindications, the two most likely failure modes, and the immediate rescue step for each. In the exam, always close a technique answer with 'if this fails or if the patient deteriorates, I would…'. Practise converting any topic into this triad until it is automatic.
Giving adult physiological values or drug doses when the stem specifies a neonate, infant, or pregnant patient, and failing to adjust for the altered pharmacokinetics and physiology of that group.
Most revision is adult-centric, and paediatric and obstetric content is often skimmed because it feels like a niche. Candidates also under-appreciate how dramatically factors such as immature hepatic metabolism, higher body-water fraction, reduced functional residual capacity, and aortocaval compression change both dosing and the response to anaesthesia.
What to do instead
Build a one-page comparison table for neonate, infant, child, parturient, and elderly covering haemoglobin, functional residual capacity, glomerular filtration, hepatic enzyme maturity, MAC, and the key dose adjustments. Before answering any paediatric or obstetric stem, explicitly state the age or gestational context and the two physiological differences that change your plan.
Interpreting a monitor value or investigation in isolation - treating a single blood pressure, capnography trace, or potassium result as the diagnosis - instead of integrating it with the clinical picture and the trend.
Exam stems deliberately present one striking abnormality, and under time pressure candidates anchor on it. Interpretation of trends, artefact recognition, and the difference between a monitor reading and a clinical state are exactly what the basic-science and clinical stations test, and they are the parts most often skipped in revision.
What to do instead
For every data-based question, use a fixed sequence: is the value plausible or likely artefact, what is the trend, what is the clinical correlate, what is the differential for this abnormality, and what is the immediate action and the confirmatory test. Practise with capnography waveforms, arterial blood gases, and ECGs by describing each aloud in that order rather than jumping to a label.
Failing to state the risks, benefits, and alternatives to the patient, or to document the discussion, when answering a consent or communication station.
Candidates treat consent as a formality to be obtained rather than a process to be conducted, and they rehearse pharmacology far more than communication. In structured oral stations on consent, breaking bad news, or an unexpected complication, the assessed behaviours are explicit: exploring the patient's understanding, quantifying risk in plain language, discussing alternatives including doing nothing, and confirming capacity.
What to do instead
Memorise a consent skeleton - indication, nature of the procedure, common and serious risks with approximate frequencies, alternatives including no treatment, opportunity for questions, and documentation - and a separate skeleton for an adverse-event conversation: acknowledge, explain what is known, express regret, state what happens next, and arrange follow-up. Rehearse each aloud in under three minutes with a colleague playing the patient.
Answering a basic-science question with a clinical platitude ('we give fluids because the patient is dry') instead of the underlying mechanism, and conversely answering a clinical question with physiology while never reaching management.
Candidates misjudge which domain a station is testing and default to whichever mode they are more comfortable in. The EDAIC oral deliberately links basic science to clinical practice, so an answer that stays at one level signals a gap in the other; examiners are instructed to probe until they find the limit of understanding.
What to do instead
Practise two-way linking for every major topic: from mechanism to bedside (e.g. Starling forces and pulmonary oedema, or the Frank–Starling curve and fluid responsiveness) and from bedside to mechanism (why does a given drug cause tachycardia?). When a question starts with 'why', stay mechanistic; when it starts with 'what would you do', give the action first and then one sentence of mechanism.
Guessing confidently when the answer is not known, or conversely going silent and apologising repeatedly, rather than stating what is known, what is uncertain, and how the uncertainty would be resolved in practice.
The oral setting feels like a test of omniscience, so candidates either bluff to protect credibility or collapse when they hit the edge of their knowledge. Both behaviours lose marks: bluffing is easily exposed by one follow-up question, and silence gives the examiner nothing to credit.
What to do instead
Adopt a scripted fallback: 'I am not certain of the exact figure, but the principle is… and in practice I would check the formulary or ask a colleague before prescribing.' Then give the safe, defensible course of action. Rehearse this so it sounds composed rather than evasive, and remember that demonstrating safe uncertainty is itself an assessed competency.
Ignoring the equipment and monitoring detail of a station - discussing the anaesthetic plan without describing the machine check, the airway plan B, or how the patient will be monitored and positioned.
Equipment and monitoring are learned as practical routines in theatre and are rarely written down in revision notes, so they are not retrieved under exam conditions. Stations on machine checks, difficult airway, or transfer are also where candidates most often omit the pre-use check and the failed-technique sequence.
What to do instead
Write and rehearse a concise machine and monitoring checklist as a spoken script, and for any airway station state the plan A, B, C, and D explicitly with the criteria for moving to the next step. Include positioning, monitoring modality, and a plan for emergence and transfer in every procedural answer.
Spending disproportionate time on the first station or first question, then rushing later answers and missing the easy marks in the final minutes.
The first question is often on familiar ground, so candidates expand, and the anxiety of the opening minutes distorts their sense of time. Structured oral circuits have fixed station times with no compensation between stations, so overrunning early costs marks that are easy to collect later.
What to do instead
Simulate the full circuit under timed conditions at least three times before the exam, with someone signalling at the halfway point and at one minute remaining. Train a habit of giving an answer of the right depth first and offering to expand, and practise closing each station with a one-sentence summary so that a rushed ending still contains the key decision.