1) Read the last line of the question
The last line of the question normally tells you two crucial bits of information: the units and rounding requirements for your final answer. For example:
Miss Sally Butamol, a 32kg girl, has been admitted to hospital after having an allergic reaction. The pharmacy would like to start her on an infusion of their magic anti-allergic infusion. The infusion rate is 250mg/kg/min. The infusion comes in 10%w/v, which needs to be diluted in equal parts water.
How many litresof solution will be infused after 1 hour? Round your answer to one decimal place.
I made it a personal task every time I did past papers to highlight the key points from the last line to prevent myself falling at the last hurdle. Not reading the last line carefully might lead you to incorrectly answer some questions that you did all the hard work for already - that’s really the difference between a pass and a fail. (BTW… the answer is 9.6!)
2) Don’t be afraid to start drawing
When it comes to the questions that are harder to understand, be it double dilutions or complex dosing regimens, I tend to map out or draw what is going on. Make sure you don’t spend ages making visual aids, but it is perfectly OK to spend a bit of extra time doing this, as long as you make up the time on the simpler questions. Doing this stops you from trying to work out the scenario in your head and makes what you have to calculate a lot clearer.
3) Reduce the moving parts as you go along
Sometimes, there are a lot of numbers jumping out at you from a question, and some of it is just unnecessary waffle. Once you’ve figured out what is important, especially in complex questions, it is better to condense the numbers. For example, a question might ask:
"Mrs Penny Cillin, a patient weighing 72kg, has been prescribed tacrolimus at a dose of 10mg/minute for one hour. Tacrolimus comes in..."
In this example, I would solve the total dose of tacrolimus (72kg x 10mg x 60minutes = 43200mg) before reading the rest of the question. Now, if the rest of the question asks how many 200mg tablets are needed, it is a lot simpler to tackle this question. (The answer is 216… probably not clinically accurate!)
4) Do timed practice under exam style conditions
To me, this is probably the most important point out there! Last results day, I did have a few people messaging the RevisePharma page saying that they had not passed the calculations part of the exam. I always tend to ask if they had done any timed papers and most of the time, they had not.
Unfortunately, the calculations exam can be challenging in two ways, the actual questions, and then the matter of having to do all 40 in 120 minutes! If you haven’t done timed practice papers, your failing to prepare for the latter challenge of the two. Make sure you get plenty of practice under timed conditions, and if you want to make it extra realistic, do the calculations off the computer screen without printing the paper!
Zhyar Said is a locum pharmacist based in Surrey and the owner of a pre-reg pharmacist educational platform on Instagram called @Revise_Pharma
