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J R Soc Med. 2005 January; 98(1): 44.
PMCID: PMC1079247

Surviving a viva

Mr Cascarini and Professor Lowe's advice to viva candidates (October 2004 JRSM1) will have struck a chord with many past examinees and certainly did so in this examiner. Correctly the authors summarize the essentials for a pass— possess a thorough knowledge and convey this to the examiners. For most serious candidates an oral examination comes down to good communication skills in convincing revered examiners of a safe understanding of the subject.

I suspect anxiety or examination nerves substantially degrade the performance of many candidates and steps can reasonably be taken to overcome these. After all, there is a huge difference between dealing with colleagues and relatives and communicating with an examiner who appears to hold all the cards. My advice is to use a modest dose of a beta-blocker such as propranolol. These agents remove the debilitating effects of the adrenalated state without lessening the pressure to perform well. Experience from lecturing in stressful situations has demonstrated that a degree of beta-blockade allows one to handle aggressive questioning with an apparent time advantage in understanding the point of the question and arranging a suitable reply even before the questioner has finished.

Educationalists question the validity of the oral examination process because of variables such as examination nerves. Could anyone object to minimizing this variable by pharmacological means? Is it unfair? I think not. Be careful, however, of pharmacological interactions immediately after the examination when comparing notes in the bar.


1. Cascarini L, Lowe DG. Surviving a viva: a guide for candidates. J R Soc Med 2004;97: 498-500 [PMC free article] [PubMed]

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