To pass the Second Part Exam, your performance needs to be at the expected level for a junior consultant. You need to be able to rapidly synthesise clinical information from multiple sources to reach a differential diagnosis and appropriate management decisions. (And achieve this while feeling the equivalent of standing at the top of an Olympic downhill ski-run, simultaneously suffering from a severe bout of gastro.)

Some general pointers include:

Get experience running the unit and calling the shots

Establish a good knowledge base - don't just practice SAQs

Write and share your own SAQs and Vivas

Make every case you see at work a practice Hot Case

Teach everyone else

Consider performance coaching

Finally, if things don't go to plan the first time, remember it's an exam not a statement on who you are as a person. Work out what worked and what didn't and why to change your approach and come back stronger.