A common approach to preparing for clinical exams is for doctors to practise as many different topics as possible. The rationale is that the more topics you prepare, the less you will be surprised on the day of the exam. This seems to make good sense, but what if there are underlying issues that limit your ability to perform well in clinical exams regardless of the topic? 

I commonly find that even a dedicated, committed and thorough preparation of potential exam topics can ignore the critical underlying issues that prevent candidates from passing their clinical exams.

And this is not the fault of specialist trainees. In preparation for exams, junior doctors are forever encouraged to cover the curriculum. Of course, covering the curriculum is absolutely necessary for success in clinical exams. But it is not sufficient. Being able to demonstrate consultant level decision making, effective communication and leadership (if this is relevant to your specialty) are the skills that are often overlooked in preparation for clinical exams. In fact, without these skills it is close to impossible to pass. Some people are able to hone these skills with their peers. Others need professional coaching and guidance. Choose an approach that works for you, but be sure not to ignore these essential parts of your preparation.