Why examiners value anticipation more than reaction

Reactive medicine appears unsafe in exams. Examiners assess whether candidates can foresee deterioration and act before harm occurs.

“Anticipation is the clearest marker of clinical maturity.” - A/Prof George Eskander

Why reaction is not enough

Candidates who react late often:

• identify red flags only after prompting
• escalate after deterioration occurs
• safety-net vaguely
• appear surprised by predictable outcomes

This suggests inexperience rather than caution.

What anticipation looks like in exams

Anticipatory candidates:

• identify high-risk features early
• discuss likely complications
• plan escalation before deterioration
• set clear review timeframes
• prepare contingency plans

They demonstrate forward-thinking care.

Why anticipation scores highly

Anticipation reassures examiners that:

• the candidate recognises patterns
• risks are being actively managed
• decisions are proactive, not defensive
• patient safety is prioritised

This applies across clinical and written exams.

Conclusion

Exams reward foresight. Candidates who anticipate risks demonstrate readiness for independent practice and score more reliably.

Reference
Reason J. Human error: models and management. BMJ. 2000.