How the ANZCA Final viva works
By the Final, the viva is testing something different from the Primary. It's less about basic science and more about clinical judgement — whether you can make a safe, defensible plan for a real patient and hold it up under questioning. This is a plain account of what that means and how to prepare, written by a consultant anaesthetist who sat it. For the exact current structure, dates and regulations, always check the official ANZCA handbook — the college is the only authority on the format.
Practise this out loud with an AI examiner. Your first 2 stations are free.
What's being tested
The Final viva probes clinical reasoning. An examiner sets up a patient or a situation and asks how you'd proceed, then pushes on your plan — the risks you named, the ones you didn't, what you'd do when it goes wrong. The question behind every question is whether you are safe. A fellow-level answer is not the longest list of considerations; it's a clear, prioritised plan that flexes to the specific patient and that you can defend when the examiner presses.
What examiners reward
Structure and safety, communicated with judgement. The strongest candidates state a plan and its trigger points early, prioritise out loud, and stay ordered when the scenario deteriorates. They answer the question actually asked rather than emptying everything they know into the room. A clear, correct plan defended calmly is what a safe colleague sounds like — which is, in the end, what the exam is deciding.
What it covers
The Final spans subspecialty anaesthesia, perioperative medicine, pain, intensive care and crisis management. The viva can put you into any of it and expects you to bring the relevant science to bear on a clinical decision. You can see the full breakdown and drill any area on the ANZCA Final practice pages.
How to prepare for the spoken part
Fellowship candidates know a great deal by the time they sit. What separates a pass from a fail on the day is usually delivery under pressure — committing to a plan, structuring it aloud, and staying composed while an examiner drills. That is a rehearsable skill, and the way to build it is volume: practice vivas with consultants and peers, and anything that forces you to run a spoken clinical plan against the clock. Keep your in-person mocks — they're the gold standard — then multiply them.
Where Viva Station fits
Viva Station runs spoken practice stations across the Final syllabus with an AI examiner that asks one question at a time, drills your plan, and marks you to the standard. It exists to add reps between the in-person mocks, on your own schedule, with no one watching. It is an independent study aid, not affiliated with or endorsed by ANZCA, and every scenario is an AI-generated original. As with any AI, verify anything load-bearing against current references and your own clinical judgement.
Rehearse the Final out loud.
Your first 2 stations are free. Email sign-in, no password, no card — just you and the examiner.
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