What I wish I’d known before sitting the CO2A exam
Article by: Dr Jenny McKeon
Dr Jenny McKeon, clinical oncology ST7 at Gloucestershire Hospitals NHS Trust, shares the strategy that made the biggest difference to her revision and challenges a common misconception about the exam.
What do you wish you'd known a few months before sitting the CO2A exam?
I wish, as always, I had not worried quite so much about it. There will always be topics you haven’t covered – any exam is always an uncomfortable experience. No matter how many hours you put in, this is the same for everyone. I was lucky enough to have tremendous support from my consultant colleagues and the other residents – take advantage. Don’t be apologetic for asking for their help, as I will certainly offer my help to the next cohort taking the exam – it’s a rite of passage!
If you could go back and change one thing about the way you prepared, what would it be?
First and foremost, the exam tests the best and safest way to manage a patient. Do not waste time memorising TNM staging if you don’t know how staging affects the management plan. Additionally, the exam is written months before you sit it. I spent a lot of time learning recently NICE-approved therapies just in case, none of which were examined.
What support or strategy made the biggest difference that you didn't discover until later in your revision?
I found practical experience made the biggest difference. I started revising for the February 2026 sitting in October to give myself a chance to ease into revision and write my notes. Writing out notes was good for consolidating knowledge, but I found they weren’t very useful unless I had covered the tumour site previously on a rotation. If you haven’t covered a tumour site on a previous rotation, I would highly recommend observing clinics or MDTs and getting stuck in. I found this enabled me to remember management plans far more easily.
Was there a moment during your preparation when something suddenly 'clicked'?
Honestly, no! I was revising over winter; I lived in hideous fluffy pyjamas surrounded by post-it notes. It is tough, especially when you’re working and commuting and some of my colleagues had children to consider as well. All I kept repeating was, ‘this is just another exam’. Remember, we have all done hundreds of exams by this point.
What does successful exam preparation look like in a typical week, rather than on a 'perfect' revision day?
Initially, I planned to do two hours of revision per day. This is not possible. No week was the same, but I felt better if I had done something every day, whether that was asking a few extra questions to my consultant in clinic or when on call, or attending an extra clinic or MDT. I would then try and consolidate this learning into practice questions using AI. Importantly for me, I need to exercise to stay sane. Exercising three to four times a week was non-negotiable.
What's one common misconception about the CO2A exam that you'd like to challenge?
The exam is not examining you on the volume of knowledge you can memorise, even though there is a lot of content that is covered. The exam is testing you on your decision-making, according to the patient and tumour information that you are given in the question. Additionally, the CO2A exam is not an exit exam, you are being tested on information you should know to make safe clinical decisions at your current level of training. Don’t get bogged down by obscure facts.