Meet Karen Raymer: Bridging Gaps in Anesthesia Education with ORACLE

Dr. Karen Raymer has been an anesthesiologist at Hamilton Health Sciences since 1995. She is the creator and instructor of ORACLE (Oral Exam Readiness for the Anesthesia Canadian Licensing Exam), an 8-week synchronous online course that equips students with the tools required to demonstrate their clinical expertise at the Royal College oral examination in anesthesia.

Dr. Raymer’s journey into medicine began at McMaster University in the mid-1980s, where she completed two years in the Life Sciences program before gaining early entry to medical school at the University of Toronto. After graduating in 1990, she completed her internship in Ottawa and residency in Anesthesia. For the past 30 years, she has been deeply involved in medical education at McMaster University, contributing at both the undergraduate and postgraduate levels. She is the author of a widely used textbook on Anesthesia targeted for medical students. She was also the program director for the Anesthesia Residency Program from 2014-2019, when Competency-Based design was introduced. 

Her involvement in preparing residents for the oral exam began during her time as a Royal College examiner from 2000 to 2006. “I had already been quite involved in assisting our residents in their preparation for the oral exam, which is the culminating licensing exam that involves a written and oral component that allows anesthesiologists to practice independently in Canada,” she says. 

After her term as a Royal College examiner, she continued her involvement in oral exam preparation with each cohort of residents at McMaster.

“This became a tremendous learning experience for me, as I learned the range of ways that residents learned how to convey their clinical knowledge within the somewhat artificial setting of an oral clinical scenario. I also learned the common obstacles that many residents faced as they developed their own personal approach to answering questions, and how I could help them recognize and overcome these roadblocks,” she says.

Through this experience, Dr. Raymer saw how international medical graduates were at a disadvantage despite possessing equivalent clinical skills. “They may have possessed equivalent clinical skills, but did not have the benefit of the ‘training’ in how to verbalize their skills within the context of the Canadian exam. This was the main impetus for me developing this course: to help level the playing field for international graduates who wish to take the Canadian oral exam in Anesthesia,” she explains. This insight led to ORACLE‘s development, which helps international graduates and Canadian residents refine their oral exam preparation.

In the course, Dr. Raymer teaches students how to translate their clinical knowledge into concise, structured answers. “Oral exam questions present scenarios where there is no ‘perfect answer,’” she notes. “Learning how to determine the lowest risk management plan, and defining ways that you will mitigate those risks, is more important than devising some sort of ‘perfect plan’ that isn’t realistic,” she adds.

“This course is a reflection of the 30 years I’ve spent training residents for the oral exam. Each resident has taught me how they learn and how I can best help them.”

ORACLE is the culmination of the learning process that Dr. Raymer has gone through, which has allowed her to develop a method that she can share with others.

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­­­Learn more about the McMaster Continuing Education ORACLE (Oral Exam Readiness for the Anesthesia Canadian Licensing Exam) program.