Although the Final FRCA examination has undergone a degree of evolution since its inception in 1996, its basic format has remained broadly unchanged, and the clinical science viva continues to test ‘the understanding of basic science to the practice of anaesthesia, intensive therapy and pain management’. The term ‘viva’ is now officially obsolete, and this part of the examination is now referred to as the ‘Structured Oral Examination’ or SOE. In colloquial reference, however, anaesthetists still talk about ‘vivas’, and so the word still appears in the title of this book, the first edition of which predated the change in terminology. In the text it has been replaced by the word ‘oral’. The College has always included the proviso that ‘it is accepted that candidates will not have acquired a detailed knowledge of every topic during the period of recognised training’, but this has on occasion contrasted uneasily with the bitter perception of at least some candidates that they had been examined almost to destruction on scientific minutiae. This perception, against a background of muted unease about this section of the exam, was acknowledged by the College, which decided therefore to introduce greater clinical emphasis into the science oral.