Stress impacts on irritability, memory, attention, dexterity, and coordination. It also impacts on all levels of experience. In particular hospital registrars on accredited training programs to become consultants, are susceptible. They have their Fellowship exams coming up and their knowledge and expertise will be evaluated in rigorous examinations. Consequently they want to improve their coordination and consistency i.e. reduce variability. They want to increase those actions under their control that will improve their clinical performance and knowledge.They also need to develop strategies to address those things not in their control that reduce performance. It is satisfying and challenging to work with these doctors who are constantly striving to be the best they can be. Primarily I focus on the skills that will enhance their performance in the written and the viva examinations. These skills include: using the brain optimally; time management; managing emotions under pressure; performance anxiety; dealing with procrastination; focusing and refocusing; sustaining concentration; and developing and maintaining confidence. Also important for the vivas is good communication through the appropriate use of body language and voice. Communication is critical, and that’s tough under pressure or fatigue conditions.