Published

Fri 03 December 2010

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Personal notes on the MRCP parts 1, 2, and PACES

Introduction

A plan of attack is necessary. Here is mine.

Part 1

Timing

I began approximately 6 months before the exam.

Books

On line question banks

  • The whole onexamination questionbank for part 1 twice

Courses

  • Didn’t go on one but think it would have been useful to help to focus efforts on high yield facts

Result

Passed first time with an average score.

Part 2

Timing

I began approximately 6 months before the exam.

Books

On line question banks

  • The whole passtest questionbank for part 2 once

Courses

  • Sharma Medibyte MRCP II Written Courses Module C - 2/3 April

Result

Failed first time then repeated having done Sharma weekend course and made notes on Sharma’s book with an average score.

Paces

Timing

I began approximately 3 months before the exam.

Books

Practice

  • Get a partner to regularly practice seeing patients with

  • Get as many different consultants/registrars to watch you seeing patients as possible

  • Use mrcpuk website to study mark schemes and exam structure

Courses

  • Passpaces course - not v.good but helpful to get a feel for standard expected early on

  • Ealing paces course - v.good, plenty of good relevant cases and excellent teachers

Specific tactics

  • Use template as appropriate

    • For each problem: what is it, how is it affecting you, how is it changing (better/worse/same), any investigations and treatments, next problem.

    • PC, HPC, PMSH, DAH, FH, SH, SR

    • DDx, Ix, Mx, P&C

    • remembering ICE, how is affecting you? and close with summary, so we’ve chatted about and agreed x, is that right? anything else you wanted to discuss? no bye then

  • Remember scoring system. You’re scored for:

    • A Physical examination

    • B Identifcation of signs

    • C Clinical communication skills (define purpose of interview, open questions initially, no jargon, *include systems review*, establish how symptoms affect patient, *summarizes and checks information “to summarise…. is that right?”*)

    • D Differential diagnosis (have a problem list)

    • E Clinical judgement (investigations and management plan that addresses problems, mention MDT, specialist nurse, pt information, and referring pt to a specialist as appropriate)

    • F Manages patient concerns (*summarises and checks information “to summarise…. is that right?”*, elicit concerns and respond to them, empathetic)

    • G Maintains patient welfare (introduce yourself, ensure patient comfort)

  • Station 1 Abdo and Resp (A. B, D, E, G) (Ask if pain at start)

    • Abdo 10mins, 5-6mins exam, 4-5 mins presentation and discussion

    • Resp 10mins, 5-6mins exam, 4-5 mins presentation and discussion

  • Station 2 History taking skills (C, D, E, F, G)

    • Either making a diagnosis or pt with chronic disease where diagnosis is clear but must review previous investigations, treatments, and search out possible complications

    • Read GP referral and make notes (structure, key points, ddx) 5 mins

    • With pt, Introduce self, define purpose of interview, open question. PC 5mins inc patient concerns, past medical, drug, and family history 4mins, social history inc EtoH and smoking 4mins, review history with patient 1min (to summarise…is this right?), anything else we’ve not covered you’d like to mention? thanks (end), prepare thoughts/*problem list* (medical probs, social probs, concerns or complaints about treatment)

    • Discussion 5mins

  • Station 3 CVS and Neuro (A. B, D, E, G) (Ask if pain at start)

    • CVS 10mins, 5-6mins exam, 4-5 mins presentation and discussion

    • Neuro 10mins, 5-6mins exam, 4-5 mins presentation and discussion

  • Station 4 Ethics and communication skills (C, E, F, G)

    • Read scenario 5mins

    • Be with patient 14mins, review history with patient 1min (to summarise…is this right?), anything else we’ve not covered you’d like to mention? thanks (end) 1 mins reflection

    • Discussion 5mins

  • Station 5 Integrated clinical assessment (skin, endocrine, mskel, and eyes) (A-G)

    • Brief clinical consultation 1, Focused history and targeted examination 8 mins, discussion 2 mins

    • Brief clinical consultation 2, Focused history and targeted examination 8 mins, discussion 2 mins

    • 8 min with pt.

      • Introduce self and define purpose of interview

      • 3 min history inc pt concerns and how affecting life (desc problem, investigation&treatment, hows that affecting you now, next)

      • 3 min examination

      • 2 min explain plan and any other concerns, review history with patient 1min (to summarise…is this right?), anything else we’ve not covered you’d like to mention? thanks (end)

      • 2 min discussion

      • *Must identify pt concerns*

      • *Must identify clinical problem*

Result

Pending……Update 21/03/2011 - Passed first time :-)

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