The postgraduate exams threadWatch
Stage in career:
Please feel free to point out if I've missed anything.
MRCP(UK) Part 1:
MRCP(UK) Part 2:
MRCS Part A:
MRCPsych Part A:
MRCPsych Part B:
Exam: MRCP Part 1
Year passed: 2018
Stage in career: FY2
Resources used: Completed PassMedicine and OnExamination, used Kalra as a reference for difficult and core topics (didn't read it from cover to cover), did the official past paper on the MRCPUK website.
Tips: I revised for this exam over three months, starting off with 50 questions a day for the first month, then 75 for the second month, and finally 100 questions a day for the final month. It's very much a marathon rather than a sprint, so if you're on nights or just really exhausted it's fine to take time to recharge. I was very lucky to get a few days of study leave - if you're able to get this it makes a lot of difference.
I increased the time spent on book learning the closer it got to the exam, but I do firmly believe this is an exam which primarily requires attempting lots of questions, reading through the explanations, and re-attempting the incorrect ones until you get them right.
The question banks are difficult and ask about minutiae and I think this is intentional, so don't feel discouraged. I found PassMedicine to be more difficult than the actual exam (though the explanations and guidelines were excellent). OnExamination was slightly easier. My scores on both were pretty low to start with but I found my average did improve over time.
The real exam was also hard and pretty tiring (six hours of exams with a 75 minute break), somewhere in between OnExamination and PassMedicine in terms of difficulty. They absolutely ask about rare, footnote-y stuff which you've probably never seen in real life. Definitely don't avoid your weak areas - they will come up.
I think one other important thing is to ensure you get a good night's sleep beforehand so it's worth staying in a hotel near to the venue if you can. The last thing you want on the day of an important and expensive exam is to deal with public transport, traffic or parking headaches, or even having to wake up extra early. It's definitely worth paying £40 for a basic room imho.
Other remarks: A lot of people on here ask about whether it's necessary to have a study partner for the MRCP Part 1. My personal opinion is that this is not necessary at all. This is an exam which basically requires you to shut yourself in a room with a laptop and maybe a textbook for a few months - I think studying in a group would probably end up being rather inefficient and distracting if anything. NB: I wouldn't say this about a practical clinical exam - group study all the way.
Year passed: 2018
Stage in career: Break between F2 and core training
Essential Notes for MRCP by P. Kalra
- I found this to be the most useful resource as it gives you lots of the random details and footnote stuff that comes up in question banks and the exam. I also found it helpful for physiology as this was not a strong point for me (having done almost no physiology since 1st year of med school), as well as epidemiology and statistics. I found a huge difference when doing questions before and after reading this book, and I doubt I would have passed without it. I read about 90% of the book, skipping only a couple of topics I was very confident in.
Basic Medical Sciences for MRCP part 1 by P. Easterbrook
- This is an excellent book but I didn't have time to read very much of it. I think I would have found it a very useful resource as a medical student, but for the exam, I wouldn't recommend it as anything more than a reference.
Onexamination, Passmedicine, MCQ books for MRCP part 1
- I went through all of the onexamination question bank, going over my weaker areas twice. I would read a chapter from Kalra, then do questions on that specialty from onexamination. Once I read the book and finished all the questions on onexamination, I moved on to doing questions on Passmedicine and from various MCQ books. I agree with Democracy that Passmedicine was the harder question bank, hence it felt appropriate to use it after I built up some knowledge via textbooks and questions.
There are a lot of people who swear by question banks and don't use any books at all. I think it is possible to pass this way, but I would strongly recommend getting the textbook by Kalra as it pretty much sets out the curriculum for Part 1 - it shows you which are the topics they will ask you about, and roughly the amount of detail you need to know . I did not get the latest edition of the book - I bought the 3rd edition which cost me around £3 on amazon. It wasn't in colour but covered what I needed adequately.
I felt that the practice paper on the MRCPUK website was much easier than the real exam. I don't know if it is always the case (I have heard a couple of people say the same thing in the past), but when I sat the exam, the first paper was pretty easy and the second paper was very hard. I would say the practice paper is at the level of the first paper - i.e. not representative of the true difficulty of the exam.
MCQ books are very good for building up knowledge - I bought a few cheap ones on eBay and amazon and found them very helpful. The problem with using a question bank is that authors tend to have their favourite topics and random facts that they want to pass on to you, and if you are using sources written by different authors, you gain more knowledge that may come in useful in the exam.
I spent roughly 4 months in total preparing. Parts of this were more intense (3-4 hours studying a day) and others were less so as I was traveling, however I aimed to do questions every day (even if it was only 30 or 50 on some days). In the past 3-4 weeks before the exam, I was doing around 150-250 a day.
Year passed: 2016
Stage in career: FY2
Resources used: Passmedicine only
Tips: From my experience it was just questions, questions, questions and learning the appropriate associations - these exams are very stereotypical in certain wording means a certain diagnosis. Took maybe about 4 to 6 weeks or so of studying question after question and learning the correct answers.
Other remarks: To be honest, this exam was probably harder than Part 2 as it included so many random basic science type questions which isn't particularly helpful to clinical practice - it's a hurdle that a lot of us have to go through though.
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Exam: MRCP Part 2
Year passed: 2017
Stage in career: FY2
Resources used: Passmedicine question bank. Also had free access to Medical Masterclass from my hospital library which was helpful as there was an app you could use on commutes.
Tips: Like Part 1, lots of questions is helpful. In my opinion this was much more interesting to study for as a lot of it is relevant to the things you come across in hospital medicine. Once again certain wording in questions will essentially give you the diagnosis :P Studying for this exam was a bit of a blur as I was on A&E at the time, but roughly 4 weeks or so of solid studying was probably enough.
Other remarks: When I took this exam it was over two days which was a pain (but a relief to be off the shop floor in A&E :P), but I believe now it is just one day. Not sure how that will affect people in the future.
Year passed: 2017 final session
Stage in career: F2
Resources used: Mini Kumar and Clark book, PassMedicine, OnExamination
Tips: I probably did more "textbook revision" than most people. But I don't really like just doing questions. I think I did around 3 months of revision.
Other remarks: In my sitting, the first paper was very very challenging, and the second paper was around the difficulty level of the online question banks.
I found Passmedicine to be much more challenging than OnExamination. I think even on my second attempt through Passmedicine (after clearing my scores), I was just around the middle of the score distribution. Whereas after one attempt at OnExamination, I was in the top 5%. My actual exam score was a completely unremarkable pass (low 600s).
Year passed: Jan 2017 sitting
Stage in career: FY1
Resources used: Anatomy - Grays, Surgery specific - I used the pastest books, Question bank - eMRCS, didn't really use a physiology/pathology text book as i was only 5 months or so post-finals and had done a lot in the lead up to that (for finals i used Naish medical sciences and Robbins pathology). The pastest books generally cover all that you need for these topics anyway
Tips: I'd say 3-4 months is that amount of time you want given that you're working full time. No doubt it could be done a lot quicker though. I started with anatomy to get my basics and then started reading through the pastest books. Would do maybe 1-2 hours a night with longer spent on days off. Started questions about 4-5 weeks prior to the exam and got through the question bank twice, i found the eMRCS question bank very similar to the exam and so felt really well prepared.
Other remarks: Have finally booked onto Part B for October and will be changing my revision technique to include a few more texts (to revisit some concepts that haven't been covered for a couple of years). By the time i sit it i'll be into my 4th surgical job having also done a rotation in ITU so am hoping it shouldn't be too bad. I will return following to document how it went and what i found useful!
Year passed: 2018
Stage in career: FY2
Resources used: Completed OnExamination and PassMedicine, did the official past paper on the MRCPUK website. Didn't really do much bookwork for this one, the notes on PassMedicine and official guidelines were sufficient. I found the standard of the irl exam to be most similar to the medium-difficulty OnExamination questions and the official MRCPUK past paper.
Tips: I revised for this exam over a period of about 10 weeks doing about 50-70 questions a day. The question stems for this exam are generally much longer than what you get in Part 1, with some of the question intros being four or five paragraphs long. Questions are usually accompanied by investigation results, including: bloods, radiographs, ECGs, CT/MR/NM scans, spirometry, cardiac catheterisation, and clinical photographs. All of this means that it actually takes a while to read through each question and sift out the relevant information. I found time management to be a challenging aspect of this exam, and certainly on the actual exam day itself I ran out of time towards the end of the second paper, so it's important to keep an eye on the clock.
There is a good amount of overlap with the concepts introduced in Part 1 so I'd suggest booking this exam as soon as possible following Part 1. Part 2 questions are more clinically oriented and have more links to "real life" medicine than Part 1, so your day job might also be helpful for preparation.
Other remarks: This exam has a pretty high pass rate (sometimes >80% for UK graduates), which is a heartening thought. As with Part 1, I don't think group study is necessary to pass this exam, just do lots of questions and look up anything you're unsure about and it should be okay.
This has 4 parts:
- Foundations in Practice (formerly part 1A)
- Theory and Science (formerly part 1B)
- Applied Knowledge in Practice (formerly part 2 written)
- MRCPCH Clinical Exam
The three written exams (FOP, TAS, AKP) can be taken in any order, but all three need to be passed before progressing to the clinical exam. FOP and TAS are each half day written exams, and are on the same day. They can be booked together for a slight discount. Plenty of people sit them together and do manage to pass both, but beware that the content for each is quite different, so only book them both together if you think you have the time to study for two exams. AKP is a 2-part written exam taken in the morning and afternoon of the same day. Clinical exam is a 12-station OSCE.
FOP / 1A
This exam is also taken by folk aiming for DCH (Diploma in Child Health). It’s the most straightforward of the exams, and is a general introduction to paediatrics. It usually has a reasonable pass rate. I mainly used question banks (pastest) and a couple of general textbooks to look up things from the question bank questions. There is now a dedicated book by RCPCH called “Clinical cases for MRCPCH FOP” – it wasn’t out when I sat this exam.
TAS / 1B
This is generally acknowledged as the harder of the written exams. Lots of obscure basic science. It usually has a fairly low pass rate. There is a new dedicated textbook for the exam, which has definitely increased the pass rate. Resources I recommend:
- The Science of Paediatrics (Will Carroll) – this is the dedicated textbook for the exam. Very expensive, but it does contain all the information you need, and is cheaper than another attempt at the exam. Try to get a second hand or library copy if you can.
- Clinical cases for MRCPCH TAS – useful cases. I got a library copy and did study the book cover to cover. Probably wouldn’t have been worth buying but definitely a good book.
- Basic Medical Sciences for MRCP part 1 – yes this is a book aimed at MRCP rather than MRCPCH, and it’s quite an old book, but it’s a really good little book and most of the science is still relevant to this exam. Has some good diagrams and clear explanations. I got it second hand off amazon and was definitely worth it.
As well as those three books, I also used pastest and went through the entire question bank.
RCPCH now run a revision course for this exam – it was a 2 day course when I went, but I believe it’s now a one day course with online resources available. It was a really good course, but expensive – I think part of the rationale in reducing it to one day was to also reduce the cost. Probably not worth it for the first attempt, but if you’ve had a couple of attempts and you’re struggling with TAS, I would highly recommend it. I managed to get mine covered in my study leave budget. It’s run by the person that actually runs / coordinates the TAS exam.
AKP / part 2 written
This is a big exam that needs a lot of study, but I found it much more straightforward than TAS. I used a couple of bigger textbooks – Nelson’s, and the recent GOSH paediatrics textbook, but mainly the “Essential revision notes in paediatrics for the MRCPCH” and MRCPCH Masterclass books, going through the curriculum. I used Pastest again. I also used “The essential revision guide to paediatric cardiology” and “Imaging picture tests for MRCPCH”– both from the library. As per the other written exams, RCPCH have written a clinical cases book, but this came out after I sat this exam.
MRCPCH Clinical Exam
This is a tough exam. You need to learn the system and what is expected. There is a lot of information online on the RCPCH website about the circuit, anchor statements and marksheets explaining how it is marked. Print this out, absorb all the information, and get to know the exam inside out. There are currently 10 stations – 2x long 22 minute stations and 8x 9 minute stations. There are clinical examination stations – neuro and cardio are guaranteed, and then resp / abdo / MSK may either be that, or something else such as a second abdo, or a different thing such as examining a child with short stature etc. Then there is a child development station, 2 communication stations, a long history taking station and (soon to change) a long video station with video clips of acute signs they can’t bring to the exam.
The essential book for this exam is “MRCPCH clinical short cases, history taking and communication skills”. It’s about £35 and is worth the investment. I took it round the wards when I was practising. It’s great to annotate. I spent about 3 months preparing, a combination of reading the relevant book sections, and then going round the wards in small groups examining patients. As soon as you can, try to time each other, as managing everything in the nine minutes is quite a skill. Use the mark sheets and anchor statements to mark each other. Get consultants and registrars to take you round and watch you examining patients. I went to lots of cardio and rheumatology clinics to examine patients.
Another useful book was Circuits for the MRCPCH Clinical – again got it from the library, but you can use it to practise in small groups.
Development – make a bag of some basic toys (I bought some wooden blocks that could be stacked and threaded), crayons and paper, a picture book… Development is great because you can even use bored siblings on the wards – doesn’t have to be an inpatient. Again learn milestones and get slick at examining in a logical way.
Courses: I went to the Ealing 2-day revision course, which I would recommend. They got loads of patients in with chronic signs for us to examine and gave really good feedback. I also went on a communication skills revision course – the Watford one day course. It was a good course, we got to practice with professional actors in timed conditions. This course is probably particularly worth doing if you know that communication is something you struggle with. I recommend going to a revision course for this exam, and most people I know, went to one.
The London School of Paediatrics has a great website with loads of useful tips and tricks, as well as a ton of really helpful videos. You need to watch these over and over again. There are also loads of videos on YouTube.
GOOD LUCK! Paediatrics is a great specialty.
as I mentioned I’m planning on taking MRCPUK part 2 examine March 2019
I’m looking for a study partner to go through Pastest
please email [email protected] we can study over Skype or whatever is convenient also otherwise we can go through MRCP step up notes by Khalid Magriby
Exam: MRCP(UK) PACES
Year passed: 2019
Stage in career: Clinical fellow i.e. ST1 equivalent
Lots! In contrast to MRCP Part 1 and 2, I did a lot of bookwork for this particular exam. I would recommend the following:
An Aid to the MRCP PACES series by Ryder et al - over 1400 pages of clinical medicine spread across three volumes with disease "routines" to get you in the mindset for presenting common scenarios, exam experiences, anecdotes, minutiae, and photographs - all in small print. I would say this is the gold standard for MRCP PACES revision but it is a massive read.
Volumes 2 and 3 are split into exam station scenarios (similar to those on the MRCP website) and a reference section where each condition and presentation is covered in considerable depth. Volume 1 focuses on Stations 1 and 3 i.e. cardio, resp, neuro, abdo. I read through Volume 1 (the shortest vol) then used Volumes 2 and 3 for practical exam practice with my study partner.
The Pocketbook for PACES by Bessant - also small print but more readable than the Ryder series. Overall an excellent resource and my main book for regular revision. More up to date than Ryder, especially for common viva questions. Has much less in the way of diagrams and photographs though.
Get Through MRCP PACES by Gulati et al - probably written in the most readable manner with normal sized print, has good viva questions and lists but there are a few errors in the text. Doesn't go too in depth so probably one for quick last minute revision.
Cases for PACES by Hoole et al - Small print but thin and well spaced out, very concise and informative. I preferred The Pocketbook for PACES as I appreciated the extra detail and viva sections but there are many doctors who say that this book alone is enough for a pass.
Youtube videos: just search MRCP PACES.
Would also recommend the UCD neurology channel: https://www.youtube.com/playlist?lis...diepvRwljoI1dF
Leeds PACES podcast: https://soundcloud.com/mededleeds/se...vision-podcast
Official MRCP(UK) scenarios: https://www.mrcpuk.org/mrcpuk-examin...mple-scenarios
I can't lie, preparing for this exam was tough, mostly due to fitting it in around work. Usual stuff about allocating adequate preparation time, booking a hotel the night before, leaving in plenty of time, not forgetting your ID, etc.
First and foremost, when you book the exam you can request a date and location, even though this is not explicitly stated. You can do this by writing a short message in the "special requests" (or something similar sounding) box towards the end of the online registration form. Of course, there's no guarantee that you will get what you ask for, but it's certainly worth asking. I got the date I wanted but I had to travel to a hospital at the other end of the country.
There are certain scenarios in this exam which come up time and time again: renal transplant, chronic liver disease, prosthetic heart valves, aortic stenosis, myotonic dystrophy, RA, pulmonary fibrosis etc. The Ryder series is especially good at going through conditions based on their likelihood of coming up in the exam based on previous candidate surveys. Becoming well acquainted with these common scenarios and being able to fluently present your findings and answer common viva questions (indications for renal transplant, approach to ascites, when to consider surgery in AS etc) is important. Sounding confident under pressure is also a very important part of the exam.
I was fortunate to be working in a large tertiary centre with renal, neuro, cardiothoracics etc and I would say one of the most important things for this exam is ensuring you have a study partner and a study group on Whatsapp (or similar). With your study partner, go round the wards (particularly specialties), see patients and get into the habit of presenting formally and being viva'd - under timed conditions. Practice Station 5 scenarios on eachother over and over again - you only have eight minutes so real life patients aren't always the best for Station 5. Start your Station 5 examination while you're taking the history. Share interesting patients on the Whatsapp group (obvious disclaimer about not breaking confidentiality etc). Practice Station 2 and 4 scenarios with any willing person - medical or non-medical. Practising presentation until you sound properly confident is really important.
PACES Station 3 neurology patients are often those with stable chronic signs as a result of surgery or trauma. Neurosurgery wards are a really useful (and from what I've noticed, underutilised) source for finding these sort of patients. Renal wards are also a good source of interesting patients, often with multiple pathologies. Some doctors also manage to go to cardiac valve, rheumatology, or ophthalmology clinics but I didn't do this.
The following things are loved by PACES examiners: awareness of DVLA guidelines, actively asking patients about smoking cessation, exploring ideas, concerns, expectations, obtaining a full social and occupational history.
- Use the official MRCP(UK) scenarios.
- Use your study leave. Attend a course if you're able to - I receieved some very good teaching and saw a lot of interesting neuro and cardiac signs I might not have otherwise seen. Downsides: cost, arranging time away. There is a good breakdown of the different courses in this article:
- Don't feel like you must wait ages after Part 2 Written before attempting PACES. There is an overlap in the knowledge covered and it's helpful to still be in the exam mindset.
- Don't be discouraged if you're not successful on the first attempt. It's a hard exam (oddly reminiscent of a driving test) and some people get some weird cases or harsh examiners on the day.
- If you don't pass, email the MRCP(UK) central office and request your exam marksheets which will contain examiner feedback. Once again, this service is not very well advertised but you can absolutely do this.
- Station 5 has a reputation for being the rheum/ophth/endocrine/derm station. Whilst these specialties frequently come up, any of the other systems can also feature including acute conditions e.g. pyelonephritis, pneumonia, TIA, etc.