Sunday, July 27, 2014

6 key steps for your MRCP PACES success

So I sat PACES (the rather nerve racking practical examination of the examination for Membership of the Royal College of Physicians) earlier this month(2014).With it out of the way , I have finished all the MRCP parts in 10 months and no I'm not that smart but I know quite few doctors who worked much harder than me in their preparation but didn't necessarily clear their MRCP as quickly as they planned.I think the main key is to be PACES-focused(rather than I want to know it all -focused! ) in your revision. For this I made a few notes on my experiences with this nasty exam, I thought I would put them up here in case they were of use to anyone.

A word of caution: these steps solely reflect my experiences and might not necessarily apply to you , it's maybe an idea to read through them and take what you think is useful and leave the rest .. you can always comment below to add what you think might benefit others ..so shall we start ...
Step 1 - Start NOW 
Just because you haven't cleared the other parts ,it doesn't mean you can't start preparing for PACES now . Get a paces book ; Cases for paces and Oxford pocketbook for paces would be perfect for the wards . You know that patient with PSM on CCU that you heard about from the CCU cover ; finish up your break five minutes earlier and go and examine them and present them to a colleague if possible (even if you're planning to take the exam next year) .I tried to learn/refresh (a) paces skill everyday .  
Step 2 - Identify your improvement points 
Get the PACES mark-sheets for different stations (from the MRCP UK website) and familiarise yourself with them early on .Now is not the time for Harrison's and Davidson's.You want a clear and focused study plan for the exam .Identify the points that still need improving in you and tackle them accordingly . You might think that you're slick enough in your examination skills but you kinda need a bit more in your clinical Judgment or the differential diagnosis and so forth.
As for me being an international medical graduate , I was told early on that my main focus should be working on my communication skills and history taking as stations and managing patients concerns and welfare as well as my presentation skills .I started working on those when I was still preparing for my part one.The key is to know that people do fail even in history taking be prepared for all the stations .
Step 3 - Don't prepare for PACES alone !
For PACES you need feedback , apart from the differential diagnoses and theoretical knowledge which you have already covered in part 1 and 2 . You do need some form of feedback to make sure your examination and presentation skills  are as good as good can be .If you can't find anyone , present in front of a camera then replay it and watch yourself .. try to identify ways to make your presentations better.
I didn't prepare with anyone who was planning to sit the exam as I was doing a full time academic placement at the time which meant that non of my colleagues were preparing for it . 
But lots of colleagues have actually helped me prepare in so many ways .Examinations ,history taking scenarios , ethical scenarios and the hours I spent whining about it to them (literally hours) . I have been helped a lot by quite few colleagues at Ealing hospital especially in the last few days before the exam when my nerves started to get the best out of me.I would rather not mention names as surely I won't be able to cover them all here! I don't want to forget my sister here - a final year medical student , the poor thing was my slave .She did countless history and communication scenarios with me (whilst fasting) bless her . 
Step 4 - Take a PACES prep course 
Now some people might think its a waste of money as attending your local teaching, group preparations and good PACES books should suffice but I did go to courses and I think they help .
Well , maybe I'm wrong .In fact according to study published rather recently , there isn't any significant difference between people who attend commercial courses and those who don't in terms of pass rate but here you go . I went to PASSPACES   I think it helped me a lot . I also went to EALING PACES  -you get a discount if you're staff- and both are well established , both are good .It's worth mentioning that I was broke afterwards (for a while) ! just plan your budget alright !Don't say I didn't warn you 
Step 5 - Invest in PACES BOOKS
Not your money but rather your time ! you can get most of them as a pdf copies ( comment below if you would like me to email  any copy-righted material , I don't think I can upload them here! ) or borrow from your hospital library .
here is what I relied on ;
Pastest website ; not exactly a book but it has quite useful tips and videos 
Podcast of common cases  presentations ; a colleague emailed it to me  it was really useful
Ryder book for history and communication stations 
Clinical medicine for MRCP PACES vol 1 for the clinical stations 

Step 6 - Meditate !
You come that far through the blog ;congratulations ! Seriously ..try to relax or at least look relaxed in front of the examiners,stethoscope off your neck ,hands behind your back when presenting ! Its easier said than done though . 
I was absolutely horrendous when I started preparing for it and I m still not the best person to give advice about it .But I was advised to Google mindfulness and practice it , I prayed as well and listened to some final pep talk from friends which did help me a lot . surround your self with some positive energy (don't ask me how !). 
I hope those steps are useful and if you are sitting the exam anytime soon, Good Luck!
and as always best friends until next time , you keep smiling !