guide to mrcpch examinations 2012 august yorks

7/28/2019 Guide to MRCPCH Examinations 2012 August Yorks

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Guide to the MRCPCH Examinations

This Guide was written by

Dr Claire HeadDr Rebecca Moon

Dr Rosada Sacranie

Dr Sebastian Grey

for Paediatric Trainees in the Wessex Deanery

It has been adapted for use in South Yorkshire by

Dr Rum Thomas

July 2012

Revision date: July 2013


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Contents

(Ctrl+Click to jump to page)

General advice....................................................................................................4

Structure.............................................................................................................5

Question types....................................................................................................5

Multiple choice questions................................................................................... 5

Best of five..........................................................................................................6

Extended matching questions............................................................................6

Reference Books.................................................................................................7

Online and question books.................................................................................7

Part 2 Written........................................................................................................8

General advice....................................................................................................8

The Exam............................................................................................................8

Question structure.............................................................................................. 8

Best of list ..........................................................................................................8

As in part 1, pick the best answer .....................................................................8

Extended matching questions ...........................................................................8

A list of options is given at the beginning of each question. In response to each

statement you must choose the most appropriate answer.................................8

N from many ......................................................................................................8

You are required to choose a number of options from a longer list, such as

treatment options...............................................................................................8

Question format..................................................................................................9

Long case histories.............................................................................................9

Data interpretation.............................................................................................9

Photographic material......................................................................................10

General textbooks............................................................................................10

Question books................................................................................................. 11

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Websites........................................................................................................... 12

Clinical examination.............................................................................................13

Approach.......................................................................................................... 13

Getting started.................................................................................................13

Clinical Teaching...............................................................................................13

Example of clinical circuit................................................................................. 13

Clinical stations.................................................................................................14

Clinical specials................................................................................................ 15

Useful books for clinical revision.......................................................................17

Clinical Revision Courses..................................................................................18

What to do if you fail........................................................................................20

To study the phenomena of disease without books is to sail an uncharted sea,

while to study books without patients is not to go to sea at all. ....................21

Sir William Osler, Father of Modern Medicine (1849-1919)............................21



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The MRCPCH exams

The MRCPCH examination is a game with its own rules and peculiarities.Although having a good knowledge of paediatrics is important, success is aboutbeing able to understand the question and then identify the correct answer(which unfortunately may not be what you have observed in clinical practice).

This guide will give you suggestions on how to prepare for all the parts of theMRCPCH examination. The Deanery will soon introduce a system of exambuddies - you will be paired up with a trainee who has passed the examsrecently they will be able to give you useful tips and techniques. The STEPPdays will be revised to include some exam focused teaching.

Part 1

General advice

Though the Nelson Textbook of Pediatrics may be a fascinating read, you maysuffer from information overload - and then not focus on the parts that arerelevant to passing the examination! Passing the exam is based on patternrecognition; the same areas are covered repeatedly.

Do as many questions as possible to help you recognize the questions and thegaps in your knowledge - then read around that particular subject. Test yourknowledge by doing more questions - use a variety of books and websites asthere is limited benefit from revising the answers to questions you already know.

The questions disproportionately cover certain areas while ignoring others. As aconsequence the cornerstone to passing the exam is having done lots of similar(and occasionally identical) questions before. Make sure that you cover certainimportant topics:

Important potentially fatal conditions: e.g. meningococcalmeningitis/sepsis, duct-dependent cardiac defects, non-accidental injury

Common syndromes Trisomy 21, Turners syndrome

Development and growth, faltering growth

Immunisations - look at Department of Health website for up to dateschedule.

Basic sciences and statistics sorry! It is usually easy to answer correctlyas the questions tend to be easier than those for other more interestingclinical topics.

Examination and revision technique and knowing your own strengths andweaknesses related to revision and written examinations are equally importantas knowing the subject.

Think of how you have revised for past exams and what worked well for you. It ismore important to cover all areas of the curriculum quite well than know lots



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about your particular areas of interest. A revision timetable may be useful forsome people in this respect, but whether or not you use one make sure you allotadequate time to all areas of the curriculum.

Use the resources available to you. The RCPCH has information on their websiteabout the syllabi for the examinations; some of this has been included in this

guide. They also have practice papers and answers found at:http://www.rcpch.ac.uk/training-examinations-professional-development/examinations/mrcpch-part-1-updates/structure-specimen

Structure

There are two papers, 1a and 1b. You may apply to take only 1a or both parts onthe same day. Each paper is 2 hours in length.

Part 1 a (designated as Foundation of Practice from 2013) is relevant to thoseworking in non hospital-based paediatrics and is the written component of theDCH examination. It includes questions that have a general practice/communitypaediatrics slant, e.g. prescribing the contraceptive pill for teenagers,presentations that are seen in general practice and the community.

Part 1b (from 2013 Theory and Science of Practice) tests knowledge on thescience of medicine anatomy, physiology, pathophysiology, pharmacologicalprinciples and more complex problem solving questions not tested in 1a.

The papers are divided into the following question types:

12 Extended matching questions (EMQ) worth 9 marks each (3 per item) 15 Multiple true-false questions worth 5 marks each (1 per item)

48 Best of five questions worth 4 marks each

Question types

Multiple choice questions

The examiners are aiming to test whether a candidate has true knowledge of afact or thinks that something similar (but wrong) sounds vaguely familiar.

These are not negatively marked so you should aim to answer all of them.

They carry the least marks as a total of the three question types - do not spendtoo long on the answers.

There are certain rules when answering these questions. This does not replacerevision and knowing the subject well, but may help you to avoid common tricksand answer questions where you are not sure of the answer.

Read the question carefully, dont miss out key words. If you areanswering a question and you miss out the word except in the phrase

all of the statements are correct except you will put down the wronganswer.

http://www.rcpch.ac.uk/training-examinations-professional-development/examinations/mrcpch-part-1-updates/structure-specimenhttp://www.rcpch.ac.uk/training-examinations-professional-development/examinations/mrcpch-part-1-updates/structure-specimenhttp://www.rcpch.ac.uk/training-examinations-professional-development/examinations/mrcpch-part-1-updates/structure-specimenhttp://www.rcpch.ac.uk/training-examinations-professional-development/examinations/mrcpch-part-1-updates/structure-specimen


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Trust your instinct - your initial answer is likely to be correct.

However do leave time to check your answers at the end and make surethat you have not read the question wrong the first time.

They usually test subjects where there is little ambiguity - a definiteyes/no answer.

However, as a rule answers with always or never are usually false asrarely in medicine does something always happen or never happen.

Beware double negatives, not uncommon and not infrequently both meanoften.

Beware the meaning of words used in questions, for example typicallymeans usually.

Answers containing numbers can be tricky. Those containing very precisefigures for example 59% are unlikely to be true. Ask yourself what thenumber means in the context of the question. For example if the questionstates 75% of infants walk by their first birthday, ask yourself do themajority of infants walk by their first birthday?

In questions where one of the answers is all of the above if you knowthat at least 2 of the stem answers are correct then it is likely that theyare all correct, and all of the above is the correct answer.

Best of five

These carry the most marks of the total in part 1 written.

These questions are designed to test judgment and experience. They start with astatement, and are followed by five answers. Some of the answers will becorrect, but only one will be the most appropriate answer to the statement. Thismakes them the most difficult question to answer as it can be hard to pick theright option of the five possible ones offered. Should only cover one aspect of atopic, so possible questions may be:

"What is the most likely diagnosis?"

"Which investigation is most likely to lead to a diagnosis?"

"What is the best next step?"

"What is the best advice to give to parents?"

"What is the most likely pathogenesis of this condition?"

"What is the most common cause of this?"

As the best of 5 carry the most marks and are more difficult to answer, youshould make sure that you complete as many of this question type as possible.

Extended matching questions

These are similar to best of five questions. A statement is given, and then thecandidate then has to pick the answer from the attached list. Examples:



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Choose the most likely diagnosis from the following.

Choose the best treatment for each of these children.

Choose the organism which matches most closely each of the followingcase scenarios.

The Student BMJ has a good article on examine technique when answeringMCQs. The article can be found at:http://careers.bmj.com/careers/advice/bmj.330.7503.s228.xml

Reference Books

Get only one or two good textbooks that work for you. With any book try beforeyou buy; most of these are available in your hospital library. The booksmarked * are available in the Illingworth Library at Sheffield ChildrensHospital.

Lissauer and Claydon: Illustrated Guide to Paediatrics (*2012)

Lots of pictures with useful summary boxes and tables

A little oversimplified

Beattie: Essential Revision notes in Paediatrics for MRCPCH

Very good reference textbook but not bedtime reading!

Easterbrook: Basic Medical Science for MRCP part 1 (*2005)

The best book for basic science

Particularly good respiratory and cardiology chapters.

Sheridan: From Birth to Five Years (*2008)

Best book for early child development

Levene: MRCPCH Mastercourse Volumes 1 &2 (*2007)

Endorsed by the RCPCH

Does not cover the complete content of the exam.

Mixture of standard text and case histories

200 includes a CD of examinations and pictures and access to awebsite

Website not very user friendly and has limited content - try before you

buy

Online and question books

PasTest offer a number good books. Pastestonline.co.uk also has awebsite of over 1500 exam questions which is good valuable for moneyand easy to use.

www.onexamination.com has a bank of over 3000 questions. These aremuch easier than the exam so aim for an average mark > 70% (the exampass mark is 60-63%).

http://careers.bmj.com/careers/advice/bmj.330.7503.s228.xmlhttp://careers.bmj.com/careers/advice/bmj.330.7503.s228.xml


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Practice papers on RCPCH website.

Sidwell and Thomson: QBase Paediatrics 3 MCQs for the Part BMRCPCH (*2008)Halpert Basic Child Health Practice Papers (*2007)

All three types of questions Short explanatory notes with the answers

Beattie and Champion: MRCPCH 1: Essential Questions in Paediatrics(*2009)

All three types of questions with explanatory notes with the answers

Split into chapters by subject to aid revision planning

Part 2 Written

General advice

The exam is a test of clinical knowledge and decision making

The questions are more predictable.

Focus on areas that are not seen routinely in clinical practice - metabolic,renal, growth and endocrine.

Do as many questions as possible, and then read about the topics.

The Exam

There are two papers each 2 hours in length, both are taken on the same day.Each question carries its own weighting. The maximum score per question will besplit by the number of correct responses required. There is no negative marking.

Question structure

Best of list

As in part 1, pick the best answer

Extended matching questions

A list of options is given at the beginning of each question. In response to eachstatement you must choose the most appropriate answer.

N from many

You are required to choose a number of options from a longer list, such as

treatment options.



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Question format

Long case histories

These are often more than a page long, with or without blood test results. Its

important to highlight key points as you read through and re-read the case oryou will miss the important points.

These include common as well as very uncommon topics.

Eliminate answers that you know it definitely is not and you will probably beleft with 2 or 3 answers, the task is then to pick out the key information thatseparates the conditions think about this when revising, look at conditionswhich present similarly and how they differ (rashes, joint swellings).

Questions will ask you to suggest the diagnosis, most appropriate

investigation or management or a combination of these.

Data interpretation

You will be asked to interpret investigations in the context of a clinical setting.Normal ranges or reference ranges will only be provided where these are likelyto be in doubt.

Haematology and biochemistry results

Blood gases

Electrocardiogramso Usually obvious diagnoses e.g.; complete heart block, WPW, SVT,

sinus tachycardia.o Read Paediatric Electrocardiograph BMJ 2002; 234:1382-5

Spirometry

Electroencephalogramso Gaon, Paediatric exams, A survival guide gives an excellent

description of abnormal diagnostic EEGs. Examples:hypssarrythmia, 3 Hz spike and wave, encephalitisand temporallobe epilepsy

Audiograms sensorineural versus conductive hearing loss

Cardiac catheter data easy to interpret with a schematic diagram

Statistics/Critical appraisal/Study design

Interpretation of p values, confidence intervals

Most appropriate study design to answer questions



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Photographic material

You will be asked to identify abnormalities, provide a diagnosis, investigations ortreatment or a combination of these.

The images are usually obvious and fairly common diagnoses

Good questions to do when you are too tired to focus on anything else

Google image syndromes, rashes and dysmorphic syndromes

Medical imaging: x-rays, CT scans, MRIs and nuclear imaging

Neonatal radiology:

o Chest

Vascular catheter and endotracheal tube placement

Air leaks Cystic lesions: diaphragmatic hernia, cystic adenomatoid

malformation, congenital lobar emphysema

Diffuse opacification: hyaline membrane disease, transienttachypneoa of the newborn, congenital pneumonia,meconium aspiration syndrome

Tracheal-oesophageal fistula, oesophageal atresia

o Abdomen

Meconium ileus, necrotizing enterocolitis, intestinal atresia

o Cranial ultrasound lesion is usually obvious

General textbooks

Paul Gaon: Paediatric Exams A Survival Guide (2004), (*2000)

Well written, includes nearly everything you need to know for the exam

Well laid out and easy to read

Lots of examples of data interpretation (cardiac catheter data, lungfunction and audiograms)

No pictures though.

Stephen Stobel: The Great Ormond Street Colour Handbook ofPaediatrics and Child Health (*2007)

Excellent photographic material with descriptions

Contains more information on slightly more unusual diagnoses

Gardiner: Oxford Specialty Training: Training in Paediatrics (*2009)

Good introduction to reading for the exams

Ewer: Core Clinical Cases Paediatics (*2011)

Clinical problem solving approach

Will also help in your clinical practice



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Question books

Make sure read question books that focus on:

Data interpretation

Radiological imaging Photographs of clinical signs - - syndromes, rashes etc.

Grey cases (See below number 3)

The PasTest revision books are generally very good. Pass Paediatrics andChurchill Livingstone also does a good range of question books.

Nick Barnes and Julian Forton: Questions for the MRCPCH Part 2Written Examination (*2004)

Focuses on grey case questions

Challenging questions, answers include complete but concise

explanations. Excellent table and diagnostic algorithm on metabolic problems (p 39,

40)

Kate Crease: MRCPCH Part 2 Questions and answers for the newformat exam (*2008)

Good range of question styles and topics covered and easy to use

No pen and paper required - answers given on the back of thequestion,

Questions seem easier than the actual exam and grey cases are notas detailed

J Robertson: 250 Questions for the MRCPCH Part 2 (*2006)Raine 100 Cases in Paediatrics (*2009)

Separate chapters on signs and data interpretation in differentsystems

Good for practice once you have an idea of how to start doing dataquestions

Good books to use in conjunction with Gaon when revising systems

Nagi Barakat: Get Through MRCPCH Part 2: Data InterpretationQuestions (*2008)

Has good examples of all the different types of questions

Christopher Schelvan: Paediatric radiology for MRCPCH and FRCR(*2010)

Excellent for radiology revision

Well laid out, good quality pictures and explanations

Nagi Barakat: Get Through MRCPCH Part 2: 125 Questions on ClinicalPhotographs (2005)

Contains good quality photographs

Content can be more obscure than in the actual exam



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Craig and Brownlee: MRCP (Paediatric) Paediatric Picture Tests(*1997)Winrow: 100 Paediatric Picture Tests (*1995)

Old but easy to read (especially when you are tired and/or fed up)

Websites

www.onexamination.com rather limited question bank, which aregenerally not the standard or format of the part 2 examination.

www.pastestonline.co.uk a greater number of questions than otheronline question banks but very few have photographs or data to interpretexcept for blood results. Cases are significantly shorter than those seen inthe exam. Good for knowledge consolidation.

Exam papers on RCPCH website

http://www.onexamination.com/http://www.pastestonline.co.uk/http://www.onexamination.com/http://www.pastestonline.co.uk/


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o Physical examination skillso Recognition of clinical signs and symptomso Child developmento Communication skillso History takingo Ability to make a diagnosis and plan management

Clinical stations

Your clinical examinations of all the systems must all be so well practicedthat they are automatic by the time you take the exam. This way you canfocus on picking up the clinical signs, rather than performing theexamination.

Pick up as many clues before you touch the child. Any clues around thechild or bed, scars, level of nutrition etc.

Remember to wash your hands and introduce yourself.

There are a few chronic conditions and clinical syndromes with lots ofsigns that lend themselves well to the clinical exam, e.g. NF1, CF, post opcardiac surgery e.g. Fallots, Marfans, glycogen storage diseases, Trisomy21, Turners syndrome, Angelman syndrome. Know them well.

Know how you will approach any eventuality that may arise. For exampledoing a cardiac examination on a bouncy 2 year old or a lower limbexamination in a child who is in a wheelchair.



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Do not panic if the child cries or refuses examination. Be nice, trydistraction but do not upset the child further. The examiners recognizethis is a problem with children. Comment on what you can and state whatelse you would ideally do and that in real life you would return later ifpossible to complete the examination.

Decide whether you will present your findings as you go or at the end.

Practice presenting your findings slickly in front of consultants who willgive you constructive feedback. This will build your confidence.Summarize your clinical findings at the end and state your diagnosis.

Remember that apart from cardiology and development, the clinicalstations do not have to be the named examination but can be other, assuch, examinations such as thyroid, haematology, eyes, can occuranywhere. Some children may also be used out of their traditional contexte.g. CF as abdomen if abdominal scar from meconium ileus.

Clinical specials

Musculoskeletal and other station

Can be a difficult station as you may be asked to do a limitedmusculoskeletal exam which many people are not familiar with.

It is important to listen carefully to what the examiner is asking you, and

focus your examination based on this.

Joints should be examined using a look, feel and move approach.

A modified pGALS should be used when examining the lower limb, upperlimb and neck. However the station is not simply a request to performpGALS.

Make sure you also have a scheme for a good eye exam for the otherstation.

Arthritis research UK has more information on the pGALS examination, andyou can request a free DVD of this examination from their website.

Development

With a little practice this becomes an easy station. A good way is to spendan afternoon in childrens outpatients playing guess the age usingsimple play. You will therefore see a mixture of normally and abnormallydeveloping children.

You may have a normally developing child as children of local doctors are

used if insufficient patients.



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For speech and language do not forget hearing try clapping or makingloud noise behind child for gross assessment.

For fine motor, do not forget to make a brief statement on vision/use ofglasses.

You can make comments to the examiner as you proceed such as thisskill would be expected of an xx year old. This may stop you forgettingwhere you are at with the examination.

Make it fun the child will interact with you better as they are likely to bebored of building towers and drawing circles if you are the 12 th person toexamine them!

Communication

They are expecting the candidate to communicate in areas that an ST4might encounter.

The main focus is communication, but they also mark you on yourknowledge base about the topic. However there are techniques to getaround this, for example if you are asked to teach a medical student on atopic that in the panic of the moment you know very little about, linessuch as I need to check up on some information, shall we meet tomorrowto discuss again, or if asked a question by a parent then I will check andget back to you. Honesty is better than saying something that is clearlyfactually incorrect, and demonstrates the approach that you wouldhopefully take in real life!

Read the question before you start and then re-read it again. There will becertain points that you need to cover in the allotted time to get the fullmarks. Even if you are amazing at communication, you will not get fullmarks if you have not covered all areas.

Explaining subjects to a medical student is quite popular now e.g.problems associated with extreme prematurity.

Other topics commonly are:o Explaining a diagnosiso Reason for admissiono Change in treatmento Conflict resolutiono Breaking bad newso Counseling in threatened preterm labour

All communication scenarios should follow a basic structure of:1. Introduction2. What the other person knows already and what they want to know3. Explanation of what they want to know4. Clarification of understanding and opportunity to ask questions5. What you are going to do now and what you expect the other

person to do

6. Offer to meet again to explain further and provide writteninformation if relevant



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Use short sentences and simple words.

Be unambiguous.

Drawing diagrams can be a useful way of explaining things.

Telephone conversations are now being used in which the other personmay be in another room. This does make some aspects more difficult asyou cannot see body language, but similarly you will not be marked onyour body language!

Video station

Wildcard station, it is difficult to prepare for this.

Designed to cover topics that cannot be covered elsewhere.

Favorites are:o Gaitso Emergencies acute asthma, bronchiolitis, diabetic ketoacidosiso Chest and cardiac signs etc using a recording stethoscope to show

the signso Lumps bumps and rasheso Non-accidental injuryo Mental health presentations

Read the question and remember to watch the video the computer

program gives you a helpful warning to remind you to watch it! Rememberto put the headphones on (surprisingly some people do forget!).

You can watch the videos as many times as you want.

You cannot go back and change an answer once you have submitted it butyou can come back to a question you have not answered.

History taking and management

Outpatient style. Half the time spent taking a history and half discussingthe management with the examiner.

Practice approach to common outpatient scenarios and theirmanagement.

o Asthmao Diabeteso Constipationo Enuresis

Useful books for clinical revision



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SJ Bedwani: MRCPCH Clinical: Short Cases, History Taking andCommunication Skills for Paediatric Membership (*2011)

Good descriptions of clinical findings in common conditions

Excellent chapter on how to approach a variety of communicationscenarios

Rebecca Casans: Communication Scenarios for the MRCPCH and DCHClinical Exams (*2008)

Lots of communication scenarios with advice on what should beincluded

Excellent for practicing in a small group

Wayne Harris: Examination Paediatrics (*2011)

Written for the Australian paediatric exams, excellent for the MRCPCHas well

Detailed approach to the examination of different systems andinterpretation of clinical findings

Mary Sheridan: From Birth to Five Years (*2008)

The classic child development text.

Stephenson: Clinical Paediatrics for Postgraduate Examinations(*2002)

Pre dates the recent changes to the syllabus but has a goodexplanation of the clinical signs and how to perform clinicalexaminations

Damian Roland: Circuits for the MRCPCH (*2007

Excellent explanation of how the examination works

Clear guidance on what is expected at the stations

Stanley Zengeya: The MRCPCH Clinical Exam Made Simple (with DVD)(*2011)

DVD highlights common mistakes made by candidates

Clinical Revision Courses

Clinical revision courses are expensive, but some people find them useful.

Many people do manage to pass MRCPCH clinical without attending clinicalrevision courses.

They do provide the opportunity to see lots of different clinical conditionsin a short space of time, and may provide some exposure to conditionsyou have not seen.

Can help to build confidence (particularly when you see other peoplesexamination techniques!)

The Imperial College MRCPCH clinical course includes a full day dedicatedto cardiology which can be useful if you have not done a cardiology job.Also covers communication, clinical examinations and video stations. Thiscourse is however expensive and is often fully booked several months



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before the exam so book early if you want to attend.(http://www1.imperial.ac.uk/medicine/research/researchthemes/reprodscience/paediatrics/mrcpchcourse/)

http://www1.imperial.ac.uk/medicine/research/researchthemes/reprodscience/paediatrics/mrcpchcourse/http://www1.imperial.ac.uk/medicine/research/researchthemes/reprodscience/paediatrics/mrcpchcourse/http://www1.imperial.ac.uk/medicine/research/researchthemes/reprodscience/paediatrics/mrcpchcourse/http://www1.imperial.ac.uk/medicine/research/researchthemes/reprodscience/paediatrics/mrcpchcourse/


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What to do if you fail

There are people who find they are good at passing exams and then there aresome who struggle with them. The section is for those of you that struggle or arestruggling with exams.

Firstly you are not alone. Secondly do not despair; you will pass if you aredetermined and focused in your preparation. The pass mark for part 1 and 2varies, but is usually between 62-65%. To pass the clinical you must get100/120.

The college will send you a breakdown of your marks for parts 1 and 2 in eachsubject. You will also get a median and mean mark to compare your breakdownto. For the clinical exam you will get a breakdown of each station, with additionalcomments from the examiner. Try to identify the areas that you struggled withand formulate an action plan to tackle them next time. It may also help to talk itthrough with someone at work or someone who has struggled with the exam.

Dr Cliff Bevan ([email protected]) at Sheffield Childrens Hospital isparticularly good at providing one-to-one coaching for candidates who havestruggled with their exams.

The main reasons that usually cause candidates to fail are:

Not revising for long enoughEveryone is different, 8 weeks revision for the first 2 parts, and 6-8 weeksfor the clinical is usually adequate. You will need to plan to revise for

longer than in the past as finding the time between working shifts is muchharder than revising at medical school.You should take the week offbefore the exam to consolidate and focus wholly on the exam. You shouldalso take a stretch of time off 1 month before to get on top of your studyand plan your preparation.

Not enough focusA few lucky people can get by and pass while still having a social life andenjoying their time off work. They are in the minority. Most people cannothave a social life whilst doing these exams. On your days off you need tobe treating your day as a normal working day and spending the daystudying - 9am to 5pm. You are probably not studying enough if you havetime to go out with friends every night or at weekends. It sounds simpleand self explanatory but many people think they can study and have a life- you cant, and that includes trying to study in Starbucks! BUT you do getit back when you pass - and you can enjoy it guilt free!

Poor revision technique.This is more relevant to the written exams. It is difficult to revise andretain all the subject areas that you could be tested on. Doing as manyquestions as possible and then, reading around that area will help yourretentive memory. The same subjects come up again and again. Findeasy ways to retain boring subjects such as drawing out flow diagrams,

using mnemonics to remember lists, etc.

Poor exam technique.

mailto:[email protected]:[email protected]


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If you think that this may be the case try and sit down with someone andgo through some questions with them, discussing the answers as you go.

The PasTest courses are expensive, but it may be worth going on a course,as they go through large numbers of questions and discuss the answers asa group.

Not enough confidenceYou need to KNOW you can pass these exams. Saying I think Im going tofail can be self fulfilling and not useful to your confidence. You have to gointo this exam with the knowledge that you can do this.

Having the wrong attitudeIf you find yourself saying if I fail then its ok - I can sit it next time thenyou are more likely to fail. In this case your attitude to studying and sittingthe exam is wrong. You need to be studying to pass.

Personal Issues

Try looking at the reasons you might be failing. If you are planning awedding, having a baby, breaking up with a boyfriend or girlfriend, movinghouse or fighting illness it is worth considering putting off the exam untilyou can focus on it. It is ok to take a break from sitting the exams to sortout your life and your attitude to the exam.

An appeals process does exist, if you feel that you have grounds. The details areavailable on the college website.

There are many resources available from the Deanery if you are struggling withthe exams. If you are worried about failing you are more likely to pass if you askfor help earlier. Many candidates struggle with at least one of the three parts of

the exam, so dont feel you are alone. Talk to your clinical supervisor,educational supervisor or someone on your team if you feel you would like somehelp.

Finally, remember to apply logic and reasoning in your reading and clinicalpractice you will be a better paediatrician if you understand the physiologicbasis of disease. This will help you to interpret clinical signs and manage clinicalproblems more effectively. Then you will enjoy reading to improve your practice,rather than just cramming for the exam.

To study the phenomena of disease without books is to sail anuncharted sea, while to study books without patients is not to goto sea at all.

Sir William Osler, Father of Modern Medicine (1849-1919)

guide to mrcpch examinations 2012 august yorks

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