mrcpsych exams and preparing trainees for the exams

MRCPsych Exams and

Preparing Trainees for the Exams

Dr Gareth Thomas

Deputy Director of Medical Education in Lancashire Care

Deputy Course Director MRCPsych Course

NW MRCPsych Course

Intro

• Exams are an important part of training

• As a trainee it is important to understand the course, resources

available and how to start exam prep (today)

• Exam progression can be a rate limiting step in trainee progression

(although trainee pass rates are much higher than a few years ago…)

BUT….

• It is important to try and not get too focussed on exams as your global

training and prep for ST/Consultant life

Today’s Session

Aims and Objectives

This session is to give an overview of the NW MRCPsych course and how to

support trainees with their exams

By the end of the workshop participants should be able to:

• Have an overview of the structure of the MRCPsych exams

• Be more confident in accessing resources for the exams

• Feel more confident in starting the exam preparation

The MRCPsych Exams

MRCPsych Examinations

Everything in the exams is in the syllabus

• Basic Psychology

• Human Development

• Basic Neurosciences

• Psychopharmacology

• Classification/Assessment

• Organisation and Delivery of Services

• General Adult

• Old Age

• Psychotherapy

• Child and adolescent

• Substance Misuse

• Forensics

• Intellectual Disability

• Research Methods and Critical

Appraisal

https://www.rcpsych.ac.uk/traininpsychiatry/examinations.aspx

https://www.rcpsych.ac.uk/traininpsychiatry/examinations.aspx


The overall components required to pass

• The MRCPsych Examinations consist of

– Two Written Papers: Papers A and B

– Clinical Assessment of Skills and Competencies

(CASC)


The written papers

• The new papers will comprise of the same areas of assessment but as:

• Paper A: ‘The scientific and theoretical basis of psychiatry’

• Paper B: ‘Critical review and the clinical topics in psychiatry’


The written papers – Paper A

• Can be sat by any fully registered medical practitioner (this will inc FY2)

• Will be three hours long

• Contains 200 marks - two-thirds SBAs and one-third EMIs.

• Paper A(i) will cover the following sections of the syllabus

– Behavioral Science and Sociocultural Psychiatry

– Human Development

– Classification and Assessment in Psychiatry

• Paper A(ii) will cover the following sections of the syllabus:

– Basic Neurosciences

– Clinical Psychopharmacology


The written papers – Paper B

• Paper B can be sat by someone in an approved post

• Will be three hours long

• Contains 200 marks - two-thirds SBAs and one-third EMIs.

• The critical review component will make up one-third of the paper, with two-thirds

covering clinical topics (of which approximately 30% will be General Adult)

• Paper B will cover the following sections of the syllabus

– General Adult Psychiatry

– Old Age Psychiatry

– Psychotherapy

– Child and Adolescent Psychiatry

– Substance Misuse/Addictions

– Forensic Psychiatry

– Psychiatry of Learning Disability

– Critical Review


The written papers - SBAs

Which of the following is not a test of executive function?

A. Luria Task

B. Wisconsin Card Sorting Test

C. Stroop Test

D. Graded naming test

E. Verbal fluency

Psychosis and Old Age:

A. Alzheimer’s Dementia

B. Lewy Body Dementia

C. Very Late Onset Schizophrenia

D. Delusional Disorder

E. Vascular Dementia

F. Severe Depression with Psychosis

G. Mania with Psychosis

H. Delirium

a. Associated with nihilistic delusions

b. Usually presents with non-bizarre

delusions

c. Most associated with visual

hallucinations


The written papers - EMIs


Updates

• Neurosciences mostly

– Syllabus revised and released shortly

– All neuroscience questions for exam checked,

outdated ones removed

– New questions written for Dec 2017 sitting


The Future

• Still trying to reduce to 150 questions

– Less questions which therefore makes the

question bank relatively bigger

– Candidates will have more time per question

– GMC have concerns re coverage of syllabus,

quality assurance and strength of each question

– GMC are making a final decision soon

• Short answer questions by writing the answer


The CASC – From Jan 2018

• Morning: 8 single stations

– 4 minutes to read the instructions and 7 minutes to complete the task.

– 6 of the stations will have a patient management focus. The remaining 2 stations will have a focus on history taking and examination.

• Afternoon: 8 single stations

– 90 seconds to read and 7 minutes to undertake the task.

• The 16 CASC station exam will therefore comprise of 5 stations focused on History Taking, 5 stations focused on Examination - both physical and mental state, including risk assessment and capacity assessment and 6 stations focused on patient management.


The CASC

• As is the case in all similar examinations, each station

is marked independently and regarded as a stand-

alone station, including the linked stations

• To pass, candidates must meet or exceed the total

borderline regression score and achieve the passing

score in a minimum of 12 stations


The CASC

• At any one sitting of the CASC, candidates will face 16 stations, usually with the following themes

– Psychopathology

– Risk assessment

– Cognitive assessment

– Psychotherapy theme

– Old age psychiatry theme

– Learning disability or child and adolescent psychiatry theme

– Forensic psychiatry theme

– Physical examination skills

– Communication skills in a challenging setting

• Remaining stations will cover general adult psychiatry themes, including sub-specialties

• Throughout these stations there will be a mix of skills required including history taking, aspects of mental state examination, communication of diagnoses, management plans, and prognosis.


The CASC

• Station 1:

– You are about to see Sarah Green, an eighteen year old student who has been brought to Accident and Emergency by her mother. It is suspected that she has ingested a recreational drug at a party just over 30 hours ago. Her mother describes her as being ‘paranoid’.

• Examine the patient to establish what abnormal beliefs she holds.

• Establish whether any other psychopathology is present.

• You are not expected to take a drug and/ or alcohol history.


The CASC


The Future

• Development – 2 streams

– How it is marked

– Using role players to assess the candidate

communication

• Help the cognitive load of examiner

• Emphasises importance of dr-pt relationship

• Possibility of feedback from 2 perspectives


In Summary

• Familiarise yourself with the RCPsych website

• Download the exam syllabus

• Look and know what will be in each exam

• Have a look at the exam dates and start to think when

you are going to sit the exam

Any questions about the structure of

the exams?

Exercise for 5-10 minutes…

• In you next supervision, you overly enthusiastic

supervisor asks you about exams and how you plan

to prepare for the exams…

• What are you going to say?

Exam Preparation

Clinical Placement Self Study

Specific Practice for Writtens

Specific Practice for CASC

MRCPsych Preparation

Clinical Placement


Exam Preparation

Clinical Placements

• Using the ‘1-hour protected supervision’ to the

trainees advantage

– Talk about the exams

– Get support for CP, JC and 555s

– Work Place Based Assessments focussed on

potential CASC scenarios

Self Study


Exam Preparation

Self Study

• Inevitable that lots of self study is required

• Familiarisation with the syllabus

• Reading but in combination with exam practice /

questions

• NW MRCPsych Course material online

• Trainees Online (TrOn) online modules for the basic

sciences – with more developing in neurosciences

• Revision course reading material

Exam Preparation

Self Study

• We recommend the following books

– Symptoms in the Mind (Sims)

– Fish’s Clinical Psychopathology (Casey/Kelly)

– Neuroanamtomy (Haines)

– Essential Psychopharmacology (Stahl)

– Psychology for the MRCPsych (Munafo)

– A Doctor’s Guide to Critical Appraisal

(Gossall/Gossall)

Practice for Writtens


Exam Preparation

Practice for Written Papers

• Questions Questions Questions

• Reading Reading Reading

• NW MRCPsych course, there are approximately 1500

questions presented to the trainees in different

formats

– LAP/Academic Days

– Timed exams with instant feedback on the VLE*

– Additional question bank on the VLE*

Exam Preparation

Self Study

• The NW MRCPsych Course Website

www.schoolofpsychiatry.net

http://www.schoolofpsychiatry.net/

Exam Preparation

Self Study

• Trainees Online (TrON)

http://tron.rcpsych.ac.uk/

http://tron.rcpsych.ac.uk/

Exam Preparation


NW Virtual Learning Environment (VLE)

www.manchesterpsychiatry.net

http://www.manchesterpsychiatry.net/

Exam Preparation


• Combination of individual and group work works well

• Start well in advance

• Top tip!

• Don’t forget 50% discount on Dominoes pizza whilst

revising!

Practice for CASC


Exam Preparation

Practice for CASC

• Talk about CASC and stations for that specialty

• Use portfolio and WPBAs during the placement –

Mini-ACE

• Look at RCPsych website for info including videos

• Think about forming a study group

• Local trusts have CASC practice

• External courses (££££)

• NW MRCPsych Course Progress Test*

Exam Preparation

Practice for CASC

• Practical OSCE Progress Test:

– Annual 8 single station OSCE

– Scenarios similar to the CASC

– Completed under exam conditions using trained

examiners

– Feedback given as mark sheets from each station

given to trainees

– May 2019

Exam Preparation

Practice for CASC

• Focus on the task

• Keep to time

• Use summary at the end

• Be aware of long sentences/questions

• Unconscious word fillers ie okay

• Body language – watch nodding/hand movements

• Too many empathetic statements which appear false

• Talking too fast / too slow

Exam Preparation

Exam Technique – as part of the regional days

• CT1

– S1: Today to look at the course and exams

– S1: Short mock written exam

– S2: Exam technique

– S2: Short mock written exam

• CT2

– S1: CASC preparation

– S2: CASC preparation

– Likely something for written too

NW MRCPsych Course

Summary

• Exams are an important part of training (but only part

of the development)

• It is important to understand about the course and

resources available and be able to support trainees

with exams

• Come and talk to us about exams and we will provide

some support, feedback, top tips

Any Questions?

[email protected]

@DrGarethEThomas

mrcpsych exams and preparing trainees for the exams

Documents