Experiencing MRCP PACES Exam
I’m going to share my PACES experience with all prospective candidates in this article because hopefully some of the information here will make the exam a little less intimidating for them.
First of all, there are three main things you should focus on before PACES. These are history taking, examination and communication. You should practice these areas and strengthen them up until exam night. Spend your evenings reading up on the causes of different landmark symptoms such as: cyanosis, dyspnea, dysphagia, joint swelling, etc Soon enough history taking will be a piece of cake. Also try to continually revise the causes of various important signs like erythema, clubbing, jaundice, murmurs, etc. in order to make your examination as smooth and possible. Analyzing these signs and symptoms to reach a provisional diagnosis will then be as simple as putting two and two together.
Personally, I didn’t find the exam cases difficult. My only problem was that the time designated for each station was too short, particularly when it came to my cardiology case. It took me most of the time to determine the lesion and I gave a muddled presentation worlds away from the one I would have liked to give, so beware of the time creeping up on you. Other cases were all the usual suspects:
– A neurology case with motor nerve injuries where I did a full neurological examination and discussed diagnosis and treatment
– A skin condition in the form of neurofibromatosis.
– Endocrinal condition in the form of a thyroid disease accompanied by ophthalmological affection.
– Respiratory system affection such as chronic obstructive pulmonary disease, Bronchiectasis and Tuberculosis.
– Musculoskeletal condition in the form of osteoarthiritis of the hands.
– An abdominal condition in the form of chronic liver disease accompanied by ascites.
Last but not least was a ‘communications’ station, which aims at examining your skills at communication not only with the patient but with the patient’s relatives. You may be met with an actress playing a grieving wife or daughter and you’ll be faced with the challenge of how to calm her down and explain the patient’s condition to her clearly and gently. In cases like these, I have two words for you: psychological support. You must also be careful not to insult previous doctors the patient is said to have seen, especially if they have misdiagnosed him. It is very important not to appear arrogant!
Be prepared with a problems list for discussion with the examiner after each history taking and examination. An important point to remember when examining these patients is that they are all actors and they’ve come to perform, so let them give you all that they’ve got!
Unfortunately, many overseas candidates have complained that one of the causes of the lower pass rates overseas are the examiners themselves. They are described as being rude and interruptive, so if you are financially capable, you might want to take the exam in the UK, itself.
Finally, I wish all prospective candidates great luck with their studying and their PACES exam.