Abstract
The Practical Assessment of Clinical Examination Skills (PACES) examination is considered the most difficult component of the three-part Membership of the Royal College of Physicians (MRCP) United Kingdom (UK) diploma, which provides budding physicians with access to a diverse pathway of subspecialties and a rewarding medical career. Preparing for the exam is onerous, especially when also juggling work and family demands. This research explored how candidates can prepare for this exam in an organised manner to improve their chances of first-pass success. Semi-structured interviews were conducted with 10 participants in the West Yorkshire region in the UK who had passed the PACES examination within 24 months. The interviews were transcribed onto QSR NVivo software, coded reflexively and analysed using thematic analysis. The analysis identified 25 codes that were aggregated into the following themes according to their density; (a) mental conditioning, (b) clinical exposure, (c) external factors and support, (d) revision courses, (e) knowledge acquisition, (f) playing the objective structured clinical examination (OSCE) game, (g) change of strategy, and (h) novel methods. In summary, it takes more than just clinical exposure and rote learning to pass the exam; preparation involves a complex, multifaceted approach. With proper mental conditioning, organisational skills and confidence, the adverse effect of test anxiety could be reduced to improve chances of success. Peer learning is an effective tool for facilitating examination preparation among candidates, besides providing a supportive framework. Cues from this study could act as a guiding framework for future PACES candidates to further refine their study strategies.
Highlights
The Membership of the Royal College of Physicians (MRCP) exam consists of three parts including (a) Part 1, (b) Part 2 written, and (c) Part 2 Practical Assessment of Clinical Examination Skills (PACES) examination
The PACES is regarded as a high-stakes examination, as the policy design is based on the strict standards stipulated by the supervisory bodies such as the General Medical Council and the Royal College of Physicians, United Kingdom (UK)
This study found that organisational skills and self-management play an important role in preparing for the PACES compared to the old adage of “practice, practice, practice” and knowledge acquisition alone
Summary
The Membership of the Royal College of Physicians (MRCP) exam consists of three parts including (a) Part 1, (b) Part 2 written, and (c) Part 2 Practical Assessment of Clinical Examination Skills (PACES) examination. Candidates are allowed to attempt each part of the examination a maximum of six times. The PACES is regarded as a high-stakes examination, as the policy design is based on the strict standards stipulated by the supervisory bodies such as the General Medical Council and the Royal College of Physicians, UK. These standards exist to keep patients and the community safe. Note: *Training status defined as having a valid UK National Training Number (NTN) in a deanery-approved training position while attempting the PACES examination. The interviews and the analysis were conducted concurrently and continued until no new themes emerged and data saturation was felt to be complete
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