Passing PACES is challenging, but these tips can make it easier for you 
 
 
Done with Part 1 of your MRCP exam? Now you must be faced with the option of sitting for either Part 2 written or Practical Assessment of Clinical Examination Skills (PACES) exam. My personal recommendation is to take the PACES exam at the end because it will be better for you in terms of preparation. 
The written components of MRCP requires that you steadily work through several hundred practice questions, soaking in the present guidelines. However, you are not likely to succeed through the same tactic with the PACES component. Unlike written exams, it is not possible to depend on only reading for passing PACES. For this reason, you need to know some tips and tricks to ace it, and that's what I am going to share with you in this blog! 
The Structure of the PACES Exam 
Let me explain to you the structure of the exam first. 
In the MRCP PACES exam, you will have to go through five clinical stations, each of 20-minute. Each of them will be separated by 5-minute breaks. 
The breakdown for each station is as follows: 
 
Station 1 
 
• 10 minutes – Respiratory 
• 10 minutes - Abdominal 
 
Station 2 
 
• 20 minutes - History taking 
 
Station 3 
 
• 10 minutes - Cardiovascular 
• 10 minutes - Neurology 
 
Station 4 
 
• 20 minutes –Ethics and communication skills and 
 
Station 5 
 
• 10 minutes - Brief clinical consultation 1 
• 10 minutes - Brief clinical consultation 2 
 
MRCP PACES's duration is 2 hours and 5 minutes. While that may sound too long, it is relatively much shorter than the Part 2 Written exam, which is 6 hours long! So, don't worry. In reality, those two hours will pass so quickly that they may feel like 15 minutes only. 
 
Dr Ramesh's Top Tips for Passing MRCP PACES 
 
TIP 1 
 
Get yourself a group, a practice partner or somebody who can help you through the whole journey. Start looking through the wards to find interesting cases, as early as possible. This does not mean that you should ignore common cases like rheumatoid arthritis and pleural effusions. 
I would recommend you to partner with individuals who are as motivated as you, if not more. This will help you in pushing yourself, mainly because you would feel guilty for not turning up for a session or be held accountable. Also, if you choose to study with a guide like me, you would get expert tips, resources and guidance that can help you ace the exam. So, choose wisely, and make the best out of it. 
 
TIP 2 
 
Practice is key to success in PACES, just like for the written exams. Make sure that you have a well-rehearsed sequence of washing your hands, introducing yourself, and putting your patient/actor at ease. This is essential because having a practised sequence will make it come to you naturally during the exam when you are under enormous pressure. 
My advice is to make sure that you have performed a minimum of twenty full examinations of every system before you attempt the exam. At the beginning of your practice, you may take the time you need and focus on ensuring that none of the pertinent steps is missed. Once you have the hang of it, you should now time each examination and try to complete it within the allowed duration. 
One thing to remember is that your examinations don't necessarily have to be directed at patients with pathology. The whole purpose of the exercise is to ingrain each motion so that it becomes automatic, like a reflex action. 
Why is this crucial? Because only when these motions are made automatic, you will have the mental capacity to focus on the more challenging aspects of the exam, for instance, formulating a diagnosis and detecting hard-to-detect physical signs. If you are still struggling with little things like the right method to assess a collapsing pulse, then spending a significant amount on the exam may not be the best decision for you right now. Work consistently and attempt it when you are prepared enough. 
 
TIP 3 
 
Make sure that you don't take presenting patients lightly and give yourself enough practice. Many candidates believe that this part of the exam won't be much of a problem. After all, they have gained enough experience through their daily clinical work during ward rounds and interacting with other specialities to discuss referrals, right? 
Unfortunately, this is not likely to be sufficient. There's still a need to polish your skills. 
 
You can get some practice by reading cases, setting yourself a time limit and presenting to yourself in front of a mirror or a quiet room. Evaluate yourself on factors like body language, eye contact, volume and continuation of your speech (pauses or stuttering). You can also record yourself and hear it back to critique yourself. 
 
When you feel you have gotten enough practice, begin presenting cases in front of two other candidates and ward patients, in a strictly exam-like environment. Best wishes! 
 
To learn more about how to succeed at MRCP PACES, keep reading our blogs. And if you need more than that, Dr Ramesh is here to help! He's the only doctor who is offering one-to-one online teaching for PACES in the UK, which are significantly more effective than other available resources. Get in touch with us today! 
 
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On 9th July 2020 at 15:01, Saidunnessa Irin wrote:
Sir, it is really very effective tips for us. Thanks for guiding us.

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