Exams
Farheen Ghafoor
Aims:
• Understand the MRCGP
• Information on additional exams e.g DRCOG
• Includes: exam format, fees, eligibility, test centre
locations, useful resources, yada yada yada.
Compulsory
(MRCGP)
MRCGP:
• Why – because you have to basically
but remember you want to be a good not a crud GP!
• 2 exams: written + practical (3rd part WBA)
• Written – Applied Knowledge Test (AKT)
• Practical – Clinical Skills Assessment (CSA)
• [Work Based Assessments (ignoring this bit!)]
AKT
AKT:
• FORMAT – 3hr, 20o questions, SBA, EMQs etc
80% core clinical medicine
10% evidence based practice
10% ethical and legal issues
• WHEN – Oct, Jan and April each year
• WHERE – nearest centre Derby (Pearson Vue)
AKT:
• HOW – computer based
• FEES – £441 (if AiT)
• ELIGIBILITY – ST2/3 only (soz nerds/nutters!)
• ATTEMPTS – max four
Example SBA:
A 17-year-old student suddenly develops chest
pain and dyspnoea after a morning swim. There is
hyper-resonance and decreased breath sounds on
the right side.
Which is the SINGLE MOST likely diagnosis?
Select ONE option only.
A. Asthma
B. Pneumothorax
C. Pulmonary embolus
D. Left ventricular failure
E. Pulmonary haemorrhage
From RCGP AKT presentation
Example EMQ:
A. Berry aneurysm
E. Ischaemic stroke
B. Cerebral glioma
F. Multiple sclerosis
C. Drug induced
G. Myasthenia gravis
D. Graves’ disease
For each patient described, select the SINGLE MOST
likely diagnosis from the list of options above.
1. A 35-year-old man who is a non-smoker, suddenly
develops a severe headache and double vision. His right
pupil is fixed and dilated.
From RCGP AKT presentation
Example EMQ:
A. Berry aneurysm
E. Ischaemic stroke
B. Cerebral glioma
F. Multiple sclerosis
C. Drug induced
G. Myasthenia gravis
D. Graves’ disease
For each patient described, select the SINGLE MOST
likely diagnosis from the list of options above.
2. A 48-year-old woman has transitory double vision
towards the end of most days. She smokes 10
cigarettes/day. She has vitiligo and hypothyroidism.
From RCGP AKT presentation
Example picture:
• A 32-year-old man has noticed painless nonitchy patches of hair loss on his beard area and
scalp.
Which is the SINGLE MOST likely diagnosis
Select ONE option only.
A. Alopecia areata
B. Eczema
C. Lichen sclerosis
D. Tinea infection
E. Vitiligo
From RCGP AKT presentation
Example data:
Which SINGLE study suggests
the WEAKEST association
between increased whole grain
intake and a risk of type 2
diabetes? Select ONE option only
A. Fung
B. Meyer
C. Montonen
D. NHS1
E. Van Dam
From RCGP AKT presentation
Example algorithm:
Medical management of menorrhagia
Non-hormonal
1 _______
2 _______
Hormonal
therapy
Combined oral
contraceptive
pill
3 _______
For each of the numbered gaps above, select ONE option from
the list to complete the algorithm, based on current evidence.
Each option may be used once, more than once or not at all.
From RCGP AKT presentation
Example algorithm:
A.
B.
C.
D.
E.
F.
G.
H.
I.
Cyclical norethisterone
Copper-bearing intra-uterine device
Inert intra-uterine device
Levonorgestrel releasing intra-uterine system
Medroxyprogesterone acetate
Mefenamic acid
Nonoxinol ‘9’
Tibolone
Tranexamic acid
From RCGP AKT presentation
Example free text:
Which SINGLE vitamin is administered to reverse
the anticoagulant effect of warfarin?
Give ONE answer only, typing on the line
Vitamin ________
From RCGP AKT presentation
CSA
CSA:
• FORMAT – 13 consultations, 10mins each.
Data gathering
Clinical management
Interpersonal skills
• WHEN – several different dates a year available
• WHERE – Croydon!
CSA:
• HOW – role play patient scenario in ‘GP room’
• FEES – £1481 (if AiT)
• ELIGIBILITY – ST3 only (must pass AKT first)
• ATTEMPTS – may need approval from deanery
to extend training time
Example scenarios:
• Depression with background of chronic illness
• Sick note requests
• Inappropriate requests for medication
• Vague symptom e.g. ‘tired all the time’
Optional
(e.g. DRCOG, DCH, BIMM)
WHY BOTHER?
• Reinforce learning e.g. if doing relevant job
• Improve knowledge in area if little experience
• Have interest in the specialty
• Looks good on CV
Diploma of Royal College
of Obstetricians and
Gynaecologists
DRCOG:
• FORMAT – 2 papers, each paper 1 1/2 hrs
Paper 1 SBA ( 30) + EMQ (18) = 30% + 12.9%
Paper 2 MCQs (200) = 57.1%
• WHEN – April and October each year
• WHERE – nearest Nottingham
DRCOG:
• HOW – written paper, don’t have to pass both!
• FEES – £ 380 (I think)
• ELIGIBILITY – any GMC registered doctor
• ATTEMPTS – max five
How I passed?
Easy peasy…
Example SBA:
A 41yr woman in the first trimester of pregnancy
presents requesting an investigation to rule out
Down’s syndrome in her unborn baby. From the
following examples, which test is best described as
being a DIAGNOSTIC test for trisomy 21?
Select ONE option only.
A. Nuchal translucency scan
B. AFP, beta HCG and PAPP-A serum levels
C. Amniocentesis
D. Combined test (NTS and triple test)
E. AFP serum levels alone
I MADE IT UP
Example EMQ:
A. Pregnancy
E. Cervical cancer
B. Ovarian cancer
F. Imperforate Hymen
C. Fibroids
G. Polyps
D. Endometriosis
For each patient described, select the SINGLE MOST
likely diagnosis from the list of options above.
1. A 16yr old girl presents complaining she has not started
her periods. She has also been having severe monthly
abdominal pain for some time. On exam she is noted to
have developed secondary sexual characteristics.
I MADE IT UP
Example MCQ:
For each of the following, select true or false.
In relation to Obstetric cholestasis:
1. Patients normally present with jaundice T / F
2. It is caused by the build up of bile acids T / F
3. Treatment includes vitamin C and
ursodeoxycholic acid
T / F
4. Affects approx 5% of pregnancies
T / F
5 . Resolves after delivery of baby
T / F
I MADE IT UP
TIPS:
• Do after Obs + Gobs job if you can (not essential
though as I did mine 2/52 into mine but helps)
• Do squillions of questions (read over weak topic)
• Guess! (MCQs it’s 50/50, no negative marking)
• Answer in head first (for EMQs then look for
answer in list, if there you are probably right)
Diploma in Child Health
DCH:
• FORMAT – written paper and clinical exam
Written paper – MRCPCH Part 1a (same as paeds)
Clinical exam – DCH clinical
• WHEN – part 1a – Oct, Feb and June
DCH clinical – April and August
• WHERE – nearest Sheffield and Birmingham
DCH:
• FEES – MRCPCH Part 1a = £218
DCH clinical = £350
• ELIGIBILITY – aimed at GP registrars
• ATTEMPTS – If pass Part 1a can do max 3
clinical before have to repeat Part 1a.
DCH:
• MRCPCH part 1a – 2 1/2 hr paper
• 12 EMQs, 15 MCQs(T/F) and 48 SBAs
(total 108),(total 75) and(total 192) = 375
• Topics include development, milestones, child
protection etc
Example SBA:
A 6-year-old girl has hereditary spherocytosis.
Splenectomy has been advised. Her parents are particularly
concerned about risks to her health in adult life. Which of
the following represents her greatest risk in adult life?
Select ONE option only.
A. Gallstones
B. Haemochromatosis
C. Lymphoma
D. Meningococcal septicaemia
E. Pneumococcal septicaemia
FROM RCPCH WEBSITE
Example EMQ:
A. Kawasaki disease
F. Pneumococcal pneumonia
B. Measles
G. Scalded skin syndrome
C. Meningococcal disease
H. Scarlet fever
D. Mycoplasma infection
I.TB meningitis
E. Pneumococcal meningitis
J. Toxic shock syndrome
Example EMQ:
Select the SINGLE MOST likely diagnosis:
1. A 10-month-old infant presents with a 1-day history of
a confluent blanching rash which started on his face and
now covers his entire body. He is miserable with
conjunctivitis and fever of 38.5º. The illness started with
runny nose and cough 5 days previously. His 3-year-old
brother has recently started nursery.
FROM RCPCH WEBSITE
Example MCQ:
For each of the following, select true or false.
At 12 month s of age a healthy boy born at term should:
1. Be dry by day
T / F
2. Cruise along the furniture
T / F
3. Feed himself with a spoon
T / F
4. Plays peek-a-boo
T / F
5. Use a 2-word phrase
T / F
FROM RCPCH WEBSITE
DCH:
• DCH clinical – 2 ‘cycles’, total of 8 stations:
• 1st cycle – 4 x 6min stations (2x
communication, data interpretation and oral)
• 2nd cycle – 4 x 9min stations (clinical
assessment, focused history/management
planning, development and safe prescribing)
British Institute of
Musculoskeletal Medicine
(diploma)
BIMM:
• FORMAT – written paper and clinical exam
Written – 1 hr paper of MCQs, EMQs and SBAs
– 2 hr paper of short answer questions
Clinical – case book (pre-exam), 10min OSCE and
30min CBD on case studies submitted
• WHEN – written February and clinical April
• WHERE – St George’s, University of London
BIMM:
• HOW – submit case book (before written paper of
cases seen personally within 2yrs), pass
written before attempt clinical. Pass all.
• FEES – written paper = £200
clinical exam = £450
• ELIGIBILITY – GMC license to practice and
completed foundation training.
BIMM:
What a kerfuffle eh?
USEFUL RESOURCES:
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www.derbygpvts.co.uk/training_library.htm
RCGP
NICE
SIGN
Pastest books / online questions for exams
OnExamination online questions for exams
RCOG greentop guidelines
RCPCH guidelines
Any questions?
Good luck chucks
(AND TA VERY MUCH FOR LISTENING)