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Info Re: MRCP I

General Medicine Examination

Since May 2003, the MRCP (UK) Part 1 Examination has consisted of two Best of Five papers, each lasting 3 hours, organized (in the UK) as follows:

09.30 Report (Paper 1)
10.00 Paper 1
13.00 Lunch break
14.15 Report (Paper 2)
14.30 Paper 2
17.30 Examination ends

Each paper contains 100 multiple-choice questions (MCQs) in the Best of Five format. Negative marking has been discontinued; one mark is awarded for each correct answer, but no marks are awarded if the answer is incorrect. One pass mark is applied and the exam is criterion referenced (i.e. its difficulty is judged against an external standard, not against the number of candidates who pass). The questions in each specialty will be randomised across both Papers.

Two key factors in the preparation for the Part 1 MRCP examination are:

Careful planning of your revision timetable.
Establishing and practising your examination technique.
Planning a revision timetable

Your revision timetable should be tailored according to the time available prior to the Part 1 MRCP examination. Ideally you should start revising several months beforehand. Two principles should guide the planning of your revision timetable:

Allocate more time to subjects that are more frequent in the examination.
Allocate more time to subjects in which you are weaker.
Time spent revising subjects that are heavily represented in the exam (e.g. Cardiology or Neurology) will gain you more marks than studying less frequent topics (e.g. Ophthalmology). Similarly you will gain more marks by thoroughly revising topics in which you are weaker compared to those in which you already have considerable knowledge.

Two example revision timetables are given below, and should be adjusted according to your individual situation. Remember that revision timetables often fall behind schedule, despite best intentions, so allow a couple of week's spare time! Don't forget to make allowance for on-call schedules in your revision timetables; you should always revise when you are at your freshest, and this may not be possible after a hard night on-call. Work for short periods of time, with frequent breaks for rest, and consider a short holiday in the middle of your timetable; remember that revising for very long periods without a break is not likely to represent effective revision.

About 2 weeks before the examination, stop systematic revision and make sure that you have attempted several full practice exams on your own, under strict exam conditions (e.g. 3 hours for each paper). Make time to read your revision notes and go over topics that you find difficult.

Examples of revision timetables

A 6-month timetable, that allows 2 weeks vacation and 2 weeks last minute revision prior to the examination.
A 2-month timetable, that allows 7 days for on-call commitments, but no holidays. Commencing revision at this late stage means little time for leisure!

Subject
Composition of the Papers by specialty from May 2003
6 months revision
No. of weeks
2 months revision
No. of days

Neurology
15
2
4

Clinical pharmacology
20
2.5
4.5

Clinical science
25
3
6

Cardiology
15
2
4

Gastroenterology
15
1.5
3.5

Respiratory Medicine
15
1.5
1

Inf. Dis./Aids/Trop. Med.
15
2
4

Endocrinology
15
1.5
3.5

Nephrology
15
1.5
3

Haematology/Oncology
15
1.5
3

Psychiatry
8
0.5
2

Rheumatology
15
1.5
3

Dermatology
8
0.5
2

Ophthalmology
4
0.5
2

Total
200
22
45.5

Clinical sciences comprise:

Cell, molecular & membrane biology
2

Clinical anatomy
3

Clinical biochemistry & metabolism
4

Clinical physiology
4

Genetics
3

Immunology
4

Statistics, epidemiology & evidence based medicine
5

Establishing and practising examination technique

Best of Five questions require that the candidate select one answer from five options. This style of question tends to test clinical reasoning, rather than just recall of facts. The question stem is usually long, perhaps providing clinical history and data, whereas the 5 options are usually short. Several of the options may be partially correct, but one of the options will be clearly better than the others.

The key to establishing good examination technique is repeated practice with good quality MCQs. PasTest publish a comprehensive range of books for the MRCP 1 exam. All questions are very topical and are in the 'best of five' format. PasTest books give the candidate the opportunity to practice specific subjects or practice full exams. Your revision strategy should begin with a read through the relevant chapter in the textbook of your choice. Then practice as many good questions on each subject as available, and read the expanded explanation carefully after marking them. Choose good quality MCQ books that contain expanded explanations to each question; this is much quicker and more time effective than having to find the explanation in a textbook. Make brief notes on any topic in which you have scored poorly, so that you can quickly jog your memory again just before the examination.

There are many good quality books with 'old style' multiple True/False questions still available (e.g. MRCP 1 Multiple True/False Revision Book, published by PasTest). These still provide an excellent learning resource, as the questions will test your knowledge of the MRCP syllabus and enhance it with concise, accurate explanations.

MRCP Part 1 questions are chosen 12 months in advance of the exam date, so do not waste time reading last week's journals but instead glance at reviews and leading articles in the British Medical Journal, Lancet and New England Journal of Medicine; these may be helpful as they periodically cover some of the topics included in recent MRCP exams.

The examination is no longer negatively marked, so the best examination strategy has changed. It is now in your best interest to answer every question; even if you do not know you must guess. There is nothing to lose from guessing, and you may well pick up some valuable marks.

Breaks are an important part of your revision strategy. Always take short tea breaks at regular intervals during a day or evening's revision (at least 20 minutes every 2 hours can be very effective). Allow for an evening out each week - try and plan ahead so that you have something to look forward to. Revising with others in a small group can be helpful and motivational, as discussing points you find difficult can help you to remember them.

Choosing a textbook

Choose a general medical textbook that is up-to-date and easily comprehensible. For revision purposes, avoid books that are too detailed. PasTest recommends the following books:

Essential Revision Notes 2nd Edition (Kalra) is specifically tailored for MRCP revision. It contains 21 chapters relevant to the syllabus.

Clinical Medicine by Kumar and Clark, 5th edition, W.B. Saunders Ltd

Lecture Notes on Clinical Medicine by Rubenstein, Wayne and Bradley, 6th edition, Blackwell Science.

It is important to spend some time on all subjects rather than too long on only a few topics. Keep a more detailed textbook (such as the Oxford Textbook of Medicine) available for reference only, but use the general medical textbook and revision notes on a regular basis.

Basic Science

The current Royal College of Physicians MRCP regulations state:

'Increased emphasis is being given to basic clinical science topics. Questions will be set mainly on topics published in leading articles and editorials in major general medical journals. Questions in both options may be set on relevant principles of cell, molecular and membrane biology, immunology, genetics, and on biochemistry, as well as anatomical, physiological, microbiological and pharmacological topics.'

A large proportion of the questions in the MRCP Part I examination are related to clinical science. This can be a hard topic to revise, and so we recommend that you read a general basic science book such as Basic Medical Sciences for MRCP Part 1 3rd edition by Easterbrook, Churchill Livingstone. If you are weak in basic science knowledge, you can practice specific basic science best of five questions using MRCP 1 Basic Medical Sciences 2nd Edition Best of Five Questions and Answers (the companion book to Easterbrooks Basic Medical Sciences, revision book for MRCP. PasTest Essential Revision Notes 2nd Edition (Kalra) also contains a chapter on 'Molecular Medicine' that will be useful.

Posted by: drazeem Posts: 12 :: 16-01-2007 :: | Reply to this Message

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