The MRCGP Exam
Overheads from talk given by Bill Irish to Swindon/Bath DRC
September 2002
4 Components:
You need to complete all
4 components over a maximum of 3 years.
Pre-certification:
-
In basic life support
(certified by an A&E or anaesthetic consultant, or more usually by a
resuscitation training officer)
-
Currently in child
health surveillance (usually by your trainer). This requirement is about to be
dropped.
How long have I
got?!!
22nd
October
7th May
2nd – 7th
December
16th – 27th
June
Pass Rates (Spring
2002)
Merits and Distinctions
Success:
1735 candidates sat
1 or more modules
719 failed one or
more component
About 59% pass rate
(ish)
Whilst these figures are
confusing (at least to me), there is little doubt that the exam has got harder
over the last 5 years.
The MRCGP Written Paper
CRQs
Questions to test your
knowledge and interpretation of general practice literature.
Questions which test
your ability to evaluate and interpret written material which is presented to
you
MEQs
Questions which
examine your ability to integrate and apply theoretical knowledge and
professional values within the setting of primary health care in the UK.
Others….
The MRCGP Written
Paper
-
12 questions
-
3 ½ hours (30 minutes
reading time). No one finishes early.
-
Prose type paper. Most
(successful) people answer in expanded note form.
-
3 types of question
(see above)
-
CRQ – current
literature type:
-
People lose
perspective.
-
A minority (2/12)
are related to the current literature: mainly the last 18 months of the
BJGP, BMJ, Evidence based medicine and the DTB.
-
Set at previous
Saunton so see "wot was hot"
-
Can (sometimes) be
spotted.
Marked using constructs
(i.e. key areas). For example (Autumn 93):
-
Your heart sinks as
you note that Miss Maud Temple, aged 76, is consulting you for the eighteenth
time in six months with some minor symptom. This now seems an established
pattern of behaviour.
-
What are the
possible origins of this pattern, and how might it be changed?
There were 5 marking
constructs on this occasion:
Doctor’s consulting
behaviour
Doctors personal
problems
Patients problems
Patient behaviour
pattern
Solutions
Each construct is marked
on a scale 0-5
-
Please refer to the
attached written material that follows which is part of a paper entitled: "The
end of antibiotic treatment in adults with acute sinusitis-like complaints in
general practice? A placebo-controlled double-blind randomized doxycycline
trial."
-
Dawn Jones, aged 23
years, presents with a six-day history of left maxillary pain and clear nasal
discharge. You are considering whether to prescribe antibiotics. Consider the
methodology of this study and:
-
list the
strengths and weaknesses of the study design
-
list the
strengths and weaknesses of the sample selection
-
list the
strengths and weaknesses of the choice of interventions
-
discuss the
appropriateness of the outcome measures
-
consider the
relevance of the study to Dawn Jones’ clinical problem. (half a side for
each)
The MRCGP MCQ Paper
Cardiovascular
Respiratory
Gastroenterology
Endocrine/Metabolic
Paediatrics
Reproductive/Renal
Medicine
Therapeutics
Psychiatry/Neurology
Dermatology, ENT &
Eyes
Infections,
Haematology, Immunology, Genetics
Biostatistics and
EBM (20%)
Administration (15%)
Single Best Answer
Paediatric eye
problems.
Select the
single correct diagnosis of this clinical photograph from the list below:
Congenital
Cataract
Hypopyon
Melanoma
Pingecula
Retinoblastoma
Multiple Best Answer
An audiogram is
likely to show a conductive pattern of hearing loss.
Randomised
controlled trials have demonstrated an improvement in symptoms during
treatment of patients with thiazide diuretics.
Tinnitus is
typically present between acute attacks.
Hearing is
characteristically normal between acute attacks
75% of cases are
unilateral.
Extended Matching
A Acute glaucoma
B Central retinal
artery occlusion
C Central serous
retinopathy
D Migraine
E Optic neuritis
F Retinal
detachment
G Retinal vein
thrombosis
H Vitreous
haemorrhage
From the list of
possible diagnoses, select the single most likely diagnosis for each scenario.
Each option may be used once, more than once or not at all..
1. A 39 year old
woman attends the out of hours centre at 11pm. During a meal at a restaurant
that evening, she has noticed bright lines of lights followed by a loss of
vision affecting a small area of the visual field in both eyes. By the time
she is seen, all her symptoms have resolved apart from slight nausea.
2. A 30 year old
accountant presented with blurred vision. This occurred suddenly and was first
noticed on waking and had not been present the previous evening. He described
a dullness of his right central vision, with objects appearing smaller and
distorted. It was more obvious with near vision and there was a blunting of
colour vision. His symptoms were more marked at night. There was no pain or
other symptoms. The visual acuity was 6/12 but could be improved with a lens
to 6/6.
3. A 63 year old
man with treated hypertension presented with a sudden loss of vision in his
left eye. His visual acuity in the left eye was reduced to hand movements
only, whilst in the right eye, his VA was 6/6. His blood pressure was poorly
controlled at 190/100. His intraocular pressures were normal and his eye was
not painful. Fundoscopy revealed flame-shaped retinal haemorrhages spreading
out from the disc
4. A 45 year old
woman who has been myopic since childhood, has noticed sudden flashes of
lights in one quadrant of her vision persisting over the last 12 hours. Her
visual acuity is normal and the eye is not inflamed or painful. On direct
questioning she has also had a dull one sided headache and also noticed some
floaters in her left eye.
Summary Completion
The MRCGP is a _______ (1) exam. Passing it is currently essential to become
a ______ (2), and it is likely that in the future all general practitioners will
need these letters after their name.
Passing each of the ______(3) modules is easy, but does require considerable
planning and preparation preferably as ________ (4) activity.
For each of the numbered gaps select the most appropriate response from the
following list. Each option may be used once, more than once or not at all.
A. A distance learning
B. A small group
C. An individual
D. Babysitter
E. Four
F. GP Principal
G. Lithuanian
H. Magnificent
I. Mickey mouse
K. Trainer
L. Twenty
M. Two
The MRCGP – Simulated
Surgery
-
For those unable to
produce a video
-
Mainly locums
-
Those who consult in
languages other than English
-
Candidates outside the
UK
-
Series of clinical
scenarios, each lasting 10 minutes with an actor (and an examiner)
-
Rather like the
surgery "from hell"
The MRCGP - Video
-
Taken by most
registrars in the UK
-
A pass gives exemption
from the video part of Summative Sssessment.
-
Single route
mechanism, via the deanery.
-
Has the highest module
fail rate.
-
Easy…
Marked :
-
7 consultations of
your choice
-
At least 1 paediatric
case and 1 mental health problem
-
A "portfolio of the
candidate’s best work"
-
Should demonstrate a
range of competences
Discover the reasons
for the patient’s attendance:
-
The doctor
encourages the patient’s contribution at appropriate points in the
consultation.
-
The doctor responds
to cues
-
The doctor elicits
appropriate details of the patient’s complaint(s) in a social and
psychological context
Define the clinical
problem:
-
The doctor obtains
sufficient additional information for no serious condition to be missed.
-
The doctor chooses
an examination which is likely to confirm or disprove a hypothesis which could
have reasonably been formed, OR to address a patient’s concern
-
The doctor makes a
clinically appropriate working diagnosis
Explain the
problem(s) to the patient:
-
The doctor explains
the diagnosis, management and effects of treatment.
-
The doctor explains
in language appropriate to the patient
Address the patient’s
problem(s)
Make effective use of
the consultation:
Merit Criteria
-
The doctor takes
the patient’s health understanding into account
-
The doctor’s
explanation takes account of some or all of the patient’s elicited health
beliefs
-
The doctor seeks to
confirm the patient’s understanding
To Pass:
To get a merit:
The MRCGP - Orals
-
In London or Edinburgh
-
Aim to test decision
making skills
-
2 20 minute orals with
a short break in between
-
Somewhat anxiety
provoking, but have a high pass rate!
-
Candidates tested in 3
areas:
-
Usually 12 4-minute
questions, previously planned by the 2 pairs of examiners.
Preparation:
BMJ, BJGP (both
on-line) as you go.
Comics (especially
Practitioner, Update but also Whingers’ Weeklies for hot political issues)
Lots, expensive
Most popular seems
to be the RCGP one in London and a few specific critical reading ones.
We can recommend Dr Una Coles's MRCGP Courses at the RCGP in
London. Her students have an admirably high pass rate. See
http://www.mrcgpcourses.co.uk/index.html
Another recommended MRCGP course is run by Dr Nigel Giam.
He is Course Organiser for the South London Faculty and North and West
London Faculty RCGP. He runs his MRCGP preparation course at the RCGP. See
www.geocities.com/mrcgpcourses for more information.
Good Luck!
Written by: Bill Irish; modified by Michael Harris
Last update:
29 August 2007
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