PACES MRCP UK - Where MRCPians Meet Since 2006

MRCP is well establised as an entry exam for advanced specialist training in many countries including Malaysia. It consists of 3 paper i.e. Part1, Part2(written tests) and PACES. PACES in full means Practical Assessment of Clinical Examination Skills. It is the third part and the candidate is assessed by fellows of RCP. I passed my PACES in 2005. I am glad that many seniors had guided me throughout my preparation for PACES and I wish to share my experiences with PACES candidates via this blog.


Tuesday, January 17, 2006

"Strategies of presentation"

  • There are 2 different ways of presentation. The first one is "hit hard" strategy and the second one would be "long story" strategy. There is no hard and fast rule in choosing this 2 strategies. It really depends on your self confidence and comfort in presenting the clinical signs after you gathered the signs.
  • However, I would prefer "hit hard" for station 5 and "long story" for station 1 and 3.
  • "Hit hard" means we present the diagnosis straight at the start followed by the evidences to support it. For example, this is rheumatoid arthritis as evidenced by symmetrical deforming arthropathy involving PIP and MCP with the sparing of DIP. There is swan neck deformity and wasting of small muscle of hands. The joints are not warm/tender and functionaly are limited by the deformities.
  • "Long story" is more applicable for major stations that involve a lots of signs. This style of presentation allows us to present systematically and avoid unnecessary omissions. I would suggest we start from peripheral signs. For example, this man is comfortable at rest. The pulse is...../min and ...collapsing. There is... peripheral signs to suggest IE. He is ...pink...jaundice....cyanosis. The JVP is.....This is a midline sternotomy scar......The apex beat is at......There ...parasternal heave......and palpable 2nd HS . The 1st HS is .........metallic in nature......2nd HS is.......loud. There is ..........signs of HF i.e. basal creps ....ankle edema. In conclusion,the man has prosthetic valve ....which valve and evidence of...........IE/HF/PHT.

Which one do you prefer?

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3 Comments:

At 2/02/2006 05:16:00 PM, Blogger AD_NG said...

Good guidance, if one is so lucky to have a single valvular lesion for CVS, I would suggest hit-hard strategy. One senior had told me before that the current trend in PACES is to give simpler cases but one can never be sure, OR it might only apply to UK Centres perhaps.

 
At 4/05/2006 06:49:00 PM, Blogger spinosum said...

Wow! How come all the MO's preparing for PACES in Penang are having the "similar", if not identical, kind of presentations! What u mentioned here are as clear in my mind as it was just yesterday, when those nice doctors(namely Dr TKF, Dr SEL and Dr GEL) taught me the ways to present in my final years -- esp the "hit hard" method was really impressive! :)

 
At 4/09/2006 09:48:00 AM, Blogger eMRCPian said...

forgot to mention another way is "running commentary"
BUT dont use it in PACES.

 

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