The MRCGP Preparation Course NEAL MASKREY Medical Director, National Prescribing Centre Dept of Pharmacology and Therapeutics, University of Liverpool
This course • This exam • This course
“Eat one live toad first thing in the morning and nothing worse will happen to you for the rest of the day”
There is no shame in not knowing; the shame is in not finding outOld Russian Proverb
“Every act of conscious learning requires the willingness to suffer an injury to one’s self esteem. That is why young children, before they are aware of their own self-importance, learn so easily; and why older persons, especially if vain or self-important, cannot learn at all.” Thomas Szasz
“What we hear we forget, What we see we remember, What we do we understand”.
Task 1 • You are about to go and buy a new car - money no object but let’s not get too silly. What would want the new car to have? • Introduce yourselves to each other. Work in three’s and four’s. • You have two minutes.
Task 2 • You are about to participate in an MRCGP preparation course. You are going to have fun but let’s not get too silly. What would want the course to cover? • Work in three’s and fours. Introduce yourselves to each other only if you have changed groups or have defective short term memory. • You have three minutes because this is a more complex task.
Examinations are formidable even to the best prepared, for the greatest fool may ask more than the wisest man can answer. Charles Colton (1780 -1832)
ABOUT THE EXAM CRITERION REFERENCING UK DRIVING TEST PEER GROUP REFERENCING 98% OF ACADEMIC EXAMINATIONS
REASONS FOR FAILING • Arriving late. • Not reading the instructions on the written papers. • Answering a different question from that asked. Perfect preparation prevents pathetically poor performance:- • not reading the literature. • not understanding the aims of the examination. • poor knowledge base. • inappropriate attitudes. • poor examination techniques. • not practising examination skills.
REASONS FOR FAILING • Not demonstrating critical thinking about patient management. • Lack of knowledge about practice organisation. • Lack of thought about prescribing. • Lack of knowledge and organisation about chronic diseases. • Narrow approaches. • Killing the patient in an emergency situation.
EXAM STRUCTURE • MODULAR / CREDIT ACCUMULATION • Written paper, MCQ, ASSESSMENT OF CONSULTATION SKILLS, ORALS • CPR • ALL TOGETHER OR SEPERATE, 3y OF APPLICATION, 2 RESITS AT ANY MODULE (FOR A FEE)
RESULTS • PASS, FAIL, MERIT (TOP 25%) IN EACH MODULE • TO OBTAIN MRCGP - PASS ALL 4 MODULES • 2 MERITS AND 2 PASSES = MRCGP WITH MERIT • 4 MERITS OR 3 MERITS + 1 PASS = MRCGP WITH DISTINCTION
DOMAINS OF COMPETENCE 1/2 • A Factual knowledge • B Evolving knowledge: uncertainty, hot topics, qualitative research • C Evidence base, knowledge of literature, quantitative research • D Critical appraisal, interpretation of literature, principles of statistics • E Application of knowledge, justification, prioritising, audit • F Problem solving (general applications) • G Problem solving (case specific), personal management ) • H Personal care: matching principles to individual patients
DOMAINS OF COMPETENCE 2/2 • I Written communication • J Verbal communication, the consultation process • K The practice context: team issues, practice management, business skills • L Regulatory framework of practice • M The wider context: medico-political, legal, societal issues • N Ethics, trans-cultural issues • O Values and attitudes: Integrity, consistency, caritas • P Self-awareness, insight, reflective learning, the doctor as a person • Q Commitment to maintaining standards, personal and professional growth, CME
Testing of domains by module • Written paper - A B C D E F G H I J K M N P • MCQ – A B C D G L N • Consulting skills – G H J O • Oral – D E F G H J K M N O P Q
Variety of roles of the doctor • Clinician, Family doctor • Patient’s advocate • Gatekeeper, resource allocater • Handler of information • Team member, team leader • Partner, colleague, employer • Manager, business-person • Learner, teacher • Reflective practitioner • Researcher • Agent and shaper of policy • Member of profession • Person and individual
Pass rates Paper1 Paper 2 Video Orals Pass (%) 59 62 75 67 Merit (%) 24 24 15 24 Fail (%) 17 14 10 9
SUMMARY • Maximise and organise knowledge base, INCLUDING CURRENT LITERATURE. • Examination techniques. • Patient centred consulting style. • Realistic approach to practice. • Justify approaches to patient management by reference to the current literature. • Revision schedule – hot topics (including chronic diseases and emergencies.) • Self - evaluation.
Feeling comfortable…. ……………with not knowing everything
“To save man from the morass of propaganda, in my opinion, is one of the chief aims of education. Education must enable one to sift and weigh evidence, to discern true from false, the real from the unreal, and the facts from the fiction.The function of education, therefore, is to teach one to think intensively and to think critically” ‘The purpose of education’ – Martin Luther King, 1948.
Consciously incompetent Assess Learn Consciously competent Unconsciously incompetent Practice Lapse Unconsciously competent
MRCGP COURSE CANDIDATE’S PRE-COURSE “BENEFITS” • Exam Format, Content, Examiners Agenda • “How Am I Doing At The Moment” - What Are My Strengths & Weaknesses - Can I Pass? • What Are The Exam Techniques ? - Practice Them • Paper 1 (Critical Reading, Statistics, Evidence Base, Meq Skills) • Orals, Mcq, Video • Increase Confidence, “Reassurance I Can Do This” • Increase Motivation • Group Work - Support - Meet Others- ?Local Study Group • Have A Good Time • Revision Guidance • Professional Development • Hot Topics
MRCGP COURSE TUTORS PRE-COURSE “BENEFITS” • HAVE A GOOD TIME • Everything You’ve Written • “MCQ” • Video • Clinical Epidemiology
ABOUT THE COURSE (1) • Try it, talk about it, get some information about it, try it again • “Participative” • How are you doing? - Group progress charts • How am I / you feeling?
PERFORMANCE STATUSKARNOFSKY ‘S RATING SCALE (1948) 100 NORMAL 90 MINOR SYMPTOMS 80 ACTIVE WITH EFFORT 70 CAN SELF CARE BUT UNABLE TO WORK 60 REQUIRE SOME HELP TO SELF CARE 50 FREQUENT MEDICAL CARE & HELP 40 DISABLED AND NEEDS SPECIALIST CARE 30 IN HOSPITAL, DEATH NOT NEAR 20 IN HOSPITAL NEAR DEATH 10 MORIBUND 0 DEAD
ABOUT THE COURSE (2) • How does it feel not to know something? • “Nobody loves a smart arse” C Tarrant. Who Wants to Be a Millionaire. September 1999 • Feedback • Orals • Has anyone sat / passed any modules? • We will do our very best to keep to the timetable (except for this bit?) • Hotel arrangements
We take the job very seriously, but we don’t take ourselves at all seriously
I am thankful for laughter, except when milk comes out of my nose.Woody Allen
Any questions?-security -feedback forms- future tutors-www.mrcgp.comhttp://groups.msn.com/MRCGPStudyGroup-hotel arrangements