PACES is the final examination before you obtain your Membership of the Royal College of Physicians. PACES can be a difficult exam to pass and so, in this blog post we share our advice on how to ensure you successfully pass your exam and make you that one step closer to securing an NHS job offer.
In the PACES exam, you will be assessed on your ability to carry out essential clinical skills. There are five clinical stations where there will be patients with a given condition or trained stand-ins. At each station, there will be two independent examiners.
You will start at any one of the five stations and then move round the stations at 20-minute intervals until you have completed the cycle. There will be a five-minute period between each station.
Station 1: Respiratory (10 minutes) Abdominal (10 minutes)
Station 2: History Taking (20 minutes)
Station 3: Cardiovascular (10 minutes) Neurological (10 minutes)
Station 4: Communication Skills and Ethics (20 minutes)
Station 5: Brief Clinical Consultation 1 (10 minutes) Brief Clinical Consultation 2 (10 minutes)
Doctors who have previously attempted MRCP PACES between 12-24 months after graduation are very unlikely to pass so bear this in mind when booking your exam. The pass rate increases to 60% for doctors who attempt between 24-36 months of graduation. While those who wait until they have 36-48 months of experience post-graduation, have a 77% pass rate. Think, the more experience the more likely you are to pass.
The most important step is to be organised and plan ahead. Look at the examination syllabus, the modules you will be tested on and then plan around that. MRCP Part 1 and 2 provides you with most of the knowledge you need to know for Medicine, however, PACES is about applying that knowledge to patient scenarios.
Once you have organised your revision schedule, you will then need to practice.
It is important to provide yourself with opportunities to examine your friends, unwell patients, examine your spouse, sibling or your parents – in English, against the exam syllabus. Focus on your examination routines until you do not have to give a second’s thought into what you are doing and what you need to do next.
When examining a patient, you should always be thinking about what you are going to need to tell them (in this case, the examiners posing as patients).
The PACES exam requires you to evidence a series of skills:
Skill A: Physical Examination – You must be able to examine a patient in a smooth, methodical and technically correct manner. To gain marks in this area you should not: miss things out, hesitate, examine a patient through their clothing, use an incorrect technique or have an unprofessional manner.
Skill B: Identifying Physical Signs – Failing to identify clinical signs is one of the most common reasons to fail PACES. You will also need to present your findings in a calm, confident and clear manner to your examiners.
Skill C: Clinical Communication Skills – It is absolutely essential to get an accurate history, address the patient’s ideas, concerns and expectations. In the exam, you should always avoid medical jargon, always speak professionally and considerately, elicit important information and provide it in an accurate and clear manner.
Skill D: Differential Diagnosis – If you fail to identify physical signs you will also lose points on differential diagnosis. To get points under this area, you will need to consider the correct diagnosis, avoid providing a long list of textbook differentials which would not likely apply to the patient in front of you.
Skill E: Clinical Judgement: This will test your ability to make a sensible plan for the patient. This includes any possible investigations and management of your diagnosis.
Skill F: Managing Patient Concerns – Here you should follow the acronym “ICE”: address all ideas, concerns and expectations. You will need to demonstrate that you have asked the patient if they have any questions and answer them in an accurate and sympathetic manner. Then you must always confirm that they understand.
Skill G: Maintaining Patient Welfare – It is essential to treat every single patient with respect and dignity. You can fail this skill by being disrespectful, being insensitive, causing pain and endangering patient safety.
If you are an international Medicine doctor who would like support in securing an NHS service post, email your CV to [email protected] and we can support you in securing an NHS job and on your journey to the UK today.
Are you a member of our Facebook Group? When you join IMG Advisor, you will join a community of doctors all looking to relocate to the UK and join the NHS. We post a series of blogs and vlogs into the group every single day. We will also always be on hand to answer all your relocation queries.
Subscribe to our YouTube channel! We have over 45 videos on everything you need to know about relocating to the UK and joining the NHS!