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 out Old Russian Proverb

Every act of conscious learning requires the willingness to suffer an injury to ones 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 lets not get too silly. What would want the new car to have? Introduce yourselves to each other. Work in threes and fours. You have two minutes.

Task 2 You are about to participate in an MRCGP preparation course. You are going to have fun but lets not get too silly. What would want the course to cover? Work in threes 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 ( )

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 Patients 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 (%) Merit(%) Fail (%)

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.

This course

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 competent Learn Unconsciously competent Practice Lapse Unconsciously incompetent Consciously incompetent Assess

MRCGP COURSE CANDIDATES 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 Youve 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 STATUS KARNOFSKY S RATING SCALE (1948) 100NORMAL 90MINOR SYMPTOMS 80ACTIVE WITH EFFORT 70CAN SELF CARE BUT UNABLE TO WORK 60REQUIRE SOME HELP TO SELF CARE 50FREQUENT MEDICAL CARE & HELP 40DISABLED AND NEEDS SPECIALIST CARE 30IN HOSPITAL, DEATH NOT NEAR 20 IN HOSPITAL NEAR DEATH 10MORIBUND 0DEAD

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

Kelly Holmes gets her MRCGP results

We take the job very seriously, but we dont 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 hotel arrangements