1. The format of the Diploma in Pharmaceutical Medicine exam Dr Juliet Roberts (Chair - Officers Board of Examiners) FPM Education Day 17 June 2014

2. Contents History / Board of Examiners Format of the current DPM exam MCQ SAQ CAP Top tips / common pitfalls

3. History 1976Joint RCP granted first UK DPM 1989Joint RCP established FPM 1994FPM took over DPM 2013Diploma became a two part exam

4. Recent Changes to the DPM 2005Negative marking stopped in MCQ 2010Viva exam changed to written CAP 2011Essay paper discontinued Exam available overseas (Cape Town) Exam specification brought in 2013Diploma split into Part 1 and Part 2 Exam also offered in Singapore 2014Cape Town no longer offered as no candidates since 2011

5. Part 1, Part 2 Split GMC ratified change from 2013 Part 1MCQ Part 2SAQ and CAP papers (~4/52 later) Must pass Part 1 before eligible for Part 2. Candidates may sit both parts same year DPM is awarded on passing Part 2 Pass Part 1 but fail Part 2 means exempt from Part 1 for the next 4 eligible attempts

6. Eligibility for DPM Medical registration It is recommended that candidates have 2+ years in a post that provides training and practical experience in pharmaceutical medicine No longer required to have undergone a period of general professional training (specified period in clinical practice), although this is required for PMST

7. Exam Specification Required by GMC Provides a more defined structure for the content of the exam Also provides for structured feedback to unsuccessful candidates SAQ Paper MCQ Paper

8. Board of Examiners (BoE) 50 to 60 examiners (9 officers board of examiners) Responsible for the UK Diploma in Pharmaceutical Medicine (DPM) Certificate of Good Clinical Practice (GCP) Certificate & Diploma in Human Pharmacology (D/CHP) Reports to the Education Committee, FPM

9. Activities BoE Examination regulations and specification Candidate guidance notes Check eligibility of candidates Set examination papers and model/core answers Set the pass mark Conduct the examination Identify and provide training to new examiners

10. Multiple Choice Question (MCQ) Paper

11. MCQ Paper 75 questions x 5 responses = 375 items of information Time allowed: 2.5 hours No negative marking Each correct answer scores 1 mark Incorrect or no answer scores 0 marks Random answers score 50%

12. MCQ Paper Questions must be: Within the syllabus Worth asking – does it matter? Clear and unambiguous In plain English Avoids tricks, such as an accurate statement but the incorrect source e.g., According to ICH GCP, appropriate caution must be exercised in the conduct of medical research that may harm the environment

13. MCQ Paper Each completion must be: A test of only one piece of knowledge Logically related to stem Grammatically related to stem Ensure the answer is true/false Independent of other completions

14. Pass mark / marking Passmark is set by a bookmarking technique. Then OBoE reviews each question to see how well it has been answered, looks for discriminators and any outliers. If required a question can be removed and computer re marking.

15. Pass mark / marking Pass or Fail since 2013 (no E,G, P, BP, BF, F) Pass mark typically ≈ 72-73% (mean in last 9 years 72.2%, range 70-74.4%)

16. Examples MCQ Paper According to ICH Good Clinical Practice, a clinical trial protocol must be signed by:  ………………….stem answer…………. Question easy – all got it correct, no discrimination

17. Examples MCQ Paper The following factors can affect the pharmacokinetic properties of a compound administered orally:  ………………….stem answer…………. The top 20% answered the question better than the bottom 20% i.e. good discrimination

18. Examples MCQ Paper With respect to bioequivalence studies: ………………….stem answer…………. The bottom 20% answered the question better than the top 20% i.e. less discriminating but not necessarily a problem But in general prompts us to double check – was the question correct or ambiguous

19. Top tips / Common Pitfalls MCQ You have to revise ! No negative marks so don’t leave blanks Questions will only test one bit of knowledge

20. Short Answer Question (SAQ) Paper

21. SAQ Paper 10 questions Tests factual actual knowledge / ability to interpret data All questions to be answered candidates must gain marks on at least 8 questions time allowed 2½ hours ( 15 mins/question) Answer in bullet form style

22. Example SAQ Questions 2013

23. Pass mark / marking Pass mark for each question set by experienced examiners pre the exam 2 examiners (same pair) mark all scripts for 1 question Average score taken If >2 marks difference then goes for adjudication (third marker blinded to other scores). Median then taken.

24. Pass mark / marking Pass or Fail since 2013 (no E,G, P, BP, BF, F) Pass mark typically ≈ 51-52% (mean in the last 11 years 51.04%, range 48-54%)

25. Top tips / Common Pitfalls SAQ You have to revise – this is a knowledge paper ANSWER THE QUESTION (you cannot get marks for answering a different question) List (bullet point) format please Allow time for attempting all questions…score zero in >3 = FAIL Start with questions you can answer easily Marking scheme guides number of points required (but some may be ½ marks --- we are increasing saying how many answers we require – but don’t assume) Use past questions to guide revision (although re use of questions is never done – topics may be similar)

26. Critical Appraisal Paper (CAP)

27. CAP Tests ability to read and critique a paper Fundamental requirement whatever discipline in pharmaceutical medicine you work in ~ 13 questions (40% factual, 60% critique) No requirement for all questions to be answered – but lose marks if you don’t! time allowed 2½ hours question paper and article given at same time Answer in bullet form style please! (no essays)

28. Pass mark / marking Pass mark for each part question set by experienced examiners pre the exam 2013 and earlier 3 examiners mark 1 script, median taken Random mixing of examiner groups 2014 (similar to SAQ) 2 examiners mark 1 script, mean taken “Blinded” third marker used where 1 examiner passes, 1 fails (median used)

29. Pass mark / marking Pass or Fail since 2013 (no E,G, P, BP, BF, F) Since conversion to a written exam Pass mark typically ≈ 57% (mean in the last few years 56.36%, range 54-59%)

30. Top tips / Common Pitfalls CAP

33. Be careful what is asking for a factual answer e.g. List or State vs. What is asking for your critique / opinion e.g. Give reasons for, Explain or Comment on ……

34. Example: Exclusion criterion = presence of a red traffic light Question: Comment on the appropriateness of the patient population ( do not simply repeat the inclusion / exclusion criteria)

35. Example: Poor answer = Red traffic light Partial answer = Red traffic light so can’t cross the road Good answer = Red traffic light, so can’t cross the road because it may be unsafe as high risk of getting run over! Now think about how to answer for a GFR or U&Es value! Not answered Qu So what

36. Top tips / Common Pitfalls CAP ANSWER THE QUESTION (you cannot get marks for answering a different question) Attempt all questions, especially those that request critique/discussion and “what next” last question List (bullet point) format please Marking scheme guides number of points required Use past questions to guide technique Remember the “so what” This is a technique paper … so practice, practice, practice

37. Role of OBoE/BoE after the exam

38. Overall Adjudication – Part 2 Any candidate who fails SAQ/CAP reviewed Could a small change in a paper affect the overall result? If yes marking reviewed BoE meeting discuss any borderline case / ratify results

39. And finally…… Do check the FPM website Will shortly upload: these slides! some more verbatim examples on poor, ok and very good answers Liz Hancox handout from a previous trainee day – top tips on how to pass the DPM!

40. Good luck to those taking the DPM Once you have your CCT, we will write to you to join the Board of Examiners Please give something back!