Well, failure in PACES is nothing to be ashamed of. All the exams need luck apart from your tremendous preparation.
Having said that, you can do many things to improve yourself.
Due to Covid 19 Pandemic, MRCP UK has announced following changes although final approval from the General Medical Council is awaited.
Station 1, 3 and 5 - mini carousel
Station 1, 3 and 5 will be run as a mini-carousel with real patients, assessing 7 skills, with more time in between stations for PPE and cleaning of equipment.
Station 2, 4 and a rest station - mini carousel *Via online*
Station 2, 4 and a third station (rest station) will be run as another mini-carousel. Candidates will be in the same centre, on the same day as station 1, 3 and 5, but surrogates and examiners will be remote. Content and timings of the stations will be the same.
The whole PACES Exam will take 3 hours, and candidates may be asked to undertake the mini-cycles in either order.
Source: MRCP UK
Will the new PACES Exam format be implemented from Diet 1, 2021?
As of 9th Aug, 2020, MRCP UK website has NOT announced whether they will introduce the new format from diet 1, 2021 or not. So, no one knows for sure at the moment.
What are the changes for the PACES Exam next year (2021)?
Station 2 (History Taking Station), Station 4 (Communication Station) and Station 5 (Brief Clinical Consultation Stations) are removed.
What is being added?
Communication stations: There will be 2x 10 mins communication stations. There will be no question and answer section with the examiners.
Consultation stations: There will be 2 x 20 mins consultation stations, where you will have to take history, perform physical examination and discuss management plans and address the patient’s concerns for 15 mins, followed by 5 mins question and answer section with the examiners.
What shall I do if I want to prepare for PACES 2021?
Though there may be changes in PACES Exam next year, you should continue practising the topics from the current PACES Exam. The basics are the same.
There will be NO changes in physical examination stations (Current Station 1 and 3).
The topics and the important points for Communication stations will be the same as the current exam. The main difference is that you will not encounter questions from the examiners.
You will have more time for consultation stations (compared to the current brief clinical consultation stations), but the topics, structure and general concept will be the same. You will have more time to think, perform and address the concerns.
Here is a list of recommended resources for PACES Examination!
Skill A: Physical Examination
This is the easiest skill. As long as you can perform the examination systemically, you will get full marks in this skill.
Tips: Practise daily either with a colleague or friend or even with a pillow. The more you practise, the more natural you will become in performing examinations.
Skill B: Identifying Physical Signs
This is an important station. It is known that British candidates find this skill a bit challenging. However, with regular examination of the patients, you will be able to pass this skill.
Tips: You need to have a PACES oriented mind. Popular cases should be rehearsed well. With proper preparation, this skill is easy to pass. Remember, if you could not identify physical signs, your diagnosis and differentials will not be correct and that will affect other skills (D,E,F).
Skill C: Clinical Communication Skills
This is one of the challenging skills, especially for non-British candidates. There are only 3 stations (Station 2,4 and 5) which assess this skill, so you need to talk clearly and loudly to deliver your message to the surrogates or patients.
Tips: If you are non-British candidates, you need to practise how to be confident and at the same time, show your sympathy and empathy. This is very important as this skill sometimes can link to skill for managing patient’s concerns (F).
Skill D: Differential Diagnosis
Some candidates failed just by one mark in this skill. After you finish your examination, put all the positive and negative findings together to give your provisional diagnosis and sensible differentials.
Tips: You should prepare differentials while you are studying. This is a very crucial advice. However, you should tailor your differentials according to YOUR case in YOUR PACES exam. If you mention differentials which are not relevant to your case, you WILL LOSE marks.
Skill E: Clinical Judgement
If your diagnosis and differentials are not correct, you will lose mark in clinical judgement too. Practise the management plan for each diagnosis before the exam.
Tips: If you are not sure of the diagnosis, your investigations and management plan should cover your differentials. You can always consult your consultant and other specialists. Remember – you are not treating this patient alone! Always remember to admit patients with serious conditions! Consider whether you need to stop the patient from driving. Don’t forget to provide safety netting.
Skill F: Managing Patients’ Concerns
This is the most difficult skill for candidates. You need to get 11/16 to pass this skill. If you lose marks in communication station (4) and in one BCC, it would be very hard for you to pass.
Tips: Time management is critical for this skill. Candidates find it difficult to finish on time in BCC. They continue to take history or do physical examination and hence they do not have enough time left to address patients’ concerns. This is a fatal mistake! You should always give sufficient time to address patients’ concerns especially in BCC.
Skill G: Maintaining Patient Welfare
Almost all candidates pass this skill. As long as you behave professionally, you will get full marks in this skill.
Tips: Do not forget to ask about pain before touching the patient. Also, cover up the patient after you have examined him.
🔺Final advice: Remember – PACES is not about how much you know about medicine. It is about how you can correlate the findings, how you behave, your thinking process, your manners, your confidence and whether you are a safe doctor or not.
Any questions, let us know. Share this with your colleagues and friends who might benefit!