An Aid to the MRCP PACES 4th Edition PDF
At the beginning of the 1980s, Bob Ryder, an SHO working in South Wales, failed the MRCP short cases three times (an SHO in modern parlance is a core medical trainee [CMT]).‡ On each occasion I passed the long case and the viva which constituted the other parts of the MRCP clinical exam in those days but each time failed the short cases. Colleagues from the year below who had been house physicians, with me the SHO, came through and passed§ while I was left humiliated and without this essential qualification for progression in hospital medicine. The battle to overcome this obstacle became a two or more year epic that took over my life.
I transformed from green and inexperienced¶ to complete expert in everything to do with the MRCP short cases as viewed from the point of view of the candidate. I experienced every manifestation of disaster (and eventually triumph) recorded by others in Volume 2, Section F. By the time of the third attempt, I was so knowledgeable that I was out of tune with the examiner on a neurology case simply because I was thinking so widely on the case concerned.∥ I believed at the time that I came close to passing at that attempt, although one never really knows and it was, after all, the occasion where I failed to feel for a collapsing pulse!** This was an important moment in the story because it was from this failure, along with the experience in the neurology case in my second attempt¶, that the examination routines and checklists, which are so central to this book, emerged. I finally passed on the fourth attempt whilst working as a registrar.†† During the journey, various consultants, senior registrars and colleague registrars tried to help in their various ways and amongst these, one of the consultants in my hospital, Afzal Mir, offered the advice that I should make a list of all the likely short cases and make notes on each and learn them off by heart.