Saturday, April 24, 2010

MRCP- Postgraduation in U.K

  • A Brief detail of MRCP:

    The membership exams of the Royal Colleges have multiple parts that are given over a space of a few years. Every Royal College responsible for its specialty publishes a Regulation and Information Manual every year that contains details on the different parts of the Membership exam, their formats, the centers where they can be taken, application forms, fees, rules of exemption from different parts of the exam - and a lot more.
    Currently the first part of the MRCP(UK) exam can only be given when 18 months have elapsed from the date of graduation. This prerequisite may or may not change. As we shall see, the NHS is overseeing extensive reforms in the SHO grade and it is quite possible that the membership exam details may be affected by these reforms. One must use only the most current Exam manual from the relevant Royal College to keep abreast of the changing situation.
    The MRCP(UK) Part 1 exam consists of two papers in an MCQ format containing 100 questions each. The composition of the different subjects tested in this exam is as follows; the number refers to the number of questions in both papers that will come from that subject.
  • Cardiology 15
  • Clinical hematology and oncology 15
  • Clinical pharmacology, therapeutics and toxicology 20
  • Clinical Sciences 25
  • Dermatology 8
  • Endocrinology 15
  • Gastroenterology 15
  • Infectious diseases and tropical medicine and sexually transmitted diseases 15
  • Nephrology 15
  • Neurology 15
  • Ophthalmology 4
  • Psychiatry 8
  • Respiratory medicine 15
  • Rheumatology 15
Clinical sciences comprise:
  • Cell, molecular and membrane biology 2
  • Clinical anatomy 3
  • Clinical biochemistry and metabolism 4
  • Clinical physiology 4
  • Genetics 3
  • Immunology 4
  • Statistics, epidemiology and evidence-based medicine 5
After passing the Part I exam (the result is mailed 4 weeks after the exam). The candidate is eligible to sit for the MRCP(UK) Part 2 exam. The Part 2 exam can be given 6 months after the Part I exam if the candidate feels he is ready.
The MRCP(UK) Part 2 exam also consists of 2 MCQ papers of 100 questions each. The composition of the exam is as follows:
  • Cardiology 20
  • Dermatology 8
  • Endocrinology and metabolic medicine 20
  • Gastroenterology 20
  • Hematology/ Immunology 10
  • Infectious diseases and GUM 18
  • Neurology/ Ophthalmology/ Psychiatry 22
  • Oncology and palliative medicine 10
  • Renal medicine 20
  • Respiratory medicine 20
  • Rheumatology 12
  • Therapeutics and toxicology 20
If the candidate fails the Part 2 exam, he is free to try again. The only restriction to the number of attempts he can make is that he must pass this exam within 7 years of passing the Part I exam.
The pass result of the Part 2 exam is valid for only two and a half years. The candidate must sit for the 3rd and last part of the membership exam before these two and a half years expire. He is eligible to sit for the third part of the exam 6 months after passing his Part 2. Therefore, the window of time available to him to pass the third part of the exam is 2 years. This 2 year period is called the Period of Eligibility and begins 6 months after the part 2 is passed. To illustrate: if a candidate passed his Part 2 in April 2005, then his period of eligibility for the third part will start from October 2005 and last till October 2007. If he has not taken the last part within the Period of Eligibility, he will be compelled to retake the Part 2 exam.
The last part of the membership exam is called PACES, the Practical Assessment of Clinical Examination Skills. To quote from the 2004 Regulations and Information to Candidates Manual:
“The MRCP(UK) Part 2 Clinical Examination (PACES) is composed of five stations (three ‘clinical’ and two ‘talking’), each assessed by two independent examiners. Candidates will start at any one of the five stations and then move round the carousel of stations at 20-minute intervals until the cycle has been completed. The stations are:
Station 1
  • Respiratory System Examination (10 minutes)
  • Abdominal System Examination(10 minutes)
Station 2
  • History Taking Skills (20 minutes)
Station 3
  • Cardiovascular System Examination (10 minutes)
  • Central Nervous System Examination (10 minutes)
Station 4
  • Communication Skills and Ethics (20 minutes)
Station 5
  • Skin / Locomotor / Endocrine / Eye Examination (20 minutes)
The MRCP(UK) Part 2 Clinical Examination (PACES) lasts a total of 120 minutes (including four 5-minute breaks between stations).”
If the candidate passes, he will be awarded the MRCP(UK) diploma.
It should be mentioned here that the MRC diploma, particularly the MRCP(UK) diploma has become internationalized. Training in the UK is not an essential prerequisite to taking any of the 3 parts of the exam. There are MRC exam centers established in 14 countries around the world (Saudi Arabia, Oman, Singapore, Kuwait, and Sri Lanka, to name a few). Pakistan has no such centers, and if Pakistani doctors are training and studying for the MRCP in Pakistan, they must travel to the UK to give them (they cannot go to a non-UK center – those centers are established only for those doctors training there).

There are thousands of MRCs across the world who only go to the UK to take the exam and after passing, return to work in their home countries or seek jobs elsewhere. Obtaining the MRCP(UK) demonstrates a competitive level of competence and can help to further the careers of overseas doctors in their own home countries as well as creating opportunities for them to find jobs in other countries. Many MRCP(UK) doctors, for example, use this qualification to seek jobs in the Gulf states, where this degree is highly valued.

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