MRCP (UK) PACES - a guide for overseas medicine doctors
- January 27, 2023
PACES is the final exam in the MRCP UK examination series.
Attaining full MRCP UK will facilitate registration with the GMC for overseas doctors, allowing you to secure a job in one of the many medical specialties in the NHS, depending on your experience and specialisation. In this article we will consider the following:
- What is PACES?
- Am I eligible to sit MRCP PACES?
- What is the content and format?
- How is PACES marked?
- As an overseas candidate where can I take the exam?
- When should I take PACES?
- How can I prepare for the exam?
- Passed? What next?
What is PACES?
The Practical Assessment of Clinical Examination Skills (PACES) is designed to test the clinical knowledge and skills of trainee doctors who hope to enter higher specialist training (ST3). The exam sets rigorous standards to ensures trainees are competent across a wide range of skills and are ready to provide high-quality care to patients.
Am I eligible to sit MRCP PACES?
You must have passed the Part 1 written examination within the last seven years before taking PACES. The Royal College strongly advises trainees to apply after competing two years practical experience and Part 2 of the examination.
What is the content and format?
PACES is based on a format that is similar to OSCEs, a practical assessment in a clinical setting. There are five clinical stations with either patients with a given condition, or trained stand-ins (surrogates).
The exam is sat over a half-day and assesses seven core skills over five stations. IMGs can expect eight patient encounters assessed independently by a total of ten examiners (two at each station).
The seven core skills:
- Physical examination – demonstrate correct, thorough, systematic, appropriate and professional technique of physical examination.
- Identify physical signs – identifying physical signs correctly.
- Clinical communication – elicit a clinical history relevant to the patient’s complaints, in a systematic, thorough and professional manner.
- Differential Diagnosis – create a sensible, clinically assessed differential diagnosis for a patient.
- Clinical Judgment – select an appropriate management plan for a patient or clinical situation. Select appropriate investigations or treatments for a patient that the candidate has clinically assessed.
- Managing patients concerns – seeks, detect, acknowledge and address patients or relatives concerns, confirming their understanding and demonstrate empathy.
- Maintain patient welfare – treat a patient or relative respectfully and sensitively in a manner that ensures their comfort, safety and dignity.
The PACES Carousel:
The Carousel consists of five stations, each assessed by two independent examiners. Candidates start at any of the five stations, moving round the carousel at 20-minute intervals, until completed. A five-minute period between each station is given.
Candidates are marked on clinical skills at each encounter in the examination. An encounter is when a candidate has an interaction with a patient or a surrogate. Stations 2 and 4 involve one encounter, whereas stations 1, 3 and 5 have two encounters.
How is PACES marked?
PACES is marked on seven skills, A-G, these are:
Skill A: Physical examination (stations 1, 3 and 5)
Skill B: Identifying physical signs (stations 1, 3 and 5)
Skill C: Clinical communication (stations 2, 4 and 5)
Skill D: Differential diagnosis (stations 1, 2, 3 and 5)
Skill E: Clinical judgement (all stations)
Skill F: Managing patients’ concerns (all stations)
Skill G: Maintaining patient welfare (all stations)
Skill B, identifying physical signs, is often considered the most challenging skill to pass.
As an overseas candidate, where and when can I take the exam?
It is a little more complicated than Part 1 or 2 exams and exam slots are often in short supply. Whilst the Royal College is working hard to increase the number of spaces, it is not always possible to offer a place to all applicants.
Priority is given to those candidates who are near the end of their stage 2 eligibility period. A full list of examination dates can be found here, please note these are subject to change.
Examination centres are subject to change, so for up-to-date information, please see the Royal College website here.
The examination is run at clinical centres across the UK (England, Scotland, Wales and Northern Ireland); these vary from diet to diet.
When should I take PACES?
Royal College performance data provides some food for thought when considering when to apply for PACES. The data suggests:
- Wait at least 36 months after graduation before applying.
- Those taking the exam before this period were less likely to pass.
- 24-36 months post-graduation – 50% pass rate
- 36-48 months after graduation – 77%
- Candidates that had already passed part 1 & 2 written examinations were significantly more likely to pass PACES at first attempt.
How can I prepare for the exam?
With lots of resources available online, we have discussed with IMGs the best place to start looking for materials relating to the exams. Most IMGs recommended starting with the Royal College, who have created useful resources to help you to prepare for the exams. See below:
Curriculum: Applicants are tested on a range of common and important disorders in General Medicine as set out in the Joint Royal Colleges Specialty Training Curriculum for Core Medical Training.
We recommend getting to know the curriculum as early as possible, using it as a road map for your study plan.
It is recommended that to give yourself the best chance, you gain clinical experience involving care of emergency patients, adults and children.We advise you to regularly invite senior colleagues to observe and provide feedback on your clinical assessments, so you will be comfortable with the PACES format and give you confidence in approaching and examining patients with examiners present.
PACES station 4 examiner guidance examples: This useful guide contains examples of the types of statements found in the examiner guidance section of station 4 scenarios.
This will help you to understand what the examiner is looking for.
PACES sample scenarios: These will provide you with the most accurate and relevant scenarios to prepare you for the real thing. Sample scenarios cover Station 2, 4 & 5 (‘history taking’, ‘communication skills and ethics’ and ‘clinical consultations’ respectively.
Most of these have been previously used in a recent exam, but please note that during the exam you will only receive the section marked ‘information for the candidate’.
Videos on what to expect on the day: These helpful videos will give you a true reflection of what to expect on the day of the exam, easing some of the pressure and ensuring you can focus on the task at hand.
PACES candidate video: Whilst there are lots of useful videos online that are easy to find, the PACES candidate video contains important information about the exam, and practical examples of how the exam will run.
Candidate guide notes: these guidenotes created by the Royal College help IMGs to understand what to expect on the day, from your arrival to the completion of the test.
It can also be useful to understand how IMGs have failed the exam in the past, as this will give you the best chance to pass first time. The ‘how I failed PACES’ guide provides tips to help you to identify where you might be going wrong, along with practical advice to help you to improve.
For a useful overview of how to prepare for exams, including advice on study groups, online community support, best use of online resources & Royal College materials and courses - take a look at our blogs on exam tips and preparation.
Passed? What next?
First of all, congratulations! After you have passed all parts of MRCP (UK) you can apply for a full registration with a license to practice. Once the GMC have approved your application, you can work as a doctor in the UK.
IMG Jobs
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Relevant Jobs
An excellent opportunity to join the dynamic team at an esteemed organization recognized for its excellence by the CQC. This is an opportune moment to become part of the Acute Medicine and Medicine Specialties Teams. With a strong history of achievements, they are committed to delivering exceptional patient-centered care. They seek a passionate and driven Acute and General Physicians to contribute to their mission of providing top-tier medical care across various clinical settings. This is a high performing and supportive department for overseas doctors new to the NHS, or UK-based doctors looking to further careers in the UK.
This is a great opportunity for overseas Consultants who want to establish themselves in the NHS, and grow their consultant career. The post is suitable for candidates holding specialisation in the EEA, or for experienced IMGs looking to complete CESR.
What is the NHS Foundation Trust like?
The NHS Foundation Trust stands as one of the nation\'s largest integrated healthcare organizations, delivering both hospital and community services to a populace exceeding 650,000 individuals. Renowned for their ambition and innovation, they boast a skilled workforce comprising over 7,000 dedicated colleagues. Operating across two acute sites for hospital services and encompassing centers and community hospitals in six towns for planned care, they extend their services even to patients\' residences.
Recognized as a high-performing entity with a history of accomplishments, the Trust has functioned as an integrated acute and community services provider since 2011 and achieved foundation trust status in 2007. Guided by their strategic framework \"Our Patients Matter,\" they articulate their short- and long-term objectives and delineate the path to their realization. This framework underscores their commitment to providing the safest, most compassionate, and seamlessly coordinated care to the communities they serve.
Within this NHS Foundation Trust, medical professionals are presented with a plethora of career prospects and exposure to diverse care settings rarely encountered elsewhere. Additionally, they have the opportunity to reside and practice in some of the most culturally rich and picturesque locations across the country!
What is the Department & Team like?
Within the Trust, there are 5 Care Groups: Urgent & Emergency Care, Integrated Medical Specialties, Surgery, Family Health, and Clinical Specialist Services. The Acute Care Team is housed under the Urgent & Emergency Care division. The Acute & General Medicine Department prides itself on delivering comprehensive and compassionate care to patients across a wide spectrum of medical conditions. Staffed by a dedicated team of consultants and junior doctors, the department ensures round-the-clock coverage to meet the needs of their patients. Their department handles a diverse range of cases, including but not limited to respiratory illnesses, cardiovascular conditions, gastrointestinal disorders, and infectious diseases. With access to state-of-the-art diagnostic and treatment facilities, including advanced imaging technologies and specialist clinics, they are equipped to provide timely and effective care to their patients.
The Acute & General Medicine Department boasts modern and well-equipped facilities, designed to optimize patient care and comfort. They have a 30-bedded Acute Medical Assessment Unit. On average, their department handles a significant number of acute and general medicine cases each year, reflecting the trust and confidence placed in their services by the community they serve. They prioritize patient safety, quality of care, and efficient service delivery, ensuring that each patient receives personalized attention and tailored treatment plans to facilitate their recovery and well-being.
The unit is adequately staffed and the working shifts are designed to ensure more doctors are present during the busy period of the day i.e. late evenings. They address the busy winter months by arranging extra locum cover during this busy period. In addition to the acute medicine registrar(s), there is a middle grade doctor, 1 IMT doctor and 4 FY1 doctors with staggered shifts throughout the day. In addition, there will be an on call registrar and 2 on call IMT doctors with staggered shifts. The night team comprises of one registrar, two FY2/IMT and one FY1 supported by an outreach nurse on most nights.
What is life like in the area?
The North East of the UK offers a diverse mix of rural and urban settings, providing doctors with a range of living options. Residents can explore stunning coastal areas like Northumberland\'s beaches or venture inland to scenic national parks such as the North Pennines. The region is home to respected schools and universities, including Newcastle University. Transportation links are robust, with efficient road and rail networks connecting residents to major cities like Newcastle, Durham, and Sunderland, as well as international airports. Housing options range from quaint cottages in picturesque villages to modern apartments in vibrant city centers, catering to various lifestyles.
Career Development & Opportunities Available
ARE YOU ELIGIBLE FOR THIS ROLE?
EEA Candidates:
- Experience of working in Acute & General Medicine
Non-EEA Candidates:
- MRCP
- Experience of working in Acute & General Medicine
UK based applicants
- Experience of working in Acute & General Medicine
An excellent opportunity to join the dynamic team at an esteemed organization recognized for its excellence by the CQC. This is an opportune moment to become part of the Acute Medicine and Medicine Specialties Teams. With a strong history of achievements, they are committed to delivering exceptional patient-centered care. They are seeking dynamic and motivated Consultant Gastroenterologists to become part of their welcoming and enthusiastic gastroenterology team. This presents a chance to join a dedicated gastroenterology team committed to delivering the highest quality comprehensive service. The service is aiming to broaden its focus on sub-specialty interests such as ERCP/EUS, nutrition, IBD, and Liver disease.
This is a great opportunity for overseas Consultants who want to establish themselves in the NHS, and grow their consultant career. The post is suitable for candidates holding specialisation in the EEA, or for experienced IMGs looking to complete CESR.
What is the NHS Foundation Trust like?
The NHS Foundation Trust stands as one of the nation\'s largest integrated healthcare organizations, delivering both hospital and community services to a populace exceeding 650,000 individuals. Renowned for their ambition and innovation, they boast a skilled workforce comprising over 7,000 dedicated colleagues. Operating across two acute sites for hospital services and encompassing centers and community hospitals in six towns for planned care, they extend their services even to patients\' residences. Recognized as a high-performing entity with a history of accomplishments, the Trust has functioned as an integrated acute and community services provider since 2011 and achieved foundation trust status in 2007. Guided by their strategic framework \"Our Patients Matter,\" they articulate their short- and long-term objectives and delineate the path to their realization. This framework underscores their commitment to providing the safest, most compassionate, and seamlessly coordinated care to the communities they serve. Within this NHS Foundation Trust, medical professionals are presented with a plethora of career prospects and exposure to diverse care settings rarely encountered elsewhere. Additionally, they have the opportunity to reside and practice in some of the most culturally rich and picturesque locations across the country!
What is the Department & Team like?
The Gastroenterology department is renowned for its excellence in patient care and comprehensive services. Led by a team of experienced and dedicated consultants, alongside skilled junior doctors, the department provides a wide range of diagnostic and therapeutic interventions for patients with gastrointestinal disorders. This encompasses conditions such as inflammatory bowel disease (IBD), liver disease, gastrointestinal cancers, functional gastrointestinal disorders, and gastrointestinal bleeding. Facilities within the department include state-of-the-art endoscopy suites equipped for various procedures including gastroscopy, colonoscopy, and advanced procedures like endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP). Additionally, the department offers specialized clinics for conditions such as inflammatory bowel disease, hepatology, and nutrition. On average, the department handles a significant number of gastroenterology cases each year, providing timely and effective care to patients across the region. With a commitment to excellence and innovation, the gastroenterology team continues to deliver high-quality care to patients with gastrointestinal disorders.
What is life like in the area?
The North East of the UK offers a diverse mix of rural and urban settings, providing doctors with a range of living options. Residents can explore stunning coastal areas like Northumberland\'s beaches or venture inland to scenic national parks such as the North Pennines. The region is home to respected schools and universities, including Newcastle University. Transportation links are robust, with efficient road and rail networks connecting residents to major cities like Newcastle, Durham, and Sunderland, as well as international airports. Housing options range from quaint cottages in picturesque villages to modern apartments in vibrant city centers, catering to various lifestyles.
Career Development & Opportunities Available
ARE YOU ELIGIBLE FOR THIS ROLE?
EEA Candidates:
- Experience of working in Gastroenterology
Non-EEA Candidates:
- MRCP
- Experience of working in Gastroenterology
UK based applicants
- Experience of working in Gastroenterology
Seeking a dynamic and motivated Dermatologist to join a Dermatology service in an NHS Foundation Trust rated \"good\" overall by the CQC. The NHS Trust provides a supportive environment for Specialty Doctors in Dermatology, including CESR support for IMGs seeking to establish their careers in the UK. Ideal for EEA-specialized candidates or experienced overseas dermatologists aiming to complete CESR.
What is the NHS Foundation Trust like?
The NHS Foundation Trust operates as a district general hospital. It oversees the management of two hospitals. This NHS Foundation Trust offers an exceptional work environment characterized by numerous dedicated teams committed to delivering top-notch patient care. They have embraced significant changes to their operational approach to effectively address the evolving landscape of the NHS, earning a Good rating from the Care Quality Commission in June 2018.
At this NHS Foundation Trust, they are pioneering the digital health revolution. Since implementing a comprehensive Electronic Patient Record system in 2017, they have embarked on a journey to establish ourselves as the safest, most efficient, and patient-centered trust within the NHS. The Electronic Patient Record system is just one component of their ongoing initiative to cultivate a digital ecosystem within the trust, ultimately striving to become a completely paper-free organization. This modernization endeavor opens up exciting avenues for future research and development in the rapidly evolving field of medicine. By joining the team, you have the opportunity to contribute to this innovative domain dedicated to enhancing patient care through advancements in technology.
Dermatology Team & Department
The Dermatology service sees 16,500 appointments yearly for diagnosing and treating various skin conditions, including skin cancers, lesions, eczema, psoriasis, urticaria, and Vulval conditions. The Dermatology Department is offering outpatient clinics and a comprehensive array of treatments, including minor operations. Additionally, a limited number of clinics and treatments are available at the newly established outpatient facility located in one of their sites.
The Dermatology service currently has over 5000 2ww Outpatient attendances per annum for the diagnosis and treatment of potential skin cancer. Outpatient clinics are run from both sites with an inpatient in-reach service run across their two sites. Facilities within the dermatology department include modern outpatient clinics, diagnostic services, and treatment rooms, ensuring a comfortable and efficient environment for patients and staff alike. They also collaborate closely with other specialties within the trust to provide multidisciplinary care when required, ensuring holistic management of complex cases.
Life in Yorkshire & Humberside
Yorkshire & Humberside offers a diverse mix of rural and urban settings, providing a range of living environments for doctors. Residents can enjoy scenic landscapes, including the Yorkshire Dales and Yorkshire Moors, ideal for outdoor activities like hiking and cycling. The region boasts top-quality schools and universities, such as the University of Leeds and the University of Sheffield. Transportation links are excellent, with easy access to major cities like Leeds, Sheffield, and Manchester via road and rail networks. Housing options vary from quaint villages to bustling city centers, catering to different preferences and lifestyles.
Career Development and Opportunities Available
With an extremely active education/teaching programme supported by the consultant team, there is opportunity to work towards and complete CESR, RCPsych exams, get involved in active research and many aspects of CPD.
Participation in research and educational activities will be encouraged.
ARE YOU ELIGIBLE FOR THIS ROLE?
All candidates must be GMC registered to be suitable for consideration.
EEA Candidates:
- Experience of working in Dermatology
- Relevant primary medical qualification
Non-EEA Candidates:
- MRCP UK or PLAB
- SCE dermatology desirable
- Experience of working in Dermatology
UK based applicants:
- Experience of working in Dermatology
Want to be a part of a supportive and dynamic team as a Consultant in Gastroenterology?
Embrace this exciting chance to be part of a healthcare environment where your expertise will be valued and your contributions deeply appreciated. An excellent NHS Foundation Trust invites talented and dedicated medical professionals to seize an outstanding opportunity in Gastroenterology at one of their hospitals. As a renowned University teaching hospital, the trust places a strong emphasis on Medical and Dental Education, ensuring that all staff receive exceptional training and patients benefit from top-notch care.
Joining their innovative and dynamic Gastroenterology Department promises a rewarding career filled with diverse cases and comprehensive support from a team of skilled healthcare professionals. As a valued member of the thriving Gastroenterology team, you will have ample career development opportunities. Overseas doctors can work towards completing their CESR and explore sub-specialty areas of interest, further expanding their professional horizons. Moreover, there are exciting opportunities to engage in teaching and supervision of undergraduate medical students, fostering the next generation of medical professionals.
In the are where the Trust is situated, you will discover a vibrant community with a rich historical heritage and a welcoming atmosphere. The city\'s picturesque setting, surrounded by the breathtaking landscapes of the Lake District and the coastline, provides a serene backdrop for both work and leisure. The area boasts a renowned university, adding an intellectual and creative dimension to the city\'s spirit. The constant influx of students fosters a commitment to learning and research, ensuring you have access to cutting-edge medical advancements and resources to further enhance your expertise.
ARE YOU ELIGIBLE?
EEA candidates:
• Recognised European Medical Degree or Specialist Qualification in Gastroenterology
• Extensive experience in Gastroenterology
Non-EEA candidates:
• MRCP
• Extensive experience in Gastroenterology
UK-based candidates:
• Extensive experience in Gastroenterology
• Within 6-months of CESR or CCT in Gastroenterology
This is a great job for any experienced overseas Gastroenterologists working towards CESR and specialist registration in the UK.
An excellent opportunity for a dynamic & motivated Consultants in Elderly Care Medicine to join a friendly and enthusiastic team. The large and dynamic department is focused in providing the highest quality care possible for older patients. The position provides an opportunity to negotiate job plans to fit specialist interests. They have a new Medical School at the centre of their community, a focus on research, clinical leadership and making their trust a rewarding and friendly place to work, there’s never been a better time to join them.
This is a great opportunity for overseas Consultants who want to establish themselves in the NHS, and grow their career. The post is suitable for candidates holding specialisation in the EEA, or for experienced IMGs looking to complete CESR.
WHAT IS THE NHS FOUNDATION TRUST LIKE?
The NHS Foundation Trust is one of the largest hospital trusts in the country, serving a population of around 759,000 people. The trust operates several hospitals and healthcare facilities. They provide a comprehensive range of healthcare services, including specialist services in areas such as cancer care, cardiology, respiratory medicine, and neurology. The NHS Foundation Trust also works closely with local healthcare partners, such as primary care providers and community services, to ensure coordinated and integrated care for patients.
The NHS Foundation Trust has a strong interest in improving the health of the communities they serve through research and innovation. Their hospitals take part in many clinical research studies and recruit high numbers of patients into research trials. They are a teaching Trust, which play a vital role in the education and training of doctors, nurses and other healthcare professionals, working closely with local universities.
The NHS Foundation Trust\'s greatest asset is their hardworking, talented and dynamic workforce - they strive for excellence every day, providing quality care and support to those who use their service.
WHAT IS THE DEPARTMENT & TEAM LIKE?
The Acute Geriatric services are provided on all 3 main Trust sites. The department provides a multidisciplinary, multi-agency falls prevention service across acute sites. The service has been operating since 2002 and has grown considerably. The Geriatricians are responsible for providing emergency care of the older person from ED/ emergency floor through to discharge. The wards are supported by daily board rounds led by a Consultant Geriatrician and strong multidisciplinary team.
The sites operate an age-related take at admission, but are implementing frailty identification early in the emergency pathway to enable prompt CGA initiation, working closely with an established Integrated Discharge Team and their community partners. The frail patients with acute medical illnesses are admitted directly to a Frailty ward from A&E. The service provides a comprehensive osteoporosis service, and has a Dementia Team, comprising of a Matron and 2 Band 6 nurses supported by Clinicians.
The post holder is expected to communicate effectively with all other medical and service departments within the hospital, and with GPs and other hospitals, to ensure continuous care for each patient. The post holder is expected to undertake non-emergency work during premium time as required. The post holder will lead on Parkinson disease and movement disorders.
WHAT IS LIFE LIKE IN THE REGION?
Life in the area offers a mix of urban and rural environments, with a variety of attractions and amenities to enhance the quality of life for residents. The area is renowned for its stunning coastline, featuring picturesque beaches, cliffs and seaside towns, and a vibrant atmosphere during the summer months. The region has a rich historical and cultural heritage. The city also offers a wealth of history, with cobbled streets, medieval architecture, and a vibrant arts scene. The area boasts a diverse and picturesque countryside.
The area is home to several reputable educational institutions, and it has good transportation links. The area is served by rail connections, including the high-speed train service that connects Canterbury and Thanet to London. The place offers a range of recreational activities to cater to different interests. From visiting historical sites and museums to enjoying water sports, golfing, or exploring the countryside, there are numerous opportunities for leisure and relaxation.
WHAT OPPORTUNITIES ARE AVAILABLE TO YOU?
The NHS Foundation Trust is one of the most research-active acute Trusts in the region and they encourage all newly appointed Consultants to take on the role of Principal Investigator, with full training and support. The successful candidate will play their part in teaching the next generation of doctors, nurses and other clinical staff. The NHS Foundation Trust will ask you to help recruit junior staff and supervise their education, including their educational contracts, regular appraisal, study leave, annual leave and rotas – and make sure you keep up-to-date on educational development.
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ARE YOU ELIGIBLE FOR THIS ROLE?
EEA Candidates:
- Experience of working in Geriatric Medicine
- Board Certified Specialist in Geriatric Medicine
Non-EEA Candidates:
- Experience of working in Geriatric Medicine
- Full MRCP UK
- Eligibility for GMC registration
- OET or IELTS (candidates who have booked their test and have good levels of English will be considered)
UK based applicants
- Experience of working in Geriatric Medicine
- Within 6 - 12 months of completing CCT