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Changes to the MRCP PACES exam - 2020
MRCP (UK) have now put in place agreed changes to the PACES exam, effective from 2020. Thankfully for those preparing to take the exams in 2020 diets, the changes are not drastic. The exam board have developed the current format, making some stations more realistic.
The MRCP PACES exam will test the same clinical skills, and there will remain five stations throughout the exam. The change comes through some tweaks to the stations themselves.
The changes are designed to make the exam better reflect the experience that patients expect from their doctor.
From the current format, the following stations are being removed and replaced:
Station 2 - history-taking
Station 4 - 20 minute single communication and ethics encounter
Station 5 - brief clinical consultations
The above will be replaced by:
Communication Encounters
Two 10-minute communication encounters assessing you on your communication skills. These encounters will no longer include a question and answer section with the examiners, the encounter will be judged on observation alone.
Clinical Consultations
Two 20-minute clinical consultations will assess candidates across all seven skills. You will have 15 minutes to take a structured history, examine the patient, explain the likely diagnosis/management and then address any questions or concerns raised. There will then be a five-minute question and answer section with the examiners.
The new carousel will amend the sequencing of the encounters. Physical examination encounters will be aligned with communication encounters. This will ensure that examiners at each station contribute more judgements in each of the skills for each candidate improving reliability.
MRCP(UK) have created a set of useful videos to help explain the changes further: click here.
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MRCP PACES - What if I can't secure an exam place?
Exam places for MRCP PACES have been hard to secure in some countries. We expect that there will be similar demand in 2020 & 2021, so what can you do to maximise your chances of securing an examination place?
We have discussed this with Royal College of Physicians, who advised that they are working to grow capacity internationally. However, this will not have an immediate impact on the number of spots available across the world.
With so many overseas doctors missing out on a spot, we have put together some of the main discussion points to help you to broaden your chances of sitting the exam as soon as possible.
All applications submitted during the application period will be treated equally, with spaces being allocated using a random lottery model. Some spaces are reserved for local trainees and some priority can be given for applicants near the end of their eligibility periods.
So, to maximise your chance of success, we suggest that not only do you apply to your closest PACES exam centre, but also to 3 more centres that you are able to travel to.
Apply to more centres
Why should I apply for more centres? The maths is easy, more applications equals more chance of securing a place. They way that it works is that if you are not successful with your 1st preference (most local centre), then you will be considered for a space in your 2nd choice centre, and so on until you secure a spot.
Of course, this means that you must be willing to travel to sit the exam. This can be costly, especially if you have to travel to a different country, flights and hotels are not cheap! As such, we suggest taking some time to carefully choose the locations that will not only have the possibility of a spare place, but where your costs will be kept to a minimum.
Candidates will be notified on the outcome of their application within 2 weeks from the closing date, giving you time to plan your travel if necessary.
Whilst this advice does not guarantee a place to sit the exam, it will increase your chances.
If you are not sure what to do, or have any other questions regarding the PACES exam, get in touch with an IMG Consultant.
Take a look at our IMG library for more information regarding postgraduate exams & PACES
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Preparing for PACES - where do I start?
As an overseas doctor where should you start with your PACES exam preparation?
With lots of resources available online, we discussed with successful candidates for them the best place to start looking for exam materials. Whilst there are lots of fantastic courses available for IMGs to help pass their PACES exam first time, most IMGs recommended starting their preperation with free resources from the Royal College of Physicians. Using these will give you strong foundations to further suppliment with any further studies or courses which you may decdie to invest in.
We have provided the Royal College's official resources below:
Curriculum
PACES station 4 examiner guidance examples
PACES sample scenarios
Videos - what to expect on the day
PACES candidate videos
Candidate guidenotes
PACES marksheets
General Exam Tips & Preparation
Passed? What next?
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.
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.
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 - 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 guidenotes:
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.
PACES Marksheets:
To help you understand how PACES is marked here are some examples of full marksheets.
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.
General Exam Tips & Preparation:
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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Read more useful articles on finding an NHS trust doctor job, pay scales & doctor’s salary in the UK, relocation and much more!
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Don’t hesitate to get in touch using the buttons above (and below) to discuss doctor job options in the NHS, including discussions regarding CESR, a typical doctor salary in the UK and the most suitable NHS jobs & hospital locations for you.

MRCP(UK) PACES - a guide for overseas medicine doctors
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 Judgement – 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.
Overseas centres, available spaces and fees are listed below:
Center
Spaces available
Fees
Center
Spaces available
Fees
Brunei
45
£1202
Malta
45
£1202
Egypt
90
£1202
Myanmar (Mandalay)
45
£1202
Hong Kong
75
HK$14,945
Myanmar (Yangon UM1)
75
£1202
India (Bengaluru)
45
£1202
Myanmar (Yangon UM2)
45
£1202
India (Chennai)
75
£1202
Oman
75
£1202
India (Hyderabad)
45
£1202
Qatar
45
£1202
India (Kochi)
60
£1202
Singapore
75
£1297
India (Kolkata)
45
£1202
Sri Lanka (Colombo)
45
£1202
India (New Delhi)
45
£1202
Sudan
45
£1202
Kuwait
60
£1202
United Arab Emirates (Al Ain)
45
£1202
Malaysia (Kuala Lumpur)
120
£1202
United Arab Emirates (Dubai inc. Sharjah)
60
£1202
Malaysia (Penang)
45
£1202
UK exam centres
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 guidenotes: 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
Specialise in gastroenterology, respiratory, neurology, dermatology, geriatrics or any other areas within speciaist meidcine? Search and find live specialist medicine NHS doctor jobs in the UK.
General & Acue medicine? Search for live vacancies here.
IMG Resources
Read more useful articles on finding an NHS trust doctor job, pay scales & doctor’s salary in the UK, relocation and much more!
Get in Touch
Get in touch using the buttons above (and below) to discuss specialist medicine job opportunities in the NHS, including discussions regarding a typical doctor salary in the UK and the most suitable hospital locations for you.