Preparing for the MRCP PACES can be a daunting task, but with the right strategy and mindset, success is within reach. We are proud to introduce our expert faculty, Dr. Joseph Barker, MRCP, and Dr. Nabil Ilyas, MRCP, who bring extensive experience and a passion for teaching to our program. Having both passed PACES, they have compiled their top tips to help you excel. 1. Understand the Exam Format The MRCP PACES exam consists of five stations, each designed to test different clinical skills. Familiarise yourself with the structure and timing of each station to manage your time effectively during the exam. Each station is 20 minutes with 5-minute intervals in between. The stations include: Station 1: Respiratory and Communication (10 minute, 10 minute)  Station 2: Consultation (15 minutes with 5 minute QA with examiner) Station 3: Cardiovascular and Neurological System Examination (10 minute, 10 minute) Station 4: Abdominal and Communication (10 minute, 10 minute) Station 5: Consultation (15 minutes with 5 minute QA with examiner) 2. Practice Clinical Examinations Thoroughly Practice as you’re examined.  Regularly practice clinical examinations on colleagues, friends, patients, mum & dad or even a pillow. Pay special attention to performing systematic examinations and articulating your findings clearly. This will help you build muscle memory and fluency in your exam technique. Make sure to practice in front of people who make you nervous, that way you get used to performing under pressure. 3. Develop a Structured Approach Create a consistent and structured approach for each clinical examination. This ensures that you cover all necessary aspects and don't miss key points under pressure. WIPE – Wash your hands, Introduce yourself, Permission, Expose … then inspection, palpation, percussion, and auscultation – look how simple the examination stations are! Same for the history – presenting complaint, patient concern*, history of presenting complaint … past medical history… you know the rest. *Bring up the patient's concerns early so you can shape the consultation around them as people. 4. Refine Your Communication Skills Effective communication is vital for ALL stations especially consultation and communication stations. Practice explaining medical conditions, treatment options, managing complaints and delivering bad news with empathy and clarity. Seek feedback from peers or mentors to improve your communication style. 5. Master the Art of Differential Diagnosis Develop a strong foundation in formulating differential diagnoses. There is no substitute for being out on the wards and this really is where the examiner can get the measure of a candidate. For each clinical scenario you encounter, practice thinking through possible diagnoses and justifying your reasoning in a STRUCTURED manner- there is a theme here. Practice out loud, we promise it will help. 6. How to investigate and manage patients You will have passed MRCP Part 1 and 2. You have the knowledge but PACES tests decision making; you need to know emergency cases thoroughly and have a logical and STRUCTURED approach to care. # Investigations start with bedside investigations, then bloods, then imaging, then special tests. For management patient care is ALWAYS “dictated by degree of severity and patient choice”, whilst management options more often than not “include conservative, medical and surgical options”  - these stock phrases buy you time to think of what goes after. Use them. 7. Simulate Exam Conditions Recreate exam conditions by timing your practice sessions and simulating the exam environment. Nominate an examiner and don’t break character until time is up, however excruciating the line of questioning. This will help you get accustomed to the time constraints and pressure of the actual exam. Consider joining a study group or attending mock exam sessions for added realism. IMG Connect Medicine Facebook group can help you find study partners. 8. Focus on Common* Conditions (*common = common for PACES) While preparing, prioritise common and high-yield conditions that are frequently tested in PACES. Things that are stable in outpatient but have excellent signs, like dialysis, transplant and congenital heart disease. Ensure you can confidently assess, diagnose, and manage conditions such as COPD, heart failure, stroke, and diabetes. Don’t forget that if a patient doesn’t show up the examiners will go and fish someone from the wards. Keep an eye out for cannulas, wrist bands and drains which can be a clue as to their inpatient status. 9. Seek Feedback and Reflect Ask anyone that will watch you to give you feedback. Your final exam technique will be the sum of the best titbits from every one of these people, whether they are supervisors, mentors, peers or family. Reflect on your performance, identify areas for improvement, and adjust your preparation strategy accordingly. Continuous feedback and self-reflection are key to ongoing improvement. 10. Balance Medicine is a marathon, not a sprint. The PACES process, including the months of build-up, is mentally and physically demanding, requiring you to stay focused on your goal for a long time. We all thought PACES was impossible at some point… and now we are teaching it. You will get there but make sure to maintain good health by getting adequate rest, exercise, nutrition and to have fun in the build up to reduce stress and improve stamina. 11. Clinical consultation (CC) station: Answering patient concerns carries more marks than one can imagine. It is the make or break of the CC station. PLEASE DO NOT wait for the “bell at 2 mins remaining” but start to address patient concerns maybe with 5 mins left on the clock as the patient/surrogate always have follow-up concerns.  Many candidates feel that they’ve got the “case” and they feel confident about the station. But they don’t realize that this cardinal mistake has happened leading them to score less than they would have liked.  12.  Examination Station Practice, Practice, Practice on presenting your examination findings in under 2 minutes in an orderly fashion. Everyone knows how to examine an abdomen, everyone knows ascites or a hepatomegaly or what ballot-able kidneys feel like but only a few know ‘how to put it all together’ and present it in a very systematic and neat manner leading to an accurate differential. Conclusion  Passing the MRCP PACES requires a combination of clinical knowledge, practical skills, effective communication and self-belief. By following these ten tips, you can enhance your preparation and boost your confidence for the exam. Remember, consistent practice, a structured approach and a positive mindset are your best allies in achieving success.   IMG Jobs  Search and find live NHS doctor jobs in the UK 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 Don’t hesitate to get in touch using the buttons above (and below) to discuss doctor job options in the NHS, including discussions regarding a typical doctor's salary in the UK and the most suitable hospital locations for you. For regular news and updates, follow IMG Connect on social media using the links below:                  

Exam places for MRCP PACES have been hard to secure in some countries. This increase in demand has continued through to 2023, so what can you do to maximise your chances of securing an examination place?  The Royal College of Physicians has 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? 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 Connect specialist. Take a look at our IMG library for more information regarding postgraduate exams & PACES IMG Jobs  Search and find live NHS doctor jobs in the UK 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 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. Follow us on social media for news and updates on GMC registration, the Royal College and NHS through the links below:             

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 Specialise in gastroenterology, respiratory, neurology, dermatology, geriatrics or any other areas within specialist medicine? Search and find live specialist medicine NHS doctor jobs in the UK. General & Acute 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. Follow us on social media for news and updates on GMC registration, the Royal College and NHS through the links below:             

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 preparation with free resources from the Royal College of Physicians. Using these will give you strong foundations to further supplement with any further studies or courses which you may decide 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  Search and find live NHS doctor jobs in the UK 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 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. Follow us on social media for news and updates on GMC registration, the Royal College and NHS through the links below: