Hearing crackles: why all GPs should pass PACES
<p>As a GP registrar, the MRCGP Clinical Skills Assessment (CSA) exam is currently at the forefront of my mind. Vocational Training Scheme teaching focuses on how to pass, evenings are spent revising, and my bank account, now £1700 lighter, still makes me shudder. And yet, perhaps naively, it...
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| Format: | Journal article |
| Language: | English |
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Royal College of General Practitioners
2016
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| _version_ | 1797057578148036608 |
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| author | Brettell, R |
| author_facet | Brettell, R |
| author_sort | Brettell, R |
| collection | OXFORD |
| description | <p>As a GP registrar, the MRCGP Clinical Skills Assessment (CSA) exam is currently at the forefront of my mind. Vocational Training Scheme teaching focuses on how to pass, evenings are spent revising, and my bank account, now £1700 lighter, still makes me shudder. And yet, perhaps naively, it was still a shock to me to find out that at no point in the CSA exam am I expected to accurately detect real clinical signs. Of course, the CSA assesses many other important skills, including problem-solving skills, personcentred care, and attitudinal aspects.1 My argument is certainly not with the inclusion of these. However, given that ‘The validity of the CSA resides in its realistic simulation of reallife consultations’,2 it seems strange that it includes no real patients, and consequentlyno real physical signs, both somewhat important components, I would argue, of many real-life consultations.</p> <br/> <p>By contrast, the clinical component of Membership of the Royal College of Physicians (MRCP), the PACES exam (Practical Assessment of Clinical Examination Skills), 3 involves real patients with a given condition. Candidates undertake a respiratory, abdominal, cardiovascular, and neurological exam, as well as a history station, communication and ethics station, and two brief clinical consultations. In these, candidates are given 8 minutes with a patient to take a focused history, carry out a relevant examination, respond to the patient’s concerns, and explain a management plan.</p> <br/> <p>This PACES exam is robust, and considered a rite of passage for medical trainees, who often require multiple attempts to pass. To a GP trainee it often seems unattainably tough. When colleagues pass, we congratulate them, but we also breathe a sigh of relief that we don’t have to go through the same arduous process, and, in doing so, we perhaps elevate our colleagues above ourselves.</p> <br/> <p>I would argue that this is wrong on many levels. This veneration of MRCP gives the impression that our exit exams are ‘easier’, or that we couldn’t pass a more robust exam should we need to. As a GP trainee who decided to undertake my MRCP exam, I would argue this is far from the truth.</p> |
| first_indexed | 2024-03-06T19:38:27Z |
| format | Journal article |
| id | oxford-uuid:1fd5db56-1f2a-4afe-8dbb-670f820746f2 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T19:38:27Z |
| publishDate | 2016 |
| publisher | Royal College of General Practitioners |
| record_format | dspace |
| spelling | oxford-uuid:1fd5db56-1f2a-4afe-8dbb-670f820746f22022-03-26T11:24:11ZHearing crackles: why all GPs should pass PACESJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:1fd5db56-1f2a-4afe-8dbb-670f820746f2EnglishSymplectic Elements at OxfordRoyal College of General Practitioners2016Brettell, R<p>As a GP registrar, the MRCGP Clinical Skills Assessment (CSA) exam is currently at the forefront of my mind. Vocational Training Scheme teaching focuses on how to pass, evenings are spent revising, and my bank account, now £1700 lighter, still makes me shudder. And yet, perhaps naively, it was still a shock to me to find out that at no point in the CSA exam am I expected to accurately detect real clinical signs. Of course, the CSA assesses many other important skills, including problem-solving skills, personcentred care, and attitudinal aspects.1 My argument is certainly not with the inclusion of these. However, given that ‘The validity of the CSA resides in its realistic simulation of reallife consultations’,2 it seems strange that it includes no real patients, and consequentlyno real physical signs, both somewhat important components, I would argue, of many real-life consultations.</p> <br/> <p>By contrast, the clinical component of Membership of the Royal College of Physicians (MRCP), the PACES exam (Practical Assessment of Clinical Examination Skills), 3 involves real patients with a given condition. Candidates undertake a respiratory, abdominal, cardiovascular, and neurological exam, as well as a history station, communication and ethics station, and two brief clinical consultations. In these, candidates are given 8 minutes with a patient to take a focused history, carry out a relevant examination, respond to the patient’s concerns, and explain a management plan.</p> <br/> <p>This PACES exam is robust, and considered a rite of passage for medical trainees, who often require multiple attempts to pass. To a GP trainee it often seems unattainably tough. When colleagues pass, we congratulate them, but we also breathe a sigh of relief that we don’t have to go through the same arduous process, and, in doing so, we perhaps elevate our colleagues above ourselves.</p> <br/> <p>I would argue that this is wrong on many levels. This veneration of MRCP gives the impression that our exit exams are ‘easier’, or that we couldn’t pass a more robust exam should we need to. As a GP trainee who decided to undertake my MRCP exam, I would argue this is far from the truth.</p> |
| spellingShingle | Brettell, R Hearing crackles: why all GPs should pass PACES |
| title | Hearing crackles: why all GPs should pass PACES |
| title_full | Hearing crackles: why all GPs should pass PACES |
| title_fullStr | Hearing crackles: why all GPs should pass PACES |
| title_full_unstemmed | Hearing crackles: why all GPs should pass PACES |
| title_short | Hearing crackles: why all GPs should pass PACES |
| title_sort | hearing crackles why all gps should pass paces |
| work_keys_str_mv | AT brettellr hearingcrackleswhyallgpsshouldpasspaces |