I had discussions with several examiners for the MRCP PACES. I asked them how they would decide on passing or failing a candidate at the physical examination stations.
They all said the first thing they look at is how well the candidate examines the patient. If the candidate does not demonstrate correct technique or if they do not examine with ease then they would fail the candidate.
If the candidate passes this first hurdle the next step is whether they detect the physical signs present. With regard to physical signs they would not mind if a difficult sign was missed but they all said they would definitely fail the candidate if they “ made up physical signs”. That is if the candidate tells the examiner that the patient has a physical sign that is not there then, the examiners will definitely fail them. I asked several candidates how they prepare for the exam and they said they memorise the physical signs of the likely cases in the exam.
This technique of exam preparation is incorrect.
This is the reason why a lot of candidates fail the exam despite examining correctly and making the correct diagnosis. Memorising the physical signs and repeating this at the exam instead of telling the examiners the findings that are present in the case in question is why most candidates fail.
So in summary the main reasons for failing the MRCP PACES physical examination stations are:
1) Incorrect technique
2) Making up physical signs
