Sunday, July 22, 2007

MRCP PACES Respiratory Station

I spoke to a candidate who failed the MRCP PACES. We discussed the case he had at the respiratory station.
He had a case of fibrosing alveolitis (interstitial lung disease). He said he easily made the diagnosis and knew everything about fibrosing alveolitis and was waiting for the examiners to ask him about fibrosing alveolitis so he could display his knowledge.
Unfortunately for him this was the MRCP PACES and what was being assessed was demonstration of practical examination and evaluation skills not, encyclopaedic knowledge of theory.
He was asked how he would demonstrate clubbing (see ACES for PACES pages 107,126) and he was then asked about the causes of clubbing (see ACES for PACES pages 126,254)
He was also asked about cyanosis and the types of cyanosis (see ACES for PACES page 116)
He made crucial mistakes in these basics and did not satisfy the examiners.
This is quite a common error. Many candidates prepare for PACES by studying all the details of likely cases rather than going through the basics. The examiners are looking to see if the candidate demonstrates ability to examine a patient correctly and then interpret the signs obtained.
Theory knowledge has already been assessed in parts 1 and 2 and will not be assessed here.