MRCGP Exam - How to prepare for the MRCGP exam

Taking the MRCGP exam is a gratifying experience, says Dr Bill Irish.

The MRCGP exam has been around in one way, shape or form since 1965. It has evolved from a minority sport into an exam taken annually by thousands of new GPs across the UK and internationally.

Why bother?

The exam costs £1,240. It is also not particularly easy, despite a reputation to the contrary among our hospital colleagues. You can anticipate evenings stuck in front of books, and if you do choose to attend one of the numerous exam preparation courses, this will leave you even further out of pocket.

But people still attempted, firstly because virtually everyone who takes the exam finds the experience useful and stimulating.

The exam tests understanding of areas such as clinical medicine, consulting or decision-making in a GP setting, and is a good way of bringing yourself up to scratch in all of these areas.

Second, it remains the only recognised 'badge of excellence' for UK general practice. I for one would not employ a young GP who did not have MRCGP written after his name.

Finally, it is about to become compulsory, in the same way that exams such as MRCP or MRCOG are already among the hospital specialities. It probably isn't wise to be one of the last few GPs entering UK practice without these crucial letters.

Current exam

It its current form, the MRCGP consists of four independent modules.

You need to pass them all to gain the diploma. However, you can take them in any order you like and have three attempts at each.

The consulting skills assessment takes the form of a single video tape containing seven consultations that candidates feel show them at their best.

A pass in this module of the MRCGP exempts you from the video component of summative assessment. A few doctors, for example those who consult in languages other than English, or locums who cannot practically produce a suitable tape, can take a 'simulated surgery' utilising actors as simulated patients.

Who can take the exam?

You need to be, or training to be, an independent GP. Most doctors who attempt the MRCGP are in their second six months as a GP registrar. However, you can also take the exam as an established GP and a small number do each year. You do need to be certified as competent in basic resuscitation skills (including defibrillation) and there are details about this on the RCGP website.

How can I prepare?

It is probably most straightforward to take the exam at the end of your GP registrar year. The contents of most half- and full-day-release schemes, your mentoring by your trainer, and the peer support from others tackling the MRCGP will be invaluable.

There are some excellent preparation guides written to help with each module, and on most vocational training schemes there is a flourishing market in second-hand copies.

Available courses

Most candidates elect to attend an MRCGP preparation course. While some of these do cover content, most focus on examination technique, particularly in the oral and video components.

Local RCGP faculties often put on excellent courses as a way of introducing future members to the college at minimum cost.

However, beware of more commercial courses whose prime focus is to make money from you. They are often disappointing, and what with exam fees and fees for certification and the PMETB, you are already spending a considerable sum of money.

The future of the exam

It is now public knowledge that the current versions of summative assessment and the MRCGP will be phased out in the next three years. There will be special arrangements made for those embroiled in the existing system to have their allocated number of goes at each module. The new MRCGP will be compulsory for all new UK GPs and will consist of three, rather than the current four modules.

These are to be a test of clinical knowledge via a multiple-choice question paper; a test of clinical skills using an oral method; and a workplace-based assessment of performance in real life, completed by local GP educationalists.

- Dr Irish is an MRCGP examiner and a GP in Bath

LEARNING POINTS

What you need to know about the MRCGP exam

1. The MRCGP exam tests deep understanding of areas such as clinical medicine, consulting and decision-making in a GP setting.

2. It is recommended that new GPs entering UK practice take the exam.

3. In its current form, the exam consists of four independent modules. You need to pass all four to gain the diploma.

4. Most doctors who attempt the MRCGP are in their second six months as a GP registrar. It is straightforward to take the exam at the end of your GP registrar year.

5. The current versions of the summative assessment and the MRCGP will be phased out in the next three years.

6. The new MRCGP will be compulsory for all new UK GPs and will consist of three, rather than the current four modules.

MRCGP exam

The current four MRCGP exam components:

- A three-hour written paper, covering problem solving in general practice, evidence- based medicine and critical reading.

- A three-hour multiple-choice question paper testing key knowledge in clinical medicine, evidence-based medicine and administration.

- Two 20-minute orals testing your ability to make decisions in areas relevant to primary care.

- Consulting skills assessment.

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