How to pass your oral examination

The MRCGP oral exam is designed to test your decision making. By Dr Bob Mortimer

The MRCGP oral examination is designed to test your decision making and the professional values that underpin those decisions. Although the questions can clearly be wide ranging, they will cover three different areas: communication; professional values and personal and professional growth. These are further subdivided into four contexts: care of patients; working with colleagues; general practice’s role in society and personal responsibility.

Each candidate sits two oral examinations, with a different pair of examiners in each. Each oral lasts exactly 20 minutes, and will  comprise five questions, each lasting four minutes. The two pairs of examiners work together for the day and will select their questions to cover as many of the above areas as possible.

At the start of the oral, the examiners will introduce themselves and try to put you at ease. The examiners will alternate questions,  and the timing means that the pace of the oral will feel fast. Do not be put off by this — it is not rudeness or a reflection of the quality of your answer, it merely means the examiner’s four minutes is up and it is time to move on. Between the two orals, you will wait outside while the examiners finish their marking.

There are two issues key to preparation. First, hone your decision-making skills while consulting with your patients. Second, practice oral questions with your trainer and with your peers.

Whenever you make a decision you have various options and it is important that you start to identify them all and ensure that you can justify what you decide to do. Make sure you have considered the implications of the various options, not just for the patient in front of you but for yourself, your colleagues in the practice and perhaps in secondary care, for the rest of your patients or even for the NHS more broadly. What we do is complex and often there are no right or wrong answers.

Do not add to your stress by arriving either late or too early. Travel to London or Edinburgh the day before, if necessary. If you are early, go for a stroll or take a book to read to pass the time and take your mind off the exam.

This is not a factual test so last-minute cramming will not help. It is far more important that you have that right balance of alertness and relaxation to allow your brain to function optimally.

It is a professional exam so you should dress appropriately, but do not wear something so formal that you feel uncomfortable.

The college staff and marshals will do their best to help you at all times. If you are unsure of something, ask, and listen carefully to the briefings.

The examiners are real GPs, many are trainers and involved in education. They understand that you will be nervous, and will try to help you where they can.

They really won’t try to trip you up or catch you out, there are no trick questions, and there generally is not a ‘party line’, so take each question at face value and try to give your own answer to a question, rather than trying to guess what you think the examiner wants you to say.

Ask for clarification if you do not understand what the examiner is getting at. Try not to commit yourself early, make sure you set out the issues you see and the options you think you have.

If you think there is a dilemma in the question, set out exactly what you think it is and what principles underpin your decision making. If the examiner is trying to push you into making a decision do try to make one; it may not matter too much which way you go, but the justification will be important.

Try not to let one question spoil your performance in the others. It is unlikely you will do well in all 10 questions, so if you think one hasn’t gone too well put it to the back of your mind when the examiners move on to the next question.

The examiner’s job is to give you the right grade for your ability and performance. Asking a series of low-challenge and superficial questions will not allow you to achieve your full potential. The examiners will stretch you: it was never going be a cosy chat.

Although the examiners will be concentrating on your answers, your demeanour and behaviour can be important. A good candidate will maintain eye contact with the examiners and appear enthusiastic and interested — this can be difficult when you are stressed, but this is why practice is important. 

Dr Mortimer is a GP trainer in Swansea, an MRCGP examiner and a teacher on the Swansea MRCGP course 

Learning points
Pointers on how to pass your oral examination

  1. The MRCGP oral exam tests your decision making and justification.
  2. The questions will be about communication, professional values and personal development.
  3. Practice oral questions with your peers.
  4. Become attuned to the many decisions you make in your working day and practice justifying them.
  5. On the day, trust the examiners and take the questions at face value.

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