The GP registrar year is a fantastic and unique experience. By the end of the year chronic disease management will be your bread and butter. You will also become accustomed to dealing with medical emergencies, thinking through ethical dilemmas, breaking bad news, managing difficult patients, keeping up to date and living with uncertainty.
The registrar year will teach you how to find out the ‘how’, ‘when’, and ‘what if’. You will learn how to manage your stress, your colleagues, clinical events and a business. The MRCGP exam and summative assessment will consolidate and test these skills.
Working towards the MRCGP exam and summative assessment is both satisfying and challenging. The MRCGP exam components and the audit are designed to test the skills required to succeed in everyday general practice.
Succeeding as a registrar requires consistent and efficient learning. Choosing educational resources carefully will prevent being swamped in paperwork. There are a number of resources to choose from, including the newly redesigned MIMS and its online version at www.healthcarerepublic.com, which both provide up-to-date essential information.
Multiple choice questions can cover any aspect of medicine, general practice, public health, medical evidence, pharmacology and guidelines. When revising for this component, it soon becomes apparent that spending hours learning about one subject does not get you very far. A wide breadth of knowledge is the key to success.
Different question types appear in the MRCGP written paper, namely clinical evidence questions, clinical management, critical appraisal, management of change and questions which require the candidate to consider the issues surrounding a given scenario. Revising for this is enjoyable and is best done in small learning sets where ideas area exchanged, frameworks developed and work shared.
Clinical evidence questions will ask about the latest and landmark trials surrounding a particular topic. Reading thousands of research papers is not a useful way to pass this paper and does not demonstrate efficiency as a busy GP. MIMS can be quoted in the exam as a reference and summarises some key trials and guidelines in ‘hot’ disease areas. For example, MIMS discusses the ASCOT trial, saving you the effort of reading the actual research paper. While reading about ASCOT, you can use MIMS to revise other cardiovascular diseases.
Within many disease areas, pathology and management principles are discussed in MIMS in a practical way that makes it a must have for your doctor’s bag as well as an important textbook when revising for clinical management questions.
The best method of revision is active learning throughout the registrar year. Much knowledge will be gained by seeing patients on a daily basis. Regularly reflecting on the cases you have seen and reading around the subject is an enjoyable and productive way to learn.Keeping a list of questions that arise during your consultations and looking up the answers later addresses your ‘doctor’s educational needs’ in a systematic way.
For example, if you have a patient with hypertension, it is important to consider primary and secondary causes, the latest hypertension guidelines and, of course, its management. It can take hours to collate up-to-date information before you even begin to read around the subject, and textbooks summarising hypertension may be out of date before they reach the shelves.
The new MIMS, updated monthly, details the latest NICE/BHS guidelines as well as all the drug information required to practise safely and pass the exam. MIMS contains information about which drug classes are used to manage hypertension and all other chronic diseases, their mode of action and contraindications.
A number of other resources should be used when working towards MRCGP and summative assessment. Websites such as RCGP, NICE and SIGN should all be used along with books and past papers. Consistent, reflective and efficient learning is the key.
Dr Thakkar is a GP in Wooburn Green, Buckinghamshire. He qualified as a GP in 2004
Make the most of available learning tools
Working towards the MRCGP and summative assessment is satisfying and challenging.
Choosing educational resources carefully will prevent you getting swamped in paperwork and becoming overwhelmed.
MIMS and the MIMS section of healthcarerepublic.com both provide up-to-date information essential to passing the MRCGP and summative assessment.
MIMS contains the latest clinical guidelines, as well as drug information, trials and contraindications.
MIMS will help you prepare for the clinical evidence questions.
Other learning resources includes the RCGP, NICE and SIGN websites.