MRCEM PART A

Trekking to be a member of Royal College Of Emergency Medicine

The pathway to MRCEM from the base to the top is quite steep, and it may look quite intimidating at the start, however, when trekked slowly and steadily, it is indeed quite rewarding.

I personally don't endorse any book, author, or a course. No hidden Agendas. 100% Vegetarian.

PART A

Exam Pattern: 

Till Aug 2016, the exam pattern was, 50 questions with 4 subquestions where you need to mark T/F, so in totality 200 questions of T/F, with no negative marking, all in 2 hours.
This changed to a single best answer question (SBAQ) paper of 180 questions in 3 hours. Previous passes in the MRCEM Part A examination remain valid.
The curriculum per se is same as the previous MRCEM  Part A

Books To Read:

In descending order (in terms of High Yield to Low Yield)
1. Mark Harrison
2. Get Through Part A
3. Jaydeep Chitinis
4. Online Revision MRCEM, on subscription
5 First Aid ( USMLE)
6. Anatomy Atlas/ Clinical Anatomy 

Mark Harrison ( Rate 3/5 stars)

This book is the primary book for part A and covers each subject fairly well. However, the language and content are sub-par, making it quite unsatisfactory. Never the less, the reason its 3/5 stars is because this is the book to go,  and at least it outlines what you must study before the test. You could mix and match the topics and read the contents from other books or notes.
















Get Through Part A ( Rate 4/5)

This book is fairly simple, and questions are fairly simple, the way you might find in the real exam. Explanations are quite adequate also. This book by no means is very well proofread, as you can see many mistakes in writing, and at few times gives total bogus answers. If you are scoring above 65% in each subject and the 3 mock papers in the back, you are in the right direction of your struggle.











Chitinis Jaydeep (4/5)

Highly competitive. Tthe questions and their answers are much harder than the real exam. Don't miss this book, if you don't want to take a chance of failing the exam.













Online Revision 3/5

I took a subscription from http://www.mcemrevision.com/ for 2 months. The answers and questions are quite a few in number, but at times they are very vast and vague. Sometimes answer  key is not appropriate also, but this was back in the day. I hope they have re-framed and improved their answer key by now. You could give it a miss if you are short of time, but never the less, its no brainer, more you study, more are the chances of you acing the exam.

First Aid USMLE 5/5

Probably the best book there is on the market for getting your basics right and more. As I had studied it during my USMLE step 1 preparation, I kept on going back to it for refining my basics. If you ever read First Aid during your MBBS days, this book is super handy, otherwise, it may seem daunting in your limited time.

Miscellaneous books, Atlas Anatomy, Clinical Anatomy are needed for references time to time

Preparation Time:

About 3-4 months

Tips for preparation

I asked my friends who passed and who did not pass in the first go, and tried to come to an average, amount of time for preparation for the exam. An average bloke who passed in the first go, took about 2-3 months of preparation, anything less is playing with fire. Strategy being, that first 2 months should have dedicated hours of studying, and last month with over zealous, full throttle studying for at least 6 hours. At-least. Without distractions. 

Note: Preparation time is quite subjective to an individual's experience, and how he/she has faired while studying for basic subjects in Med School. I had previously done USMLE step 1 & 2 exams, so for me, it became a tad easier.

Months before the exam, try to find a study partner, but if you can't find one, or find one which actually is slowing you down, going solo Rambo! is absolutely fine, though not desirable.

There are 2 ways to prepare for this exam, in a retrospective fashion, that is questions first, know what is being asked, then the text(theory) from Mark Harrison , or vice versa. Both are equally fine, I chose the former one.


Personal log:  ( My personal experience in preparation for Part A)

My exam was on June 5th, 2014, so I started preparing for the exam round about from Jan 23rd, preparing means, emptying myself of the luggage. Luggage is your personal family commitments, thesis (if you are a part of any residency) , any due pending work, which you have always procrastinated (such as fixing your car, etc), these will your unwelcome obstacles, in your final stride of preparation. So plan months in advance

So after the major haul of shedding my personal and professional luggage, I started dedicated studies from March 1st on-words, about 100 days before the exam.

The basic subjects such as Anatomy, Physiology, and Pathophysiology take the front seat in your preparation, followed by smaller subjects such as Microbiology, Pharmacology, and Stats. Again this is subjected to your preparation done while in your Med School. For instance, one of my friends never studied microbiology well in school, so he had to put in lot more efforts and time into it. Address your weakness. You could gauge it by doing mock papers as early as possible.

So in short, start with anatomy, physio, -- the major subjects-superficially, then finish your smaller subjects in the subsequent months, such that, by the end of second last month you know exactly needs to be drilled into the brain. 

Your revision time should be for a wholesome month, which should include first 15 days for all the subjects other than anatomy and physiology, next 10 days for anatomy and physiology, and last 5 days summarizing your notes and quick rapid revision of all subjects.

Also to note, that you should be doing questions side by side, daily, and never to do in a bundle, as doing side by side fortifies your preparation.

I was quite nervous before giving the exam, and as the exam day approached, it felt as if I was reading it for the first time. Scratching my head on who on mother earth has marked with the highlighter. But don't worry, it happens to everyone, without exception. Stride on, it will all be fine on the exam day.

I felt the preparation was intimidating, and I did struggle a lot, especially as I had to balance my Emergency Duties such that I could study in a stretch. I had put a solid 8 hours or more, studying daily in last 1 and half month. 

All in all, I felt the real exam was quite a breeze. I later thought I over-prepared, but thinking of it, I could not take a chance of under preparing and go through the ordeal of repeating the exam after 6 months.

Mind you, time and time again, that the path is trodden and may seem quite an uphill task, however, the only way you will pass the exam is not through an IQ of 110, but through mere perseverance and sheer aching your bums sitting on the chair for long hours.


Take Home Points for ADHD's: 

Mark Harrison
Get Through Part A
Jaydeep Chitinis
Preparation Time: About 3-4 months
Cast aside Luggage, Anatomy, Physiology, and Pathophysiology takes the front seat
followed by smaller subjects such as Microbiology, Pharmacology, and Stats.
Revision time should be for a wholesome month
Doing questions side by side, daily
Put a solid 8 hours or more, studying daily in last 1 month. 

I hope you at least have an orientation on what it is like to prepare for the exam. There might be many questions you might like to ask, please feel free to ask in the comments section below.

Share at will.
  
Part B preparation: http://drabidnisar.blogspot.com/2016/08/mrcem-part-b.html 

Part C preparation: http://drabidnisar.blogspot.com/2016/08/mrcem-part-c.html

MRCEM PART B

If you are reading this part of the blog, I am assuming that you have surpassed Part A, many congratulations!

A General overview of the exam

(Pre August 2016)

MRCEM Part B (SAQs) - This exam can be taken 36 months after qualifying as a doctor (usually the 2nd year of ACCS). It comprises of a short answer paper that examines your ability to interpret investigations and how to apply that knowledge. e.g. an x-ray, an ECG etc. It consisted of 16 questions and lasted 2 hours.

(Post August 2016)
FRCEM Intermediate Certificate

This replaces MRCEM Parts B and C for the UK and International trainees. It consists of the following methods of assessment:

Short Answer Question (SAQ) paper (replaces MRCEM Part B) consisting of 60, 3 mark questions in 3 hours. The subject matter and level of the examination remain unchanged to that of the current MRCEM Part B. Previous passes in the MRCEM Part B examination remain valid.

For candidates in the UK recognized training program, the MRCEM Part C will remain a GMC approved qualification for the purposes of CCT if passed up to and prior to August 2018. After this time, all candidates will be required to pass the FRCEM Intermediate Certificate SJP (plus the FRCEM Primary and Intermediate Certificate SAQ) in order to be eligible to sit the FRCEM Final examination components.

After August 2018, candidates who have passed the MRCEM Part A and B but not the Part C will be required to pass the FRCEM Intermediate Certificate SJP in order to be eligible to sit the FRCEM Final examination components.

Books To Read:

Oxford Handbook Of Emergency Medicine 4.5/5

Covers all the topics fairly well, very concise, at times very concise. Meaning you have to shuffle to other sources for extra information, as some topics are not covered very well. However, as this is a handbook, it is easily portable, and should be in your bag at all times for quick reference

Victoria Stacey 4.5/5:

To go book for your preparation for Part B. All the topics are sufficiently covered. Very good sample question in the end of each chapter, the type you should expect in the real exam

Highly Recommended

Get Through Mcem Part B: 3.5/5 

An apt book for preparation especially in the last few months. Very elaborate answers, and a tad hard also. 

Sometimes answers are misleading and not up to date. So be mindful. All in all, a must book to read, for your near perfect preparation.

Courses: BLS/ACLS, ATLS, PALS (5/5) are must before you sit for part B & C, more importantly before Part C, Try to achieve instructor potential in each as this invariably makes you more thoroughly prepared for Part B and part C, as you teach.

Clinical Duties: (5/5) Much of the question they ask are from day to day clinical practice, Some people who shunned their emergency duties and stuck to book have not faired well in the exam, Clinical duties are very very prudent in your preparation, however, the last month should be dedicated more to books.

Online question Bank and Resources: (3/5)

1. enlightenme.org, which has been replaced by http://www.e-lfh.org.uk/programmes/emergency-medicine/, basically to enhance knowledge.

2. Dr. Sajjad Pathan

accident-emergencymedicine.blogspot.com

Preparation Time:

4-5 months along with your clinical practice, with last month of 10-12 hours of dedicated study, preferably sans medical duties.

Tips for preparation

1. Make sure you continue to do your clinical duties at least until last 15 days before the exam, seeing the patient and practicing OSCE, discussing cases with your colleagues and recalling NICE guidelines while on Handovers is the key for this exam.

2. Don't be stingy on the days given for preparation, chances of success increase with the amount of dedication, Get Rid of your luggage, such as your thesis, family commitments 3-4 months prior to the exam, so that you have no distractions in your long haul of preparation.

3. Make study groups if possible, and prepare topic wise, challenging each other.

4. The above materials mentioned are very important, make sure you read and re-read Victoria Stacey  3 times, oxford 2 times and online questions 2 times, before the exam.

There are two ways you could start your preparation

1. In unison with Part C, hand in hand.
or
2. Giving the exam individually part b first, and then part c, usually about 6 months apart

Personal log ( My personal experience in preparation for Part B)

I chose the former one because I felt that I could study holistically, or maybe I was a little greedy that I could finish the whole ordeal in one go. A lot of my friends found this way too intimidating and pressurizing, so much that they could not give 100% to each. They ended up failing one or both, while only a few survived both at once.

Choosing the 2nd option makes sense, if you have time at hand, for instance, you are part of the residency, which is going to finish in the subsequent year. From my experience, this is better for maintaining your sanity.

After passing Part A in July 2014, I thought I will take a break from studies and focus on clinical hands-on and give my exam in June 2016, that is, after one and half year. However, I thought to myself in mid-October that, as I didn't have anything much to do, I could very well try in June 2015 itself, so that in case if I fail, I can still take the exam during my residency. It was a gamble, which I was willing to take, and moreover, I had amazing senior friends who were giving the exam in June 2015, and they became my study mates.

So, by November I started gathering books and went on browsing the books and making time table. It takes about a month to orient yourself, and another month to dispose of your luggage( namely thesis, social and family constraints).

In short, I studied little by little from December onward, striding on with baby steps chapters after chapters. I had a set goal to finish Victoria Stacey thoroughly at least 1 time before March Mid, where I was scheduled for MRCEM B and C Exam Revision and Skills course in Chennai.

I picked up oxford emergency handbook and tried to complete it within 20 days, at least the major topics. I did not pay attention to dosage , as I knew, I would not remember in the long term. I practiced dosage and various criteria in the last week of my preparation.

Nevertheless, I put all my energy in Victoria Stacey and Oxford till March Begining, with obvious references from various resources. At that time I used enlightenme.org, which has been replaced by http://www.e-lfh.org.uk/programmes/emergency-medicine/, basically to enhance my knowledge, a very handy tool to practice question with pictures describing diseases.

I was also practicing OSCE's with my colleagues, about twice a week to thrice a week for an hour or so. It was always good to catch on each other's preparation and always acted as a motivator and where one stands in terms of preparation

March came almost suddenly, and my preparation was not up to the mark. I went to Chennai for the course, and didn't fare very well in the mock papers, this acted as an eye opener, just about 3 months before the exam.

Giving the mock paper, helped me identify my weak links, which were pediatrics, derma, and toxicology to name a few.

*a typical page in my victoria Stacey

April:
Now that I completed Oxford once and Victoria Stacey about 2 times, I started doing online questions and get through Mcem. I also made a lot of notes for last moment preparation this while,

May meant all my tedious preparation would funnel down for the last final stride.  I studied for at least 10-12 hours a day, and luckily I had scheduled my duties with the help of my HOD, such that I was more or less free this month. My colleagues and juniors were also very supportive in letting me study through the stipulated duties also.

* Make notes in the book itself from other resources, for last min revisions

I almost stopped preparing for my OSCE after March, cause preparation for Part B was very overwhelming. I had ill-scheduled ATLS course in the end of may, as I could not get any dates before than that. This also consumed 5-6 days of my preparation time.

June 4th was my Part B exam and Part C two days after it. I tried to revise the questions and victoria Stacey once again for last week, but I still felt that there was much more to study.

The exam day: I was trying to get a wink of sleep the whole night, but couldn't as I was  contemplating about the exam the next day. In the end, I had barely slept for 2-3 hours. I gulped up Red Bull for the caffeine boost ( I don't Drink Energy Drinks often by the way). I was also very amazed to see so many candidates from across the globe waiting outside the exam center. I felt a Lil pang in the stomach and decided to walk away as they were discussing so many topics I have never heard of, amongst each other. Finally, the moment of truth, the exam itself : it was tough, more than I expected.

One has to race against time while writing this exam, as 2 hours is very little for reading,analyzing and writing answers to 16 questions. After the exam, I was numb. I felt I did fairly well, but after coming out, while discussing answers with my friends, my fairly well thoughts, shrunk to thoughts that would I even pass. I had to recuperate and now think for an another monster to battle, Part C, which I didn't practice for a month, and which was in 2 days time.

Take home points for ADHD's among us:

Oxford Handbook Of Emergency Medicine 
Victoria Stacey 
Get Through Mcem Part B
Courses: BLS/ACLS, ATLS, PALS 
Clinical Duties
4-5 months along with your clinical practice, with last month of 10-12 hours of dedicated study, preferably sans medical duties.
recalling NICE guidelines whenever you get the chance
Get Rid of your luggage for focused studies months prior to exam
Give mock papers,  identify your weak links

Make notes in the book itself from other resources, for last min revisions

Well, all is good what ends good, I did pass the exams, both of them,




*A typical rough page to practice writing clearly in the exam

*My graduation Ceremony 

I hope you at least have an orientation on what it is like to prepare for the exam. There might be many questions you might like to ask, please feel free to ask in the comments section below.

Share at will.
  


Part A preparation: http://drabidnisar.blogspot.com/2016/08/mrcem-part-a.html 

Part C preparation: http://drabidnisar.blogspot.com/2016/08/mrcem-part-c.html

MRCEM Part C

Part C

General Overview

Pre-August 2016 

MRCEM Part C (OSCEs) - This exam is made up of a series of OSCE stations.  Usually between 15-20.  They are designed to assess your knowledge, psychomotor ability, interpersonal skills (including communication and conflict resolution), professional behavior and clinical decision-making skills.  You rotate around the stations spending about 8-10 minutes one each.

(Post august 2016) 

Situational Judgement Paper (SJP) - replaces MRCEM Part C - consisting of 120 single best answer questions(SBAQ) in 2 hours.

Preparation Time: 

2-3 months, such that you practice it on your patients daily

Preparation Material:

East of England: Emergency Medicine Course Part B and Part C (4.5/5)

http://emcourses-india.org/

A team of UK senior consultants conducts courses in India about 3 months before the exam, which prepare you for real exam situations and scenarios. It is excellently organized course for 5 days. On the downside, it can be quite expensive, added are the cost of travel and stay in the city they are organizing it, however, as they say, cheap things aren't necessarily best, but best things can't come cheap. 

Highly recommended 

Mcem Part C Once Station: (4.5/5)

A very well written, and precisely what's more than required for Part C preparation. Look out for the new edition

Bromley Courses

http://www.bromleyemergency.com/

Quite popular among Mrcem enthusiasts, they offer many courses from Ultrasound in ED to whole Part A-C preparation material, I have not taken it myself, so can't recommend it personally, Do check out their Part C OSCE videos available online/youtube.

Tips:

Well if I had 2 words to say about Part C exam, it certainly would be Communication Skills

1. Train well in advance your vocational skill, learn to speak clearly, loud enough so that you are audible clearly to the examiner behind you and the patient in front of you, and always warmly while respecting their privacy.

2. All the stations start with knocking, requesting to enter, washing hands(acting), and cordially greeting the patient, making sure you have always considered the patient's privacy (by asking a chaperone) and getting the name of the patient with their specific complaints. Practice it each time as a ritual, while practicing it on the daily basis. 

3. There are usually 1-2 teaching stations, so learn how to teach, especially by asking the 5Ws to the actor. Courses you taught as an instructor (BLS/ACLS, PALS, ATLS) come in handy here.

4, I can't emphasize how much important the courses of BLS/ACLS, ATLS, PALS are. Make sure you have completed it months before you plan to give the exam, such that you have through knowledge of various protocols we follow while resuscitating a patient.

5. Clinical duties are must as mentioned before, more the number of patients you see, more the experience in practicing OSCE.

6. OSCE has to be practiced with a study group, as one can rectify your mistakes, and throw in some curve balls, in order to give you robust practice and to control the situation in case if your case is going nowhere, which happens quite often in a real exam.

7. Time yourself, you should be able to finish the whole scenario by 6 mins 30 secs. By practising multiple times, you will get a sense of time management.

Reminding you, time and time again, that the path to MRCEM is trodden and may seem quite an uphill task, however, the only way you will pass the exam is not through an IQ of 110 or above, but through mere perseverance and sheer aching your bums sitting on the chair for long hours.

Take-home Points for ADHD's:

2-3 months preparation time, such that you practice it on your patients daily
East of England: Emergency Medicine Course Part B and Part C
Mcem Part C Once Station
Communication Skills
Courses of BLS/ACLS, ATLS, PALS 
Clinical duties

Study group
Practise Practise Practise

I hope you at least have an orientation on what it is like to prepare for the exam. There might be many questions you might like to ask, please feel free to ask in the comments section below.

Share at will.