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Top Tips for MRCS Part A

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Join us at 19:30pm on Tuesday 28th March for our 'Top Tips on How to Succeed at MRCS Part A'; Ideal for those sitting the exam May 2023 or those thinking about booking soon. Sign up to this event via the MedAll link

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No, we could not ready yet. We're away. Perfect. Hi, everyone. Um Welcome to the on mrcs part A tips. Um like myself and Kyle are going to speak through a little bit about mrcs booking it um the logistics of the day uh and basically how you can prepare what things we found helpful when we were sitting part a and maybe like a strategy um of how you can approach it when revising for like the next one in May and then the following one in September, I think a few people are joining um at the moment. But if you have any questions as we go throughout, just put it in the chat and we'll monitor that and answer them all at the end. Um Yeah, so we'll just get started. I'll just go through a brief of like what, what mrcs is, who consider it and talk it through. Is it possible to get the next cycle? Sorry. So basically part A is obviously the two stage exam to be a member of the royal culture of surgeons and you needed to get to ST three level. So part A is a two part exam. You've got paper, one with paper too. So, on the day, basically, you start at like 10 o'clock, I think it is. It's three hours for the first paper and it's all your applied basic sciences, your anatomy, your physiology. Um, and then you have an our break and then you sit paper to which is to our exam and it's more clinical based um on the principles of surgery in general. And then to complete your membership for the Royal College, you sit part B, which is an all ski um that you sit after you've passed mrcs part A. So part A, you can sit anytime from when you have basically, well, you can book at any time from when you have your G M C number, so you can book it and find your for September. And then after that, obviously, the next sitting is in January. Um So you can set it from when you're an F one. Um So next side. So the next um so the last one was in January. Um The next one is in May. The booking for May is closed now. So for anyone that's sitting in May, um you can't look for it, but the next one that you can book and the booking is still open is in September. Um and that is on the 12th September and deadline is the 16th of June. All information about dates closing times. Can we all find on the Royal College website? Depend on whatever Royal College you go through. It doesn't matter which college you sit part A through, that doesn't necessarily have to be the college that you become a member of. And so I actually sat mine through RCs. I, but, um, I'll probably want to do part B with the Royal College of Edinburgh and then that's who you would do your, like, membership with. Um, so it doesn't, doesn't matter for part a where you said it, the only reason I put, um, Royal College of Ireland was because they were the first people to confirm with me that I could definitely sit in Belfast. But Royal College of Edinburgh, they can all, you can sit them at all in Belfast. So next slide. So for anyone obviously sitting in, in Northern Ireland, um I put this in because it's in the Pearson Vue Center, it's all online. It's in the like that's where you people would take the driving test. It's where we done R S J T. There are two Pearson Vue addresses on for Belfast one on the website, which is the correct one. And then sometimes you type in Google, second one comes up because that's where it used to be. Just make sure when you're sitting it, that you've definitely got the right one that it's the one that's on the website and, and you know where you can park close to it. So basically, a lot of people came out for the whole day, obviously thought they could park outside and then got tickets for the whole day. There's a car park just marked um around the corner and you literally parked there all day and just pay as you go. So basically, incident in any Pearson Vue Center across northern Ireland. So this has been the powerpoint slides being put into a PDF, but basically underneath, it was a map of everywhere you could set it. So there was one in Omagh, there's one in Antrim, there's one in Belfast and I think there might be one somewhere else. Um, but there are all the options of where you can sit it to have somewhere close to you. So when you're sitting part A, you have six attempts, um that you are allowed, um, pass rates very year on year. So I think the past rate for the one in January was 69% of to pass on average year and year. It's 30 to 40% of candidates who said the exam past exam and then the statistics according to a number of years ago was that f one was the highest and pass rate. Um, but after that, it didn't, it didn't really matter what stage you were at. Um And I don't know whether that's just because you're closer to finals or why that is, but that was some of the statistics put out by the Royal College of, um, of all the Royal Colleges and with regards to anyone sitting it. So I suppose that earlier, you said it may be the higher chance you have your closer to finals and you remember more things I did find that finals information was helpful. Um And also you were still in the kind of zone of revising. You hadn't really got out of that. So it was not easy to get back into it cause it's really hard when you're working, but it probably wasn't as hard if I it and maybe like we left it for a few years. Um, but pick it when do it, when you have a job where you're going to have time, you know, you're gonna have time to go and advise it otherwise there's no point. It doesn't matter whether you're enough one or not. If you're really busy jobs and you don't have time or can set time aside after work to revise or before work, then it's not gonna work and then next side. So this is the syllabus and Kyle's gonna talk then a little bit about all the different aspects it's covered. Yeah, I think, I think as well. Emma and the people who said it early are the ones who are motivated actually to, to do well and, and decide it early and that probably is where the higher sort of pass rate comes from. And my name's Kyle, um, occurrence after in the Belfast trust. And I just wanted to talk a bit more specifically about what's actually covered in in the party exam. Really, it sort of covers the core aspects um of applied basic knowledge and skills which underpin all the surgical specialties, that sort of anatomy and physiology, which underpins all the specialties. It doesn't really test specific surgical knowledge be very unfair at an early stage to expect you to know the intricacies of of certain sort of special surgical conditions or, or procedures. And then it really sort of tests the knowledge, the level sort of expected of trainees completing their core training, um e completing part A and part B. Then by the time you apply for your S T three number, the intercollegiate um MRCS um sort of website actually nicely sets out and the sort of course syllabus, remember that that each of these modules are tested not only just in part A but also in in part B. So if you, if you look at some of the modules, they're clearly very specific to part A um such as the basic knowledge relevant to surgical practice, common surgical conditions and but also it sort of brings in sort of assessment and management perioperative care and a little bit on organ tissue and we're gonna tissue transplantation, um a little bit of pediatric care and the the sort of some of these areas are more appropriately assessed. Obviously, in part B, you think of the assessment and management and maybe unvaccinated 80 Husky Station rather than rather than party. But of course, any of these topics can potentially come up in party. But obviously, as I said, somewhere more specific to party than part B and it's actually really helpful to follow, follow the link there. Um, because each of the modules or sort of topics, um, are broken down quite extensively and, and that sort of really forms the core sort of syllabus for at least for part A. Um So just try to think about the common topics. I, I tried to look back at the, the, the syllabus um on the intercollegiate website and then as well when I was going through and then sort of prepping and it really, really breaks down into sort of two key areas. I think the first paper, the basic sciences paper looks at applied anatomy, um, applied physiology and pathology. There's a little bit of pharmacology, microbiology, um and a little bit of imaging. Although I think imaging probably comes under the second paper more I found than, than the actual first paper, um, maybe sort of the most appropriate image to investigate a certain certain condition. I think that was more common in the second paper than, than the first paper, certainly. Um And then it can really encompass, you know, the second point, the second paper on the day can encompass all different sorts of surgical disease and pathology and really a broken town and into the above the gastrointestinal breast, vascular, etcetera. And so, really, really, it's, it's important to think, to have a broad knowledge of these rather than, rather than a very specific knowledge of maybe a couple. It's, it's better. No. Uh, a little bit about a lot rather than the sort of intricacies of maybe the most complicated thyroid pathology and the surgical sort of treatment of the above and looking more specifically than that anatomy. Um, I suppose, I think I was maybe in a luckier position. I did a master's in anatomy at Queen's. Um, so it was a little bit easier to prepare for this part of myself. Although I did, I did certainly look back at a lot of anatomy. I think I forgot, had forgotten most of it. And by the time I came down to, to study and again, um, I tried to think of the sort of key areas that, that were examined in the sort of key areas that came up, of course. Um, everyone knows him for a 2nd, 1st and 2nd year anatomy, abdominal regions. Um, and, and organ relations and they, they sort of come up in sort of clinically sort of oriented questions with. They may be talked about someone with a stab and they left upper quadrant and, and the potential um consequences there of um, uh, like a perforated viscous such as the stomach or maybe, um, hispanic lacerations. In, of course, everyone dreads the inguinal canal. Um, and I think that comes up basically every year. And if you think about sort of, and the borders of the Inguinal Canal and I think you just have to, to route, learn it and it's, it's probably a guaranteed market, see if it comes up. And then obviously they're, they're really common and sort of limb areas, public tail and cubital forces think just you just have to, again, have to root, learn the boundaries and the contents of, and they'll probably ask a question again about and maybe the cubital fossa in, in a fracture dislocation of the elbow or, or a stab wound or, or something like that, um, neurovascular supply to the limbs. Um Again, yes, probably the nervous more than the arterial supply and is questioned. I think a lot more and certainly, certainly learn um the function of each of the nerves. Um And with common nerve injuries associated with, with fractures or dislocations. If you think like the classic, like auxiliary nerve and shoulder dislocation, unfortunately, embryology is involved and I absolutely hated um, embryology. Um Personally, I, when, when I saw the, the clefts, an aortic arch is I, I don't think I specifically learned an awful lot and it does come up through, um, it's probably one mark, but I sort of figured that the amount of time it would have to spend learning, learning there was, it probably wasn't worth it for the one mark. And thankfully it paid off for me, but it's, it's maybe a bit, maybe a bit risky to take that, take that on and, and it's certainly, there's, I think there's six or eight and they can be easily learned off if you have time lack of mugla nerve innovation. Again, it's pretty complex. Um, and I can't even remember it off the top of my head head now, but I'm pretty sure I learned it for the exam and I don't know if it's specifically come, come up in, in my questions. But again, it's frequently asked lymphoma drainage. Again, it's very important. Brachial plexus injuries are very common and, and always test that. I think E MRCS has heaps and heaps of questions on the brachial plexus. Um and specifically about the sort of branches and above um and sort of related the break of practice and auxiliary artery as well. Very common questions. Um surface anatomy, vertebral levels such as, um, you know, sort of anatomical relations that say t four level very commonly, um Common questions. Um Again, because it sort of clinically oriented anatomy questions, then they're looking specifically for types of nerve injuries and the consequences of with surgery. Um There's quite a bit of neuro anatomy and the neuro anatomy is actually can be quite difficult. Um So, yeah, they, they do ask a lot of um no other nerve anatomy above. Um And then finally, it's quite helpful to have the sort of rough guide of the derma tunes and in your head and the thing that I can think of the thought my head for first final injuries just I wanted to mention just before you moved on, on the anatomy part, I thought like I knew anatomy, okay. But the questions are really, really specific about like certain relations. They almost want like a specific answer. Like if you were to talk, like if you were to someone to ask you the question, you could explain it and talk around it, but sometimes they really want like a specific relation. And usually I found like those specific things in the notes of the mrcs, like textbook um of what exactly that they're looking for because sometimes you can think you actually know the anatomy and then you go and do the questions and you get them all wrong, but you kind of generally thought you knew, then going to or you knew the relations of the spleen. But actually, sometimes there be just been really specific about what way they've asked the question. So I would just like dial in on like, what question comes up? What commonly are they asking about in terms of like relations and stuff? Because I think you can, you could go away and learn the anatomy, but actually you could get a lot of the questions wrong. Well, is what I found anyway. But no, no, I, I totally agree with you. Um So physiology and this is probably something that I actually slightly overlooked when I, when I was revising, um, I didn't realize actually how heavily physiology appeared in the exam. Um, I probably could have prepared, um, a lot more for physiology that than I did. But, but I suppose it was okay in the end, um, it is worthwhile probably specifically getting a physiology textbook or an mrcs textbooks that has a lot of physiology in it's, and because it does feature actually quite heavily and the sort of common things that, that Emma and I thought come up include general home use the assist. If you think back to sort of 1st and 2nd year physiology, there's a lot of acid base balance and assessing blood gasses and given reasons for, for blood gasses that are particularly off, there is a fair bit of fluid balance and, and replacement and knowing the exact fluids and the indications um for, for using those as above bleeding and coagulation, of course, comes up if you think of sort of um the general physiology of sort of vasospasm played uh plugs and then the coagulation cascade and they ask very specific questions about the intrinsic and extrinsic pathways um involved. And then that sort of brings in some pharmacology as well um into the intrinsic and extrinsic pathways and how the, how they're affected. Of course, when um they're gonna ask for some specific organ physiology that might be things like the thyroid or, or um sort of anything really, you can think of and sort of gi physiology, even cardiovascular physiology can come up. Um There is obviously some pharmacology in terms of antibiotics and how they sort of target or work for specific conditions. And the Renan Andrew tell them it's in aldosterone system. Um again, features quite heavily and it's really good to, to know that diagram off the top of your head and know how each of the sort of factors and play and the overall effect that that has in terms of um fluid retention and increasing BP, etcetera. And I definitely got asked at least I think two questions on that um shock featured quite heavily as well. And of course, everyone knows it's a really important thing to know about and you should know all the sort of different types of shock and, and specifically, they do ask about hemorrhagic shock and it's, there's quite a busy table. I think that most people should know about the classes of hemorrhagic shock and the percentage of blood loss and, and the effect on heart rate, BP, etcetera. It's quite good to, to learn that off. It is, it is quite busy and there's a lot to learn, but it definitely will pay off. Um If anyone's done basic surgical skills, electric Allery does come up when it can be quite tricky and difficult, but it's worthwhile. No one a point in terms of respiratory physiology. Again, if you think back to you, I think the first or second year, again, physiology and all the lung volumes that definitely comes up a lot of the mrcs and it does come up in the exam in terms of sort of like residual lung volumes and then those kinds of things. Um I really want to highlight um baroreceptor and chemoreceptor and being bridge reflex. This came up, I think, like three or four and three or four different separate questions. And it wasn't something that I had particularly looked into, but this did come up and it's fairly easy to learn and it will, it will definitely pay off this again. This came up three or four different times um across the two different papers and came up two or three different times within each paper. Um It's, it's quite simple and definitely, it definitely pays off. It's quite a high yield topic and they really love their hypersensitivity reactions. Um There's a nice, nice little Pneumonic um that I can't remember off the top of my head. Um That I said that's it. Yeah, the breaks down each of the hypersensitivity reactions. Um It'll, it'll pay off if you learn it. Um sort of endocrinology, um sort of thyroid and parathyroid physiology again comes up and then the oxygen's association curve, they will probably ask very specific questions about left or right shift. So it's worthwhile knowing about, sorry, these slides are exceptionally busy and we just tried to try to put on as many things as we could that we're sort of recurring themes or topics. Yeah. Statistics unfortunately does come up. Um, it'll only be maybe two questions, I think. Um, but if you, if you do spend a little bit of time on it and you should get the marks and the table up on the top I learned in the sort of day or two before, um, and could rewrite out on the page on the day and with the little um equations below it, it will nearly always come up. Um And it's an easy market. It does if you, if you've learned it and they do ask some specific questions about different statistical tests and how appropriate they are in different scenarios. I still don't really understand it and it's quite difficult and I didn't spend an awful lot of time but, but certainly it will come up and it will be, it will be a mark. Um One of the thing that's gonna be a little bit easier that we may be know from medical school and were the different types of, of trials and the phases of clinical trials. Um And then I think that was, that was a fairly easy question if we come up with just asked which phase of a trial? And was this if, if, if the above really? Um So yeah, unfortunately, statistics does come up and then sort of moving on to the clinical paper. Um There are certain surgical conditions which come up time and time and again. And one that I found kept coming up again and again, we're, we're head injuries. Um really, you should know off the top of your head and exceptionally quickly be able to calculate the patient's G C s. Um Let's put the table there. You can get simple questions. Just what is this patient's dcs? If they are, you know, eyes to voice, um obeying commands and maybe confused. That should be an easy mark if you get it. And then they do ask more specific questions and about the different types of of hemorrhage, sort of extra drill, subdurals and traumatic subarachnoid. And it's worthwhile. No one, there was maybe in a little more detail and the indications for ember holes and evacuation, etcetera. Again, boil obstructions, a really common common topic. It's worthwhile knowing the management in terms of ng's fluid resuscitation, the causes and um and then the treatment there of billary pathology. Again, exceptionally common. You should, you should have a fairly good understanding of the sort of spectrum of disease in terms of biliary colic colecystitis could enjoy this and, and the rest and they will ask specific questions about shark who's triaged and that kind of thing. Um Inguinal hernias again, exceptionally common, direct and indirect and how to differentiate compartment syndrome will almost certainly come up. And I think it's probably one of those things that they have to ask about in. Um Yeah, definitely will come up, you should know all the different and signs in terms of the, the six P S I think. Um I know that absent pulses is a late sign and you should be able to pick it up early with peeing out of keeping and parasthesia and that kind of thing. And they will ask about specific fracture patterns. You, there's no point looking at the most in depth, sort of like Schatzker classification of tibial plateau fa and fractures. That's not really going to come up, I don't think. Um but things like hip fractures in the difference between injury and extracapsular and and how you manage is really fair questions, breast, I think it really does come up an awful lot again and you should feel the diagnose benign and malignant number based on sort of clinical description. And sometimes it's really nice clues in terms of in terms of breast trauma, which maybe points towards fat necrosis or something like that against malignant sort of diagnosis. Vascular. Of course, comes up in terms of critical and acute limb ischemia. It's worthwhile knowing again the six paise and the difference between, between those and potential investigations and then treatment there of in terms of angioplasty and bypassing etcetera. There's a couple of questions on consent forms and the different types of consent forms and maybe a little bit about competence, competencies and consent. Of course, um the who checklist comes up and again, this is really common actually interview question as well. So if you spend a wee bit of time now learning it, it should pay off. And for the reason when they come along as well, there's a couple different screening programs you should be aware of um off the top of my head. Um Triple A's boil and breast and it's worthwhile knowing how those are screened for in terms of say ultrasound for the Triple A's the different sizes and what that means in terms of surveillance um or, or treatment and the sort of age is that there was there screen programs involved again, like the U checklist, um trauma and A T L s of course, does come up. Um I myself haven't been able to book on DNA TLS course yet. I can't seem to find any suitable dates, they're all booked up, but you can certainly look it up and it's not too dissimilar to A L s and then very annoyingly, um E mrcs brings up a lot of um anesthetics and anesthesia. Um and the different, the different agents used. Um I didn't spend an awful lot of time, time on it and I don't think I actually got any questions on it in the paper, but it's fair game for the, for the paper. Um So just looking at sort of what resources and there are them out there. So there's quite a few question banks. Um Certainly E M R C s which is basically just the past medicine of mrcs is the one I think that basically everybody uses when I was preparing, I asked around um colleagues and everyone used mrcs and, and sort of felt it was quite useful. Um You probably do need to pay for the six month version rather than the four month and you probably should be preparing probably longer than the four months. And, but there are other question banks in terms of past test, um, etcetera. Um It's quite helpful. There's a textbook and there's notes in mrcs and the explanations of questions and which are actually, which are really helpful. The others are we most common resource that people use is past test. It's um, I think it actually is the most questions and it's the largest bank of questions and it has um some past paper questions as well and you can clearly see it's, it's more expensive than the mrcs. Um I only used E Mrcs question bank rather than past test, but it's worthwhile probably using both to prepare. I looked at doing past test, but I found that there was just so many questions and a lot of, uh I didn't think when I done the few that I've done weren't as relevant or as high yield, they were really, really, really specific. I mean, if you felt like there was a certain topic on EMR CS that you were doing really badly and maybe consider doing the questions on past test, but I didn't think that you really needed to do. The past test was the only thing I use past test for was the past papers, which are really, really good. And I used those in the last, like, 2 to 3 months beforehand so that I could practice running through them. Um, and they were much better than the time, like, tests that you could do on EMR CS. So it was the only thing I actually used past test for really, which I find it worked for me pretty well. Yes, certainly E M R C s is probably enough. But if you find that you've got through your E M R C s and I don't know how, but if you completed it, then you can maybe, um, use past test for a little bit. But certainly just before the exam I would, I would go back to EMR CS, um, for the final revision and so passed back to, um, a then for the next few sides. Yeah. And so for anatomy, um, if I was really struggling to find, I didn't go back and learn the anatomy and then do the questions. I done the questions first to get an idea. This is what works for me anyway. I like to get an idea of what they're holding in on what they're being really specific about. Um, I felt if I went and learned anatomy first and then went down the questions, like I wouldn't have been any better off. Whereas when I had done the questions, I have an idea of what exactly they were looking for. And then there was one that I was particularly getting wrong in certain areas where I wasn't knowing the relations and stuff. Right. I would then go on the Auckland Anatomy videos and then I could see it in three D and C the videos. Basically, if you're a Royal College of Edinburgh affiliate member, which I think is like 10 point for the year or something like that, you get access to all the Auckland Anatomy videos and it is like dissections of the entire body goes through specific areas such as the inguinal canal. So if you're finding something specific, that's quite high yield like inguinal canal or cable fossa or brachial plexus, I would go and watch those videos and dial in on those rather than. So I would kind of work backwards from the questions rather than learning all the actual anatomy videos and then go into the questions. That's what I find works best for me. And they're really good videos. They go through like they go through everything you need to know and they're really well explained and they're not that long. So, um I really recommend it for anatomy, especially if you're certain areas are struggling with, you can pick like specific videos to watch on the different areas. You don't have to like watch like a, a whole week of a video to find the one area looking for. It's all broken down into like smaller videos. So it's actually quite handy. It's not that expensive. Um in terms of getting the resource from the Royal College of Edinburgh. So I find that quite helpful for anatomy. And then the next slide is, yes, this was something that was shown to me quite late on in my revision. It's I don't even know how to say this Fall Wazi Sheet basically. Um I had her, I had, I had heard this from people who had said it before that when they had looked at this, they had, I thought that a lot of the questions that came up in this were similar to what they got in the paper. Um The Royal Colleges know that these sheets and like past questions are out there. So they kind of calmed down on it. But I still find this really, really helpful to go through, especially when you're looking at topic areas where maybe you aren't as strong, especially when it comes to some of the physiology and the anatomy. And the first paper I find that there's so there's a PDF online if you type in this into Google that you can download a past paper and the answer questions. Um, I did find that a lot of the topics that came up on this were similar to the questions that I got in. The real thing in January but they're very slightly changed. So if you were to wrote, learn any of the questions, you would probably get the wrong answer if you didn't understand it and you wrote, learn the question. So I would just be really careful that you actually understand the questions from that collection of past paper questions. Um because they know about it and they specifically added questions that are similar and then change things and people who wrote, learn it, then get it all wrong. Um But I find it really, really helpful. I only found it like maybe two weeks, week or two weeks before. And um and I thought it was really good. Um If anyone can't find it, they can email the or email on the Google Drive on the gmail at Northern Ireland um fdss and we can like send it out to you if you want. Um I found it really good. Um Did you know about it, Kyle? No, I, I had never heard of that. And yeah, I was, if I was to turn back time, I definitely would use it. I think that's why then that you're describing basically understand why the, the question that is correct is correct. But also if you understand why each of the other answers are incorrect and then would be the best way to, to use this. And the, and the marks came for this like PDF that someone's met is someone else's answers. So I actually found some of them were wrong. So I really went through and home through on like why each one was right or wrong. So I would just, I would be careful if I was using it, but I found it really, really, really good. Um I was told about it from one of the ent guys who I work with and he had failed twice, I think. And then he went to a course where they talked about this and he done this and he passed the next time. So he said he found it really helpful. I would probably, I would really recommend it, but just be careful and know that some of the past that the answers that someone has written down for this, some of them are wrong, like definitely that I found anyway. Um but my main aim was just to try and understand why each one, like what I thought and why like used it to get identify areas that I wasn't as strong. And so I thought that was good. So just in terms of like strategy, I suppose this is probably not gonna be that helpful for anyone that's sitting in May and, but maybe anyone that's sitting in September and that's booking it. Now, we're thinking about sitting it. I did think about it, you know, 5 to 6 months in advance, I didn't start like proper revision, but I definitely knew that I wanted to sit it and like what I was going to try and do while I was working. Um, so for me, I know that I work better when I have questions and I see exactly what I'm getting wrong and I see a pattern of the things that I'm getting wrong and then I go back and hone in on those things in my revision and then I make flash cards on the things that I'm getting wrong. And then I see those all the time and I do those every day. That's what works best for me. And that's what I did about 4 to 5 months out. And then I done flashcards each day, which meant that I was seeing a little bit every day. Um It's when you look anything up on sitting mrcs, normally most people recommend that you try and get through E mrcs two or three times. I, I only did E mrcs fully once I did it by section first and then I had made flashcards on all the stuff that I got wrong. Um, and all the things that maybe I had got right. But actually I didn't really know I was just a guess and I didn't really know the topic area under it when it came to, when you answer it and it gives you the little blurb underneath us to that area and why the questions, right? Anything I didn't know I put in my notes then and then I would see them every day. So although I didn't sit E M R or like go three mrcs like three times. I did see a lot of the questions daily on the flashcards. Um And then I went through, like, read, like we can go through all the ones you got wrong again. And I've done that closer to the exam and then 1 to 2 months out, um I done the papers from past test. Um They take ages to go through like so long. It was honestly like demoralizing because, you know, you're sitting like part A and part B or like not part of the part B, you're sitting like part one of the exam, which is a three hour exam, then you're sitting part two, which is two hours, like it's five hours to sit one exam I suppose of mrcs part A on the past, on the past test. So it takes a long time, but I would recommend trying to sit down and not met me doing the full five hours, but doing like the three hour paper all at once if you can um using it to get your time. And I did find that it was really tight for time. I don't know about you, Kyle, but I thought that, I think you need like a minute per question. I did find it tight for time. Like if you were, if you're on a question and you never heard of the thing before and you'd never, you literally have included. It didn't matter whether you came back to or not. I just went with my gut and left it because I knew if I flagged it and looked at it and went back to, I wouldn't have any more knowledge to answer it any differently. I only flagged the questions which maybe I, my head was a bit fuzzy. It was taking me too long to work out, but I thought I would be able to get the right answer. They are the only ones that I flagged in the actual things. I find it quite type of time. So I think practicing a past paper and being able to get it through in the right amount of time allocated amount of time. I would definitely recommend, I think some people maybe just use the past papers as questions. But I would try if you can at least for some of them anyway to sit it the full paper at once for the three hours and then set the next two are one and then go through it and try and I usually identify things by themes of stuff that I'm getting wrong and then like work my way back and go over the things that I'm getting wrong. Um I found that I was getting a lot of the trauma stuff wrong. So I wish and I didn't know that the time that I looked at the A T L s like trauma part of it, um I thought the, those specific things like ct guidance of when I get ct brain, like I would kind of know it, but I wouldn't know it really, really well to ask answer the specific question that you were asking. So things like that where you're finding that you maybe thought you knew something and you're actually like when it comes to specific question, you don't really, you don't really know the answer. So, um I would definitely recommend I did not like two months out and I started building up doing them beforehand. Um, and then a few days before I would not recommend sitting a full paper, like it's exhausted enough having to do it on the day. Um Never mind in the few days leading up sitting full papers I would use in the last few days leading up to I was actually in surgery and, and NF one. So when I, I went, I, some of them knew that I was sitting it and I just got one of the court trainees to just quiz me on all the stuff that he could remember from mrcs. Like just loads of questions and we would chat about anything that I didn't know. And this was just like in between the borderlands. Obviously, I know not everyone's gonna be in surgery, not everyone be able to do that. But even if you have a friend that is Hassan got or, um, um, is a surgeon or trainee like it was really, really helpful. He was good at pointing at stuff. I maybe didn't know as well. And then it kind of made me feel better. But I knew like enough that I could answer a lot of the questions that he was thrown at me. So I would definitely recommend that. And then, like I said about a few days before when he learned the statistics off by heart, like that table, I used the last few days to learn anything that I felt like wasn't really high yield, but like altogether those little things add up in terms of marks. So like the statistics questions, like maybe it might be two or three questions, but altogether, it's still like a few marks. And so anything I felt like I was not prepared to learn while I was right, revising any route learning I had to do, I would do that in the last few days and like, sure I've forgotten half of that stuff. Um to be honest, but I get you through the exam and that's what I wanted. And I would just try, obviously, it's different for the people sitting at May, maybe I don't know whether but change over. But obviously, again, the day of the exam off and I emailed really early for my Rhoda and I said that I categorically would not be in on this day and the two days before I wouldn't be in, I didn't have one, so I couldn't get any, um, study leave. So I took annual leave. So I had days before it, which I could take for annual leave and I made sure that I wasn't on nights on the lead up running up to because it is a really long exam. Like, it is five hours. It's a really long day. Um, if you're tired from work, you're just, it's not help yourself. Obviously, sometimes there's nothing you can do. But ideally if you can work at where you're not doing nights in the run up, you've got the two days off before it and obviously the day off, um, and make sure you have that organized early because it's just a bit of a stress. Um, but I was in surgery at the time, a lot of them understood and they're really nice about it and it was fine. So, um, should be ground if you maybe email enough in, in advance. But every hospital is different. Um, yeah. And then there are just a list of different resources that I used to prop up things. I felt like I didn't know that well. Um, or was there was anything specific? I wanted to look up, to be honest. I didn't use any textbooks. Um, I did hear that the basic, um, physiology textbook was really good. I found actually when I was getting specific physiology questions wrong, I went and looked up the EMR CS textbook and I found it had enough detail that got me through, especially the renal physiology, which was just a real pain to learn. Um But I felt like a lot of the questions were coming up related to renal physiology, not just specific physiology, questions, but were they were really eating a lot of it clinically? So even in the second part of the paper, I felt like they were relating a lot of clinical stuff to anatomy and physiology even though it was the clinical paper, um I didn't actually find it that clinical, I found it very similar to the first paper when I saw in January anyway, um apart from obviously the few questions, um but just, yeah, like I would, I used mrcs for that. No, either RAAS system know where all the drugs work in the renal system, all that kind of thing. And I find that that was enough physiology detail to be able to answer the majority of the questions. And they also tie in a lot of physiology with like all the different types of shock and that released to renal physiology as well. So I just find that that was an area that I was very weak on. And I felt like I had enough from the mrcs textbook, but some people say that the basic scientist was really good. So if you're finding that that's not enough, I would maybe recommend getting that book. Um But yeah, that's just what I did before hand the work for me. Did you do anything differently? Kyle? I, yeah, I think it's on the next slide. Maybe what I did know, it's not sure keep going on and I'll chat about what I, I basically that's probably leading up exam. That's really what I said before. Just, I would practice, passed papers in the lead up in like, the 2 to 3 to like, one or two months beforehand. But then in the week before hand or even a few days before, and it wouldn't be sitting like a full paper because you just wreck yourself. Um, and then, yeah, again, like with remote learning doing that in the last few days before the exam. And I find it, I find it best before the exam just to ask questions and like, talk through things. Um, so that's why I did before the exam as well and a few days up leading up, I was over that. And then, yeah, on the day it's a really long day. Like, you just have to be ready for it and it is a big crop and be there early. Like our exam started at 10. Um, I'm pretty sure it started at 10 no matter where you saw it. And so the first obviously is three hours, they're really strict on timings. So be there half an hour when they say be there half an hour early, they actually do mean be there half an hour early. Um, in the Pearson Vue in Belfast, you have to buzz in, there's car parking around the corner, so park there, know where you're going. Um, bring your I D, your exam, um, number. Um, and they start like, letting the, you have a locker, you have to put everything in it. You're not allowed to watch. You're not allowed a wristband, you're not allowed, you know, like food, you're not like water, you know, like anything in with you for the exam. They're really, really strict in it. Um, you have to leave everything, even if it's like not an apple watch or anything, the watch goes in the, like a normal watch goes in the locker and they check you before you go in. So they're really strict. Um, you don't get paper in the exam but you get a whiteboard and like a pen, um, like a wipeable one. Um, from memory you do. So you do have something to write with, um, and they can give you, they can give you other things because you can't take it. They don't want you taking it out with you. So they don't give you paper. Um, so it's like a wipeable pen and marker and stuff that's in there. There's headphones in there. I didn't have any disturbances during my exam. I thought it was really good. Um, really well done. Actually, all the people that were, there were actually sitting part a, it wasn't like people sitting there driving test and walking I/O. Um So I felt from that perspective it was quite good. Um I put on the headphones too just so myself out. Um And yeah, um again about the flag and questions don't flag stuff that you're going to come back to that you don't need to know because there's so many questions, especially in the first paper, you're never gonna be able to flag everything you didn't know, flag, the ones that you think if you came back to. You just need a little bit more time to work out. Maybe the statistics question or whatever and then you don't get a break for the first three hours. Um And then you get our break, um from the first paper to the second paper, it's an ARB but it's not really in our because like you have the time from when you leave the per first paper, gather all your stuff up, stop the exam, get the person to let you out and then you have like time to like go to the toilet, eat something and like have a chat, relax and then like you go back in for, you have to be in before the hour is up. So you really only have like 45 minutes. Really, I'm, I find, but to be honest, I just kind of want to get the second part done at that point. Um Bring plenty of water. I brought an energy drink, I can't really eat and I find if I eat a big meal or anything, like I slump completely. So I had like caffeine, I brought like fruit. So like while I will give you a sugar spike, there's fiber with it. So it would be like slightly slower, literally sing. Um So I would prepare whatever snacks work best for you um for the middle part and definitely take the full break that you can. Um Yeah, I think that was really it for on the day, if anything of logistics of everything. Um, it's quite good, like in terms of them facilitating that they're quite good. Yeah, I am, I sat one at eight AM start, which was really early. Yeah, it was very, really, so I think I was up from like half six in the morning that day. Um, so it was, it was very long. Um, I got out, I finished it like three PM but I was exhausted. Um, because I, I arrived at the test center at like half seven. Um, and obviously made sure I was early and, and parked the car, I think in that car park there's a little like the app now. So it was quite, actually straightforward and I could pay on the app and didn't have to worry about that. Um, and I had never, actually it was a different test center. Um, I think it's the one you're talking about just down from Castle Cort. Yeah, it's like you don't really know that it's, it looks like an abandoned building, almost. There's just a glass, there's just a glass door and so we're always going. So I left extra time. So it's like a glass glass window and it has like three different companies in the one building and like there's like a poster and one of them is Pearson Vue. That's literally all they have to like identify the building. It, yeah, you have to buzz up. Um Yeah, so I just want to finish, basically explain how I prepared. Um I used these two resources. Um So I, I sat it last September. Um I think I booked it in February March, April time. I can't remember exactly. And I booked it through the Royal College of Surgeons Ireland, mainly because I didn't realize that it was then done through piercing review and you could actually sit anywhere. So I think if you book it through any college and everyone sit, sit at a piercing view center and then you just choose the piercing view center that's the most convenient to yourself. On that note. I actually end up in more for booking it with the Royal College of Ireland because of the Euro in the pound or whatever. So it was like 20 lb more to work with them. So, I mean, you can sit with any college obviously, but, and it's probably actually a little bit cheaper, although not by much um to set it with like Edinburgh or England. And yes. So then once I had worked to set the paper and then I started just casually doing E mrcs questions and I just randomized them and try to do at least like 15 minutes a day. Obviously, some days are better if you finish at five and you can sit for like an hour and a half, two hours before dinner, after dinner. But of course, it's, it's not always that easy when you're working a full time job. Clearly, there's days and, and weeks that you don't really get an awful lot done. And if you think if you're on like the long weekend or on long days, it's basically, there's no chance that you're gonna, you're gonna be able to prepare, revise. And so for about four or five months out, I just randomized E mrcs and at least try to do 15 minutes of questions a day. Um, over time that's slowly built up and built up the questions that I did and then I started doing maybe two hours, three hours in the evening. And then I am about two months before then I got stuck into sort of proper revision and the basic sciences for the MRCS. There's a free PDF online. If you just Google Basic Science for MRCS free PDF, the whole book is, is free to download online. Um It's about 600 pages. Um So it's, it's a good chunk to get through. Um But I left myself about eight weeks or so. Um, and then finished it in about seven. Um, but that was really intense. That would have been, um, like eight or 8 to 10 hours revision every day over the weekend and about four hours each evening, which was exhausting. Um, after work, to be honest, but I was in, I was doing a neurology job in the Royal, which was, which was fairly easy and we finished a half four in the afternoon. Um So I kind of was lucky in that way that I, that I had the time in the energy to do that. So then when I, I finished that, um about, I think it was about a week to go and then I basically just went back to EMR CS. I must add that when I was doing the basic science for mrcs, I would have maybe done 10 minutes of questions through E mrcs at the sort of same time to be at the start of the end of the end of the session just to keep going with the questions in about the last week, then before the exam last September, um I would have, I would have just basically gone mad with the mrcs and, and done as much as I could, I would maybe set like 100 questions, you know, when the, you can set a mock exam, I think on, on the mrcs um and, and do that mock exam. Um and then, and then go through the questions thereafter and, and read, read through the text book to explain if I got the question right or wrong and try and understand exactly exactly why. Um, in all, then I only went through a mrcs once, um, which I think was probably enough basic science for mrcs was, was okay, like, it probably didn't go into enough detail in anatomy. Um But as an overall resource, I think it covered the basics of everything, okay. Um And, and certainly things that were in the book definitely did come up. Um So yes, then I sat it in, in Belfast then at Pearson Vue and eight AM start. So it was, it was an early, early, early, early start and I was definitely was tired by the end of it. Um I was working the long weekend before I had the Monday off and then sat on the Tuesday. Um No, that's a lie. I was on the long weekend and I was able to swap out of the long weekend. So I did Friday, Saturdays. Yeah, Saturday, Sunday, Monday off Monday. I applied for study leave. Think you can get study leaving after you can't get enough on which is a bit frustrating. Um So I was rejected the Monday study leave because it wasn't the day of the exam named it rejected it. Um So they only permitted study leave for the Tuesday the day of the exam. So I book study leave for the Monday and definitely was worthwhile, having, having those three days off before and even to just get a lie in um and sort of recover from, from work and was in an opportunity to maybe do a little bit more casual revision in the lead up and maybe only four or five hours a day just to try and consolidate everything that I've been through and had to try and relax as much as possible for, for the exam. So, I think, I think that's everything and hope that isn't scary and it's certainly, it's a difficult exam but it's certainly, certainly shouldn't be scared. I think there's a lot of information that you probably don't even realize that, you know, um, that will come up and I'm pretty, pretty sure you will do very well. And, um, unfortunately it is, it is a difficult exam and it does require a good bit of preparation. But if you do the preparation you should do very, very well. So I think that brings, brings us to reclusiveness. Emma, you have anything extra that you want to add. Um, no, not really. Um, I think like, what I find anyway, from just talking to everyone. I suppose everyone gives you advice when you, if you say you're sitting in urine surgery, everyone gives their experience of what they've done and what works for them or didn't work for them or maybe why they had passed or why they field and I found when I was asking people about that, why they field, they would say they, they booked it and they knew that they weren't gonna have time to revise and they didn't put in the work. Um, they had done the work and we're actually really good clinically and like, would be really good in surgery would be class on the take. But when it came to actually like exam questions and like the way the questions are worded would just flop. Um So I would really hone in on the way they're asking questions and like specific things that they're asking about because they are very specific. Um I think you could be really good clinically and know a lot of things and know a lot of anatomy physiology, understand how everything works. And then actually when it comes to the actual questions, just maybe not pick up on the right thing. So I would just say that and yeah, I think you just need to, I maybe didn't revise as, maybe as much as you did Kyle in the, in the amount of ours, but then maybe revise for longer if you know what I mean? And your sounded really intense. Like, I don't know if I like, I just couldn't, I was so exhausted from work, especially starting F one um that I found it really difficult to revise. So it actually probably benefited me early thinking about it earlier and then just doing a little bit. Um, as I went because I, like, I didn't find it really hard, um, to finish work. A thing that worked for me was I wouldn't leave work. I would go to the computer room or the library before when, like, at work finished at five or six. And I would go to the library for like, an hour and a half, two hours, three hours. And then I would go home because I found, when I went home, I just crumbled and chatted to my, one of my house and at dinner and watch Netflix. Um, and then before, you know, it was bad and you have to get up for work again. So I found that, that helped me in the lead up, um, in the, like few months before when I wanted to, like, be proper serious about, um, the revision. Yeah, you can't underestimate how difficult I think it is to balance on job and, and prepare. I didn't really appreciate when everyone said, like, how hard it would be because I was like, I just that finals, like, you know, it'll be grand. Like, you know, I find everyone says finals is the worst exam you never sit or like the hardest exams you'll sit because it's everything. But actually, like, properly doing a job and going home to revise is great. Like it is, it's just grim. Um, and that's why I wanted it over and done with as soon as possible. Um, so, like, I think you just have to be willing to accept that. It's just going to be a bit shit for a while and it'll be fine. You'll get it done. It will be worth it. Yeah, exactly. Yeah. Does anyone have any questions that they want to put into the group chat? Maybe you should have actually done a poll, um, to see who was, had Bruckman was sitting in May, but there are mrcs flash cards for download online. Um I think there is, um I didn't use any flashcards. I'm, I just use those two resources that I talked about. I'm not sure if there's any flash cards available. There must be, I'm sure there is, there is ones on my use Ankie, I've always used Ankie um Threat Medical School um for mrcs. Um There are Ankie E mrcs quite. So the mrcs questions have been made into close deletion, Ankie cards online and you can download them from the Ankie shared decks online and they're really, really good. I like using Ankie because I could do it anywhere. So even if I was like sitting about and worked and doing much and I could flick through a few cards, um, do a few reviews um of E M A R C s questions and things and that's why I added anything I got wrong too. Um But if you used Ankie before, it's really good, I would highly recommend and definitely makes it easier to revise if you're really busy and work or you've got a lot of work on, but maybe you're like, got a lull and you're on your long in the evening or, and you're on nights and you've got a lull for an hour, like, you could do, fly through a load of, um, a lot of questions on and you can get the app on your phone. So I would just do them on my phone. Like, so I don't need a laptop. I made it, I tried to make my revisions so that it was as easy to do as possible because I knew it was going to be really annoying today. Um So I find that really helpful. Is there any other questions in the group chop? I don't see any. Um I hope, I hope that wasn't scared me. I think it was, we're trying to just share as much as the most common topics that came up and all the sort of resources available and to revise. And certainly I think by the stage everyone do is the best way that they revise. And if you are preparing for May and I wouldn't, I wouldn't get scared as such that there's other resources there that maybe haven't used because, because I only used to resources and then did absolutely fine in the end. Um But of course, we're just sort of making you whether the resources out there and if you do have time maybe to, to pay for past test and do some of the past papers, then it may benefit you even further. Um So thank you so much for joining and anyone who's sitting in the near future or like, well, um, all the best of luck, um, if anyone has any specific questions that they wanted to ask, um I suppose you could, you could ask them maybe to the foundation trainee email and, and, um, and I can try and answer them over the next few days or weeks if you have any other questions that maybe come up, I'd be happy someone put in a question there about percentage mark two AM four and mrcs and I only went to, yeah, I only went three mrcs once. Um, so my, my mark was pretty crap, to be honest, I can't even remember, but it wasn't great. Um, I think people said am around 75. That's pretty high. That's pretty high. Yeah, over my overall, which probably would have been about 60 or 60%. And then in the, when I did the mock tests, it probably would have been a little bit higher. Um, I can't remember exactly. I would go off the mock exams for your percentage on past that they give you the average of what that year was or whatever. I would go off them rather than maybe, well, I only went three MRC. What else wants. So, um, I, my average thing on it was, was crap, I think. Um, I noted everything I got wrong so I did see it all again. But, and I must admit there was some, there was some pretty rubbish questions on the mrcs which I think we both knew that probably just weren't going to come up and so you can kind of just discount those. Um, but yeah, I think, I think a mrcs overall is probably a little bit more difficult than the actual paper on the day. And so if you're only averaging 60 65% you will probably be fine on the day. And again, it doesn't matter what score you get, all, all you have to do is just get over the past mark and it passes the pass. Perfect. Yeah, I assume there's no further questions. Um I think that's them all. Thanks everyone for joining and if you provide feedback would really appreciate that. Yeah, that would be great. And if anyone wants those sheets or PDFs emailed, um if you just email the account, if you can't find them online there. Yeah, and you know what your room? Perfect. Thanks guys.