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Are good to go. Yeah, all good. Thank you. Ok. So, um these are all very welcome to our second um teaching event um in the series. So tonight, I'm delighted to welcome Doctor Michael mclaren. Um He's gonna talk to us about the MRC S part A. Um So Michael is an FD in the Ulster, um and he completed his part A in January. Um and he also has passed his part B in October. So, um Michael, it's over to you. Thanks, Grace. Um Yeah, thanks everyone for coming. Thanks for having me, um stick these slides up now and, and just get started. Um Today I'm gonna talk about preparing for the MRC SA. Um And I suppose, um just the way I paired and some things that I thought um were useful along the way I can maybe signpost you towards. Um So it's an intercollegiate exam so it doesn't matter who you sit it with, you get the same qualification uh at the end of it all. Um So what I'm gonna do today is talk about why you sit the exam, um sort of when to sit it. Uh the dates of the exams. How would it be good? How much it costs where you sit it, um, the time of the exam then how long, maybe you should think about preparing for. I'll talk briefly about the structure of the exam. But, um, I suppose that's something, it's very easy to look up yourself and then, uh, different resources that I use or ones that you might want to think about yourself, um, that I didn't use and then some tips that, that help me. Um So when to sit the exam and why sit another exam. Um So there's a paper in the BMJ in 2017, um that basically shows the earlier you sit your part a um out of medical school. Um The higher the chance you have of, of passing on first attempt. Um Obviously, uh the, the type of people that tend to sit it earlier are maybe more likely to pass. So there's a degree of that, but there is also a big overlap in content um between finals on your part eye exam and it is a written exam. Um It, it's theory based. So if all of that's fresh in your head out of finals, I think it, it makes sense to maybe give it a go early. Um You also have a limited number of attempts and you need to get it by a certain stage. So, um you know, trying to throw your, your, your hand in early might be a good option. Um, it's also a barrier to higher training, so not core training, but you need to have done both parts of your exams to be an ST three. Um, and, uh, I know, uh, I heard the other day that, you know, the other problem through programs, like, say you get in at ST one, if you haven't got your exams, by the time you get to ST three, you might not be able to progress on that scheme. So I think it's in your interests to sort of try and have them in the bag before you start. Um, it does also look good at interviews even if you don't get points anymore to get to interview. Um, there are some exceptions. So run through training, I know for orthopedics in Scotland and, uh, if you're doing your surgery or probably thoracic surgery, those run through programs, I think they're still allocating points. Uh, and then some of the academic programs didn't attend to talk this year, but I know last year, um, Mr Trevor Thompson, who, who is involved with the core training applications and things talked about it and said it's one of the most desirable things that they still look for at interviews. Um, so I guess that was my rationale preceding it early. So about the exam, you can, instead of three times a year, um, you can do it as soon as you graduate, you get six attempts to do it. Um, and then once you do get it, you have to get your part b within seven years. So there's a validity of seven years. Um, as I said before, it's intercollegiate, which means, um, if you sit it in Scotland, um, or with the Royal College in Edinburgh, with the Royal College in Ireland and the Royal College in England. It's, it's the same exam that you'll sit on the same day. It's 550 quid, which is fairly steep and that's out of your own pocket, Re Botox. And that you sit at one of the Pearson View test centers. So, same place you'd sit your driving test for your S JT. Um And uh there's a couple of them around the country. Um And at the moment, the May uh 2024 setting is open for applications. I know at least uh in Dublin when I have a look, it does have a, a relatively low cost rate for an exam. Um It sort of fluctuates but it's anywhere between 35 and 45%. Um So, yeah, this is just on the right there. Uh If you go under the Royal College website, there's a button where you can apply and you sign up and take it from there. And then once you've been successfully, successfully applied through the college, you'll get an invitation from Pearson View uh to book. And then when the bookings open up, there's so many spaces. Uh So, uh I saw mine in Belfast but I think you can sit them in a few other places. Uh, if you say you're living at home or elsewhere, um, in terms of a timeline, um, I think they recommended, you know, sort of when you look online or certainly what I heard was between four and six months of preparation. Um, I think that makes the most sense when you're working because, uh there's just weeks where you're not going to get very much done and the longer you leave yourself the better. Um So I have somebody that through medical school tried to do little and often I think that helped when you came in the post grad exams. Um But I think I if you do cramp and that could be a struggle. However, if you are someone that does it last minute, I would allow at the very minimum, maybe two months of intensive uh study. And how's the exam structured? So it's a five hour exam which is fairly brutal. Um Takes a fair bit of stamina. You have two papers, uh a three hour paper and a two hour paper. You show up about half an hour before in the test center. Um And then you get allocated, um once it starts, you get allocated a seat and you can start within your own time. Um It's like it's very quiet and I think you can ask for uh like a piece of paper and a marker pen and you can rub out if you need to do any like sums or anything or, or just write things down to keep it in your head or figure it out. But everything you answer will be on the computer. Um You just select ad in your answers and then at the very end, there's an option to go back and review them all or you can flag as you go along if there's ones in particular that you want to review, so you can go review all or review flagged. Um So the practice papers um on some of the websites work similarly. So I tried to practice that format and sort of have a strategy before I went in the um you can bring food and stuff in the day and there's a locker. Um The first paper it applied basic sciences is more preclinical. So uh it'll maybe be anatomy, questions, pathology, questions, acid base balance, that sort of thing. And then uh the second paper is um more clinical scenarios and questions. Um But there is a, a degree of overlap. I don't think the papers are that um different in general. There's paper is usually, I think people find it harder. The one I saw, I think most people actually find the second one harder so it can vary. Um Trying to think anything else to say that. No. Uh And then if you want just like a breakdown of everything that could be on the, um, exam. Uh, the Intercollegiate Committee has the syllabus where they map out everything. So it might be helpful from a perspective of having, um, learning outcomes. I've linked to there. And then in terms of there, there, there are things that come up, time and time again every year. So find this online sort of the most commonly asked topics. And when you're doing the past paper questions, you'll see there's loads of questions about brachial plexus stuff and nerve deficits. Um, they like asking about thyroid and mental A and B all that sort of stuff. Um, and, uh, an acid base balance is a big one that comes up. Some of the other ones I've listed there, um, some good as well. And so it's not, uh, and then in terms of study at annual leave, which is, I think is an important consideration and it's something I'd think about before I sat it. Uh, if you're, if you're an F one or F two in northern Ireland as an F one, you get no study leave. So you do have to take annual leave. Um, so I took, um, some annual leave around the exam, but I did, um, email ahead, my reading coordinator as soon as I booked the exam and said, you know, I'm sitting the exam in this date of no study leave. Can I, you know, can we try to get things moved around and stuff? But so before I even started the ROTA, there were some changes that they had made to make, that made me work maybe, uh, a little bit more intensely after the exam could give me a few days, uh, extra before it and made it easier for me to take some leave around it. If you're in England or elsewhere in the UK, um, you get 15 days of study leave F one. and then if you're set it as an F two, you're entitled to 30 study days. Um, those 30 study days aren't all for exams. Um, some of them, there's 10 mandatory ones for flight modules, which you said an F two. And, um, if you do a taster week, those kind of study days, um, but you do get five for an exam, you can take that only up to once per year. Um So if you set up more than once in a year, you can take study the second time. Um, and I think that's the same from F two onwards. Uh on the NTO website. If you just type in like nin to study leave, it brings up the application, you fill it out, you have to get it signed by, I think your educational and clinical supervisors and then also get signed off by your router coordinator. So, uh that's something I prioritize pretty early on as soon as you know, you're going to set up. And inevitably I think most people end up taking a few days of annual leave as well. It, it just depends how much time you want to give yourself before the exam, especially if you're a crammer. Like, um I knew you having five or six days before the exam where I could work uh intensely for, you know, 10 or 12 hours a day would make a difference. So, um something to prioritize and there's the link uh for a plan for study leave in terms of different uh resources, I'll talk you through some of them. So question banks, there's a thing called false sheets will become apparent. There are online groups which are quite helpful and uh there's different courses and books that you might want to look at. So in terms of question banks, um I think the best one and the, the most affordable one is the E MRC S and that's the uh if, if you look at the one on the top left, it looks very similar to past medicine you might have used in medical school and it's by the same people. It has um, you know, like over 2000 questions, I think. And uh it, they, they tend to be in a similar format to the actual exam. I think they're quite helpful and I think that the book, um they have like a, the inbuilt textbook is quite useful as well. Um I tended to go through past meds or E MRC S. Um The first time round and just did it, uh, answering them all without really looking at why things are wrong, just using it more for pattern recognition. Um, and then for, um, the second run through where I go through the ones I got wrong and then maybe read, um, why I got wrong and, and, and learn that way. Um, pass test then is a little bit more expensive. I think the questions are a bit different and they're not quite as good, which I think is also maybe similar to medical school. Um, but the one advantage it does have is time to pass papers. It is time to pass papers for each year. It says, like, you know, September 2017 paper and it gives you, um, the three hour paper followed by the two hour paper and separates them by, they applied, uh, the, you know, the principles of, and then they applied exam and that was useful just in terms of like timings and review, um, coming up to the exam. But I only really use that for the last 10 days. Um, and I'm not sure if there was in their own exams that they had as marks for that time or they're the actual exams that, uh, were, were sat, um, are, are written by the college. Um, but I do know that, um, there was gonna be 10 of those questions that came up, um, word for word on the day. Uh, then there's these things called falz sheets, which I'd heard of but didn't actually use. But I know some other people that have sat their part a that have found them very useful. Um, they're so, if you are based in like UAE, um, a lot of these places, them in the Middle East, they still sit, um, the, uh, our exams, the MRC S and they've formed loads of their own resources um, for A, to t the exam. And the Fosia Sheet is this like a master sheet of mock exams with uh explained answers and uh, or answers to explanations and why each is right and why each is wrong. And there's usually 15 to 20 questions apparently of the year I saw it. And similarly, most years that are almost word for word off that um you can get the, that uh you can pay for it online or else you can see like free downloads online or else there are people that have like four hour videos on youtube where they go through one of the papers and talk through it all, um which is another free way to get access to it. And the next thing that, that's useful, the Facebook group, um most of the MRC S part A um has a lot of members and there's another one that's quite big if you search into Facebook, MRC S and uh there's people uh if you join those groups that just send in loads of their resources and, uh are, um, a, apparently it's quite good for answering your questions and, and Reddit's the same on the junior doctors. Uh, Reddit. I know that, uh, my regs in my last job all said that they use the Facebook group and found it really useful and also just for getting links to free resources that they might have otherwise had to pay for. Um, and getting people to rate which ones maybe are worth um getting in much aren't worth getting then in terms of courses. And so for part B maybe, but for part A, I don't think you need to set a course. Um there's multiple ones online. Um but ii if you are somebody that sitting courses, you know, maybe before finals, you, you do things like that, it, it'll help you study and it'll help you put the time aside, then it could be worth looking at. Um So Doctors Academy is a big one if you look online. Um But I think the, the best one is probably MRC E. Um So I use that for part B. Um and it's like a textbook and a course, but in terms of their notes for everything, uh they, they just put everything that's been asked in terms of questions in the past and then break down model answers for everything. Um And that's, that's like a snippet um from online that I find um some of their notes um in that bottom photo in terms of books. Personally, I didn't use any, um, the most popular one. Basic science for the MC SA revision guide for surgical trainees. Actually, someone let me make a copy of it but I never opened it. It seemed really content heavy. Um, it's a big book but, um, apparently it does cover everything quite well. Uh II think I was studying just with the purpose to pass. But, um, if you were also maybe working a, a surgical where you wanted to, um, read around it or, or know why it's the right answer. Not just that it is the right answer. Uh, a textbook could be quite good. There's also a guy Andre Tan who was a, um, student in London and he compiled for like his finals revision of surgery. This like 80 page, um, uh, document that you can get for free online that has loads and loads and loads of information and, um, I guess way more comprehensive than you need for finals. People said that they've used that for MRC S with some success. Um, and then as I said before, with the courses, um, the MRC S and you can get it for free as well if you search around online or you can buy it off their website for 330. And then I guess lastly, how did I approach the exam? Um, and, and there are different ways to do it. Um, but the way I did. It was, I allowed about five months. So I knew I was sitting in, in December so I actually started looking at stuff, um, a couple of weeks before I, or sorry, I was sitting in January, uh, a couple of weeks before I started work, uh, in one and then I just did an hour a day. Um, I use flash cards a lot. Um, so I was like, no matter what, I'll make sure I do that. And then if, because you work long days, um, a lot of the time over the weekend, you get days off afterwards, the Monday, Tuesday. So any weekdays that I had off, I would be like, I get up and do at least four hours in the morning on those days. And that was kind of how I paced myself. So it felt like I was studying a lot for over a long period of time. But, uh, I wasn't really burning out, um, as I went along. Um, sometimes people talk as well about, uh, waiting until you've done a surgical job to set it or, um, you know, a particular time of the year, personally, I think it doesn't really make a difference. Like I did my surgical f one afterwards. But, uh, you know, the questions are so preclinical, um, and a lot of the f one jobs you're maybe only getting the ward around, um, and seeing certain things. So I'm not sure you would get that much exposure that would actually help you pass the exam. Um Maybe an SA job would be a bit more helpful. Um But II don't think you need it at all. Um Then study leave. Um which an F one was annual leave. Um, take that a couple of days before the exam. And I said I used my flash cards and I had the M CQ bank for six months. So only an extra like five or um and I had to get it for that versus to get it for four months. And I maybe did a couple of questions at the start on those longer days that I was off. Um And uh then coming closer to the exam, I sort of switched from theory on my flash boards to go a lot more heavily on to uh just taking questions. Uh And I think, yeah, as I said, with your work schedule, um you'll have good weeks and bad weeks and, and, and your road a lot of the time, they're not, it's not that well balanced. Um So I think it's the easier, the longer you leave it because you could be a couple of weeks out and have a bad week where you can't really do anything that week. But yeah, just to talk briefly about flashcards and AKI. So personally, it is the most useful thing for me. Um AKI is uh they're, they're different um Flashcard apps. I know that uh people use. But the one I used through medical school as well was AKI and uh it was originally kind of popularized for two things. The, the first one was for learning languages. Um And the second one was in America um for the US MLA exams because it's so content heavy to try and space out um the, the knowledge and to get it into your head, people use the anti space repetition and um you can download or you can upload your, your decks of your own cards online and share them with other people. So people would do that. Um And it was a good way to, I guess, cover all the content and do little and often. So if you actually go on the web and search shared decks, people have made ones for the MRC S. Um So I downloaded one of those, the one I've highlighted there I think was from past test and there's another one in part a um from EE MRC S and uh put those together and then started doing those early on um in my revision. And then as I went through past med or past test, if there was anything that I hadn't seen before or that wasn't covered in the cards, I can add that in um the way the cards work is they space out the repetition. So if you look at something on day one, you'll see it again on day four. And then depending on how, well, you know what, you might see it in a week for two weeks. Um, so your, your volume of stuff that you're looking at, uh, doesn't really increase over time and hopefully the stuff that's there, um, becomes more consolidated with time. Er, so, so I find that useful and then the bottom photo there, er, the bright and blue would be like, er, uh, blanked out and then I would tap space bar and then it'll reveal that. Um, so that's a good way of revising anatomy and you can also blank out um, the labels and, and stuff. Um, there's an app for your phone which is like 20 lbs. Um, just sleep for an app that d doesn't do anything different than the free desktop version. But it was useful because if I was working night shifts or I had like a bit of a little in the afternoon and work or even if I was sitting in a car before work, I would try and get as much of my hour a day done uh, in working hours or like when I was commuting or walking anywhere. Um, just ju just, just to get it done and, and to keep up that consistency. But the one caveat with the flashcards is they will pile up if you're not doing them. So you have to do it every day. And then how did I approach past paper questions? I've kind of said it already but started more content and not heavy and exclusively in the flashcards at the start. And then as I close, close through the exam moved on to past paper questions. Um, I did a first pass of the MRC S and then I, you know, there's an option to review questions you got wrong and I went and looked at them in more depth and then so, and, and did them all again and then the ones that I still got wrong I went and reviewed, um, until there was nothing that I hadn't got wrong. And I didn't look at the MRC S again and I just went to pass test uh, for the last couple of days and, uh, like focused solely on their time tests. There was like 12 of them. So if I got through uh, one or two of the five hour exams a day, I was happy and then finally, uh some of my clothes and so thoughts, um, I think it's a very achievable exam. It does have a low pass rate. But I think a lot of that is because you don't have time to study when you start, um, work and it's hard to balance it with your work. I don't think a lot of people fail because the exams are actually too hard. Um, if you went to Queens, I think that all the sort of, we were very heavy in 1st and 2nd year and preclinical stuff. Um, anatomy but, you know, physiology. And then once you got to third year, the scientific, basic clinical practice stuff, um, just mean, the pathology all came up again and was re useful for this. And even though I, you know, I couldn't tell you off the top of my head, uh, you recognize it at least. So it made it easier to, to look at on the second, you know, for the second time as a booster for the first time, the questions I think are harder than finals. Um, the contents quite niche but, uh, unlike in finals, they're not out to get you. So there's no double negatives or there's no ones where you're like, hm, there's three there. That could be right. I think there's usually a clear answer. Um, it's financially motivating in that it's 550 lbs every time you sit it. So personally, I was like, I really don't want to have to sit this again, um, and pay that out and I also didn't want to have to at the time it again. Um, so I think that made me give it AAA bigger stab from the start, I think for, uh, for mentioned reasons, it is worth setting it earlier earlier, the better. And then if you don't get it in the first attempt and you have a higher chance of getting it the second time and, uh, you've given yourself enough time to do that and because a lot of the stuff is repeated. A lot of it is pattern recognition and there are certain topics that they do love. Um And there's such a broad content base. It makes more sense to study smarter, not harder. Um And that's it. And thanks very much for this. I'm happy to take any questions. Thank you very much Michael. Um Let's um just a few questions we had about. Would you have any advice for the actual day of the exam and sit in the exam? Like any tips for that? Um I'm trying to think, I think you, you get a break in the middle but uh I thought it would probably be the case but you don't have a chance to leave during it. Um And there's not that you'd expect, but there's, there's no word to like, um, uh you know, eat food or get food or any access there. So bring all of your own water and your own uh food and snacks and anything you're gonna have, you can bring notes on the day. Um, but I'm not sure you'd want to sit and do that in your half an hour break, but you can, and uh I would just show up early to avoid any stress. Um If you're doing it in Belfast, there's nowhere really to park handy near the exam. Uh So I made sure to go in a good bit earlier. Um So I wasn't worried about any of that. Um And uh, the other thing is because everyone starts at slightly different times and finishes at slightly different times. You have that window, but when you go into the, um, into the room, they time you on an individual basis and you press start when you're ready to go. So you maybe have like 10 minutes where the loading screen before it'll start and as soon as you're ready you can go. So you might see other people, um, getting up and going and moving about, but just stick to your own timings. Um, and personally, even if I had lots of time rather than ending early, um, I made sure to use all the time I had. Perfect. Um, another question was any advice on how you revise on a busy road. Like if you were on a busy patch of the road tips. Um, II don't know, it is hard. Um, I think some of the, so I asked some of the other guys as well in work that have sat up because everybody's a different approach and a lot of them said they were too tired by the time they get in, in the evenings. So they would get up and do an hour before work. Um, and sometimes I did that where the work commute would, would take me a lot longer if I was going in for nine on the dot Than if I went in for eight. So I would go in early and then I would take time off my commute. I'll have that back to do a bit of work in the morning and then I'm not losing that in the evening. Um, and I'd have my laptop in work and then I could maybe stay on for an extra hour, um, and go to like a room in work and then not be busy going home again either. So, uh I felt like I was getting time back on my commute, uh and also getting some of the work done. And I think then apart from that, it's just allowing as much time as possible and looking at your rota and seeing when you've got time to um to do the work and, and try and keep that time free. So, um, I was pretty, uh like maybe like the last two months before I was pretty antis sociable with my weekends because I made sure to keep them free for studying, um which is just hard to do and it's a bit of a sacrifice. Um And I think it is in the back of your head. Um But because you know, it's a hard exam to pass, you don't want to give up uh a lot of your free time to do it. Um But, but that's kind of what I had to do in the end. Perfect. Uh Thank you. And then just another question about, I know you used a mixture of a MRC Ss and PA test. Do you think it was beneficial to you, like, you know, you said past test is slightly different types of questions? Like, what do you think kind of reflected the exam a bit better or? Um, I thought that the, um, E MRC s, um, questions overall were better. Um, but the past test ones that they have on their, uh, websites that aren't the actual exam ones were quite hard. Um, and I'm not sure they were as relevant whereas the past paper questions like were relevant. Um So I think I would use some of both, but I would use us more just for the past papers and use E MRC S for testing yourself. Uh Another thing I found was the past test, the past uh E MRC S ones were slightly easier in general probably than the actual exam. So I was scoring a lot higher on them than when I went to do the past uh test ones. Something I didn't actually mention in the presentation, which I probably should have was that the past marks usually between like 66 67% and like 7374. It just depends on how hard it is. I think for mine, it was like 6768. Um But II was finding it harder to get, you know, uh 70% plus in the past test ones versus the E MRC S. So I think uh the those questions were use more useful in the end for gauging where you're at. Um Another thing that I meant to mention when I was talking about the exam breakdown was that you have to pass both parts individually as well as overall like paper A and paper B or paper one and two. So um having that ma test format was really useful because you get a separate mark for both and that's what you're gonna need to do in the day. Yeah, perfect. Thank you. Thank you very much. Um I think that is all the questions that I've got. Um So yeah, that's us. Thank you very much. No worries. Thanks very much and thanks and, and just a reminder that there is a on Monday evening as well on the M SRA from one of the quadrans. Uh Yeah, thanks very much for coming.