15.12.17

MRCPI clinical Exam PART 2 (MRCPI PACES): Breakdown of long and short Cases: Explained

MRCPI CLINICAL EXAM PART 2

Long & Short Cases in MRCPI Clinical Exam:
You will be asked to examine two 25-minute long cases and five ten-minute short cases, one of which is a communication and ethics interaction with a role player.

Long case stations
At each long case station you will examine a patient for 25 minutes. You have 20 minutes in which to take a history while observed by one examiner and to perform a focused and directed examination. A 10 minute notification will be given. You then have 5 minutes to discuss investigations and management.

Short case stations
There are five short case stations. Four of the stations will have a patient. The fifth station focuses on communication and will have a role-player instead of a patient.

The timing breakdown:
1. For the short case, In the first six minutes at each station you will be asked to examine the patient and elicit and interpret physical signs. During the next four minutes, the examiner will ask questions relevant to the clinical examination that you have just carried out.
2. For the Long Case examination is as follows:
o 25 minutes total:
o 20 minutes in which
• to take a history while observed by one examiner and
• to perform a focused and directed examination
• a 10 minute time notification will be given
o 5 minutes to discuss investigations and management
 The main assessment outcomes are to assess candidate’s competence in
o Clinical communication skills (CCS)
o Managing relationships with patients (MRP)
o Physical examination (PE)
o Identifying physical signs (IPS)
o Differential diagnosis (DD)
o Clinical judgment (CJ)
o Maintaining patient safety and quality of care (MPSQ)
Short Cases:
Candidates will be subject to 5 short cases, each lasting approximately 10 minutes, and marked by 2 OR 1 examiners. Typically 6 minutes is given to examine the salient features, and 4 minutes are then used for questioning by the examiners. It is important to note that the candidate is given an overall mark (1–5), which has been agreed by examiners before the start of exam, based on the aforementioned marking scheme and difficulty of exam.

MRCPI CLINICAL EXAM PART 2: FORMAT Explained

MRCPI CLINICAL EXAM PART 2

MRCPI clinical examination format 5 marks for long case, 5 marks for short cases.

Marking system •   
5: Clear pass.  Competent in all aspects of history, examination, presentation and knowledge. This mark compensates for a 3 (redeemable fail) in the other section of the exam.
4: Pass.  Adequate presentation of the case, clinical examination, and clinical acumen; represents achievement of an adequate standard. 
3: Redeemable.  Overall performance below required  standard.
•   For example, this may be due to a poorly presented history (with accurate information), or sub-par knowledge of subject.
•   This mark may be compensated by achieving a 5 in the other section of the exam. 
2: Fail.  Below standard in all respects. •   Cannot pass MRCPI clinical with this mark.
1: Bad fail.  Candidate lacks skills and knowledge to pass the examination. This candidate will require specifi c training and supervision prior to retaking the examination.
Must achieve a combined total mark of at least 8 to pass.
•   Candidates randomly assigned to long or short cases first.
•   Real inpatients for long case.
•   Outpatients may be recruited for short cases.
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