Khairulorama – Life and Medicine

Be Forceful and Methodical! BFM!

Thoughts on PACES

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50% disagree vs 50% agree!

I disagree that UK candidates are more superior than overseas candidates. I am a malaysian, trained in malaysia. The only thing that differentiate us from the UK candidates is our shyness and feeling of inferiority compared to the UK candidates because we may not have the english accent! I have seen UK candidates do badly on the talking and short cases stations and hence failed their exams. It’s our own attitude and negative thoughts that have failed us.
I agreed that paces candidates should not rely too much on information from books as regurgitating from books will certainly end up in a grave soon (learned from my mistakes!!!).
The objective of the PACES exam is to assess candidates on their daily clinical work and the candidates’ ability to communicate effectively with patients as well as among their colleages. If anyone applied and practices PACES skill in their daily clinical work, I am sure they’ll sail through the exam without any problem.
The trick to the exam in my humble opinion is to nail the history and communication skills stations in order to compensate for any downfalls in other clinical skill stations (it’s an absolute must). Foreign candidates failed badly in these two stations mainly because we don’t practice enough on these two stations(these two stations carry ~30% of the total marks) and concentrate mainly on the short cases stations.
Practice, practice and practice examining patients under timing with your paces partner, try to work out the diagnosis from first principle and explain reasons for favouring one differential diagnosis from the other one based on the clinical signs illicited from the patient that one examined and not regurgitate from books. Challenge each others constructively. It’s extremely useful if one can find a “hawk” senior registrar/consultant to take you to see patients. The art of explaining in paces exam is valuable if you’re prepared beforehand. I was challenged like crazy during my last paces exam and the examiners wanted to see my reaction and firmness on my diagnosis, so be prepared for this mental battle and be prepared to disagree with the examiners with reasons!!! Good luck to all of you guys who will be appearing in the upcoming PACES exam and God bless!

95% of the time, I learned from my seniors, peers, teaching medical students as well as seeing patients endlessly during my daily clinical work and apply paces method each time when I see patients. Always think about what paces station this could be when I clerk in patients and use the opportunity to present cases to my peers, seniors. Remember 4Cs, try to work out the condition, cause(s), functional capacity and complication(s) and management plan(include investigations) for each cases. Always ask myself why is this differential diagnosis is more valid than the other one. The main aim of the exam is to test the candidate’s ability to responds to problem(given as scenario for each cases), examine thoroughly and relevant parts, explaining signs and based on the physical signs Take on criticisms with an open minded mannor and reply in a sensible mannor with valid reasons. 5% of the time I spent it on reading about the condition if it’s complicated cases. Don’t spend too much time reading books cos will end up memorising stuffs from the books and regurgitate them(I find this a basic human nature and a big mistake that I’ve made before, so I ended up putting all the books aside). Remember, “The journey of a thousand miles begins with a single step”. I have learned from my peers, seniors, medical students, most importantly my mistakes. Good luck and god bless.
a glitch with the garfield reply above. I missed out something with a statement:
based on the physical signs, come up with sensible diagnosis or differential diagnosis and explain them. Need to lead the examiners with your sensible and logical thoughts. Never be absolutely sure about a diagnosis cos the examiners may perceive that as over-confident or cockiness, nothing in medicine and life are textbook based, mind you the examiners sometimes do not know the definate diagnosis as well.
Another thing I found useful is to volunteer to help out in organising your local hospital PACES exam. Hope these comments helpful.
Garfield said
Don’t spend too much time reading books cos will end up memorising stuffs from the books and regurgitate them(I find this a basic human nature and a big mistake that I’ve made before, so I ended up putting all the books aside).

Thanks
This is good advice

Learn good clinical methods
Practice
Revise common topics – diabetes , thyroid disease , valvular heart disease , rheumatoid arthritis etc – the same common topics that come in part 1 and part 2
You will pass
Do not get fooled into thinking that studying a few cases and going for the exam is going to make you pass
In summary, you are going to become a clinical physician, therefore they want to ask and assess your clinical skills.

Written by khairulorama

May 14, 2016 at 8:15 am

Posted in Uncategorized

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