Demystifying PACES - Candidate Perspective (17 Jul 2024)

SPEAKER_01 0:00

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SPEAKER_03 0:44

I'm going to be hosting this episode today. I work with the Trainees and Members Committee at the Royal College of Physicians of Edinburgh, and we are a group of trainees who work to represent the views of those training in physicians specialties. We also produce a lot of educational material and this demystifying PACES series is a mini-series in our career conversations podcast. Today we're going to be talking to three candidates who have recently passed their PACES exam about their personal experiences of preparing for the exam and sitting the exam. I'm going to ask them to introduce themselves one at a time. So if we start with Olubenga Alabi, who's recently passed his PACES exam.

SPEAKER_00 1:27

Thanks so much for inviting me. Surprisingly, you pronounced the name rightly. Yeah, it's uh Olubenga Alabi, and I'm currently IMT2 in the Belfast Trust in Northern Ireland. I'm currently doing my oncology rotation now. Thank you for having me.

SPEAKER_03 1:41

Brilliant. Thanks so much. And then if we just introduce Aparna next.

SPEAKER_02 1:45

My name is Aparna. I'm currently an IMT1 in the East Midlands. Like I'm also on the Trainee and Members Committee, and I have an interest in dermatology. Currently I'm doing my geriatrics rotation.

SPEAKER_03 1:58

Perfect. And then we've got Yasmin.

SPEAKER_04 2:00

Hi, I'm Yasmin Cookim. I'm also an IMT1 trainee in South London, and I'm currently on my rehabilitated medicine paired dermatology block at the moment. And I am also on the trainees and members committee.

SPEAKER_03 2:12

Brilliant. So we thought we'd start the episode by having a chat about how each of you prepared for the exam, whether this be the timing that you chose to sit the exam at in your training, or any resources that you used, or any particular techniques of revision that you use that you found helpful. So if we start with you, Olu Benger, just share any experiences there.

SPEAKER_00 2:34

I think I'll probably start from the booking of the exam itself. I have a friend room when we were doing rotation together in um ICU. And that was my second rotation in 82. And I said, let's look this exams together. And said uh it's not prepared yet. I was like, I'll just give it a try. And I booked for first diet in January 2023, and that's the first diet of the new basis. And it was okay initially. And I think talking through materials, it quite depends on the nature of your own personal learning. I'm quite photography. And if I see things, they tend to stay more than me having to read also. So I have to use more visual special uh materials, so videos and watching people do things, I can mimic that. So I think that was those are some of the things I did then. I had to book the exam in IMT2 because I felt I've had enough exposure. As you know, I trained in Nigeria, Walla Bisendo Banjo University, and having to come here to start IMT and then I so I probably needed to integrate more. And so after my IMT1, doing all the um part one, part two of MRCP, I was like, now I can face um the clinical exam. So and I also have to plan my rotation to suit the nature of the exam. So I ensure that I go through some of the specialties. I may not have had exposures to so much fire stars. Most medical students would not have exposure to dermatology, to rheumatology, which are things you could meet in the real basic exam. So I had a three-month experience in rheumatology in my consultation. And luckily, I saw by station five were rheumatology cases completely, and these were things I was seeing on the wall. So it was like I was just having a chat with my consultant on the wall in Moscow. But that was the way, and I used some paid resources material, some websites which would also mention in the course of this podcast.

SPEAKER_03 4:26

Yeah, brilliant. I think that's really key, isn't it? Thinking about when is a good time in your training according to particularly key rotations that you've done, and a rheumatology or dermatology rotation is a great experience that not everyone gets and can be very relevant. Apana, did you have a particular reason for picking the time that you did paces or any standout materials or preparation methods that you used?

SPEAKER_02 4:50

So I sat my exam at the very start of IMT one. It was the first sitting of pieces available to me during IMT1. And my reason for that was mainly just so that I could get the exams done about the way as the compulsory thing for training and to get into uh HST. So I just wanted it out the way. And I also thought that the knowledge and skills and professional capabilities which you acquire during the process of revising and preparing actually holds you well during the day job. So that was my main reasoning for setting it then. And I also had quite a few medical rotations during FY1 and FY2, so did have a bit of clinical experience as well. In terms of revising for the exam, I don't recommend this, but I didn't have very much time just because I booked the exam in July, and then we got the kind of exam date at the end of August, and then my exam ended up being in October, so I only ended up having six and a half weeks, which was very stressful and it goes for that thing. But along with juggling that with commuting to work and working full-time in itself, so you know, anybody who's pressured with time or is juggling a number of different things, I hope this kind of reassures you that, you know, it can be done if you are short of time. That was kind of my reasoning and my timing of setting the exams. In terms of how I went about preparing for it, I used kind of popular books such as Cases for Paces to revise for it, and also a book by Rupert Bessant as well. Yeah, because they were, you know, very tried and tested materials and weren't very expensive and very high yields for topics which come up. I also looked through the curriculum for PACE and IMT and looked at sample exam scenarios as well as a guide as well as marking schemes to know what examiners were looking for. And I looked at official videos just to see what examiners wanted and spoke to people as well, and I used that kind of knowledge to help plan my revision. And you know, I had another IMT one who was also sitting PACES at the same time as me. So we went round the hospital and found cases and just prepped with each other. There was a PACES group in my hospital, however, I didn't end up going to that because I think it just worked out that I had quite a few on-call shifts when it was running. And also when it was on, they were just doing lecture type tutorials. And I just felt that, you know, me and my PACES buddy would have gotten much more of it out of our time by actually examining patients and testing each other. So, you know, I picked and choose what I used then. And we also asked a few consultants who examined for pieces to help out with scenarios as well, and that was super duper helpful. There's also quite a few podcasts, you know, the RCPE podcasts on the Tuesday, and there's quite a few other pieces podcasts which were quite good. And in my comments to work, I just listened to that, and that was an effective use of time. And there was quite a few online websites which had examples of people doing the examinations or doing consultation stations and then discussing the scenarios, which I found pretty helpful as well. So doing that, and I also have a very nice partner who was a very willing patient to practice on. And I just practiced every day with him and he was very sick of it. And I think Loki felt stressed out as well. But that just helped with muscle memory. So, you know, I did that as well.

SPEAKER_03 8:37

Yeah, I think what was interesting there is the amount of times that myself, having done PACES maybe two years ago, were agreeing with your strategies there, and I could hear Oli Benger agree with books you'd used or strategies you'd use for revision. And I think that idea of having a PACES buddy is, if it can be arranged, super helpful. Because as you say, that feeling of being examined and being watched by someone you trust or respect or who's supporting you through that process is really the best revision practice. Yasmin, you've got the tricky task of going last, which maybe you'll say some of the same things again, but I actually think that's really interesting that the same themes are coming up of how people prepared. So just let us know again a little bit about how you chose when to do PACES and if there was any particular revision strategies that were useful for you.

SPEAKER_04 9:23

Yeah, of course. So I set mine in IMT1 and I was the second cohort of doing the PACE 23, the new adjustments that they implemented. I sat my MRCP part two in September of 2023, just at the start of IMT1. And then I was actually debating whether or not to do PACES next because I felt quite tired after doing the paper. And I think I was on stroke and neuromedicine at the time, and then I was rotating on to acute medicine, which is when the next diet of the PACES would have been. And I was torn with a very busy rotor and doing paces, or waiting until the summer when I was on like more chiller rotation, which is recap medicine with dermatology. And then when I got asking around what others did, I think sometimes there is no real good time to do it. You just have to do it when you're in a training programme, it's mandatory. Ideally need to complete it by IMT2. And when I was thinking about it, I know I'm quite keen on a group two specialty. So having that under my belt and my exams done before applying would be so helpful. And when thinking about acute medicine, a lot of the stuff you see on Clarking or on PAKEC or, you know, when you're covering the wards on acute med actually all paces patients anyway. So I it was kind of like revising every day. So in my head, I thought, let's try and sign up, see how it goes. I hear people need to do it a few times anyway, because it's quite a tough exam. So I thought I'd head to my bet and just try and see, even with the rotor. And I tried to sort of see each day as like, let me try and learn something from a patient I saw that day. And I found that an easier strategy because even if I was doing the long days and night shift, if someone said, Oh, there's someone who came in with a murmur or some a renal transplant has come in, I'd try and take that opportunity to take 10-15 minutes out of the day to go and see them. So that was my strategy and my reasoning for taking it at that time. People might have thought differently and thought, oh, I need to do more book work. But for me, I learned better with seeing, and then I'd read up on it after I learned better that way. Then with revision strategies, I'd sort of echo what the others said really. I started off with asking a lot of people who'd passed pages this gone and those who did the Pages 23 diet, like in the time when a partner did it. I asked around what they did, what they found helpful, and tried to sort of gather what I thought would be helpful for me as a learner, because it is quite different to your written. So what I found helpful was to start off with a book and website materials. So for websites, there's loads out there, but I signed up to pass tests and I found that a helpful strategy was learning how to do the examination. And then secondly, it's sort of a core book. So my core book was my Cases for Pacers. I thought it was not detailed enough that I get bogged down and stressed that I needed to learn absolutely everything from there. But a good starting point with common cases that come up in PACE for cardiology, neurology or respiratory, and then using that on white key medicine to try and find those patients, for example, with COPD or with aortic stenosis. So I found that helpful. And then I layered from there, similar to what Parna did and what Olibenga was saying. So listening to podcasts, so the RCP, the prepages podcast, I found really helpful.

SPEAKER_00 12:23

There is this um I think is in medical links.

SPEAKER_04 12:27

Oh yeah, the links, yeah.

SPEAKER_00 12:28

Yeah, they have some that is yeah, it's just a real now.

SPEAKER_04 12:34

Yeah, it's really good. I found there was out of fact so many resources, it's quite hard to cherry pick what was you know, what you had time to sort of go for. But I think once you get going, you sort of can realise what your weaker stations might be. So for me, that was neurology, and actually I found cardiology could be more difficult than you realize. So I thought reading up on those and trying to find the online materials like learn heme or ploughing through paces with another good website quite helpful to refresh your memory on things.

SPEAKER_03 13:03

Brilliant. And I think that idea of seeing your everyday job as revision is so important. And I think Oli Bangi, you said something about when you were actually in the station, it felt like you were just talking to your consultants, like you had been at work. And I think every time I got stressed, when I just came back to the fact that actually we all do this every single day, and we don't get stressed about it because it's so normal. That helped me feel a little bit calmer. I think I did use that on exam day of just being like, I'm just gonna try and be the best version of me that I can be at work. And that's all I can really ask of myself. So I think that's a really great strategy to have for both revision and kind of preparing for the exam day. Maybe now we can move on a little bit to talking about the exam day itself. So whether you had any surprises, any tips or tricks for approaching the exam day itself, and any strategies that you'd pass on to preparing candidates for dealing with those nerves on the day, maybe stations that they feel like didn't go well and how to recover from those. I know we said we were going to go around in the same order, but maybe if we reverse it just to give everyone a chance to say different things. So yes, what do you want to go first?

SPEAKER_04 14:17

Yeah, so my exam was actually up in Scotland and Glasgow. So I'd travelled from London to Glasgow. So what I did is leading up to the exam time, I actually took a couple days annually before and I travelled up two, three days earlier just to settle in. And also I was quite worried about train job flights getting cancelled. I flew up and I stayed there for two, three days before. I was so nervous leading up to it to be honest. And I feel like the week before there was so much I wanted to go over that I hadn't gone over, but I sort of had accepted what I do every day is hopefully enough, and what I know is what I know, and you can't anticipate what cases you're going to get on the day either. So I sort of tried to take it easy those two days before. Um I went to the hospital a bit earlier, so about an hour earlier. There was a couple of other people there we chilled in the cafeteria. And in terms of dealing with nerves on the day, I think just like you were saying about reminding yourself that it's what you do every day, what you see your medical registrars doing every day, trying to put that hat on like what would they do, what would a consultant expect of you. And then in terms of surprises that you might get, for me, I thought I found the consultation stations probably the most difficult because 15 minutes to get a history, an exam, to go through the patient's ideas, concerns and expectations, and also go through investigations and management plan with them is actually quite tight. But I think the patients that you're sort of equipped with are well trained and well versed to give you the sort of focused history that they need to give you and not prolong the consultation as long as it needs to be. And I found that that was probably the bit that people should focus on practicing most. I think I didn't practice enough of that. Yes, being on take help, but timing myself would have been a bit helpful. But I know in your day-to-day job you can't really do that because a lot of people aren't as well versed as the patient on the day. And I think avoid in terms of surprises that might come up, you know, a condition or really being unsure with how the consultation's going to go or how to navigate through it. It's just going back to your basics. So I think for me, prior to entering the room, you get given a vignette, so what the patients come in with, how old they are, and you have about five minutes to prepare. So I found going through specialty systems, I'd write endo, rest, neuros, and I'd write out my differentials for each one, and also sort of key questions I'd want to say to include or exclude my differentials. I found that really helpful with dealing with nerves or surprises. So at least it shows your logical, what you do every day, and bringing it back down to your basics of I have an algorithm and this is how I safely deal with patients I see every day, and I'm not forgetting or omitting sort of cute things that we should be identifying.

SPEAKER_03 16:56

I really like that idea, and I think I use it in my day job as well of when you have a moment where you're stressed, which is essentially what the PACES exam mimics, doesn't it? It mimics that extreme stress that you sometimes get at work from whatever reason, to have that system to fall back on, whether that be a kind of way of organizing your thoughts around a differential diagnosis or a process of taking a history, it's to show that you have those systems to fall back on in those times of stress. And I think the idea of writing those out or having a way of remembering them in that kind of vital five minutes before you go in the station is a really nice way to make yourself feel safe and that you can deal with whatever comes up.

SPEAKER_04 17:34

I also think the patients try to give cues as well. So it's picking up on patient cues and exploring them, whether that is a medical concern or a social concern, is all quite important.

SPEAKER_03 17:44

Yeah. Abana, did you have anything to add about particular your experiences on the actual day, anything that went well or badly, anything you'd change?

SPEAKER_02 17:52

Like Yasmin, I went to the exam kind of centre. Mine was in Aberdeen, so we drove up the day before and stayed in a hotel which was quite close within walking distance of the exam centre, just so that we didn't have to deal with you know last-minute cancel trains or anything like that. On the exam day, I also went to the exam centre early, and my centre was very well organized, and you know, they tried to keep me nice and calm. And then on the day of the exam, I felt randomly quite calm. I think the day before I was just super duper nervous. I had chest pain, palpitations, was super worried. I think I just, you know, got the nerves out of my system the day before. And then on the exam day, I was just like, you know what, I'll just give it my best shot. If I'm nervous, that's only going to hinder me. I just thought, you know, it's better to go in giving off an aura of confidence and just showing what I know and just giving it my best shot. And you know, if it doesn't go as planned, then I can always sit to again. Loads of fantastic wretches who I know didn't pass first time. So it's not a marker of how you are as a doctor or your knowledge base or your acumen at all. There is some luck involved, so I was saying just give it your best shot. It's not a marker of yourself worth or anything. And with each station, I think I just like Jasmine, I just read the vignette. I thought about you know what the key issues are, what are the important things that I can't miss and with the main safety issues here. And you just kind of go in, be polite, friendly, ensure that you give off like a good first impression. And then if there were some stations where I was caught by surprise or I wasn't too sure what was going on, I just left that behind me. I just moved on and I just concentrated on what was ahead. Because sometimes, you know, how you think you're doing isn't actually how you end up doing. There was a few stations where I thought I didn't do very well, but then I ended up getting full marks and things like that. So you're not a very good judge of your own performance at times. And here's the story on my consultation station, I offered to check the pupils because the patient had diabetes, and I just thought, you know, I'll offer to do it because I see the fundus comp there. And I thought that they would say, Oh, you can just put it down and you don't need to actually perform it. And the heartbreaking moment was that they went and switched off the light so that I had to pebble. And I'm awful at fundoscopy.

SPEAKER_03 20:26

It's tricky.

SPEAKER_02 20:27

It's so tricky. And to be honest, I'd done a little bit, but I was kind of placing my bets on that it wouldn't come up, but whatever, it came up and that station didn't go well. But you can put that behind you and just move forward. Just taking each station as it is, thinking through key issues, and you know, the examiners, they're not looking for you to be perfect, they just want you to be somebody who can be a safe pair of hands, you know, managing a DGH managing take. That's the kind of vibe which they're looking for. And they just want to know that you know most things at a good level and that you'll be safe and competent. I think that's what they're looking for. And I try to remember that.

SPEAKER_03 21:09

Yeah, I think that idea of having a moment or a station that you feel hasn't gone well and trying to move on from that is so hard. And I think a few things you said there, Uhana, about remembering that in that moment you're not a good judge of how well it's gone. That's just your perspective and your very stressed, nervous perspective, and to try and put that aside and just draw a line and do the best for the next station is definitely a challenge, but it's one that I think would really help candidates in that scenario. Oli Benga, again, you've got the challenge of going last this time, but anything that you would want to share about your experience of the exam day, whether it be the physical logistics of getting there or the techniques that you use to face challenges along the way, we'd love to hear about it.

SPEAKER_00 21:54

You know, I work in Northern Ireland, so the implication of that is that I can't write my exam in Belfast. So I They have to cross the sea. So I flew down to Edinburgh a day before the exams. So that was a Friday. My exam was on Saturday, and I stayed with a friend and very lovely family. So I felt at home eating my local dishes and the night. So that seems to probably calm the tension a bit. But I must say the adrenaline rush, the tachycardia, they are all normal and everyone should feel that rush. So if you don't feel it, then I'll probably say there's something wrong with the sympathetic system. So on the exam day, I had my breakfast, but I could not complete the food because obviously I was a bit scared. And sometimes if you need to do things to slow down your heart, provided it's not going to harm your heart, go ahead and probably so you need that composure on that day. So my exam was in the royal infirmary in Edinburgh. And I must say it's one of the most organized exams I've seen in my life. It was in OPD2 or so. That was my first time in the hospital, and I got there about one hour before, like from my other panelists. And we got there, I got to the station there. I was told it's not yet our time yet. So I had to go back to sit somewhere. And I have to probably just take a walk around the very big hospital, like our royal in Belfast here. I found that in a place hoping to probably revise, but I could not. So I just felt just drink something and hurry out as Blagos. As opposed to Yasmin, uh, I don't like cardiology, but I love neurology. So I knew neurology is my rest station. But once I go into cardiology, I know it's gonna be tough. And unfortunately for me, my young Young are both in the same room because they are both in station three. So my intention was to go in, smash your neurology, and then make do with whatever you get in cardiology. And that was why I did. Because I would know this is the system, this is an absolute mom. If you decide the mama, I can tell you what it is. But the good thing about cardiology is the management is almost generic for assistance. And I'm sure uh Yasmin mentioned that Len Game website, they have a very good resource for teaching you how to say things, and I practically wrote down the way I was gonna say things for my cardiology station. For other sessions, I know I could probably write my way, but cardiology, I knew this once I think that this is the systemic moment, this is what I was gonna say all through. And that was what I did, even though I not serve mark my sleeper.

SPEAKER_03 24:22

So it's good to have those scripts to fall back on, especially if you know that's an area that you struggle with.

SPEAKER_00 24:28

Then so on the real exam went in on my session one was that you know, for most IMGs, sometimes I struggle with communication. So I have to do my best to ensure that I say things. But the simulators or the solid is they are quite good and well trained. And sometimes if you make mistakes, they could probably ask you again so that they are sure of what you have said. And on that case, you can backtrack, or if you want to say I'm sure of this, then you can carry on. And again, always remember driving advice if there are implications for you in the exam. So once you get in, you get your veg neck and dick before you go into the room, write your plan. And for me, my review of system, I do it while fitting you. So I start from head, head and neck. So any headache, any seizures, any idea, and then I go to the neck, any dysphagia, chest, any cough, and then ask chest time, then go to the abdomen, go to the muscles. So that's the way I look at you and do my review of system, and that was the way I factored out to do things. And Yasmin also mentioned earlier that you probably have to take the take as a station two and five, which I think was very helpful because I never had a very close uh body. So what I did was when I go in, I'd say I'm spending 20 minutes to see this patient, and I go in, pam, pam, pam, pam, do all those things and come out and do I have a plan. Yes, I have a plan. Because those are exchanging patients who are stable and who are patients that could probably be fit for the same day assessment unit, so you could always sort things out that way, and that's what you probably need finding the exams also. And so for the exam proper things went that way. And one thing I did was in each of my five minutes in the v-net, I was get access for water, and they're very nice to us. So they just bring the water to me because my mouth would have been dried up, and I just use the water to water things, to wet things down, then before I go into the next ship. So that was how things went, and we're hoping for the best and expecting whatever happens, happens. And someone told me, as a general rule, that some guys, if you go in and feel you've not done very great in the exam, you probably will have passed that exam.

SPEAKER_03 26:35

Maybe that's a good thing to remember on the day for those moments where you feel like you've done rubbish. Just remember, well, some people have said that that's actually an indicator they were asking you hard questions or pushing you hard. Yeah. And I think what you said there is quite interesting, Oli Benger, in that everyone is actually on your side on exam day, whether it's the staff that are organising the exam and bringing you water when you need it, or whether it's the examiners who are trying to give you the opportunity to share the knowledge that you hopefully have. So be led by their questions if you get the opportunity to be. And for the last part of the podcast, we just wanted to talk about your experience after the exam. And I know we've got three fab candidates here who all passed first time, so don't have the experience of getting negative results and how to deal with those and how to pick yourself up for perhaps a next sitting, which is obviously a challenging experience. But I'll just give you a minute or two each to share the experience of waiting for your results, how you felt in that time, and if there's any last hints and tips that you feel we haven't covered that you'd like to share with candidates. So maybe if we go a pana first this time.

SPEAKER_02 27:42

So there was a bit of a gap. I'm sure it was the same for Yasmin and Olubenga between setting the exam and then waiting for the exam result. And I know previously that people used to only wait like two weeks to kind of hear back, but because this is a new format, they wanted to ensure that the exam was standardized and appropriate, and that the actual design of the exam wasn't faulty in any kind of way. So it ended up being that it wasn't till December that I heard back. And actually, they didn't give us an official date, so I didn't know how long I was going to be waiting. So it was at the back of my mind. I kind of forgot about it, but you know, I did prepare myself and I, you know, applied for the next sitting, and I hadn't revised anything, but I was kind of gearing myself up just in case if I did have to repeat the exam in the next sitting. And the kind of exams process was very stressful because I saw on a forum somebody mentioning that the status had changed on our exam from having sat the exam to results processing. Okay. And so on the Friday, I was just freshing the website, just waiting for exam results. And it was just, you know, I was so nervous on the day, and lo and behold, the results didn't get released on the Friday. So then I had the whole weekend of sitting like a nervous wreck waiting for results. And then Monday came when I was like, oh my god, it could be today. So I was just nervous all that day. And then again on that on Reddit, they said, Oh, I've gotten my results. And then that was just it was an awful kind of feeling, super nervous. I tried logging onto the website, and because everybody was trying to get on to the website, it just wouldn't load. So I had it trying to load on my phone and then on my work computer. And so I was just a nervous bull for a good one hour, 45 minutes, and then I got the results. And it was good news, thankful. But honestly, it was just I felt physiologically exhausted after having been nervous for several days and just having to wait for that last moment. So I don't know what to say from that, apart from that, it's a nerve-wracking process and that you know there might be a delay from results processing to actually getting your results. And I think it's just best if you just apply for the next sitting whilst waiting for your exam results, because you do well, I actually didn't end up paying for the actual exam fee. But even if you do, you do get that money back.

SPEAKER_03 30:17

Yeah, I remember also going through the process of paying for the next sitting and then getting refunded when the results came through. So I think that's good for people to know that that is the process, and that's quite commonly done for people going through this process. Also, I think it's interesting how long we probably all spent and most people would spend preparing for the nerves on the exam day and in the days before, but you don't think about the nerves and the stress involved in receiving your results, do you? But obviously a lot rides on that and it's really tricky. Olli Benger, did you have any good or bad experiences with getting your results or any last things you'd want to let people know who are studying at this point?

SPEAKER_00 30:54

Yes, because I already knew from their email that um the waiting period was gonna be long. And when I was applying, I had to ask for my exams to be put in March, though I applied in November, so that my waiting period would not be so long. So that was one thing I did, and I gave them reasons because I have to plan for my road time the likes. Yeah. Thankfully, they agreed to that. I got my exam date was March 9th. So finished the exam and things were going well. And in between that period, I had a meeting with my educational supervisor, was trying to write up my ESR, and I kicked all my boxes, completed my mini-cake, CBDs, all cards, required thing, and the only thing left was just for me to get the diploma. And so he told me, I remember here, he's a really good man, he's one of the neuropathologists here. He said, assume you have passed the exams until proven otherwise, because you've done your part, you've reading the exam. And also, I need to flash back something. One of the girls that we wrote the exam with on my exam day, we were five, four males, one female. She said something that was very funny. She said, When we finished the exam, she said, This exam is tough, and we all agree it was tough. And she said, But I will look at it as being the best mock exams I have written for patients. Yeah. Such that even if I fail, I'm happy to pay another 657 again to write another one. And that was the mindset. She said that, and I picked it out. This is all I was gonna use. So I think that and traveled back to Madame Ireland and uh work going to work coming back. And then when I had the meeting with my ES, it was quite a prayer feeling because that's just the last thing you need to get your outcome one, hopefully. And then the day before they release the exam, I just went in, it got to a stage, Google Chrome was saying your most recent website was in my MRCP page. That had, and I was like, oh my god. So when I saw that the result has been results being processed, or that oh, it's gonna be registration. And if you pass your mind back for MRCP one and two, it's usually released, I think, on Wednesday. So I think Wednesday third. So I was thinking, oh, now that it's this two being processed, uh, hopefully they're gonna release the result. And result was all released. And on Thursday, I had another meeting, my induction meeting with my new uh clinical supervisor. And when we had the meeting, he asked, Where are you with your exams? I explained to him and he said, Okay, you're about to you're doing very well, just get that precious pause and that everything is fine. And I was like, Okay, and I did not find that result being processed. So it was a Friday. I went to the mocks to pray, finished praying, and while I still pray, I was still checking. And after the prayer, I went back. I was going back to the world, and then I saw that result released, and I never knew the way the result will be released, just like the air pass one part two, you just see pass. I was thinking you are going to see it when you download the whole result. So I just clicked to download, and then when I download, I just saw pass and I was out of this world. Yeah. That thing, that feeling was different. I just ran into the world and I told my other colleagues one day, I entered it. I just said, as fast faces. And within 10-20 minutes, my play cast for us walked into the world to get a view, or you know, usually after the post after the world round, they call me in the evening to ask where we will take. And he came in and I said, Prof, I fast faces. Oh, it's like congratulations, fantastic. Now you're a good man, and ever since, so many things changed. Your life changed because people tend to hold you more responsible, people tend to listen to you more, and they know that whatever you're saying appears standardized, and that you're probably saying the right thing because you've gone through the rigor. So it was a life-changing event for me, and I'm very grateful for that day of April 5th when the results was released.

SPEAKER_03 34:56

Congratulations. And I think it's quite a universal experience, isn't it? Like you said, talking to your professors or senior consultants, everyone remembers that day of finding out that they passed. So everyone would be absolutely delighted for you, I'm sure. And Yasmin, just to end on you, any kind of personal experiences after the exam or any last kind of lessons you'd want to end on for anyone revising?

SPEAKER_04 35:18

Yeah, just thinking back to my exam day, I think what I found really helpful, everyone's different though, but I find it really helpful to debrief with the others. For me and a couple of the guys who had just finished the exam, I think it was quite nice to hear that they also found it equally really tough and really hard. So you're not alone in it. Because when you're coming out, like a Pana made a good point of kind of putting that station behind you, thinking what's next, and just trying to get the mark, do your best, put your best self out there. But when debriefing, I found that really helpful. And even just chatting with others who sat it in that paces period or diet, hearing them all they also had some tough stations and it's standardized for a reason. And as like Olibenka mentioned, like it's a tough exam and it's got a certain level of rigour to it. During that interim period, I actually I saw on the RCP website it told you sort of when the results would be released from, but it didn't tell you your exact date, and because of the new diet, it said anywhere between eight to twelve weeks. So I sat mine at the end of the diet, so mine was March 24th. So I sort of tried to it block it out until at least from April or whatever. And it was nerve-wracking, but I thought, you know, just kind of forget about it for now. And so they they released the results early, actually, the weekend before. But they did it for half of the people who sat at Pacers diet. I was at the end, so me and a couple of others hadn't heard that all of our friends who sat early in like February had got their results. So we were so nervous, but I still didn't say results processing. So for the week following, we were like constantly refreshing on the mic recipe, like waiting. And then when it said results processing, then it's that like that agonizing weight of will it be an hour, will it be the next day, will it be a few days? Yeah, so I mean I made top tips apart from I think I'm just really just eager to know. Then I found out at work and then sort of let my team know and yeah, they were very happy and called my family. Yeah, just reflecting on it, I think there's always that certain degree of fear of failure, like fear of like, oh, if I find out at work, I don't want to open it at work. But I was sort of debating if the email came through, would I open it when I'm at work or wait until I get home? But I think you never really know until on the day. I think I'm always like I just I think I said to myself, now I'll wait until I get home. But I think even if I had opened it at work and I found out I had failed, I think a lot of people in the room and who we work around know it's a tough exam. And there'll be people there who have failed. So sometimes you get that support from people there from what I've heard from others who've had that experience. And in terms of like final top tips, I think when you're applying, you do have the option to sort of put in any special circumstances. I had put in that I'd preferably want the end of March because I wanted that extra revision period, but also with my voter, my march is a bit calmer. And they honored that, which was really good. So I think that's good to know for others applying because some people I applied with didn't know that. Have a good revision strategy. So I think asking others who had passed or who had even failed what they thought went wrong or right, you could always learn from others and think about what revision strategies they did would suit you. So things that I picked up from others that I applied was like trying to have a revision buddy, like a partner, thinking about what books might suit you if you're a book reader or if you prefer websites or videos or like Oli Banger said he's a digital learner. And then identifying weaknesses. So for me, I knew neurology was mine. That was my fear. So I really tried hardest revising not only the book work but also seeing as many cases as possible. And then I think the final bit that I didn't mention earlier was probably getting slick with your examinations. So that's one thing I didn't really appreciate until I did a course in the end of Jan. So probably about six weeks before my exam, I did a Pacers course. I read up how to do the examinations, but I wasn't slick enough, I don't think, when I did the course. And I think if I had of nailed down the cardio rest neuro abdo exam, like the back of my hand, like I knew it. It was like no to memory. I probably could have picked up the clinical signs a lot better in both of you maybe you have for the patients of the courses. I think that's what what I'd recommend for people signing up for courses or just make sure you're flick with your exam, then you're just there to learn the physical signs, which is what people tend to fail on.

SPEAKER_03 39:25

Yeah, I think you've almost if you've got that pattern of examination, like without having to think about it, it frees your brain up to really look or really notice stuff that's in front of you. And those courses where they do have patients that have rarer signs that are more difficult to see in our everyday jobs. It's lovely to have your brain relaxed on the physical steps of the examination to make the most of those signs in front of you.

SPEAKER_00 39:49

For the examination, one thing I find, as Jasmine has said, is I would say don't practice completing the exam in six minutes. I would probably say practice completing it within five minutes, 30 seconds, so that you have 30 seconds to integrate your thoughts together before you face the examiners and they can start with it. So uh what that implies is practicing such that you don't have to think about the next aspect. All I need is what is the uh I've seen a feedback before where the examiner wrote that is very on practice. So that means that probably and it was a neurostation, probably even the way the candidate that was holding the tender mama. We know most of us don't do this, but we probably have to do things the right way and standardize our approach. And I try to say, okay, if you can get it done within five minutes, 30 seconds in your practice session, in the exam, you may be faster than that, and you'll still pick all the sites, and then things will go on way. But you don't have to think to examine patients. One of my consultants in my home country will say it should be at the level of your codiaquina.

SPEAKER_03 40:58

Yeah.

SPEAKER_00 40:58

It does not need to get to your frontal cortex, it should be down below. So you don't have to think, just go ahead and do it. And that's just what I'll have to add.

SPEAKER_03 41:06

Yeah, to get those steps second nature is really important and really something that only comes with doing them what feels like a painful number of times when you're practicing. Yeah, thank you so much for sharing that. So, yeah, thank you so much to the three of you. It's actually quite a vulnerable thing talking about your PACE's experience because it like you've all said, it's such a stressful time. So really thank you for taking the time and sharing your experiences with us. The last thing I'd like to reflect on is, and I think we've touched on it a few times, what kind of like a career-defining moment both preparing for your paces and doing your paces and the period afterwards is for all of us. And when you talk to your senior colleagues, everyone remembers that process. And I think, although maybe I wouldn't have said it at the time, there's something a bit of a rite of passage and something almost enjoyable about gaining that huge wealth of knowledge and doing it alongside colleagues who then become friends because you've been through this really tricky experience with them, and then also being able to share that experience with your senior colleagues and like you guys have passing that knowledge on to people who are preparing. So thank you so much for sharing that. So good luck to anyone who is preparing at the moment, who's made the most of this resource, and we really hope you've found it helpful. Just to remind you that if you access any of the other RCP podcast resources, there's many other episodes in our Demystifying Paces series, which might help you prepare for more specific stations in the exam if you're struggling there. And if you have an interest in particular clinical topics or other areas in medicine that are non-clinical, there's both the clinical conversations podcast series and the career conversations podcast series, which we hope you enjoy. Thank you again and good luck to everyone preparing for pieces.