How to Prepare for the Membership of the Royal College of Physicians (UK) Part 2 Clinical Examination (Practical Assessment of Clinical Examination Skills): An Exploratory Study

The Practical Assessment of Clinical Examination Skills (PACES) examination is considered the most difficult component of the three-part Membership of the Royal College of Physicians (MRCP) United Kingdom (UK) diploma, which provides budding physicians with access to a diverse pathway of subspecialties and a rewarding medical career. Preparing for the exam is onerous, especially when also juggling work and family demands. This research explored how candidates can prepare for this exam in an organised manner to improve their chances of first-pass success. Semi-structured interviews were conducted with 10 participants in the West Yorkshire region in the UK who had passed the PACES examination within 24 months. The interviews were transcribed onto QSR NVivo software, coded reflexively and analysed using thematic analysis. The analysis identified 25 codes that were aggregated into the following themes according to their density; (a) mental conditioning, (b) clinical exposure, (c) external factors and support, (d) revision courses, (e) knowledge acquisition, (f) playing the objective structured clinical examination (OSCE) game, (g) change of strategy, and (h) novel methods. In summary, it takes more than just clinical exposure and rote learning to pass the exam; preparation involves a complex, multifaceted approach. With proper mental conditioning, organisational skills and confidence, the adverse effect of test anxiety could be reduced to improve chances of success. Peer learning is an effective tool for facilitating examination preparation among candidates, besides providing a supportive framework. Cues from this study could act as a guiding framework for future PACES candidates to further refine their study strategies.