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0. Everyone is tweeting about the new F1s, but my beloved IMTs are close to taking the most dreaded exam. So here is...
Tips for doctors taking PACES (the deadline is 4th August!)
Credentials: did it. Failed it. Ran it.
Tips for doctors taking PACES (the deadline is 4th August!)
Credentials: did it. Failed it. Ran it.
1. The most scary thing about PACES is that you haven’t examined anyone in front of another person in about 3 years by this point. The big fear of the exam is more embarrassment and looking stupid. Also, your neuro exam for X years has been “moving all four limbs”.
2. Find a PACES buddy. You’ll rely on them to keep you motivated, and you’ll need a load of motivation when you stay late to find cases and run through things.
3. Remember patient meal times when you go to examine and practice- usually at 5-530 they are having dinner. Run through short cases/comm skills at this time.
4. Practice classic examination in front of a friendly registrar. Let go of being embarrassed about your rusty exam skills. You need to perfect your examination first, and get super slick, so its muscle memory and your focus is picking up the signs.
5. I’ve said this before - the hands behind back, stethoscope off thing is old school. My 2nd attempt I went in thinking I was the on call med reg, discussing a patient with the post take consultant. It worked for me, but I see the other way can help focus.
6. Don’t show any personality or be interesting in any way. The examiners have seen people examine a million times so they won’t be that interested in watching you. When you do something out of order, they will be on you like a hawk. You don’t want this.
7. Accept the high probability you’ll fail the neuro station. It’s tough station with the time limit, and it just flusters everyone because it’s “neuro”. The examiners mostly want you to identify the level of the lesion rather than come up with an obscure diagnosis.
8. The examiners examine the patient before you get in there. They are usually non specialists (ie cardio doing gastro) and they expect you to pick up what they did. No tricks.
9. Never make up findings to fit a diagnosis. Patients drop out, and if worse comes to worst, they’ll recruit one of the volunteers. They will have normal exams. One poor volunteer had such flustered candidates they gave him a variety of genetic disorders.
10. The style of marking, test multiple domains ie clinical reasoning, examination, differential diagnosis in one station. You can do a good exam and a crap differential and fail the station but still pass. Therefore if you tank one station, you will not fail the exam.
11. You do not need expensive courses to pass this exam. If your course is paid for, go to it and pick up all the interesting cases. It’s not essential though, and you’re likely to pick up similar skills talking to previous candidates and seeing lots of patients at work.
12. Make everyone aware you’re doing the exam. Turn any situation into an opportunity to present. Ambulatory care is a great place to practice short cases. Clerking is a great place to present physical exams.
13. All you need is cases for paces. Do not read anything more, it is normally unhelpful and over complicates things. The Oxford handbook is a good example of this - it’s helpful to some extent but in my opinion too much information.
14. 6 weeks of focused revision is all you need. Don’t start too early, you will burn out. Don’t start too late, you’ll panic.
15. PACES, like most postgraduate exams, do not prove how good a doctor you are. Unfortunately we haven’t got a sophisticated exam to test that yet. PACES remains a game. Games are unfair because there is chance involved. A 3rd attempt pass means just as much as a 1st attempt.
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