Carolyn AllenMBChB MRCP
Consultant Physician, Rotorua Hospital,
Rotorua, New Zealand
Suzanne ForbesBSc MBChB MRCP
Specialist Registrar in Nephrology, Royal London Hospital,
UK
David HuntMBBS BSc PhD MRCP
Clinical Teaching Fellow, Newham University Hospital,
UK
Heather LewisMBChB MRCP
Specialist Registrar in Gastroenterology, Newham University Hospital,
UK
Ravi MenonMBBS MRCP MD
Honorary Clinical Lecturer, Newham University Hospital,
UK
Luke MooreMBChB MRCP(Lond.) FRCPath MSc MPH DTM&H
Lecturer, Division of Infectious Diseases & Immunology, Imperial College,
London, UK
Edited by
Aruna DiasBSc MBBS MRCP
Consultant Gastroenterologist, Newham University Hospital,
UK
Eric BeckMBBS FRCP FRCPG FRCPE
Former Chairman of MRCP(UK) Part 2 Board and former Member of the MRCP (UK) Part 1 Board, University College London,
UK
Published by JP Medical Ltd
83 Victoria Street, London SW1H 0HW, UK
Tel: +44 (0)20 3170 8910
Fax: +44 (0)20 3008 6180
Email: info@jpmedpub.com
Web: www.jpmedpub.com
The rights of Carolyn Allen, Suzanne Forbes, David Hunt, Heather Lewis, Ravi Menon, Luke Moore, Aruna Dias and Eric Beck to be identified as authors of this work have been asserted by them in accordance with the Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this publication may be reproduced, stored or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission in writing of the publishers. Permissions may be sought directly from JP Medical Ltd at the address printed above.
All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book.
Medical knowledge and practice change constantly. This book is designed to provide accurate, authoritative information about the subject matter in question. However, readers are advised to check the most current information available on procedures included and check information from the manufacturer of each product to be administered, to verify the recommended dose, formula, method and duration of administration, adverse effects and contraindications. It is the responsibility of the practitioner to take all appropriate safety precautions. Neither the publisher nor the authors assume any liability for any injury and/or damage to persons or property arising from or related to use of material in this book.
This book is sold on the understanding that the publisher is not engaged in providing professional medical services. If such advice or services are required, the services of a competent medical professional should be sought.
Every effort has been made where necessary to contact holders of copyright to obtain permission to reproduce copyright material. If any have been inadvertently overlooked, the publisher will be pleased to make the necessary arrangements at the first opportunity.
9781907816451
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging in Publication Data
A catalog record for this book is available from the Library of Congress
JP Medical Ltd is a subsidiary of Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India
Publisher: | Richard Furn |
Development Editor: | Thomas Fletcher |
Design: | Designers Collective Ltd |
Indexed, copy-edited, typeset, printed and bound in India.
5Preface
‘Assessment drives learning’ is a crucial mantra; it emphasises the broad educational value of the best of five (BOF) MCQs in this book. Its value is further enhanced by the inclusion of explanatory answers, making this a valuable source of continuing medical education and continuing professional development. However, the prime readership will, of course, be candidates preparing for the written Part 2 MRCP examination.
In this book you will find authentic questions, comprehensively covering the curriculum, devised by ‘battle-hardened’, recently successful examinees who are now teachers. The chapters reflect the specialties covered by the MRCP Part 2 exam. The number of questions per specialty is directly proportional to the weight each specialty area will carry in the exam. Each chapter covers a broad range of topics within the specialty, and questions range in difficulty between relatively easy and very difficult, as in the exam itself. For each answer, there is a section explaining why that answer is the most appropriate and also why the other options are not correct.
The emphasis of the Part 2 examination is in testing the application of basic medical science knowledge to more clinical situations. By passing the Part 1 examination, you have already demonstrated your command of this knowledge. This book gives you an opportunity to practise applying it. Apart from practice, there are no special techniques or tricks to be learned to pass the exam because the examiners take considerable care to use plain English and avoid including ambiguities or clues when setting questions. Nevertheless, always remember the general exhortation for all written examinations: ‘read the question carefully before answering!’
The final ingredient required for success is what we all wish you – ‘Good Luck’.
Eric Beck
January 2013
9Exam revision advice
Format
The MRCP(UK) exam consists of three elements. Part 1 is a written exam, whereas Part 2 is split into a written exam and a clinical exam (PACES). Part 2 can be attempted only by candidates who have passed Part 1 within the previous 7 years. The Part 2 written exam and PACES can be attempted in either order.
The MRCP(UK) Part 2 written exam has a three-paper format. Each paper lasts 3 hours and consists of 90 multiple choice questions. The examination lasts 2 days, with two of the papers taken on the first day and the remaining paper on the second day. As in the Part 1 exam, questions take a best of five (BOF) approach, where the most appropriate answer must be selected from a choice of five possibilities, with questions covering the full range of medical specialties. However, one major difference between the two exams is that a proportion of Part 2 questions will be illustrated with a medical image (e.g. ECG, radiograph, CT, MRI, blood film, photograph of a clinical finding), interpretation of which is key to correctly answering the question. The composition of the papers is demonstrated in .
There is no specific syllabus for the MRCP(UK) Part 2 examination, but the Royal Colleges recommend that candidates refer to the Specialty Training Curriculum for General Internal Medicine, prepared by the Joint Royal Colleges of Physicians Training Board.
The MRCP(UK) Part 2 exam is now marked using a process called equating. Using the equating system means that rather than being given a percentage overall score, candidates will instead be given an ‘overall scaled score’. This score is a number between 0 and 999, which is calculated from the number of questions a candidate has answered correctly (out of the maximum possible) and takes into account the relative difficulty of the exam. Since no two exams contain the same questions, it is inevitable that some papers may be slightly harder (or easier) than others, and equating is a statistical process that addresses this. At present, the equated score required to pass MRCP(UK) Part 2 is 425.
Candidates are strongly advised to visit the MRCP(UK) website for further details of the exam.
How to prepare for MRCP (UK) Part 2
Here are some general tips to help prepare for the exam:
- Start early – it is advisable to start revision at least 3 months before the exam date.
- Approach revision specialty by specialty.
- Cover all topics, particularly focusing on the topics from which a greater number of questions will be drawn.
- Remember to think laterally when revising – for example, a question on vasculitis could appear in the renal, rheumatology, respiratory, neurology or dermatology sections.
- Tackle the questions as you would in the exam, by reading the rubric carefully and thinking of what the correct answer might be before reading the A–E options. Next, select which of the options best fits the answer that you were thinking of.
- There are no ‘trick’ questions, but there are definitely questions that are not as straightforward as they may initially appear. Read the question very carefully. In this book only the minimum relevant information necessary to get the correct answer is provided. In the actual exam the questions may be longer but the information given may not necessarily be useful.
- Use the information in the answer to confirm and expand upon what you already know, or to help understand and remember why a certain answer is more appropriate than others.
- As a large part of the exam is on the practical application of knowledge, you will be expected to know the current guidelines of the various medical societies, which can be found on their websites. Review these before the exam.
Medical Society websites
Association of British Neurologists – http://www.theabn.org
British Association of Dermatologists – http://www.bad.org.uk
British Cardiovascular Society – http://www.bcs.com
British Infection Association – http://www.britishinfection.org
British Society of Gastroenterology – http://www.bsg.org.uk
British Society for Haematology – http://www.b-s-h.org.uk
British Society for Rheumatology – http://www.rheumatology.org.uk
British Thoracic Society – http://www.brit-thoracic.org.uk
National Institute for Health and Clinical Excellence (NICE) – http://www.nice.org.uk
Renal Association – http://www.renal.org
Society for Endocrinology – http://www.endocrinology.org
13Acknowledgements
We are deeply indebted to the many people who provided helpful suggestions through all stages of preparing this book. We would especially like to thank the following individuals:
Dr Peter Byrne, Consultant Psychiatrist, Dr Iyas Assalman, Specialist Registrar in Psychiatry, Newham University Hospital and Dr Jelena Jankovic, Consultant Psychiatrist, at Dudley and Walsall Mental Health Partnership NHS Trust for reviewing the psychiatry questions.
Dr Chulanie De Silva, Consultant Rheumatologist at Norfolk and Norwich University Hospital, for reviewing the rheumatology questions.
Dr Olivia Kreze, Consultant Haematologist, and Kathir Mahadevan, Section Leader of the Haematology Laboratory at Newham University Hospital, for supplying the blood films and reviewing the haematology questions.
Dr Mark Blunden, Consultant Nephrologist, and Michael Sheaff, Professor of Pathology, at the Royal London Hospital for providing the renal biopsy images and reviewing the renal questions.
Dr Catherine Harwood, Consultant Dermatologist at the Royal London Hospital, and Dr Ferina Ismail, Consultant Dermatologist at the Royal Free Hospital, for providing the dermatology images and reviewing the dermatology questions.
Dr Sean O'Sullivan, Consultant Neurologist at Cork University Hospital, Ireland, and Dr Benjamin Turner, Consultant Neurologist at the Royal London Hospital, for reviewing the neurology questions.
Dr Shamira Perera, Consultant Ophthalmologist at the Singapore National Eye Centre, Singapore, Dr Sam Khandhadia, Clinical Research Fellow at University Hospitals Southampton, and Anila Nair at the Newham Diabetic Retinal Screening Service for providing the ophthalmology images and reviewing the ophthalmology questions.
Dr Francesca Ng, Speciality Registrar in Radiology at Northwick Park Hospital, Dr Hussein Kamel, Consultant Radiologist at Newham University Hospital, Enhui Yong at Barts and the London Medical School, and Dr Ava Jackson and Dr Hafiz Syed, Consultant Stroke Physicians at Newham University Hospital, for providing the radiological imaging.
We are very grateful to Dr Aruna Dias, Consultant Gastroenterologist and Physician, Newham University Hospital, for his constant help and tireless support throughout all stages of writing and editing this book. We would also like to thank Dr Eric Beck for giving his time to provide helpful editorial input. We are very appreciative of the dedication and commitment that Hannah Applin, Richard Furn and Thomas Fletcher from JP Medical have shown to us at all times.
CA, SF, DH, HL, RM, LM
15Dedication
To our families.