How to pass the MRCPsych

examination
Dr Bruce Owen
 Outcomes
• By the end of this session, participants will be
able to
– recognise one model of medical skills and how they
are assessed
– Recognise the structure of the core curricula
– Describe the structure, content and function of the
different parts of the assessment system in psychiatry
– Recognise the concept of learning styles and how to
structure their learning for maximum effectiveness
“The most important things are not measured”
W Edwards Deming
 Two purposes of assessment
• Formative • Summative
– ‘Assessment for learning’ – ‘Assessment of learning
Miller’s pyramid

Does Performance

Shows how Competence

Knows how

Knows
 Miller’s pyramid and assessment

360˚
Performance Does CEX
WPBA
DOPs
CbD
Competence Shows how
OSCE (CASC)

Knows how Written tests

MCQ/EMI

Knows

WPBA = Workplace based assessment

OSCE = Observed structured clinical examination
 Design Principles
 Outcome orientated
 Spiral
 Constructive alignment
Outcome orientation
 Intended learning
outcomes
 Competencies
 Objectives
Spiral curriculum
 The same outcome is
revisited and: -
 Extended
 Deepened
 Applied in more complex
ways
 Applied more efficiently
and with greater
autonomy
ARCP Guide for Core Psychiatry Training

http://www.rcpsych.ac.uk/training/curriculum2010.aspx
 Constructive Alignment

Biggs and Tang (2007) Teaching for Quality Learning at University. Open University Press
 Outcomes
• By the end of this session, participants will be
able to
– recognise one model of medical skills and how they
are assessed
– Recognise the structure of the core curricula
– Describe the structure, content and function of the
different parts of the assessment system in psychiatry
– Recognise the concept of learning styles and how to
structure their learning for maximum effectiveness
 The Assessment System
• Includes:
– Standardised (national) exams – mainly
summative
– Workplace-based assessments – mainly formative
– Integration – ultimately summative
 National exams
• Fully registered medical practioner
• Two written papers, 200 marks, 2/3 MCQ, 1/3 EMI
• 3 hours
• Paper A
• Part i:
Behavioural Science and Sociocultural Psychiatry
Human Development
Classification and Assessment in Psychiatry
• Part ii:
Basic Neurosciences
Clinical Psychopharmacology

316 candidates were successful at the MRCPsych Paper A Examination held in June
2018. A total of 663 candidates sat the Examination. The overall Pass Rate is 47.7%.The
Trainee Pass Rate is 56.6%
 National exams

• Approved training Programme – recommend 12 month experience (or trust approved

training)
• Paper B
– Critical review (1/3) and clinical topics
Organisation and Delivery of Psychiatric Services
General Adult Psychiatry
Old Age Psychiatry
Psychotherapy
Child and Adolescent Psychiatry
Substance Misuse/Addictions
Forensic Psychiatry
Psychiatry of Learning Disability
Critical Review
 MCQ
• No negative marking
• Which of the following is correct regarding
child abuse?
– a) Boys experience more physical abuse than girls.
– b) Boys experience more sexual abuse than girls.
– c) Most people who were abused as children
become abusive to their own children.
– d) Mothers are equally as likely as fathers to
sexually abuse their children.
– e) The risk of abuse is inversely related to family
size.
• A. Anankastic personality disorder EMI
• B. Anxious personality disorder
• C. Dependent personality disorder
• D. Dissocial personality disorder
• E. Emotionally unstable personality disorder borderline type
• F. Emotionally unstable personality disorder impulsive type
• G. Histrionic personality disorder
• H. Narcissistic personality disorder
• I. Paranoid personality disorder
• J. Schizoid personality disorder

Lead in: For each of the clinical vignettes select the ONE most appropriate differential diagnosis
from the option list.
Each option might be used once, more than once, or not at all.
• You are asked to see a 21-year-old graduate who is having difficulty coping with his new job
as an administrative officer. He arrives for his appointment half an hour early because he
wanted to make sure he was not late. He reports that he is finding his job very stressful
because he is having problems at work. He has worked out a routine of how the mail needs
to be managed and drawn up a flow chart to make sure everything runs as smoothly as
possible but other members of staff are not following the flow chart. Choose ONE option
 National clinical exam
• The CASC comprises two circuits of individual stations which
will test your clinical skills:
• The morning circuit will have 4 minutes to read the
instructions and 7 minutes to complete the task
• The afternoon circuit will have 90 seconds to read the
instructions and 7 minutes to complete the task.
• The sixteen CASC station exam will comprise of:
– five stations focused on History Taking, including risk
assessment
– five stations focused on Examination - both physical and
mental state, including capacity assessment.
– six stations focused on patient Management
 CASC

1 x station
6 x stations 1 x station
Circuit 1 focused 4 minutes 7 minute
focused on focused on
on History reading task
Management Examination
Taking

4 x stations
4 x stations
focused 90 seconds 7 minute
Circuit 2 focused on
on History reading task
Examination
Taking
 Resources
• MRCpsych course
• Trust courses
• Online resources- TrOn
• Clinical job
 Miller’s pyramid and assessment

360˚
Performance Does CEX
WPBA
DOPs
CbD
Competence Shows how
OSCE (CASC)

Knows how Written tests

MCQ/EMI

Knows

WPBA = Workplace based assessment

OSCE = Observed structured clinical examination
 WPBA in psychiatry
• Lots of acronyms, only four methods
 Four core methods 1
• Based on documents:
– Log book assessment
– Case based Discussion
(Chart Stimulated Recall)
 Four core methods 2
• Direct observation of a
procedure
– DOPS
– DONCS
– Teaching
– Case presentation
– Journal Club
presentation
 Four core methods 3
• Observed clinical
encounters
– Mini-Assessed Clinical
Encounter
– Assessment of Clinical
Expertise
 Four core methods 4
• Multi-source feedback
(360°)
– Mini-Peer Assessment
Tool
 Integration – the tasks of the Annual Review
of Competency Progression

• Assess the evidence

– Contained in Portfolio
– Formal assessments
– Reports
• Make a decision based
on the evidence
– Summative pass/fail
ARCP decisions: -

1. Progress onwards
2. Need to develop -
within time
3. Need to develop -
additional time
4. Leave the programme
5. Incomplete evidence
6. Completion of core
competancies
 Outcomes
• By the end of this session, participants will be
able to
– recognise one model of medical skills and how
they are assessed
– Describe the structure, content and function of
the different parts of the assessment system in
psychiatry
– Recognise the concept of learning styles and how
to structure their learning for maximum
effectiveness
 Learning/teaching activities
• How do you approach learning?
 Kolb’s Learning Cycle
Perform part of an Watching your
interview contributing trainer perform a
to risk assessment risk assessment
Active Concrete
experimentation experience

Abstract Reflective
conceptualisation observation
Guided reading of Discussion of
psychiatric observations in
literature supervision

Kolb (1984) Experiential learning: experience as the source of learning and development. Prentice Hall
 Which type of learner are you?
• Reflector – watch and feel
– Watch, think and review
• Theorist – watch and think
– Think a problem through
• Pragmatist – do and think
– Likes to apply new learning
• Activist – do and feel
– Likes to experience new things
Thank you!

Any questions?