Passing the MRCP - an approach to REALLY hard questions. In your revision for the MRCP you will come across very tricky

2017-08-05 11:52:50

Passing the MRCP - an approach to REALLY hard questions.

In your revision for the MRCP you will come across very tricky MCQs. You know the ones ... the ones that you have no idea what the correct answer is, or the correct answer surprises you, or they are discussed by other candidates who can't agree on the best answer. The classic examples of these types of questions are where even the online course providers don't seem to agree on the correct answer. You go back to your textbooks and they don't even seem to cover the topic in question. Panic starts to set it. What if this question comes up in the exam? You even start to imagine seeing the question appear on the exam paper on exam day. Nightmare.

So, what should a candidate preparing for the exam do when confronted with such a question?

Here are 3 suggestions:

1) Know your enemy. This is timeless advice for preparing for any exam. The exam is NOT best described as being on a particular textbook, or advised by some revision website, or some discussion forum, or a handout from a course. It is best described by the Royal College of Physicians who set the exam.

So let's introduce a dose of reality in to the challenge of the really tricky question. The question will have been written and approved by a small number of physicians and although they will mostly be in the specialty of the question topic the writing group will include at least one other from a different specialty. Think about that. The MRCP exam has always relied on a balance of perspectives from other physicians which prevents it becoming too specialised a quiz detached from the reality of clinical medicine.

If there is genuinely so much debate on the correct answer to a particular question think of what the physician from another specialty in the item writing group would say. They would object about the question. It may be that such a question appeared in an exam once but whether it appears again is debatable. Even if it does whether it is included in the final analysis is also debatable.

2) Ignore hard questions read about the topic more broadly if you need to but ignore really hard detail. Even on the exam day itself the best advice - when you come across a question you have no idea about - is to move on to other questions and gain points there. This should be no different in your revision.

The best approach to hard questions in your revision is to think to yourself "is this a topic I know something about?". If it is then simply move on to other questions and shelve it for some possible future date to have a look at. If you don't know much about the topic then don't even attempt to start reading up detail about the question - go and read about the broad topic first. Only when you have done that come back to the question and reconsider it. If it is still too hard then ignore it.

3) Use the clinical importance test. If you do not want to ignore the question and want to give it a try (in the exam or in your revision) then using a clinical importance test should be a first step. In my experience the most challenging of challenging MCQs in the MRCP exam (and I have seen a few) are those that the correct answer relies on you recognising an important clinical distinction - typically a life threatening one. So this is an approach I'd suggest:

Hide the options and read the question stem. Imagine if possible the patient presenting to medical admissions. What type of feature might the nurse or paramedic point out to you as something they are concerned about (Airway, Breathing, Circulation ... that sort of thing)? Have a look at the options and which one matches the best? Think hard about that one as that may be the most critical to consider.

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Passing the MRCP - an approach to REALLY hard questions. In your revision for the MRCP you will come across very tricky

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