Nocturnale

MRCP PACES Courses… They are sprouting up everywhere in recent years. And which of these should an MRCP aspirant apply to? Which is the winner and which one an afterthought?

Yes, prospective candidates long know that the one in Seremban organized by the International Medical University, Malaysia is gaining a solid reputation Asia-wide and so is the course in Singapore by the National University of Singapore.

Allow me to recommend another excellent up-and-coming course: Excel PACES, a four-day intensive preparatory course based in Kerala Institute of Medical Sciences, Kerala, India. 

The Edge

The main draw of this course is simple. Excel PACES is conducted purely and entirely by a faculty of active examiners who are all Fellows of the Royal Colleges of Physicians of the UK (FRCP). This distinction is important to understand. It is true that most commercial PACES courses are tutored by physicians who are just holders of MRCP diplomas but have no real examiner experience. FRCP tutors cum PACES examiners are few and far between. Blame this on the Royal Colleges which prohibit Fellows from participating in commercial MRCP PACES courses as they are not allowed to reap profits from their roles as examiners.

Excel PACES is unique in that respect. It is a not-for-profit endeavor. The tutors comprise of only FRCP senior consultants with years of experience in examining PACES candidates. This group of fellows pack enough intellectual punch to be named the Who and Who in Clinical Medicine. They are running the course pro bono, out of their own initiatives and sincere desires to improve the performance of Asian candidates in this traditionally difficult exam.

The Gangs of Excel PACES

That is not all. Excel PACES is planned and marshaled by an enthusiastic and seasoned British MRCP PACES examiner, Alan Patrick, MD, FRCP. His presence and tutelage is a boost for the course as he provides the candidates with a rare standpoint and perspective as an outsider from the United Kingdom. Dr Patrick, being a Scotsman and the only British tutor, no doubt was the most popular man in the course as he was constantly bombarded with questions from eager candidates who wanted the answer to the question, “What does it take really to pass PACES?”

Not to forget is the group of other very eager and talented crème de la crème FRCP examiners from India, Middle East and UK. I remember fondly my spar with Drs. Rajan, Nair, Mahadevan, and Saifudeen. They are all skilled examiners who gave many helpful feedbacks for the clinical exam.

Dr. Nair was very perspicacious and censorious. He is careful in pointing out the many nuances of the examination. Dr Nair demonstrated the way to face the examiner, how to present the case and why you must stop displaying all peculiar mannerisms (‘Indian nods’ for instance) before the examiners. 

I don’t think you will get this from any other courses, especially when the advice came straight down from a Royal College appointed examiner. Dr Nair must not be missed. His piercing welcome-to-the-real-world criticisms were harsh but on hindsight he is perhaps the most on-the-ball. His parting words to me at the end of one session,” Who do you think I will pass?” My fellow participants pointed at me and his nodding at my direction gave me encouragements. I will not disappoint him on my upcoming exam.

Dr Saifudeen, a consultant hematologist was awe-inspiring. His clinical thinking and approach was formidable. If anything, I have learnt to emulate his organized and structured thinking process.

Dr Rajan was also outstanding. His clear-headed clinical reasoning (which is exactly what the MRCP PACES examiners are looking for in a candidate) is something that I am still trying to master and grasp.

Dr Mahadevan, a consultant chest physician from the UK was insightful as he gave us plentiful advice on the intricacies of the examination: scoring systems, examiner’s instructions, examiner’s scoring discrepancy, the disposition of different examiners etc. 

It’s the Technique

One other distinct feature about Excel PACES is the emphasis the tutors place on honing the right examination technique, modus operandi and manner in approaching the exam. This is important as Dr Alan Patrick rightly pointed out: Asian candidates do not lack the knowledge, it is the technique and examination skill that bring to their downfall. After all, at its core PACES is about a clinical examination testing basic skills in eliciting and interpreting clinical signs. Many candidates, Dr Patrick lamented, fail to understand this.

Organization

Despite being a maiden course, Excel PACES runs like clockwork with squeaky clean efficiency. The organizing secretary Ms Jessy was very helpful. She helped arrange my accommodation and transportation in India. My 2-week adventure in India was to say the least unforgettable. The hotel where I stayed in during the course was clean and affordable ^a. The food, needless to say, was excellent. At the end of the course, we were even treated to a free buffet dinner at an upscale hotel where we got up close and personal with all the examiners. We gossiped about, what else, but MRCP PACES exam!

Conclusion

I wholeheartedly recommend this course to all MRCP PACES candidates, especially to my colleagues from the Indian Subcontinent, Southeast Asia, Hong Kong and Middle East because:-

1. Tutors are all experienced FRCP examiners. This is definitely the dream team.
2. Emphasis on the technical know-how (bedside manner, presentation, showmanship etc).
3. Realistic mock exams with individual feedbacks from real life FRCP examiners.
4. Interact with British examiners and tap their insights on PACES.
5. It is a terrific primer course as it put abundant weight on getting the technique right in the first place. There is nothing more crucial than acquiring the correct footing and gaining a strong foundation. Make this your first MRCP PACES course if you have never been to one before!
6. India is a geographically accessible country from many other Asian nations ^b. You no longer need to travel to the United Kingdom to experience first hand the tutelage of official FRCP examiners. 

With the successful inception of its maiden course ^c, Excel PACES is likely to become very popular and coveted. Book early for the next available program in October 2009.

a Hotel Geeth, an immaculate place with a decent restaurant and friendly reception.
b For Malaysians and Singaporeans, you can travel via Tiger Airways which offers reasonable air fares to India.
c Winning rave reviews from all participants.