How to Consolidate Your MRCP Knowledge
On average I tend to only be able to study for 45 minutes to an hour per day. Any more than this and I begin to zone out, think about food or dream about holidays – I’m a simple man indeed. And even within this hour I struggle to spend more than 15 – 20 minutes reading a paper or journal unless I’m very interested in the topic. (Hint: if I’m only reading something to pass an exam then I’m not that interested).
If you’re able to study for several hours or more per day then that’s great but what if we’re in the same shoes? The key is the same with everything in life: consistency. It’s actually better to revise 1 hour every day for 14 days then take 13 days off and cram 14 hours of revision on the last day. The reason is three-fold:
- Sleeping has a function in memory consolidation and in the first scenario we have more sleep hours post-revision than the latter case.
- The act of forgetting then “remembering” is a key aspect of good quality revision. When we’re studying Alport’s syndrome on Monday night most of us don’t expect to remember 100% of the information. 60% would be a good result. On Tuesday we might even show off to our medical students little snippets of information (don’t pretend you’ve not done that!) but it’s during Tuesday, Wednesday and Thursday that we realise we don’t know as much about Alport’s as we first thought. We skim through the material again on Friday and this time it only takes a quarter of the initial time but you now “remember” the info you had forgotten and your retention increases to 85%. Repeating this takes advantage of a concept called spaced repetition and helps us approach that 100% figure.
- Good habit creation. For MRCP I did a lot of cramming over a relatively short period of time and by the time I was finished I was so exhausted I didn’t want to touch another book again. The result was over 18 months of going through the motions of working and very little learning post-PACES. All the knowledge I gained during my 10 months tackling MRCP was washing down the sink. Consultants seemed to assume I was very recently post-PACES and I was just too embarrassed about how much I had been de-skilled. Instead, avoid my mistake and set yourself an achievable target of 1 hour per day 5 – 6 times per week. Like with dieting, if you go too extreme at the beginning you’ll become demotivated and start binge-eating, the equivalent to taking two weeks off revision when your exam is next month.
When you’re studying for MRCP remember that there are different types of learning.
The first type is rote memorisation, and unfortunately there is a lot of this in medicine. For the management of pneumothorax, for example, there is little more you can do than to memorise the famous BTS pneumothorax flowchart. Sometimes guidelines don’t always lay out information in the best way for us and there is some scope for you to alter the way it’s presented. For example instead of getting confused with all the arrows and boxes, why not reformat the information?
We can reformat the flowchart so that primary can be stratified as “uncomplicated” (or whatever you like to call it) where the patient is asymptomatic and the pneumothorax is less than 2cm. Or the primary pneumothorax is “complicated” which will require a syringe aspiration +/- drain. Secondary pneumothorax is stratified into three different categories: symptomatic or more than 2cm; asymptomatic and between 1 – 2cm; and asymptomatic and <1cm.
The golden chalice of effective revision, however, is the second type which I call complete understanding or mastery. This is where you learn core concepts e.g. understanding the pharmacological management of heart failure with the mainstay of treatment being based around ACE-inhibitors, beta blockers and mineralocorticoid antagonists because the information just “makes sense”. Put simply, ACE-inhibitors reduce salt and water retention reducing pressure on the heart, and has some effects of cardiac remodelling. Beta blockers obviously reduce the work of the heart letting it “rest” and MRAs are diuretics.
You can build on this knowledge by understanding new drugs such as Entresto or further your knowledge with cardiac resynchronisation therapy but I personally found heart failure management to be very straightforward and logical.
It’s not possible to avoid rote memorisation in medicine but it’s clear you can reformat information so this less pleasant aspect is made more palatable. Hope this article helped.
If you enjoyed this article make sure you get your own copy of my MRCP Part 1 & 2 Written Guide. In this guide, I explore the above and other concepts such as time allocation and the most preferable resources for the written exams in much more detail.
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