Total Immersion for MRCP Success

When we first begin as foundation doctors the mountain of stress and knowledge we have to overcome is truly a monster. The cardiac arrest bleep feels like a grenade; we can’t even perform a simple peripheral cannula without screwing it up three times and that’s on someone with “easy” veins; and speaking to families about any sensitive issues is best avoided as half of the time we’re pretending to understand what’s happening.

Fast forward a few months and you can physically see that FYs are a lot more relaxed and comfortable and this is due to the concept of total immersion. Although completely counter-productive for a social life, the back to back night shifts, weekend on-calls and evenings stuck in the hospital has and will transform you into a completely different doctor.

The snowball effect of seeing hundreds and thousands of acutely unwell patients is that you begin to develop your own system, your intuition and many things that used to be difficult become second nature. Those lumbar punctures or ascitic drains that used to give you trouble are easy – you even forget you were once a newbie and wonder why your juniors are having so much trouble.

Passing MRCP follows the identical concept but is especially difficult because there does not seem to be enough backlash if we fail. If we fail to review a sick patient, a person could lose their life and we may not be able to practice as doctors ever again and there is enough negative consequence to push us to improve. If we fail MRCP it’s only £500.

But there’s also the time and opportunity cost of possibly delaying attempts at part 2 and PACES and entry into ST3.

When you first begin studying for MRCP it feels like a monster exam. Learn to embrace difficulty. Embrace the power of hustle and embrace the discomfort associated with not knowing. It’s far better knowing what we don’t know (known unknowns) rather than feeling like we know everything (unknown unknowns).

The more practice questions you get wrong the more the fear of failure will set in and therefore it’s much more useful to attempt 25 questions one evening with a 35% success rate rather getting 100% in 15 questions. In the former situation you’ve highlighted a knowledge gap whereas in the latter situation you’ve actually wasted your time.

We only learn from our failures so let’s hope we get more practice questions wrong.

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.

Alternatively, if you’ve passed the written exams then How to Pass MRCP PACES in 8 Weeks will take you through your next and final hurdle. The reason an entire new guide has been written about this mammoth clinical exam reflects the different skills and attitude you need when tackling MRCP PACES. Instead of simply relying on reading textbooks, you’ll need to utilise a concept called the PACES Triangle to successfully navigate the examiners’ obstacles.

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