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MCQs in MRCPsych Exams

This is a draft article that we will soon republish in a clear format, referencing the original source. The purpose is to find all the evidence regarding the RCPsych Exams and make them accessible to help researchers and students prepare for the MRCPsych Examinations. These articles are already available in journals, particularly the BJPsych Bulletin, albeit in the least-accessible format. We are thankful that the Royal College has published previous print-only articles as scanned PDFs under the Creative Commons license. The articles I am publishing here are currently not creative-commons. We will soon discuss and hope to make them available under a similar license so everyone can benefit by sharing them anywhere. 

The publication of four articles on MCQs in the MRCPsych (Psychiatric Bulletin, February 1991, 15, 87, 88, 90 and 108) is to be applauded for providing some helpful guidelines on how to approach them and should be welcomed by trainees as the uncertainty of what awaits and is expected of them is a source of considerable anxiety. Such strategies as those suggested may help reduce the anxieties induced by this part of the exam and improve candidates' performance. The candidate must pass the clinical examination and that the brief-answer paper and clinical vignettes are more alien to most medical graduates means similar attention to all aspects of the exam may well be profitable.

Obviously, there is no substitute for an adequate level of knowledge, which is presumably to be gained from studying the major post-graduate textbooks and selecting key references. The Examiners state they derive the MCQ content from uncontentious material available to all trainees but do not detail these sources. A member of the Collegiate Trainees' Committee informed me that a member of the Examinations Committee had told him that all the relevant information could be learned from the Edinburgh Companion, the Oxford Textbook, Hildegard & Atkinson's Psychology Test, McGumn's Scientific Basis of Psychopathology and the regularly updated Current Opinion in Psychiatry. The College would do well to substantiate or refute such rumors, perhaps by providing an authoritative exam reference syllabus.

Dr. Smith's suggested study technique is an especially valuable contribution. As he says, reading textbooks and key references while thinking about what MCQs could be derived from the material can alert one to potential questions and identify areas that probably cannot be examined in MCQs, that are perhaps more likely to be tested in other parts of the exam. It also provides a much-needed novel way of revising and allows candidates to appreciate some difficulties facing examiners. There is at least one MCQ book that accompanies the Edinburgh Companion that shows this process.

And practicing MCQs oneself, candidates can gain from doing so as part of a study group where the opportunity to discuss how others approach MCQs and answer specific questions can be very illuminating. Similar benefits can accrue from practicing brief answers, clinical vignettes, and even clinical examination in such a setting. The study group also provides some 'group supportive psychotherapy' for assuaging anxieties as exams loom.

It is, of course, important to attempt past papers and many people find MCQ tests invaluable. There is a glut of these on the market so people can afford to be selective about which one to use. Ideally, such a test should provide one with a detailed explanation of an MCQ answer, preferably with a reference. These texts that merely give questions and a true/false answer give little information on how to approach them while further depleting financial resources when many can ill afford it! Finally, there is at least one drug company (Dista) that can offer a computerized MCQ experience if requested.


Royal Edinburgh Hospital

Edinburgh EH105HF


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