How to Prepare for the MRCPsych CASC Exam

Introduction

What is the MRCPsych CASC exam?

The MRCPsych CASC (Clinical Assessment of Skills and Competencies) exam is a competency-based examination that assesses the practical skills and knowledge of mental health professionals in the field of psychiatry. The exam is designed to test the ability of candidates to manage complex clinical cases and make appropriate decisions in a simulated clinical setting.

Why is it important for mental health professionals?

The MRCPsych CASC exam is a crucial step for mental health professionals who want to attain consultant level in the field of psychiatry. It is also a requirement for those who want to work in the UK National Health Service (NHS) as a consultant psychiatrist. Passing the MRCPsych CASC exam demonstrates that a mental health professional has the necessary skills and knowledge to provide high-quality care to patients.

Set Realistic Goals

Determine your current level of knowledge and skills

Before preparing for the MRCPsych CASC exam, it is essential to determine your current level of knowledge and skills in the field of psychiatry. This can be done by reviewing previous coursework, taking practice exams, or speaking with colleagues or mentors.

Set achievable goals based on your starting point

Based on your current level of knowledge and skills, set achievable goals that are realistic and attainable. This could include a certain number of hours of study per week, a certain number of practice cases to complete, or a specific date for taking the exam.

Break down your goals into manageable steps

Breaking down your goals into smaller, manageable steps can make the exam preparation process less overwhelming. For example, you could set a goal to complete a certain number of practice cases each week or to read a certain number of chapters from your study materials each day.

Develop a Study Plan

Choose a study method that works best for you

Everyone has a unique learning style, and it is important to choose a study method that works best for you. This could include self-study, group study, online courses, or attending review courses.

Allocate sufficient time for studying and practicing

To ensure that you are well prepared for the MRCPsych CASC exam, it is essential to allocate sufficient time for studying and practicing. This should include regular review of study materials, participation in mock exams, and practice with real-life cases.

Create a schedule and stick to it

Creating a study schedule and sticking to it is essential to ensure that you make steady progress towards your goals. Your schedule should include dedicated time for studying and practicing, as well as time for rest and relaxation.

Understand the Exam Format

Familiarize yourself with the exam structure and format

It is important to familiarize yourself with the exam structure and format, including the types of cases and scenarios that you may encounter. This information can be found on the Royal College of Psychiatrists website.

Read and understand the exam guidelines and regulations

Reading and understanding the exam guidelines and regulations is crucial to ensure that you are aware of the rules and expectations of the MRCPsych CASC exam. This information can also be found on the Royal College of Psychiatrists website.

Get a clear understanding of the types of cases and scenarios you may encounter

Getting a clear understanding of the types of cases and scenarios you may encounter during the MRCPsych CASC exam can help you to prepare more effectively. This includes understanding the types of clinical cases and situations you may face, as well as the types of questions that you may be asked.

Practice, Practice, Practice

Participate in mock exams to get a feel for the exam format

Participating in mock exams is a great way to get a feel for the exam format and to identify areas that you need to improve on. You can participate in mock exams with colleagues or through online resources.

Practice dealing with different cases and scenarios

Practicing dealing with different cases and scenarios will help you to develop your decision-making skills and to become more confident in your abilities. This can be done through role-playing, case simulations, or by working through practice cases.

Identify your strengths and weaknesses and focus on improving them

Identifying your strengths and weaknesses through practicing and taking mock exams will help you to focus your efforts on the areas that need improvement. This will ensure that you are well prepared and confident on the day of the exam.

Stay Focused and Positive

Stay motivated and positive throughout the exam preparation process

Staying motivated and positive throughout the exam preparation process is important to maintain your focus and to ensure that you are able to perform at your best on the day of the exam.

Surround yourself with positive and supportive people

Surrounding yourself with positive and supportive people, such as friends, family, or study partners, can provide encouragement and help to maintain a positive mindset.

Avoid negative self-talk and beliefs

Avoiding negative self-talk and beliefs is crucial to maintain a positive mindset and to ensure that you are able to perform at your best on the day of the exam. It is important to focus on your strengths and to believe in yourself.

Conclusion

Sum up the key points of the article

In this article, we have discussed the importance of the MRCPsych CASC exam for mental health professionals and the steps that can be taken to prepare for it. This includes setting realistic goals, developing a study plan, understanding the exam format, practicing and participating in mock exams, staying focused and positive, and surrounding yourself with positive and supportive people.

Reiterate the importance of preparing well for the MRCPsych CASC exam

It is important to take the MRCPsych CASC exam preparation process seriously and to allocate sufficient time and effort towards it. A well-prepared candidate is more likely to perform at their best and to pass the exam on their first attempt.

Wish the readers good luck on their exam

We wish all readers the best of luck on their MRCPsych CASC exam. Remember to stay focused, positive, and to believe in yourself. With the right preparation and mindset, you can achieve your goals and become a successful consultant psychiatrist.

Bibliography

1. MRCPsych CASC Guide, Royal College of Psychiatrists, https://www.rcpsych.ac.uk/traininpsychiatry/examinations/casc
2. MRCPsych CASC Exam Preparation Tips, Revisions in Psychiatry, https://revisionsinpsychiatry.com/mrcpsych-casc-exam-preparation-tips/.
3. The MRCPsych CASC Exam: What You Need to Know, The British Psychological Society, https://www.bps.org.uk/system/files/Public%20files/BPS%20Division%20of%20Clinical%20Psychology/Professional%20Development/CASC/CASC%20Exam%20Information/The%20MRCPsych%20CASC%20Exam%20What%20you%20need%20to%20know.pdf.
4. MRCPsych CASC Exam Success: How to Prepare, The Psychiatrist, https://thepsychiatrist.bmj.com/content/41/9/406.
5. Study Materials for MRCPsych CASC Exam, The Psychiatry Portal, https://www.psychiatryportal.com/examination-preparation/mrcpsych-casc/.
6. MRCPsych CASC Exam: Frequently Asked Questions, Royal College of Psychiatrists, https://www.rcpsych.ac.uk/traininpsychiatry/examinations/casc/mrcpsych-casc-exam-frequently-asked-questions.

These resources provide comprehensive information and guidance on the MRCPsych CASC exam, including the format, content, and preparation tips. They also offer helpful advice and suggestions on how to effectively prepare for the exam and increase your chances of success.

Get Through MRCPsych Part 2: Clinical Exam: Long Case Presentations

"Get Through MRCPsych Part 2: Clinical Exam: Long Case Presentations" is a comprehensive guide to preparing for the clinical component of the MRCPsych exam. This book is specifically designed to help candidates prepare for the long case presentation component of the exam, which is an important aspect of the MRCPsych clinical examination.

Ace the MRCPsych Clinical Exam with 'Get Through MRCPsych Part 2: Clinical Exam: Long Case Presentations.' Your comprehensive guide to preparing for the long case presentation and other key components of the exam. Get ready to showcase your expertise in psychiatry and take your career to the next leve

The book provides a detailed overview of the MRCPsych clinical examination format and covers the key skills and knowledge that candidates need to demonstrate during the exam. The book is well-structured, with clear explanations of the examination process and helpful advice on how to prepare and perform well on the day of the exam.

One of the strengths of this book is its focus on the long case presentation, which is a unique and challenging aspect of the MRCPsych clinical examination. The book provides numerous examples of long case presentations, as well as practical tips on how to structure and present a compelling case study. This makes the book an essential resource for any candidate preparing for the MRCPsych clinical examination.

In addition to its comprehensive coverage of the long case presentation, the book also includes important information on other aspects of the MRCPsych clinical examination, including the short case presentation, the mental state examination, and communication skills. This makes the book an all-in-one resource for MRCPsych candidates, providing everything they need to know to prepare for and succeed on the clinical examination.

Overall, "Get Through MRCPsych Part 2: Clinical Exam: Long Case Presentations" is a well-written, comprehensive guide to the MRCPsych clinical examination. Whether you are a trainee psychiatrist, a consultant psychiatrist, or simply looking to enhance your knowledge and skills in psychiatry, this book is an essential resource for your MRCPsych exam preparation.

Get Through MRCPsych Parts 1 and 2: 1001 EMIQs

Get Through MRCPsych Parts 1 and 2: 1001 EMIQs is an excellent and essential revision guide for all candidates taking the Membership examinations.

This is one of the first EMIQ books for the MRCPsych examinations. The Editor, Albert Michael, has written several successful MRCPsych texts and is a Consultant Psychiatrist. He and his team of 16 international contributors have created a unique selection of 1001 questions spread over the 200 themes which form the MRCPsych syllabus.

Topics featured include:

learning theory * diagnosis of eating disorders * uncommon syndromes * delerium * memory disorders * cognitive function tests * psychometry * couple therapy * drug dosing * mood stabilisers * dynamics of adverse effects * management of schizophrenia * child abuse * developmental syndromes * statistical concepts

Extended Matching Items for the MRCPsych Part 1

Michael Reilly, Bangaru Raju

Extended Matching Items for the Mrcpsych Part 1:Coverpage

The importance of Extended Matching Items (EMIs) in the MRCPsych written test is growing. This book helps candidates get ready by outlining the structure of EMIs and then providing numerous examples of common exam problems. It covers the four key areas of the exam: clinical theory and skills, psychopharmacology, descriptive and psychodynamic psychopathology, and psychology and human development. To allow applicants who are unfamiliar with the format of EMIs to gradually assess their exam readiness, questions are arranged in order of increasing difficulty. Complete responses, justifications, and references are given.

Edition: reprint

Publisher CRC Press, 2018

ISBN 1315345269, 9781315345260

Length 256 pages

Practice Examination Papers for the Mrcpsych: Part 1

This useful manual equips primary care team members and GP practise managers with the skills necessary to handle stress and conflict in general practise. All important abilities are covered, including change management, handling criticism, dealing with anger, and negotiating. The reader is encouraged to invest in their own personal and professional development by the book's abundance of useful examples, exercises, and reading lists that are cited throughout.

1500 Questions in Psychiatry: For the MRCPsych

This title is directed primarily towards postgraduate trainees in psychiatry preparing for examinations such as the MRCPsych. It contains 1525 questions with answers, explanations and references - ideal for self-testing before exams. The questions specifically focus on topics which occur most frequently in real exams. The comprehensive answers and targeted, exam-relevant topics make this book invaluable for anybody revising their MRCPsych.

• Prepared by organisers of the Cambridge MRCPych course, which has a pass rate nearly double the UK average. 
• Offers a wide variety of questions on targeted, exam-relevant topics together with explanatory answers with a level of detail beyond most self-testing books
• Topics selected to reflect those most frequently found in real exams
• Topics are presented in manageable chapters, each containing 25 questions - ideal for 'dipping in and out' when time is limited
• Answers contain full explanations and references for further detail, perfect for general revision and improving areas of need

Revision Notes for MRCPsych Paper A

Cover page: Revision Notes for the MRCPsych Paper A

This list-based revision guide offers thorough covering of the material and is completely current with the current MRCPsych Paper 1 exam. Instead of depending just on MCQs and EMIs for self-testing, it provides a concentrated set of critical notes that build a strong knowledge base for the candidate. Each of the curriculum's major subjects is covered in its own chapter, and the concise, bullet-point structure helps with recall and provides a practical, approachable way to retain information. The presentation of key ideas in digestible chunks encourages confidence and further research. Revision Notes for MRCPsych Paper 1 is the most pertinent and closely related resource for candidates, and it was written by a current trainee. Additionally, it is a very helpful resource for all Royal College aspirants, as well as for medical and nursing students looking for an approachable introduction to psychiatry.

MRCPsychmentor for MRCPsych Examinations

The Good

MRCPsychmentor is one of the more popular resources that MRCPsych aspirants use during preparation. It comprises approximately 2000 questions for the MRCPsych Paper A, which costs £45 for 4-month access and £55 for 6-month access. Similarly, they offer a nearly equal number of questions for the MRCPsych Paper B at a similar price. In addition, the MRCPsychmentor offers mock examinations for written papers at no additional charge. The authors of MRCPsychmentor make some bold claims: 

" 

• We are committed to assisting you in passing the MRCPsych exams. MRCPsychmentor offers a thorough online revision course for the MRCPsych written papers.
• MRCPsychmentor is much more than a question bank. It employs a sophisticated database to display only the best questions on the website. In addition, the database compares your performance to that of other users, highlighting your strengths and flaws and aiding you in concentrating on your revision.
• Passing the MRCPsych examinations involves recognising similar themes and topics. We recognise this and base our questions on prior test questions and the college curriculum. Our MCQs and EMIs follow the same format as those on the real MRCPsych examination ('best answer 1 of 5' approach).
• We understand that contextual learning is the most effective. As a result, lengthy annotations accompany each question (backed by the most recent evidence) to ensure that you comprehend the response and can recall the inquiry in the future.
• To make sure you pass the examination the first time, you must get practice working under examination conditions. We offer you this experience by using an unlimited number of timed tests (for no extra charge).
• Our team at MRCPsychmentor understands that your time is precious. Because of this, we offer you a revision course that makes every second of your revision count.

"

MRCPychmentor homepage - online learning for the MRCPsych exams

The Bad

However, compared to the SPMM Course, the number of questions in this bank is meagre. The majority of the questions are in the outdated single-line format that tests the recall of facts. Similarly, unlike their claims of almost 50% repetition, the RCPsych and most educational testing agencies are now conscious of repeated questions and demand real—lifelike original scenarios each time they test the candidate's ability to apply their knowledge. 

MRCPsychmentor is one of the oldest resources for MRCPsych preparation. Because of this, it fails to follow the current guidelines for making best-choice questions. For example, many questions are in the negative format, eg, which one of the following is NOT. Many questions contain the typical lead-in, asking which one is true or false. The current guidelines for writing MCQs forbid such negative lead-in questions, true-false questions, etc. Similarly, the RCPsych guidelines for authors of MCQs have prohibited abbreviations in the stems, unlike the convention in the MRCPsychmentor question bank. 

Furthermore, the RCPsych has delineated the rules for enlisting distracters/options to prevent candidates from guessing the answer; the MRCPsych question bank has not followed several of these rules, pushing it farther away from the future examinations.  

An examiner would only enlist an irregular, awkward choice because it can not be avoided, ie, the correct answer, thus making it easy to guess. 

See the free RCPsych Module on "Question Writing for the MRCPsych" at their eLearning hub to familiarise yourself with the modern rules of writing questions. This will help you understand what you can expect on your test.

eLearning Hub (rcpsych.ac.uk)

The most concerning matter with the question bank is that a substantial number of questions and answers are based on outdated statistics, facts, and guidelines. Unfortunately, when answering questions, it does not cite exact sources, as in other scientific writings, making it difficult to confirm. For example, compare the following answer with the official CDC statistics. 

Disparities in Suicide | CDC

Moreover, the RCPsych uses a method of score calculation that does not depend on how many questions one gets right or wrong. The statistical method they use, "Angoff Analysis," is a sophisticated technique that rates candidates only on questions that truly correlate with higher scores. Of thumb,  questions which are too difficult or too easy do not correlate well with high scores, and thus, the method does not include such items in the scoring. To learn more about Angoff-Analysis, check out: 

A fair exam (rcpsych.ac.uk)

Finally, unlike what the website owners claim, a considerable number of candidates think that going through MRCPsychmentor is a waste of time if you have already covered the SPMM Course or have decided to go through it. 

To know the general perception about the importance of the MRCPsychmentor, Join the Psychiatry Training UK group on Facebook, search for MRCPsychmentor (or MRCPsych mentor) in the group, and read the comments of those who have been through the process. 

Psychiatry Training in UK | Facebook

The Punchline

Still, MRCPsychmentor is one of the most popular practice resources that give test-takers an idea of they test what topics and which areas on the actual examination. The biggest portion of the question bank and its answers are not outdated, and even if the question format differs from the RCPsych, the practice and the comparative scores make candidates aware of where they are standing. Importantly, they have priced their question bank pretty low, within the range of everyone's pocket. Yet, some candidates never subscribe to the SPMM Course for its hefty price; people claim to have succeeded in the College exams solely on the shoulders of the MRCPsychmentor.   

Final MRCPsych Examinations Need to be Rigorous (Davies et. al)

Final MRCPsych Examinations must be Rigorous

The Royal College accepts you into the Psychiatry Training Program in the UK when you have passed all three parts of the MRCPsych Examinations and have two years of experience of work in psychiatry. So, the final or the exit exam serves as a selection-criterion. Davis et al. has criticized and suggested changes to the system.

What are the aims of the Counseling Sessions?

Counseling Sessions are an important part of psychiatric management. The following list sums up the Aims of Counselling Sessions; 

1. Establish mutual trust
2. Clarification and explanation
3. Freely expresses emotions
4. Reassurance
5. Understanding of health
6. Indent various choices
7. Making decisions
8. Seeking support
9. Learning the necessary skills

 

Using Watch For Physical Examination During CASC

Since September 2018, the college expects candidates to provide their own timing device should there be a physical or other examination that requires the use of one. Digital watches/timing devices will not be permitted. Similarly, the Royal College has clarified that they do not permit mobile phones and other such devices these in CASC and will lead to disqualification if used. The candidate brings their device to the exam center. As with other components of the MRCPsych examination, the College does NOT provide spare timing devices and they will accept no liability if a candidate’s device is defective. The Royal College entertains no appeal if you do not bring your own timing device or a defective one and cannot perform a task requiring timing to the satisfaction of the examiner.

CASC means the clinical assessment of skill and applied knowledge 

SAMPLE SIZE CALCULATION MRCPsych Paper B

MRCPsych Paper B

SAMPLE SIZE CALCULATION

Critical Review

Question

You are checking the frequency of “the Perceived stress scale among doctors serving at various Government and private hospitals in Faisalabad. (JPMA-2020-02-232)”

If you aimed for a specific category of doctors, then that will be your target population. For example juniors, seniors, permanent visiting, etc.

Introduction

Once we plan a survey or a research experiment, then we have a target population in mind. For example, some surveys cover the entire population of the country like census and political elections. If we take an example for census first, then what sample size do you think would be the correct representative in that case? The obvious answer is 100% of the population of the country, not a single percent less.

Examples

Now take the example of the political elections, let’s say 50% was the turnout on polls. Would that be an excellent election turn out? Probably not, because half the population of the country didn’t take Part in it. If the turnout was 80% then it is stronger because a good proportion took part and we can conclude that the results represent the voters in our country.

The above examples highlight that sample size determination will depend upon what population we aim to get the data from and what is the purpose of the data collection.

You are checking the frequency of “the Perceived stress scale among doctors serving at various Government and private hospitals in Faisalabad. (JPMA-2020-02-232)”

What you need to ask yourself is that what is the total population of such doctors in this hospital? If you aimed for a specific category of doctors, then that will be your target population. For example juniors, seniors, permanent visiting, etc.

Let's assume that you know the population of such doctors in question. And for sake of a hypothetical exercise, let’s say that 100 doctors are your target population. If you are checking the frequency then how much sample size do you think would represent these doctors?

Follow this link on the sample size calculator website and put the values Sample Size Calculator. Once you put a population size of 100, then you find that to be 95% confident that this sample truly represents the target population you need to examine at least 80 people out of 100. Now 5% is the margin of error. If you increase the margin of error to 20%, you will need a sample size of 20 only. Now put your population size into this calculator and choose your margin of error, and you will find the sample size that you must have aimed for.

Tuberous Sclerosis

Tuberous sclerosis (epiloia) has an Autosomal dominant inheritance pattern. Clinical features include Epilepsy, adenoma sebaceous on the face, white skin patches, shagreen skin, retinal phakoma, subungual fibromata, multiple renal, and other tumors. ID usually is Mild. Autism and other psychiatric disorders are common.

Is it possible to enter a psychiatric residency in the UK having no specialty experience in your country?

Yes, you can apply for core training in psychiatry. You will need to maintain a portfolio of evidence of your practice/competencies and pass the MRSA exam. Taking a non-training junior doctor post in the UK as a first job will help in getting the above. There are a lot of blog posts explaining the process, please search google.

Do you need two years of experience to be eligible for the MRCPsych CASC exam? 

No, you do not need enrollment in a fellowship or MD program in psychiatry; you just need to show that you have two years or more of experience in the psychiatry department. This could be an RMO in India or Pakistan, for example. 

Is it worth taking the MRCPsych Exam for an Indian?

There is such passionate debate going on about the award of MRCPsych without examination. Those who have struggled to achieve Membership through examination feel that the value of this has been somewhat lowered or tarnished. They awarded me Membership without examination and would like to share what this means to me and what advantages it has afforded.

MRCPsych Paper B: 600 MCQs and EMIs

MRCPsych examination has changed from Paper 1,2,3 to Paper A and B and the first-ever sitting of the `Paper B' examination was on 14th April 2015. MRCPsych Paper B: 600 MCQs and EMIs is the sole review book that covers the new Paper B examination syllabus. 

This book comprises 3 full test papers; 2 matching the syllabus to help with revision and one unstructured to provide authentic mock examination paper practice. MRCPsych Paper B: 600 MCQs and EMIs offer the most up-to-date and comprehensive collection of practice questions for trainees preparing for the new MRCPsych Paper B. they have plotted the questions plotted per the syllabus to present organised revisions on all the key topics, allowing readers to focus on areas of weakness. 

Featuring a wealth of practice questions and answers, this book is an essential revision tool to maximise the chances of examination success.

Key Points

• 600 MCQs and EMIs reflect the breadth of topics encountered in the examination
• Straightforward answers to help you merge knowledge and understand key concepts
• An unstructured mock paper allows candidates to practice under exam conditions

Extended matching items 

What are the extended matching questions and how many can you expect in the MRCPsych Exam?

An extended-matching items/question (EMI or EMQ) is a written examination format similar to multiple-choice questions but with one key difference, that they test knowledge in a far more applied, in-depth, sense. We often use it in medical education and other healthcare subject areas to test diagnostic reasoning.

Structure

The structure has three key elements:

Answer option list

Sources suggest using a minimum of eight answer options for a ratio of five scenarios or vignettes to ensure that the probability of getting the correct answer by chance remains reasonably low.[1] The logical number of realistic options should dictate the exact number of answer options. The logical number of realistic options should dictate the exact number of answer options. This ensures that the test item has authenticity and validity.

Lead-in question:

This should be as specific as possible and upon reading the lead-in question it should understand exactly what the student needs to do - without needing to look at the answer options. If you need to look at the answers to understand the question, the item has not been well-written.

Two or more scenarios or vignettes:

There should be at least two vignettes, otherwise, this becomes an MCQ. Because the item allows for an in-depth test of knowledge, we should relate each of the scenarios to one another by a theme that summarises the question overall. Each scenario should be roughly similar in structure and content, and each has one 'best' answer from amongst the series of answer options given.

Preparing for MRCPsych Paper B with Parsa Amin

I passed paper B using an online exam in October and thought I’d just share what I did while it’s still fresh in my brain so it can help a few. I had an extremely comfortable pass & this is what I did. 1. SPMM Qbank - as I meant to do this exam in March 2020 (Thanks COVID19)- I ended up doing the Qbank average 4 - 5 times. (I didn’t study between March 2020-May2020). I technically did 4 months before this exam knowledge from previous revision pre-March 2020. I used google/ NICE guidelines to read up on only topics I didn’t understand. Focus on EMI’s on SPMM the month before the exam - if you are scoring well, it shows you know your stuff. SPMM 13 timed mocks (they updated it to simulate a real exam, worth the price) - did only once- timed like in the exam situation, I sat them using the area I sat the actual exam. Cambridge Critical Appraisal course - I also did it twice as I was meant to take an exam in March. SPMM statistics videos - they are so good. I also did the SPMM paper B crash course in Feb 2020 - could have potentially skipped this. I did mrcpsychmentor only once - I really didn’t like it, so I avoided it I made my own flashcards with high yield materials only. 

Logistics: 

Please get an Ethernet cable for the exam - way too many people had terrible experiences because of the poor internet. The last thing you need.

Pneumoencephalography

Pneumoencephalography (sometimes abbreviated PEG, and some knew it as an "air study") was a common medical procedure in which they would drain most of the cerebrospinal fluid from around the brain with a lumbar puncture and replaced it with air, oxygen, or helium to allow the structure of the brain to show up more clearly on an X-ray image. 

They derived it from ventriculography, an earlier and more primitive method where they would inject the air through holes drilled in the skull.