Showing posts with label Paper A. Show all posts
Showing posts with label Paper A. Show all posts

Wednesday, 28 September 2022

Extended Matching Items for the MRCPsych Part 1

Extended Matching Items for the MRCPsych Part 1

Michael Reilly, Bangaru Raju

Cover Page Extended Matching Items
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

Friday, 27 May 2022

McQs for the New Mrcpsych Paper A with Answers Explained

McQs for the New Mrcpsych Paper A with Answers Explained

Comprising of 400 MCQs, this book provides essential revision content to help you pass the recently introduced MRCPsych Paper The book follows the most recent guidelines for the new curriculum in compiling the content. MCQs for the New MRCPsych Paper A with Answers Explained is an invaluable aid for all candidates for the examination of the Royal College of Psychiatrists. Other clinicians and undergraduate students in medicine and health sciences will also find it useful.

About the Authors

Edited byDavid Browne, MB, BCH, BAO, DCP, MScLMD, Mogadiscio, ACC, MRCPsych, consultant psychiatrist, Ashlin Centre, Beaumont Hospital, Dublin, Ireland

Selena Morgan Pillay, MB, BAO, BCH, DCP, MRCPsych, MMEDSc, senior clinical lecturer RCSI & consultant psychiatrist, Beaumont Hospital, Beaumont Rd., Dublin, Ireland

Guy J. Molyneux, MB, BCH, BAO, MRCPsych, Postgraduate Diploma in CBT, Diploma in Management, clinical director in psychiatry at HSE Dublin North City and County Mental Health Services and MMUH, and consultant in adult psychiatry at St. Vincent's Hospital, Fairview, Ireland

Brenda Wright, MB BCh BAO MRCPsych, MFFLM, consultant forensic psychiatrist, National Forensic Mental Health Service, 

Dundrum, Dublin, IrelandRaju Bangaru, MD, MBA, BS, MRCPsych, DPM, executive clinical director, North Dublin Mental Health Services, Consultant Psychiatrist, Connolly Hospital, IrelandIjaz Hussain, MMedSc, MBBS, MRCPsych, DCP, consultant physician, Fraser Health, Surrey Mental Health, British Columbia, CanadaMohamed Ali Siddig Ahmed, MMedSc, MBBS, MRCPsych, DCP, MD, senior consultant psychiatrist & clinical director, Hamad Medical Corporation, Doha, QatarMichael Reilly, MB, BCh, BAO, MRCPsych, Diploma in Management, consultant psychiatrist Sligo Mental Health Services, Ballytivnan, Ireland

Revision Notes for MRCPsych Paper A

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.

Saturday, 7 May 2022

MRCPsychmentor for MRCPsych Examinations

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 (

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. 

Question on Suicide rate among the elderly

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 (

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.   

Tuesday, 12 January 2021

Functional Magnetic Resonance Imaging (fMRI)

Functional Magnetic Resonance Imaging (fMRI)


Structural imaging reveals the static physical characteristics of the brain. It makes it useful in diagnosing disease. Functional imaging reveals dynamic changes in brain physiology that might correlate with cognitive functioning, for example. Neural activity consumes oxygen from the blood. This triggers an increase in blood flow to that region and a change for deoxyhemoglobin in that region. As the brain is always physiologically active, functional imaging needs to measure relative changes in physiological activity.

The most basic experimental design in functional imaging research is to subtract the activity in each part of the brain whilst doing one task away from the activity in each part of the brain whilst doing a slightly unfamiliar task. We call this cognitive subtraction.

Other methods, including parametric and factorial designs, can minimize many of the problems associated with cognitive subtraction. There is no foolproof way of mapping a point on one brain onto the putatively same point on another brain because of individual differences in structural and functional anatomy.

Current imaging methods cope with this problem by mapping individual data onto a common standard brain (that is, stereotactic normalization) and by diffusing regions of significance (a process we call smoothing).

A region of activity refers to a local increase in metabolism in the experimental task compared to the baseline, but it does not mean that the region is essential for performing the task. Lesion studies might provide evidence concerning the necessity of a region for a task.

Functional imaging can make crude discriminations about what someone is thinking and feeling and might outperform the traditional lie detectors. However, it is highly unlikely that they will ever be able to produce detailed accounts of another person’s thoughts or memories.

An fMRI measures regional cerebral blood flow. Cognitive functions are region-specific, if a task involves a certain cognitive function, the areas involved will become more active, need more oxygen and more blood. fMRI measures regional levels of blood oxygen by detecting magnetic changes in red blood cells when they become deoxygenated

A man looking at fMRI on his computer

Magnetic Resonance Imaging

Magnetic resonance imaging creates images of soft tissue in the body, which x-rays pass through undistorted (so computerized tomography would not capture well). The density/intensity of the images is water-based, with different amounts of water for different tissues. It enables a 3D image of the layout of these tissues. Structural MRI produces a static image of the brain structure. It has a high spatial resolution. It is used to overlap functional images on to.

Metal items and MRI

We remove metal items before the functional imaging because the strong electromagnetic fields will attract them. Patients who use pacemakers cannot have magnetic resonance imaging or its functional variant.

Underlying Mechanisms of fMRI

The fMRI uses a strong magnetic field to line up protons. It measures oxygenated blood by recording the spin of protons, which have a magnetic charge. After aligning protons in fMRI it sends a radio pulse through the lined-up protons, to record how they resonate.

Different proton resonance patterns.

Different protons (different tissues) resonate differently (magnetic susceptibility), allowing the composition of a tissue image. fMRI uses the differential response of oxygenated and deoxygenated blood for the imaging. Oxygenated blood resonates differently from deoxygenated blood, allowing the composition of an (indirect) image of the brain activity.

It is T1-contrast (measures a different magnetic property to functional scans).

The spatial resolution of fMRI

Although fMRI is not as spatially resolute as MRI, it can record 3x3x3 mm and more detail with a 7T (stronger tesla coil strength) scanner.

Both spatial and temporal T2 contrast rely on tesla strength. Temporal T2 contrast measures a different magnetic property to structural scans.

In structural MRI, the magnetic field aligns protons. It aligns protons in water molecules that have weak magnetic fields, initially randomly oriented, but some align with the external field.  A radio pulse knocks orientation by 90 degrees, which leads to a change in the magnetic field. After this change in the magnetic field, the protons become stead and we can repeat the procedure for fresh slices of the brain. A whole-brain image in 2 seconds (3 mm slices) 1: relaxation time. T1-images structural scans.

It relies on the brain to store a large amount of oxygen and glucose. It does not store oxygen though still consumes around 20% of the body’s oxygen supplies. The brain tissue does not store oxygen; oxygen must be supplied from the fresh blood supply. Active tissue consumes more oxygen compared to less active brain tissue. Oxygen-rich blood is lost in areas of higher brain activity.

Magnetic properties of blood

Oxyhemoglobin is diamagnetic while deoxyhemoglobin is paramagnetic. Hemoglobin molecules resonate differently in these different magnetic states.

Diamagnetic substance

A diamagnetic is magnetic when exposed to the external magnetic field for example oxyhemoglobin.

Paramagnetic substance

A paramagnetic substance is normally magnetic for example deoxyhemoglobin.

Blood Oxygenation Level Dependent (BOLD) Signal?

It compares the level of oxygenated with deoxygenated blood derived from the magnetic properties of blood. It is an indirect measure of brain activity.

Factors on while BOLD Signal depends:

1) Cerebral metabolic rate of oxygen (goes up when tissue is active *of genuine interest* more oxygen when spending energy, so de-oxygen goes down)

2) Cerebral blood flow

3) Cerebral blood volume

fMRI compares the differences between magnetic spins of protons in oxygenated blood and deoxygenated

Hemodynamic Response Function.

Initial Dip

Neurons consume oxygen leading to a small rise for deoxyhemoglobin causing reduction of BOLD signal.


In response to the increased consumption of oxygen, blood flow to the region increases. Increased blood flow is greater than increased consumption >> BOLD signal increased


Blood flow and oxygen consumption dip before returning to original levels. This may reflect a relaxation of the venous system.

Active' areas

Active areas in fMRI refer to a physiological response that is greater relative to some other conditions. To label active areas, we need a baseline response, well-matched to the experimental task. Example: Petersen, Fox, Posner, Mintun, and Raichle (1988) Study brain activity involved in word recognition, phonology, and retrieval of word meaning, cognitive subtraction.

Research designs can exploit this difference by finding two tasks, an experimental task and a baseline task, which differ in terms of a few cognitive components.

Subtraction design

Subtraction is taking a task with the cognitive component in it, and then subtract another task with only that component is taken out

Neuronal structures underlying a single process P

Contrast: [Task with P] [control task without P].


Conjunction requires a set of orthogonal tasks that has a particular component in common. Look for regions of activation that are shared across several subtractions. A test for such activation common to several independent contrasts is called a conjunction. It resembles a factorial design in ANOVA.

Issues with subtraction design

1)    The assumption of pure insertion is the assumption that we can insert a single cognitive process into another set of cognitive processes without affecting the functioning of the rest.

2)    At baseline the brain is always active, and the level of activity is not consistent which makes it challenge where to make comparisons.

Donders coined the term pure insertion as a criticism of reaction time methods. One way to minimize the baseline/pure insertion problem is to isolate the same process by two or more separate comparisons and inspect the resulting simple effects for commonalities. 

Example of this cognitive subtraction in Petersen, Posner 1998

Brain activity involved in word recognition, phonology and retrieval of word meaning cognitive subtraction e.g. contrasts passive viewing of (words vs fixation cross) e.g. (read aloud word vs look at the word) e.g. generate (a word associated with viewed word vs read aloud a written word)

The issue with pure insertion is that adding an extra component does not affect the operation of earlier ones in the sequence.  BUT: interactions are likely to occur– Baseline task: should be as like the experimental task as possible.

Examples of conjunctions and factorial designs by Frith:

1)    Why cannot we tickle ourselves (Blakemore, Rees, and Frith,1998).

2)    Factors touch (felt/not) self-movements (moved/not)

Parametric fMRI design

To get around baseline continuous manipulation of the factor of interest. We treat the variable of interest as a continuous dimension rather than a categorical distinction. Associations between brain activity rather than differences between two or more conditions. passive listening to spoken words at six different rates. Different brain regions show different response profiles to different rates of word presentation. Adapted from Price et al. (1992), and Friston (1997). no baseline necessary.

Functional specialization

Functional specialization: region responds to a limited range of stimuli/conditions. This distinguishes it from the responsiveness of other neighboring regions (no localization).

Functional integration

How different regions communicate with each other. It models how activity in different regions is interdependent. Effective connectivity or functional connectivity between regions when performing a task. Use techniques like the principal component analysis. 


A word production vs repeating letters in patients with schizophrenia and controls.

Block design

In a block design, stimuli in one condition are grouped. Strong BOLD contrast: higher signal-to-noise ratio simple design and analysis - practice/fatigue effects cannot be used when participants should not know which condition is coming next.

Event-related design

When stimuli are presented completely randomly, we call it event-related (new as temporal difficulties, etc.) design.  This design works with infrequent and random stimuli. If conditions defined by the participant-sorting what happened in a trial (e.g. correct/incorrect trials; biostable percept (Necker cube); the presence of a hallucination - see right). Different stimuli or conditions are interspersed with each other (e fMRI). Intermingled conditions are subsequently separated for analysis. no practice/fatigue effects can be used when participants should not know which condition is coming next: randomization can be used when trials can only be classified after the experiment- weaker BOLD contrast: lower signal-to-noise ratio more complex design and analysis


a scanning session, all the data collected from a participant. Usually comprises a structural scan and several runs of functional scans.


A continuous period of scanning consists of a specified number of volumes


A Set of slices taken in succession: a 3D spatial image, with a temporal dimension. Expressed in TR (Repetition Time): how long does it take to acquire a volume.


A period when a certain condition is presented. Conditions (epochs) can be grouped (blocked design) or randomly intermixed (event-related design).

Correcting for head movements:

Spatial resolution >> small spatial distortions–Individual differences in brain size and shape stereotactic normalization (adjust the measurement of overall dimensions to the 'standard brain'– Individual head aligned differently in scanner over time due to movements. Regions are harder to detect False-positive results. Physically restraining head (using foam or something) and participant instructions Correction


Spreads some raw activation level of a voxel to neighboring voxels. Smoothing enhances signal-to-noise ratio Compensates for individual differences in anatomy.


Smoothing assumes that Cognition does not occur in single voxels. Increases the spatial extent of the active region. more likely to find overlap between participants

Steps of fMRI Analysis

Individual differences “averaging over many participants–Correction for head movement– Stereotactic normalization–Smoothing–Statistical comparison

Stereotactic normalization

Mapping regions on each brain onto a standard brain (brain template is squashed or stretched until it fits). Tailarach and Tournoux (1988).

Brain Atlas (based on one brain), Tailarach coordinates–X left/right–Y-front/back–Z top/bottom.

Alternative: Montreal Neurological Institute (average of 305 brains)—Voxels (volume elements), 3-D coordinates.

Tens of thousands of voxels “capitalization on chance Lower significance level (Bonferroni). Choosing a statistical threshold based on spatial smoothness (random field theory).

Analyze the pre-determined region. Reported, corrected, or uncorrected statistical parameters (ROI?)

We start a stat comparison by dividing up data according to design-then perform stat comparison.

Three points of interpretation:

1)    Inhibition versus excitation

2)    Activation versus deactivation

3)    Necessity versus sufficiency.

Inhibition versus excitation?

Functional imaging signals are assumed to be related to the metabolic activity of neurons, and synapses. However: activity can be excitatory or inhibitory. The BOLD signal is more sensitive to neuronal input into a region than the output from the region. Unclear whether functional imaging can distinguish between two neural functions.

Activation versus deactivation

Activation/deactivation Merely refers to the difference between the two conditions. Does not say anything about the direction of the difference.

Necessity versus sufficiency

Necessity: Are active regions critical to the task? Sufficiency: functional imaging shows us active regions, but these may not be crucial. Use methods in conjunction with other methods. 

Thursday, 7 January 2021

Assessment of Risk Factors in Post-traumatic Stress Disorder

A 37-year-old woman, who is an intelligent computer programmer, presented with insomnia, restlessness, and anxiety. On detailed assessment, she reveals that the symptoms started after some thieves robbed their house 3 months ago. In the incident, they had killed one of her sons. She also experiences intense imagery related to the event and often wakes up after experiencing a nightmare. The woman feels uncomfortable talking about the event and requests not to talk about it. She had experienced another such incident when she was a child. She also received treatment for depression three years ago. Personality assessment revealed neurotic traits. No one else in the family developed such symptoms, even though all of them experienced the event. 

Common Crisis Situations in Clinical Practice

Common Crisis Situations in Clinical Practice

Point out the crises seen in day to day clinical practice.

  1. Developmental crises common to all occur in Stressful states of human maturation and transition. e.g. hospitalization
  2. Situational crises person faces stressful and traumatic event e.g. flood, earthquake, rape, etc.

WHO Guidelines for the Treatment of Alcohol Withdrawal

Transitional Object

Transitional Object

Mary Ainsworth studied and showed that attachment helps to lessen anxiety.


It allows a child to leave the attached figure and explore the surroundings. A transitional object, which is an inanimate object, such as a teddy bear or a blanket, also works as a secure-base. Children carry it along as they examine the environment. 


  1. Sadock, B. J., & Sadock, V. A. (2015). Kaplan & Sadock Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry. Wolters Kluwer, Philadelphia, Pa.

  2. Duschinsky R. The emergence of the disorganized/disoriented (D) attachment classification, 1979-1982. Hist Psychol. 2015;18(1):32–46. doi:10.1037/a0038524

Interactions of clozapine

Interactions of Clozapine

The cytochrome P450 system of enzymes in the liver inactivates and removes the toxic substances, including drugs, from the body. These enzymes include CYP 2D6, 2C9, 2C19, and 1 A2. But certain drugs can inhibit or induce these enzymes themselves. Some SSRIs are potent inhibitors of an individual or multiple hepatic cytochrome P450 (CYP) pathways and the magnitude of these effects is dose-related. Several clinically significant drug interactions can, therefore, be predicted. For example, fluvoxamine is a potent inhibitor of CYP1A2 which can result in increased theophylline serum levels, fluoxetine is a potent inhibitor of CYP2D6 which can cause increased seizure risk with clozapine, and paroxetine is a potent inhibitor of CYP2D6 which can cause treatment failure with tamoxifen (a prodrug), leading to increased mortality. Escitalopram has the least impact on these enzymes.

QID: 20200407130027659

Wednesday, 6 January 2021

Is mrcpsychmentor alone enough for MRCPsych paper A

Some candidates do not use SPMM for any of the MRCPsych exams. It is too expensive. 

Types of Learning According to the Theories of Learning


Types of Learning | Theories of Learning

What are the types of learning according to the theories of learning?  

  1. Classical Conditioning or associative learning.

  2. Operant Conditioning or Instrumental Conditioning  

  3. Cognitive learning

    1. Signal Response

      1. The predictive power of conditioned-response; the higher it is, the greater the conditioned response. 

      2. Response-Outcome Relations

      3. The cognitive judgment of the individual relating the response to the outcome, rather than an unconscious stamping in of the conditioning. 

    2. Latent Learning:

      1. Learning but not exhibiting the learned behavior until adequate reinforcement is presented. 

  4. Observational Learning through Modeling 

Tuesday, 5 January 2021

Extended-Matching Items

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.


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.

Tuesday, 15 December 2020

Can you apply for the MTI UK Scheme before passing MRCPsych?

You do not need to pass MRCPsych paper-A or Paper B before you apply for the MTI. You can apply to the program before passing any part of the MRCPsych exams. The following are your requirements to enter the MTI scheme. 

  1. GMC-recognized primary medical qualification from an internationally accepted medical institution. 
  2. An acceptable internship (or equivalent) of 12 months. 
  3. Three years of experience working in Psychiatry in the last five years. 
  4. Working in psychiatry for the last year. 
  5. A score of 7.5 in IELTS academic or grade b on OET taken in the last 18 months.  
  6. You have received or will work towards a postgraduate qualification in psychiatry.

Friday, 7 June 2019

Development in the first year of life summarised

Development in the first year of life summarised
  1. Smiling starts at 3 weeks. 
  2. Selective smiling starts at 6 months. 
  3. Fear of strangers starts at 8 months, while separation anxiety starts later to that. 
  4. At the end of the first year, children also learn a few simple words like mama, dada, etc. 
  5. Weaning starts at around 6 months and should have completed by the end of the year. 
  6. An ordered sleep-wake cycle has also got established, Children learn to point at objects in the first year of life.

Saturday, 6 January 2018

The Safest NSAID for a patient on lithium

The Safest NSAID for a patient on lithium

What is the most suitable non-steroidal anti-inflammatory drug (NSAID) you can prescribe to a patient who is on Lithium therapy?

>> Aspirin or Sulindac. 

Monday, 11 July 2016

Mnemonic for the Adult Traits Associated with Freud's Oral Phase of Development

According to the theory of psychosexual development, subjects develop the following traits with fixation at the oral stage of development: 
  1. Dependency
  2. Optimism
  3. Gullibility
  4. Sarcasm
  5. Hostility
  6. Aggression
  7. Pessimism, passivity



Tuesday, 28 June 2016

Mnemonic for Freud's Stages of Psychosexual Development

Mnemonic for Freud's Stages of Psychosexual Development

The following sentence helps me remember the stages of psychosexual development in order. 

Onions And Potatoes Look Great

  1. Oral
  2. Anal
  3. Phallic
  4. Latency 
  5. Genital 

Sunday, 12 June 2016

Risk Factors for PTSD (Post-Traumatic Stress Disorder)

Risk Factors for Post-Traumatic Stress Disorder

The following description of risk factors also answers QID:919472837474

The best answer would be d) her intelligence quotient. The patient has developed symptoms of post-traumatic stress disorder, including the most specific “intrusive symptoms.” These have occurred after the life-threatening event she went through. Both the international classification of diseases and the diagnostic and statistical manual require such a precipitating factor for making the diagnosis. It is an event that is life-threatening, or according to the diagnostic and statistical manual, one that threatens body-integrity (e.g. rape). One may either be a bystander or directly threatened by the event. However, this factor interacts with other predisposing or vulnerability factors in an individual to trigger the condition. Genetic factors account for about one-third of the vulnerability, according to a study conducted on twins working in the U.S. military. Other notable predisposing factors include female gender, a history of anxiety or depression, lower levels of intelligence, neurotic traits, a history of trauma, and lower social support. Her gender, her history of depression, of experiencing a similar event, and her personality, may all have predisposed her to develop post-traumatic stress disorder. Low and not an elevated level of intelligence predisposes to post-traumatic stress disorder. Thus, her elevated level of intelligence may not have added to her risk.


  •      Female Gender, Family History of Psychiatric Illness
  •      Anxiety/mood disorder (history of)
  •      Intelligence (low)
  •      Neuroticism
  •      Trauma, history of
  •      Social support (poor)

Saturday, 9 June 2012

General Advice for Written Papers (MRCPsych Paper A and B)

General Advice for Written Papers (MRCPsych Paper A and B)

We need preparation for the written exams, and we would suggest you think about starting your revision at least three months before each one. Although it’s difficult to balance examination revision with a full-time job, it is possible with wonderful organisation and discipline. Furthermore, many people have other responsibilities, such as children, which makes it much more difficult to fit in. It may have been years since you took your medical school examinations, and getting back into the swing of things can take some time. One technique is to start with half a day on weekends or a couple of evenings each week, then escalate the time as the examination approaches. There will be times when you can’t do any revision, for example, during weeks of night shifts. Although individuals strive to cram as much studying as possible into the weeks leading up to the test, it is equally crucial to relax and enjoy yourself. Rather than making your preparation less time-effective, scheduling some relaxation time will make your revision period more productive.


A good first step would be to study the Royal College of Psychiatrists’ examination web pages. There are details of the syllabus, regulations, frequently asked questions, and lots more useful bits and pieces. Google’ MRCPsych examinations’ to find the official College website.


Regarding what to revise, make sure you look carefully at the syllabus for each examination on the Royal College website to check the areas you need to cover in your revision. There is no point in covering areas that don’t appear in the examination, and you would better spend your time learning things. Although the proportion of questions in each subject area is worth bearing in mind, it isn’t the only factor. It would likely be better to allocate your time to concentrate on the areas you find most challenging.


The biggest change in the written exams has been moving from 3 written papers to 2. There are now 2 written exams, papers A and B, each comprising 200 questions over three hours. The exams contain multiple-choice questions (MCQs) and extended matching items (EMIs), with a rough split of 2/3 MCQs and 1/3 EMIs.

Examination online sites from the Royal College of Psychiatrists are a fantastic place to start. There are syllabus details, restrictions, frequently asked questions, and a slew of other valuable information. The official College website may be found by searching for "MRCPsych exams."

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