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Don't be the first to fail the summative assessment MCQs

t's always a little disconcerting when everyone repeatedly says how easy an exam is, especially when they have already passed.

It's all very well knowing that nobody on your VTS or indeed in the known universe has ever failed summative assessment MCQs. But that's no help when you have a nagging suspicion you may be the first to do so.

Even if all your friends say there is no point in preparation and you only need to turn up, you still might like to do a little closet revision. Here are a few tips.

It's true that since the exam is on pretty much everything remotely medical, it is difficult to 'revise' in the usual way.

As with any MCQ exam, probably the best way to prepare is to practise. Your training practice should have a copy of the PEP ('phased evaluation programme') CDs.

The first CD is probably most useful for summative assessment. It has 11 modules comprising MCQs and case histories ranging from dermatology to geriatrics and includes one module on the MRCGP exam. Each module takes one to two hours to finish, so ploughing though the whole CD should certainly keep you busy.

It may be a good idea to list subjects where you lack confidence (this should become increasingly apparent as you go through the MCQs). You can then look them up in a textbook in more detail (try the online Kumar and Clark at www.doctors.net.uk).

If your training practice doesn't have these CDs, try contacting the educational lead GP at your PCT who should be able to supply a copy.

Exemption from MCQs

If you prefer revising distinctly 'offline', while curled up on the settee with tea and a bar of chocolate, there are plenty of MCQ books including a recent one published by Pastest, for the MRCGP. Preparing for the summative assessment MCQs should certainly be good practice for the MRCGP.

In fact, passing paper 2 of the MRCGP exempts you from summative assessment MCQs. This does, however, require a certain degree of confidence.

The exam takes place four times a year and it appears to be quite popular. Don't forget to reserve your place from the summative assessment co-ordinator at your deanery at least a month in advance, as it can get booked up (maybe because it's free).

It's worth attempting fairly early on in the registrar year because, if you fail, you simply try again next time. You get three hours for 300 questions. This is more than enough time and most people leave early.

It is not negatively marked, so attempt all questions. Don't worry if you haven't got a clue about some ­ it's not surprising when you consider you are being tested on the whole of medicine, surgery, paediatrics and so on.

Questions are a mix of MCQs, multiple true or false questions and EMQs (there will be 220 standard true or false questions and 60 EMQs). Subjects are shown in the box above.

'Practice management' may sound daunting, but you will know the answers to many from your time in practice. Pay attention to which form is which when you're in surgery and to when you should classify a patient as temporary as opposed to immediately necessary or an emergency.

You need a vague idea of which benefits patients can claim and, more importantly, what you are allowed to claim for as a GMS principal (it all helps with planning that early retirement). If you are still worried, a few hours spent with your practice manager will help to fill in the gaps in your knowledge.

The MCQ exam is said to be easy,

but Dr Rupal Shah has a few tips

just in case

Breakdown of subjects

Internal medicine 45%

(this includes surgery)

Child health 16.6%

Obs and gynae 16.6%

External medicine 16.6%

(this includes ENT,

dermatology and so on)

Practice management 5%

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