Preface To The Third Edition

Furthei !<> the changes of the written parts of the MRCP exam, notably the removal of negative marking in Part 1 and the change to MCQ ('Best of Five') based questions in Part 2A, there has also been a change in the content of the MRCP 2A papers. The exam is increasingly orientated around evidence based medicine, up-to-date patient management and current guidelines. This is a move away from the esoteric questions seen in the past and it makes a more useful exam. Candidates have said that a large proportion of questions could now be answered with adequate clinical experience. That does however mean that preparation for Part 2A needs to inc lude the British Medical Journal, the journal of the Royal College of Physicians and the Drugs and Therapeutics Bulletin. The candidates need to be aware of the latest guidelines regarding the treatment of bread and butter entities such as hypertension, diabetes and chronic chest disease. The bodies involved in these guidelines besides the National Institute of Clinical Excellence (NICE) are the respective societies such as the British Thoracic Society and the British Society of Gastroenterology. Fortunately these are all now available on the internet and time is well invested in checking the headlines on the respective sites. A short list of these can be found on page ix.

The first few of the new papers for Part 2A contained 70-75 questions, most of which consisted of a single stem. For each possible correct answer there are 5 possible options i.e. if the question asks for two differential diagnoses there will be ten possible answers. Remember the exam is not negatively marked, therefore all questions must be answered, but do not tick more than requested.

If in doubt choose the answer that represents the logical next step in patient management as you would do with a patient in Accident and Emergency or the Outpatient department. Bear in mind this is an entry exam to higher medical training, and increasingly aiming to assess good patient management skills.

That does however not invalidate my motto from the previous editions: 'Übung machi den Meister!' So get practicing.

For this particular edition I am indebted to my friend Ed Gamble, stroke physician South Manchester University Hospitals for his efforts to keep my medicine up-to-date.

Good Luck

Many thanks also to those who have taken the trouble to send in comments. All feedback serves to improve the next edition.

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