Tips on MRCP, PACES, MRCGP exams

The following "The way I see it" articles published in BMJ Careers may be of interest to those who are preparing for the MRCP, FACES, MRCGP exams.

"When should I sit the MRCP?" - a consultant nephrologist suggested that taking the exams early has competitive advantage.

"Taking the MRCP early on" - a founadtion doctor thought that taking the exam early will help stand out from the crowd and has many advantages.

"Passing the MRCP written papers" - a SpR gave useful tips on passing the exam.


"The new MRCP PACES station 5" - 2 SpRs wrote about the changes and format of the new station 5 and offered advice on how to prepare for the exam - "the key is timing and maintaing professional behaviour throughout."

"Passing PACES" - a SpR offered Dos and Don'ts to help you "don't fall at the final hurdle - the PACES exam".

"MRCGP applied knowledge test" - a GP trainee offered advice on preparing for the new MRCGP AKT.

See also previous post on Passing postgraduate exam techniques

Share your views and experience to help others better prepare for the exams! If you like to add more information on this topic, click on "comment" and "send."

Is light drinking during pregnancy safe?

The finding from a UCL study suggesting that a glass of wine a week during pregnancy will not harm your child's development has caused controversy but the lead author said that the more the social factors were taken into account, the weaker the association became.


The study involved over 11,000 women who were asked about their drinking habits and their child's development until they were 5 years old. They found that children born to light drinkers were 30% less likely to have behavioural problems and achieve higher scores on cognitive tests than those whose mothers did not drink during pregnancy.

Some experts said that the study was flawed because it only looked at children up to the age of 5. The Dep of Health said "After assessing the available evidence, we cannot say with confidence that drinking during pregnancy is safe and will not harm your baby...... Our advice to pregnant women and women trying to conceive is to avoid alcohol", reported in the Telegraph.

An US alcohol epidemiologist said that alcohol is the leading fetal neurotoxin in the world, there is no safe amount of alcohol a pregnant woman can drink based on the evidence that alcohol kills brain cells in the developing fetus, reported in White Coat Note.

So the debate goes on.

Source: Light drinking during pregnancy: still no increased risk for socioemotional difficulties or cognitive deficits at 5 years of age? Journal of Epidemiology and Community Health 2010, October

Mild Alzheimer's patients to get treatment on NHS

BBC News reported that following a U-turn by the health watchdog, patients in the early stages of Alzheimer's disease could get drug treatments that were previously only available to patients with more advanced cases.

NICE has now given new draft guidance for the treatment of Alzheimer's disease that people with mild symptoms should also get the drugs and recommends a 4th drug, Ebixa, for patients with severe Alzheimer's. The final decision will be made later this year.

Latest data shows that about 380,000 people in England and Wales have Alzheimer's and more than 50% are estimated to have mild to moderately severe disease.

Hands-only CPR saves more lives

According to a study published in JAMA this week, hands-only CPR saves more lives in cardiac arrests.

Out of hospital cardiac arrest is a major public health problem in the US, in 2005, Arizona launched a programme to encourage the public to use compression-only CPR (COCPR) to improve survival.

The study included 2900 patients who received no bystander CPR, 666 conventional CPR and 849 COCPR. The researchers found that "among patients who received bystander CPR, the proportion with COCPR increased significantly over time, from 19.6% in 2005 to 75.9% in 2009", COPR was associated with a 60% improved odds of survival comapred with no bystander CPR or conventional CPR. The authors said that COPR has the advantage of minimizing interruptions in chest compressions during CPR.

In an accompanying editorial, the author said that the findings should encourage continuing investigations into the compressio-only CPR method. "Healthcare professionals involved in resuscitation should look to new Guidelines 2010 dodcuments for the international consensus on the science of compression-only CPR ........ to encourage the general public to learn this simple and potentially lifesaving skills".

However, a Lancet article published in April 2010 (17;375(9723):1347-54. Epub 2010 Mar 2. )states that "for children who have out-of-hospital cardiac arrests from non-cardiac causes, conventional CPR by bystander is the preferable approach to resuscitation. For arrests of cardiac causes, either conventional or compression-only CPR is similarly effective".

The 2010 Resuscitation guidelines will be available at Resuscitation Council (UK) website on 18 October 2010.

Source : Chest Compression–Only CPR by Lay Rescuers and Survival From Out-of-Hospital Cardiac Arrest. JAMA. 2010;304(13):1447-1454. doi:10.1001/jama.2010.1392 (f/t via Athens)

Editorial : Compression-Only CPR . JAMA. 2010;304(13):1493-1495. doi:10.1001/jama.2010.1420 (f/t via Athens)

Want to be happy?

A popular theroy of happiness states that happiness is 50% genetic but a new study finds that the choices you make in life can equally affect long-term happiness.

The findings are based on the data collected from a 25-year study on 60,000 Germans from 1984 to 2008. The researchers found that choices relating to partner, balance between work and leisure, participation in social activities and healthy lifestyle are key factors in determining satisfaction in life. For example, the findings show that having neurotic partners significantly reduce life happiness. People who prioritise altruistic and family goals are happier than those who prioritise career and material success. Church attendance, getting involved in social and community events and regular exercises are equally important in affecting happiness.

The authors says the study is the most extensive of its kind and a breakthrough in psychological research. They concluded that life happiness is chosen not predetermined, it has a lot to do with life choices and people can change their life goals. Although the study was based on Germans, the findings can also be applied in other parts of the world. The study is published in Proceedings of the National Academy of Sciences (PNAS).

Source: Long-running German panel survey shows that personal and economic choices, not just genes, matter for happiness. PNAS. doi: 10.1073/pnas.1008612107 . Published online before print October 4, 2010, free open access article

Look AHEAD trial - lifestyle intervention for diabetes

Following the Avandia scandal in July 2010, the European Medicines Agency (EMA) on 23 Sept recommended the suspension of the rosiglitazone-containing anti-diabetes medicines Avandia, Avandamet and Avaglim, they will be banned in Europe within the next few months. At the same time, the US government put toughened resrictions on the use of the drug. Critics say these "decisions will virtually eliminate use of the drug around the world".

According to a new study published in the Archives of Internal Medicine, 27 September, lifestyle interventions are recommended to improve glycemic control and risk factors in type 2 diabetes to prevent long-term complications, but the evidence of their efficacy is limited to short-term studies.

The authors said that the Look AHEAD study, a 4-year non-drug approach using intensive lifestyle interventions helped reduce cardiovascular risk factors in type 2 diabetics. The trial randomized 5145 patients with type 2 diabetes to following an intensive lifestyle- intervention program or to receive standard diabetes support and education. The intensive program including a combination of diet modification and physical exercises, with training and group support, was designed to achieve 7% weight loss in the first year and to maintain the weight in subsequent years.

After 4 years, the intensive intervention group maintained a weight loss of 6.15% of their weight compared with 0.88 % in the standard support group. They also experienced greater improvements in fitness, blood sugar, blood pressure, triglycerides and good cholesterol. The standard group had lower levels of bad cholesterol.

The authors said that the result indicated that the intensive intervention group had been exposed to lower cardiovascular disease risk factors during the trial, although it would be too early to say that intensive intervention can prevent heart attacks, there may be long-term benefits from the 4-year period. The study is continuing for several more years.

Should we look beyond Avandia and other drugs for diabetes treatment and invest in more preventive efforts?

Source: Long-term Effects of a Lifestyle Intervention on Weight and Cardiovascular Risk Factors in Individuals With Type 2 Diabetes Mellitus - Four-Year Results of the Look AHEAD Trial. The Look AHEAD Research Group. Arch Intern Med. 2010;170(17):1566-1575. (f/t via Athens)