"The man who reads nothing at all is better than educated than the man who reads nothing but newspapers"
"When wrongs are pressed because it is believed they will be borne, resistance becomes morality"
President Thomas Jefferson
Every now and then I receive an email or a phone call or even a formal letter from friends, colleagues...etc saying that they are intending to be physicians and they are about to start reading and studying for the MRCP examination. Many are standing dazed and confused in the center of a circle of disorientation. What book(s) to choose, what website(s) to to subscribe with, do I need more than a few months, what questions to anticipate?...etc.
Few years ago, the net was some what defective in providing the required information about the horror of the MRCP, and the resources composed almost entirely of small books and 1 or 2 websites offering an "online" form of teaching. Now a days, the net is overflowing with information, resources, websites, personal blogs, forums...etc. But, should we believe and trust all of them? Do they really reflect the real examination? Are they counterproductive in reality? Do they deserve the cost?
I've conducted a small and short listed questionare for those who are preparing for part I examination. The out come:
a. Difficulty: 87% think that it is a "very difficult" examination". 11% said that it is "somewhat" difficult", and the remaining wrote " not that difficult". No one ever said that it is an easy one.
b. Reason for difficulty (for someone who did not participate in that examination): 83% said that they have a friend or a colleague who was successful in passing part I examination after at least one trial. 9% had read the "stories and advices" about past examinations in the net and they construct a foggy picture about what to face. 8% said that the questions are being put by the royal college, so the examination "must" be difficult.
c. Areas of weakness: 93% think they are defective in immunology. 89% said they are confused when reading neurology. 88% for pharmacology and toxicology. Other subspecialties were below 40%.
d. Duration of studying and preparation for part I: 78% said that they were "advised" to study for 4 months only. 15% from 4 months to a year. 6% for more than a year. Only 1% said that they don't know how much time do they need to fill in their areas of weakness.
e. Resources: The options were multitude;
1- Medical textbooks: 62% for Kumar. 36% for Davidson's. 2% only read other textbooks (Harrison's, Cecil's...etc). Additional 43% add Kalra book with their main textbook.
2- MCQs and Best of Five books: The percentages were scattered somewhat equally throughout many books available in the market.
3- Websites:
a. Only 36% had subscribed for an account in one of the non-official MRCP websites.
b. Why that website specifically: 70% said that it is "mentioned too frequently" in the MRCP forums. 10% "suggested" by a colleague or friend. 10% through web search". 10% no specific reason.
c. Cost: 96% agreed to be to "much expensive for such a short period". 3% not that expensive. 1% only think that its cost is fair.
d. The interactive "thing": 40% "enjoyed" the active participation. 40% Don't care. 10% did not like this time consuming process.
f. Is it better than reading a "real BOF/MCQs book"?: 100% said no.
The comments were (some of them): My internet line is slow, I don't like "PC studying", I pay too much for "something that I will not have eventually", I have no other choice, It is a way of spending time while studying.
Any way, long time ago, I noticed that almost all MRCP candidates read only "small" best of five commercial books, and some do non-official MRCP websites, and they depend heavily on them to "finish" the preparation "quickly".
The first thing to drag attention is the title; like MRCP questions, rapid preparation course for MRCP, MRCP best of fives...etc. Second is the "British" origin of the book, whether the publisher or the writer or the website. Very very few candidates "read" non-MRCP entitled books and non-UK based books or websites during the journey of the MRCP. Third is the price! A small booklet may cost you 40 USD!
The "fresh" MRCP candidate thinks that an MRCP book reflects the real examination, always! They don't know that many "MRCP books" and "non-official MRCP websites" are a "business", that is a way of making profits! The word MRCP is being abused every day and by many to sell few pages or questions to new candidates (who are frightened and having an MRCP phobia).
Now a days there is a propaganda describing the MRCP examination as being a very hard and expensive examination with a very high rate of failure, and that the candidate should be equipped with "certain" materials. These materials need to be purchased! An example is to pay about 200 USD to subscribe for an online written course covering only few months (while Harrison's needs about 80 USD!!!). Another example is to pay more than 1000 GBP for a 5-day clinical course!
Some may advertise about themselves in a cleaver way; a great example is posting in the MRCP forums (a previous epidemic, burnt out now) where someone posts a message saying that:
1- How I managed to get 85% in part I (and mentioning the name of a book or a commercial website, over a period of 2-4 months only!).
2-I did this "commercial" website and got 80% and I recommend it.
3-I'm new to MRCP, I'm doing this website, any one to study with?
4- I have a password of this website account valid for 2 months, any one to buy it?
5- This MRCP book is for sale?
6- Who appeared in this examination diet (or I appeared in this examination diet)? Please post what you remember ( a way to know about the current examination questions and themes and to make questions covering them, and to draw a gloomy picture that no one was good and he should have done this commercial website in order to make a fair pass!).
7- What do you think about this website or book? Any one?
8- And many other ways...
I understand that those writers and their websites and courses "run a business", and they spend money to maintain servers, pay salaries, advertise, pay taxes...etc. But unfortunately, it is becoming out of control, like a stock market!
I can assure you that:
1- The failure rate is some what high simply because of lack of preparation. What do you expect from someone who has a poor background and tries to be efficient after 2-4 months of reading superficial things!? I think it is an easy one, cheap, and no need for such distracters and this money scattering.
2- Not every MRCP book or website is trustworthy; some might be yes, but some are purely commercial with many scientific and clinical mistakes. Better is to read trustworthy well-known textbooks (which may have a self-assessment booklet).
3- Don't be fooled by what is published as "stories and experiences" in the MRCP forums. Almost all are fake and destructive, and are a way to create a propaganda. You will notice that someone appears in the forum, makes many posts ( actually a propaganda) and then disappears all of a sudden! Take the story from your friend, colleague, or a famous journal article.
Best wishes to all future MRCP candidates
Osama Amin
