MRCPI Part II General Medical Clinical Examination!

MRCPI Part II General Medical Clinical Examination:

I've received many emails and letters asking about the MRCPI Part II General Medical Clinical Examination tips and notes, methods of conduction, examiners, examination centers, rate of success, cases...etc.

It does not differ much from that of UK (PACES) and is composed of 2 parts: long case and short ones.
The examination is usually conducted over a 3-4 day period, according the examination center and number of candidates participating. Each day is divided into a morning group and an afternoon one (7-10 candidates in each). The 7-10 candidates are distributed into "batches" (like batch1, 2, and 3). The morning group candidates should reach the examination department (a medical ward) according to the time set by the Royal College; usually between 8 to 8:30 AM (may differ a little between centers), while the afternoon ones should be there around 11 to 11:30 AM. Don't forget to bring your RCPI examination ID card. You will find there a list, with the names and code numbers of the candidates, their examination date, time, and "batch", and examination number.
You may start with the long case or the short ones (according to your batch).
Suppose you start with the long case.

1- The long case:
You will be escorted to the patient's bed. You have 45 minutes to talk and to examine him thoroughly. You will be given a clipboard to write down your notes and findings. In addition, you must come up with a list of differential diagnosis, or if the case is clear cut, a complete diagnosis. There is bedside table provided with some medical instrument (a sphygmomanometer, ophthalmoscope, tongue depressor, torch…etc) but I would suggest using "your" own instrument (a minimum requirement is to bring a stethoscope, ophthalmoscope, and patellar hammer, but I would suggest the addition of tuning forks, tape measure, red head pin, a piece of cotton wool, and a pocket Snellen's chart; these are extremely invaluable during the short cases; note that, for example, you may be given a "strange" ophthalmoscope that you are inexperienced with!).
There is clock near the bed that will ring after 45 minutes indicating that you must stop everything, and someone will take you to sit near a room where the examiners (2 in no.) are awaiting. After a short moment of greetings, start telling the story. You should deliver the overall clinical picture in a short time, fluently, professionally with compacted sentences. Don't try to talk to much, like saying no headache, no tremor, no diplopia, no…no.. no...etc; it is a postgraduate examination! Give a provisional diagnosis, a list of differential diagnosis, and what is supposed to be done then (investigations, treatment…etc). At each step, sentence, or a phrase, they may interrupt you by asking something. Expect anything to be asked, even a mortality figure, or a result of a large clinical trial (related to your case). Regarding the ethical issue and communication skills, one of the examiners may act a patient and may ask for example to explain his hepatitis B status in the long term after being exposed to an infected patient sexually!
You have 10 minutes to express your case and 20-30 minutes of discussion. The long case has a maximum score of 6.

2- The short cases:
After that, you will be taken to a room before the short cases. The interval to start them may take an hour or two depending on the examination center. Then you will be taken to short cases. Another 2 or 3 examiners will greet you. The number of cases differs, but generally from 4-6 in numbers. Expect any combination of cases, not necessarily all systems would be met. For example, you may not face an endocrinology case or an eye fundus one; the most important 4 systems are cardiology, respiratory, abdomen, and neurology. The other 2 may be any one of these: eye, endocrinology, on spot leg case, dermatology, hand…etc. At each bed, there will be small paper demonstrating a short history and what you should do next. For example: "this young girl has double vision. Examine her", or "this old man has palpitations, assess his cardiovascular status". Sometimes the order is vague, like this one: "this middle-aged man has leg edema. Examine him and try to find out why?".
A clock will be in the hands of the examiners to ring after 30 minutes. There is no "time limit for each case" (unlike UK PACES); so you should conduct you examination rapidly, smoothly but efficiently and professionally, and your answers should be short and fluent. Don’t spend more than a few minuets at each case.
Honestly, I think this is more difficult than the UK PACES as you don’t know how much time has elapsed and how much is left! Just imagine that you are examining the 3rd case and bell rings! How much did you score! God knows! The short cases have a maximum score of 6. Combined marks of 10/12 (i.e. long + short cases) and more are required to get a pass. 9 and less is a fail. Needless to say, it is better to bring and use your own instruments, and to wear a white coat. Again, don’t forget your RCPI examination ID card. Remember, practice makes perfect.
Ryder's book is an excellent aid, and Baliga's is useful for the "discussion notes".

An example of a Mock Examination:
A- Long Case:
A 67-year-old retired sales executive who was reasonably well and fit presents with a 1-hour history of left sided weakness. The weakness was noticed after awaking in the morning as an inability to get out bed at 8:30 AM. His wife helped him to sit in bed, and called for medical help. He arrived to the A/E department after 1 hour, where he was examined by a senior house officer, undergone a battery of investigations, and accordingly he was admitted. He denies being on medications, including illicit drugs. The patient neither smokes nor drinks alcohol, nor his wife who lives with him in a 2-story house, and there is no family history of note. The patient denies any head trauma, but admits to the presence of occasional bouts of palpitations for which he is unconcerned since 3 months. No history of chronic illnesses was obtained with no past history of surgical procedures. He is right handed.
Examination reveals an old man, not in apparent distress. His blood pressure is 110/85 mmHg, with the left radial pulse being 110 beat per minute irregular in rate and volume, a respiratory rate of 16 cycles per minute. His axillary temperature is 36.7 Co. He is fully conscious and oriented with normal speech apart from slight slurring due to a problem with labial constants caused by left sided upper motor neuron facial palsy. There is left sided hemiplegia of grade 3-pyramidal type and upoging planter, with hemianesthesia and homonymous hemianopia. His precordium is unremarkable apart from rapid heart beats with variable intensity of heart sounds. Other parts of examination were unremarkable.
My provisional diagnosis is cardio-embolic ischemic stroke to the right main stem of the middle cerebral artery causing this devastating stroke in a patient with undiagnosed chronic atrial fibrialltion. However, I would like to exclude other causes having a similar clinical picture, like right sided subdural hematoma and brain tumor, by ordering brain imaging starting with brain CT scan.
The questions that might be asked: management of AF, managing him in the medical ward, long term management and prognosis, eligibility for cerebral thrombolytic therapy, role of anticoagulants in ischemic stroke, general nursing (diet, swallowing, prevention of DVT and bed sores, bowel and bladder...etc), trials of stroke, medications of AF, various drugs interactions, secondary prevention . You may be given a CT scan or an ECG to read. The examiner may act as the patient's wife and asks you to explain his long term prognosis; in addition he (she) may say that he (she) is unpleased because the CT scan result was delayed and this is the cause of not receiving rtPA.

B- Short Cases (you may have any 4-6 combinations):
1- This young lady has progressive exercise intolerance, examine her cardiovascular system (?mitral stenosis).
2- This old man has severe shortness of breath, examine his chest anteriorly (?right sided lung collapse).
3- This middle aged man has abdominal discomfort, try to know why (?massive splenomegaly).
4- Look at the hands of this old lady; come up with a differential diagnosis (bilateral hand muscles wasting-?causes).
5- Look at this old Chinese lady (having a strikingly tanned face); where would you like to examine further (?Addison's disease).
6- Have a look at both eye fundi and give a complete diagnosis (?proliferative diabetic retinopathy treated with panretinal laser therapy).
7- This young man has this skin lesion, what is it? Ask him few questions to know why? (?erythema nodosum-?causes).

Note that stations 2 and 4 in the UK counterpart are covered in the long case.
I can assure 100% that if you are "well-prepared" then you will pass from the first trial! Note that the failure rate from the first attempt is high, simply because of lack preparation and unfamiliarity with examination's "environment"; a common "belief" is that the examiners are tough and trying to fail every one or the RCPI is looking at high standers! No; many candidates simply fail to impress their examiners, or to conduct the examination efficiently. Being well-informed in theory and written books does not mean that you are clinically efficient! Another thing is that many failed candidates say that this or that examination center is a disaster or tries to fail everyone or has poker-faced examiners…etc. Again, lack of preparation explains the end point.

Hope that these notes are useful. Good luck to all future MRCPI candidates.

Dr. Osama S. M. Amin MBChB MRCPI

What you see is what you get ! The Journey of the MRCP!

We are happy to announce the launching of our new domain www.neurology4mrcp.com , which covers both Neurology and Internal Medicine in 1500 best of five and multiple choice questions for MRCP(UK) and MRCP(I) part I and part II written with photographic materials. Many thanks go to our visitors who supported us all the way while we were in the OrgFree and Ueuo servers. The contiuous input and feedback from MRCPians enlightened and encouraged us about how to make many steps forward and to progress in our job. Tow E-Books are now online, totally free, and without even a simple registration that can be downloaded in zipped PDFs and can be browsed online:

1- "One Year of Hard Work":
2nd edition; a pure neurology book for MRCP(UK) and MRCP(I), part I and part II written. Clinical scenarios, data interpretations, case histories, and photographic materials are included. Best of Fives, Best of Many, MCQs, with papers for MRCP(I) part II written can be seen. This is the only MRCP E-book with 810 questions that can be obtained for free. For example, you may buy a small book with 300 BOFs for 30 Sterlings (i.e. 60 USDs!). You may also browse its chapters online as separate papers. At the end you will find Answer Sheets to fill in and to calculate your scores.

2- "Teaching Best of Five Questions with Clinical Scenarios":
3rd Edition, for MRCP(UK) and MRCP(I) part I. Covers all aspects of internal medicine but neurology. You can download it as a zipped PDF. Again, at the end you will find an answer sheet for you to assess your performance. Needless to say, this is the only MRCP (internal medicine) book that is free.

Within few minutes, you will get 1500 MRCP questions! No need to stay for hours or days "online"!

Thank you for visiting our new website.
Dr. Osama S. M. Amin MBChB MRCPI
Neurologist and Head of Team Neurology4MRCP

American College of Physicians/ Diabetes Portal!

Clinician Resources from ACP Diabetes Portal:
This site contains a comprehensive collection of resources that are designed to assist the entire clinical team in implementing a team-based system that will deliver care of the highest quality. The primary sources of material are listed to the right under the "Legend" and include ACP publications as well as external sources. The majority of the interactive "Enabling Tools" have been developed for ACP Diabetes Care Guide: A Team-based Practice Manual and Self-Assessment Program, created through the Diabetes Initiative project funded by an unrestricted grant from Novo Nordisk.
View the Neurological Complications.

NeuroPat Dote Hu

NeuroPat is the largest collection of neurology links with excellent quality studying materials.
Check out, for example, these Neurology Quizzes: No.1, No.2, and No.3, and these Neuro-Anatomy structures Slides.
Find out more here...

RCPI STATEMENT ON ELECTION OF PRESIDENT

PRESS RELEASE Immediate Publication 27th June 2007

RCPI STATEMENT ON ELECTION OF PRESIDENT

Three candidates will go forward for election to the position of President of the Royal College of Physicians of Ireland, which takes place on Friday, July 6th 2007. These are:

Dr. John Donohoe Dr. Kathleen (Kate) McGarry Dr. Frank Murray

Balloting takes place simultaneously in four locations at 5:30 p.m. on Friday, July 6th 2007: Belfast - Ramada Hotel; Cork - The Kingsley Hotel and Residence; Dublin - RCPI, 6 Kildare Street; Galway - The Ardilaun House Hotel.

The elected President will take up the position immediately following the announcement of the result.

ENDS

InterActive Atlas of Neuro-Oncology...

Aims of the Atlas of Neuro-oncology
Thanks to the possibilities offered by the Internet, the simplified presentation of this atlas aims not only to facilitate access to information on the neuropathology of central nervous system tumors but also:
* to encourage use of a common morphologic language by all concerned specialists (neurologists, neurosurgeons, neuroradiologists, neuropathologists, oncologists, etc.)
* to serve as a useful and original teaching tool thanks to integration of modern information technology in the daily routine of physicians, teachers, and medical students
* to be a rapid source of initial assistance , providing a description of basic principles for regular or occasional practitioners of neuro-oncology
* to promote further development of the atlas by "interactive" participation of other teams.
This atlas currently consists of a "permanent reference collection" of 197 images illustrating the major anatomopathological features of CNS tumors and the essential criteria for their diagnosis. In a future stage, neuropathologists will have the possibility to suggest the addition of other documents to enrich the basic iconography.
In addition, a "neuropathology forum" , which will be annexed to the atlas, will permit users to present exceptional cases, submit difficult cases for evaluation, and participate in discussions on certain documents of the atlas. While this interactivity will be spontaneous and left up to individual initiative, invitations to participate may be issued by one of the authors of the atlas. The authors will serve as the "editorial board" in charge of checking the quality of the documents that will be published on the site under the responsibility of their authors.
In the near future, the scope of this atlas will be expanded to include neuroradiology along with neuropathology . As a means of emphasizing the necessary close cooperation among neuro-oncologists, neurosurgeons, neuropathologists, and neuroradiologists, the latter will be able to propose characteristic images of each tumor entity. Following approval by the "editorial board", these images will be progessively incorporated in the atlas under the responsibility of their authors.
The authors are grateful to the University of Nice-Sophia Antipolis , and in particular the Medical School , and the ANOCEF (Association of French-speaking Neuro-oncologists) for their assistance in preparation of this atlas, which is accessible in English, French and Spanish.
End

RCPI Public Meeting Series 2007...

The Royal College of Physicians of Ireland's annual programme to inform members of the public on key healthcare issues and to provide an opportunity for the public to communicate their concerns to the RCPI.

Is our relationship with Alcohol causing more pleasure or pain?

Healthcare-associated infection - Microbiological facts and public perception

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Dr.Osama Amin MRCPI

From Sign.ac.UK :
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Diagnosis and management of headache in adultsWednesday 5th September 2007Royal College of Physicians of Edinburgh
10.00 Registration and coffee
10.30 Welcome and introduction to SIGN guideline developmentMember of SIGN Council
10.40 Chair’s introductionDr David Watson, General Practitioner, Aberdeen and Chair of the SIGN GuidelineDevelopment Group on the Diagnosis and Management of Headache in Adults
10.50 The patient’s and carer’s perspectiveMs Heather Wallace, Chairman, Pain Concern
Session One: DiagnosisChair: Dr Roger Cull, Honorary Consultant Neurologist, Western General Hospital, Edinburgh
11.00 Signs and symptomsDr Callum Duncan, Specialist Registrar in Neurology, Western General Hospital, Edinburgh
11.10 T oolsDr David Watson, General Practitioner, Aberdeen
11.15 InvestigationsDr Anne Coker, General Practitioner, Dundee
11.25 Panel discussionincluding Dr Murray Fleming, General Practitioner, Clydebank
11.40 Coffee/Tea
Session Two: Management of migraineChair: Dr Gillian Smith, Oral Medicine Consultant, Glasgow Dental Hospital
12.00 Treatment of acute migraine headacheMs Arlene Coulson, Principal Clinical Pharmacist, Ninewells Hospital, Dundee
12.10 Preventive treatmentDr Alok Tyagi, Consultant Neurologist, Southern General Hospital, Glasgow
12.20 Panel discussionincluding Dr Roger Cull, Honorary Consultant Neurologist, Western General Hospital,Edinburgh and Dr Anne Coker, General Practitioner, Dundee
12.45 L unch
Session Three: Management of headacheChair: Dr Murray Fleming, General Practitioner, Clydebank
13.45 Cluster headache and other autonomic trigeminal cephalgiasDr Alok Tyagi, Consultant Neurologist, Southern General Hospital, Glasgow
13.55 Chronic headache and medication overuse headacheDr Callum Duncan, Specialist Registrar in Neurology, Western General Hospital, Edinburgh
14.05 Panel discussionIncluding: Ms Arlene Coulson, Principal Clinical Pharmacist, Ninewells Hospital, Dundee andDr Anne Coker, General Practitioner, Dundee
Session Four: Other therapiesChair: tbc
14.30 Lifestyle factorsDr Gillian Smith, Oral Medicine Consultant, Glasgow Dental Hospital
14.40 Psychological therapiesMs Penelope Fraser, Lead Clinician and Consultant Clinical Psychologist, Ninewells Hospital,Dundee
14.50 Physical and complementary therapiesMs Suzie Scott, Physiotherapist, Glasgow Royal Infirmary
15.00 Headache and hormonesDr Roger Cull, Honorary Consultant Neurologist, Western General Hospital, Edinburgh
15.10 Panel discussionincluding Ms Heather Wallace, Chairman, Pain Concern
Session Four: Feedback, questions and conclusionsDr David Watson, General Practitioner, Aberdeen and Chair of the SIGN GuidelineDevelopment Group on the Diagnosis and Management of Headache in Adults
15.30 General discussion and response to written questions
15.50 Concluding remarks
16.00 Close of meeting
PDF versions of this programme and registration form can be downloaded here.
Diagnosis and management of headache in adults. Programme
Diagnosis and management of headache in adults. Registration form

End

PACES MRCP UK Blog...

It's been long time since I've visited PACES MRCPUK Blog , really they are doing a good job after a relatively long period of silence. For those preparing for MRCP(Ireland) Clinical Examination or PACES (UK), i would recommend spending extra time reviewing this blog. Few clips were added. All the best from me and my team.

Dr. Osama Amin

Iraqi Orphans with Cerebral Palsy and Mental Retardation Illnesses On CBS News!

Although I don't like politics at all, I found this really shocking; 4 years after the"liberation or occupation" of Iraq! I have no comment, just see and judge.
Osama Amin
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From CBS News:

(CBS) It was a scene that shocked battle-hardened soldiers, captured in photographs obtained exclusively by CBS News.

On a daytime patrol in central Baghdad just over than a week ago, a U.S. military advisory team and Iraqi soldiers happened to look over a wall and found something horrific.

"They saw multiple bodies laying on the floor of the facility," Staff Sgt. Mitchell Gibson of the 82nd Airborne Division told CBS News chief foreign correspondent Lara Logan. "They thought they were all dead, so they threw a basketball (to) try and get some attention, and actually one of the kids lifted up their head, tilted it over and just looked and then went back down. And they said, 'oh, they're alive' and so they went into the building."

Inside the building, a government-run orphanage for special needs children, the soldiers found more emaciated little bodies tied to the cribs. They had been kept this way for more than a month, according to the soldiers called in to rescue the 24 boys.

"I saw children that you could see literally every bone in their body that were so skinny, they had no energy to move whatsoever, no expression on their face," Staff Sgt. Michael Beale said.

"The kids were tied up, naked, covered in their own waste — feces — and there were three people that were cooking themselves food, but nothing for the kids," Lt. Stephen Duperre said.

Logan asked: So there were three people cooking their own food?

"They were in the kitchen, yes ma'am," Duperre said.

With all these kids starving around them?

"Yes ma'am," Duperre said.

It didn't stop there. The soldiers found kitchen shelves packed with food and in the stockroom, rows of brand-new clothing still in their plastic wrapping.

Instead of giving it to the boys, the soldiers believe it was being sold to local markets.

The man in charge, the orphanage caretaker, had a well-kept office — a stark contrast to the terrible conditions just outside that room.

"I got extremely angry with the caretaker when I got there," Capt. Benjamin Morales said. "It took every muscle in my body to restrain myself from not going after that guy."

He has since disappeared and is believed to be on the run. But two security guards are in custody, arrested on the orders of Iraqi Prime Minister Nouri al-Maliki. Two women also working there, who posed for pictures in front of the naked boys as if there was nothing wrong, have also disappeared.

"My first thought when I walked in there was shock, and then I got a little angry that they were treating kids like that, then that's when everybody just started getting upset," Capt. Jim Cook said. "There were people crying. It was definitely a bad emotional scene."

There was nothing more emotional than finding one boy who Army medics did not expect to survive. For Gibson, that was the hardest part:

Seeing a boy who was at the orphanage, where Logan reported from, "with thousands of flies covering his body, unable to move any part of his body, you know we had to actually hold his head up and tilt his head to make sure that he was OK, and the only thing basically that was moving was his eyeballs," Gibson explained. "Flies in the mouth, in the eyes, in the nose, ears, eating all the open wounds from sleeping on the concrete."

All that, and the boy was laying in the boiling sun — temperatures of 120 degrees or so, according to Gibson.

Looking at the boy today, as he sits up in his crib without help, it is hard to believe he is the same boy, one week later — now clean and being cared for along with all the other boys in a different orphanage located only a few minutes away from where they suffered their ordeal.

Another little boy right shown in the photos was carried out of the orphanage by Beale. He was very emaciated.

"I picked him up and then immediately the kid started smiling, and as I got a little bit closer to the ambulance he just started laughing. It was almost like he completely understood what was going on," Beale said.

When CBS News visited the orphanage with the soldiers, it was clear the boys had been starved of human contact as much as anything else, Logan said. Some still had marks on their ankles from where they were tied. Since only one boy can talk, it's impossible to know what terrible memories they might have locked away.

The memory of what he saw when he helped rescue the boys that night haunts Ali Soheil, the local council head, who wept during the interview.

Later at the hospital, Lt. Jason Smith brushed teeth and helped clean up the boys. He and his wife are both special education teachers, and he was proud to tell her what the soldiers had done.

"She said that one day was worth my entire deployment," Smith said. "It makes the whole thing worthwhile."

This is a tough test for the Iraqi government: How a nation cares for its most vulnerable is one of the most important benchmarks for the health of any society.

See video no.1, and video no.2.

End.

More Patients Getting Into Stroke Units But 21st Century Care Still Lacking

From the website of the Royal College of Physicians (London):

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More Patients Getting Into Stroke Units But 21st Century Care Still Lacking...

The results of the 2006 National Sentinel Audit for Stroke show that patients are spending more of their time on stroke units, but there are still unacceptable waits for brain scans and starting treatment. Results from Wales are still falling behind those from England, and are a major cause for concern. A separate release on the Welsh results is available.
The Audit, funded by the Healthcare Commission, was carried out on behalf of the Intercollegiate Stroke Group by the Royal College of Physicians’ Clinical Effectiveness and Evaluation Unit (CEEu), and covers 100% of eligible hospitals in England and Wales. As in 2005, results for each participating site are published on the RCP website:
http://www.rcplondon.ac.uk/pubs/books/strokeaudit/strokeaudit2006.pdf

Read more...

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American Academy of Neurology Practice Guidelines...

The American Academy of Neurology (AAN) develops clinical practice guidelines to assist its members in clinical decision making related to the prevention, diagnosis, treatment, and prognosis of neurologic disorders. Each guideline makes specific practice recommendations based upon a rigorous and comprehensive evaluation of all available scientific data.

AAN guidelines are used to:
**Improve health outcomes of patients
**Stay abreast of the latest in clinical research
**Appeal payment denials
**Provide Medico-legal protection
**Advocate for fair reimbursement
**Determine whether your practice follows current, best evidence
**Affirm the role of neurologists in the diagnosis and treatment of neurological disorders
**Influence public or hospital policy
**Promote efficient use of resources
**Identify research priorities based on gaps in current literature

Review the latest practice guidelines.

AIR POLLUTION AND STROKE: IS A CAUSATIVE ASSOCIATION PLAUSIBLE?

An article from behind the medical headlines by Professor A Seaton:

Summary:
The links between air pollution and respiratory disease are well established. Research has now suggested that air pollution could also have a causative effect in stroke. How plausible is this association? Prof Anthony Seaton reviews the evidence...
Read the article.

RCPI STATEMENT ON CONSULTANT CONTRACT NEGOTIATIONS

From the website of the Royal College of Physicians of Ireland:

PRESS STATEMENT Immediate Publication 4th May 2007 :

RCPI has no role or involvement in issues regarding industrial relations, and it has not been the practice of RCPI to comment on such matters. However, issues relating to the current consultant contract negotiations have the potential to impact negatively on future standards in medical training, specialty practice and ultimately on patient care, and it is incumbent on RCPI to clearly state its position on these issues.
The future well-being of the Irish Health Service and the quality of care afforded to patients depends to a very significant degree on all key participants – consultants, doctors-in-training, management, nurses and other healthcare professionals and workers – working together in an environment where there is mutual respect and trust. In the interests of patient care, it is the responsibility of each and every one of these groups to play a part in creating this environment, particularly during the course of a very difficult process of change.
It is clear, given the nature of their expertise and position and as has been acknowledged by the HSE, that consultants have a critically important leadership role to play in the reform of the health service. In this context, it is essential that existing consultants and prospective candidates for consultant positions have confidence in the contractual arrangement for those positions and the process by which doctors are selected for those positions.
RCPI strongly supports the projected increase in consultant numbers, and is prepared to engage in the recruitment process from the perspective of maintaining standards in the context of an agreed contract. Further, RCPI believes that the primary goal of the consultant recruitment process must be to select candidates of the highest calibre who have demonstrated a high standard of practice in their speciality as evidenced by successful completion of an accredited training programme. In this regard, RCPI reiterates its view that all appointees to consultant positions must, at a minimum, be on the Specialist Register of the Medical Council.
One of the major successes of the health service in Ireland over the past number of years has been the development of high quality training programmes for doctors, which enable doctors to reach the standard required for entry onto the Medical Council’s Specialist Register. This has allowed the health service to recruit and retain highly talented and motivated doctors at all levels. It is of fundamental importance to the quality of patient care that such doctors continue to train and to seek employment in Ireland.
RCPI is deeply concerned that our existing cohort of Specialist Registrars (doctors undertaking a 4-7 year training programme in a specific medical specialty, such as Cardiology, Medical Oncology, Respiratory Medicine etc), have informed us that they believe that the current situation in relation to the consultant contract will undermine high standards of medical practice and medical training and deter them from continuing to work in the Irish health service.
All postgraduate medical training programmes are entirely dependent on the leadership and time given to those programmes by consultants in their roles as Trainers and National Speciality Directors. Their role in training and education of future specialists is absolutely central. The maintenance and development of high quality training programmes is entirely dependent on the employment of consultants of the highest standard. If any other standard is accepted, the quality of training programmes will be directly and immediately affected and as a consequence patient care compromised.
Within the current negotiations, RCPI believes that there is an opportunity to reach agreement on a contract that will attract the best candidates from Ireland and abroad, and will provide a real platform to enable clinical leadership and commitment to high standards in training and practice. This will directly impact on the quality and nature of patient care in Ireland for decades to come. The importance of this outcome demands that all parties redouble efforts to resolve outstanding issues as a matter of urgency.
End
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Read the statment in a PDF format from this link.

RCPI Masterclasses!

From the official website of the Royal College of Physicians of Ireland:

The aim of the Masterclasses is to bring together experts in topics of established or emerging importance and to provide an opportunity for in-depth review.

2007 Series :
TREATING THE ACUTELY ILL PATIENT

Keeping up to date on evolving medical practice outside your own subspecialty area is challenging. To facilitate your continuing medical education needs the Royal College of Physicians of Ireland (RCPI) is introducing this new Master Class Series.
It will run in the RCPI over 7 sessions once a month (January to June and October/November). Each session would concentrate on a particular specialty, e.g.
Neurology, Cardiology, Respiratory, Infectious Diseases, Haematology, Geriatrics, Oncology, Endocrine, Rheumatology, Renal, Gastroenterology, Heaptology, Pharmacology and Therapeutics, Toxicology, Medicolegal, etc.
The Masterclass series will focus on optimum early management and what should be done in the crucial first 24 hours. Recent advances in management of common medical conditions that frequently require hospital admission will be highlighted. Early intervention that may prevent hospital admission or facilitate appropriate discharge early will be highlighted.

Previous Masterclasses:

Osteoporosis 2006: A short comprehensive review

Hearts & Minds: Exploring the cardiovascular risk burden in psychiatric disease

Note that the Masterclass series is approved for 21 CME/CPD credits in total (or 3 CME/CPD credits per meeting)

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Best Wishes

From BMC Medicine:
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Performance in the MRCP(UK) Examination 2003-4: Analysis of pass rates of UK graduates in relation to self-declared ethnicity and gender:

Abstract (provisional)

Background

Male students and students from ethnic minorities have been reported to underperform in undergraduate medical examinations. We examined the effects of ethnicity and gender on pass rates in UK medical graduates sitting the Membership of the Royal Colleges of Physicians in the United Kingdom [MRCP(UK)] examination in 2003-4.

Methods

Pass rates for each Part of the Examination were analysed for differences between graduate groupings based on self-declared ethnicity and gender.

Results

All candidates declared their gender, and 84-90% declared their ethnicity. In all three parts of the examination, white candidates performed better than other ethnic groups (P < p =" 0.011)," p =" 0.176)." p =" 0.151).">

Conclusions

The cause of these differences is most likely to be multifactorial, but cannot be readily explained in terms of previous educational experience or differential performance on particular parts of the examination. Potential examiner prejudice, significant only in the cases where there were two non-white examiners and the candidate was non-white, might indicate different cultural interpretations of the judgements being made.

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.

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Our MRCP UK and Ireland Part I Examinations Teaching BOF Book/ Free Download!!

Neurology4MRCP is the first website to offer a totally free MRCP teaching best of fives book, freely downloadable from the net as a high quality zipped PDF. The book is in 2 volumes, covering all major medical subspecialties, clues on repeatedly encountered MRCP questions, many past examination questions , a sample BOF answer sheet paper from the RCPI, and tips on how to solve difficult questions.

The author, Dr. Osama Amin MRCP(Ireland), insisted that the book is not to be copyrighted, so that everyone may download, browse, forward, and print the book, as away of helping the fresh and future MRCP candidates (but our website and author should be credited and mentioned).

Contents Volume I:

Chapter I: Cardiology.

Chapter II: Pulmonary Medicine.

Chapter III: Hematology.

Chapter IV: Gastro-Enterology and Hepatology.

Chapter V: Nephrology, Electrolytes, and Acid-Base Disturbance.

Contents Volume II:

Chapter I: Endocrinology and Diabetes Mellitus.

Chapter II: Rheumatology.

Chapter III: Infectious Diseases.

Chapter IV: Dermatology.

Chapter V: Psychiatry.

Chapter VI: Immunology and Genetics.

Chapter VII: Toxicology.

Addendum:

1- MCQs "answer sheet"; a sample paper.

2- BOFs "answer sheet"; a sample paper.

Note that the neurology chapter has been removed to join its counterparts in our official website (where more than 1000 neurology questions can be found for free, with no registration required).

The book will be available online as HTML web pages soon; this is specifically designed for those who have no Adobe Reader.

Please for any question, feedback, or suggestion, email Neurology4MRCP at Gmail.Com.

Thank you for visiting our websites. Many thanks go to our "solitary writer", Dr. Osama Amin; who, for more than 2 years, has been leading and directing us voluntarily. We would like to sincerely thank and acknowledge Free WebHostingArea.Com (Orgfree.Com and Ueuo.Com); without their excellent server and free services, this book and our free websites would not have been possible.

Team Neurology4MRCP
May 2007

Behind the Medical Headlines! Current Treatment of MS!

A wonderful article is published by behindthemedicalheadlines.com about the current treatment of multiple sclerosis. Click here to view the article.

Key Points (from the article):

• Multiple sclerosis (MS) is a variable lifelong condition. There are several disease patterns, and these clinical sub-types may alter in an individual over time.
• The severity of the condition, in terms of relapse frequency, degree of visability and level of symptoms varies within and between individuals.
• The treatment of MS is aimed at symptoms, relapse and clinical course.
• Steroids are the only drugs shown to be of benefit in acute relapse.
• Beta Interferons, glatarimer acetate, some monoclonal antibodies against adhesion molecules and some chemotherapeutic agents have been shown to alter disease course.
• Future treatments which have not yet been evaluated may include neural growth factors and stem cell therapy.

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Team Neurology4MRCP

Free MRCP Clinical Courses...

Neurology4MRCP will conduct a full clinical course for MRCP UK PACES/ MRCP Ireland part II general medical clinical examination, covering all examination stations and steps. This course is designed specifically for helping Iraqi doctors to be prepared for the MRCP clinical examination and to improve their performances and skills.
Key points:
1- Date: 20-28 April 2007.
2- There will be 3 days concentrating on neurology and neuro-ophthalmology.
3- Venue: Sulaimaniya General Hospital/ Sulaimanyia/ Iraq.
4- Fee: FREE. Registration is open to all (Iraqis and non-Iraqis). To register please contact Neurology4MRCP at Gmail Dot Com.
5- Tutor: Dr. Osama Amin MRCPI
6- We will provide you with: stethoscope, patellar hammer, ophthalmoscope, red head pin, tunning forks (128, 256), tape measure, a peace of cottonwool, pin, tubes (warm and cold, for temperature sensation), and tongue depressor.
Best wishes...
Team Neurology4MRCP

"Always bear in mind that your own resolution to succeed is more important than any one thing"

And

"I will prepare and some day my chance will come"

President Abraham Lincoln

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Dr. O Amin MRCPI