Swansea MRCGP Course
The nMRCGP Handbook
Foreword to the second edition
I am retired now and I still dream of failing finals. I also dream of the little man knocking at my door and saying: 'Found you out, you are a fake aren't you'. That is the trouble with exams, they are both memorable and important. I still remember my viva for the MRCGP in 1974 because it was searching, relevant and it found me out - not quite enough to fail, but enough to tell me that my learning was nowhere near done.
The MRCGP exam became part of my own life, and after 25 years as an examiner I retired as Convenor just as the old exam metamorphosed into the new. The nMRCGP exam, unlike the old MRCGP, is a licensing exam. This means that it is not an optional extra but an essential requirement to be a primary care doctor. It marks the end of your initial training.
General practice remains one of the hardest of all medical disciplines to do well: it requires a complex synthesis of knowledge, curiosity, tenacity and humanity. Over the last 60 years general practitioners have often been derided by more specialised colleagues as academically slightly below par; in some cases this was true, but for most patients it is the skill of the generalist that is needed by the specialist as much as the other way round. These arguments have become less heated and less relevant, but such attitudes are still around in hospitals and medical schools.
This book is about the academic underpinning of the discipline you have chosen. You owe it to your patients and to yourself to practice general medicine to the best of your knowledge and ability. This of course means not just passing the nMRCGP, but also learning how to learn and keep learning. This book will enable you to catch a glimpse of the thinking of the generations of general practitioners who have contributed to the development of the examination.
Bob Mortimer has produced a straightforward, easy-to-read book that gives you all the information to help you surmount this hurdle in your life without too much difficulty. The exam is modern, very wide ranging, searching and stimulating - yes, stimulating! This wonderful little book tells you all you need to know about the examination, its ethos and its methods. It is written by a good friend who is an examiner of many years standing and a working GP. I am able to hear Bob's voice as I read the text. You will find it full of good advice, spot on up-to-date information, technical tips, and inside knowledge, but to me the best of all is the humanity, wisdom and experience of the author that illuminates the whole. This is not just a book about how to pass an exam, but is a manual to help you learn for a whole career.
Dr Peter Tate MBE FRCGP
Foreword to the first edition
I never enjoyed taking exams. Who does? But several decades ago, when I was coming to the end of my vocational training as a fledgling GP, I took the Membership of the Royal College of General Practitioners (MRCGP) Examination. I have never been a good judge of how I was doing during exams, and my pessimism was often justified. On this occasion I thought I was floundering. None of the questions had seemed straightforward, and my doubts and insecurity were increasing by the minute. And so, when the examiner asked me how I would deal with a patient who had been bitten by a dog shortly before boarding a plane in India the previous day, I just shrugged. 'I'm sorry', I said despairingly, 'I just don't know anything at all about rabies. I'd look it up'.
But instead of groaning, both examiners grinned. One said: 'I've been asking this question for five days. You're the first one to give me the right answer'.
And he was not joking. For a UK family doctor to treat possible rabies from memory would indeed be unsafe and unwise. Ultimately my result was better than I had ever dreamt of, and I decided this was a 'real-world' organisation that I could do business with. All too many examinations in the past seemed to have been built on theory alone. The Royal College of General Practitioners (RCGP) seemed to me to focus on the uncertain and unpredictable world that real GPs face with real patients, and over many years working with the RCGP, including 15 years as an examiner, my view has not changed.
That was then. This is now. The arrival of the Postgraduate Medical Education Training Board has led to the introduction of new curricula across every medical specialty, providing common standards, clarity and transparency to training, as well as promoting the continuous development of doctors' skills in order to meet patient need. General Practice, at long last, has now been recognised as a medical specialty equivalent to every other, and new assessment methodologies have been developed to match.
But change is always rather confusing, and it certainly feels threatening for learners as well as their trainers. At this time of great change in the MRCGP Examination, this book offers real insight and real support. Quite rightly, it stresses that the best way of passing the exam is by becoming a good GP. Exam technique, and understanding how exams work is important, but nothing counts for as much as being a caring, learning, and listening GP.
The nMRCGP is now a licensing exam. Every new GP in the UK will have to pass it. This is exactly how it should be - after all, being a GP is one of the most complex and skilled jobs in medicine, and it has always seemed insulting that lower mandatory standards were acceptable in our specialty. But now they are not. You have to pass, and the nation's patients deserve nothing less.
Reading this beautifully written, informative and supportive book will demystify many of the changes in the nMRCGP exam, and allows the reader to focus on what really matters - the patients and the care we can offer. High quality General Practice is of vital importance to patients everywhere. After all, good GPs really do make a difference.
Professor David Haslam CBE, FRCP, FFPH, PRCGP
Page last updated Saturday, 28 November 2009, 10:44am