First things first, my previous study strategy needed to be revised if I was to secure a passing grade on the MRCS part B resit. Despite falling by a narrow margin, it still wasn’t a pass, and I knew I required significant improvement. My first attempt was very independent, with minimal conferring. However, recognising the limitations of my initial approach, I understood that seeking guidance from others would be essential this time. I needed to delve deeper and ask the right questions. I contacted four colleagues who had successfully completed the exam and sought their practical advice.
I opened my conversations with a candid confession: my first attempt at the MRCS did not succeed. I was, however, determined to learn from my mistakes and hear more about my colleagues’ experiences. I inquired about their preparation methods, go-to literature, and recommended training courses. What I discovered was surprising: three out of four had also bombed on their first try. These were gifted surgeons whose intellect and skill I admired. This realisation led me to three profound insights. Firstly, failing the MRCS does not reflect a lack of brilliance or intelligence but rather a lack of proper preparation or a misunderstanding of expectations. Secondly, communication posed a challenge for most IMGs taking the MRCS part B. Paradoxically, UK-trained doctors excelled in this area. I needed to leverage this weakness and transform it into a strength. Lastly, the number of times you retake the MRCS is meaningless compared to the ultimate goal of passing. No one scrutinises or cares about your past attempts; the only relevant thing for you is to pass it. So be kind to yourself and focus on the future. With the right preparation, you will crush it.
Following my calls, I noted the intersecting advice, recommended books, useful resources, and tactical insights. With limited time to prepare, I promptly put these learnings into action. One valuable recommendation was to join an online MRCS Part B study group – multiple options were available, including Dr. Salah’s (https://www.facebook.com/mrcspartab), Dr. Reda’s (https://redaharbycourses.com/), and Dr. Tourky’s course (https://www.tourkymrcsb.com/). While the average cost of these courses is $500, it is worth the investment. I ultimately enrolled in Dr. Salah’s program.
The course is well-designed and rolled out in 3-month calendar cycles to optimise learning outcomes. The initial two months of this structure comprise the high-yield knowledge areas that are presented as MRCS-style examination stations. The key areas are broken down into Anatomy, Pathology, Applied Surgical Skills and Critical Care (ASSCC), Examination, Communication, History, and Procedural Skills. Once the core content has been covered, the completion month is entirely dedicated to practice mocks. These rehearsals are crafted to mirror in the style of the actual MRCS exams, providing an opportunity to practice and listen to others practising. One learns how to fluently respond to questions in a fast-paced, highly stressful situation.
The sessions are conducted online via Zoom, allowing for flexibility. This also ensures learners can participate from anywhere in the world, bringing together many talented doctors from diverse backgrounds. Each session is planned to last between 2-3 hours every evening. However, it is essential to dedicate oneself to attending all, if not most, sessions to maximise the benefits of the program’s comprehensive curriculum.
I joined the course a month late, posing a challenge, but I quickly got to work on catching up. I leveraged my driving time by listening to previously recorded course sessions in a podcast style, often playing them at an accelerated speed of x1.25 – x1.5. I supplemented this by listening to MRCS on the Move podcast on Spotify (https://open.spotify.com/show/2AGlnuFvU0eNflE8Wi3NdD) and practising stations while on a walk or driving. I dove into the reading resources and booklets provided by the course team, focusing on high-yield topics. Additionally, I found value in reading the Care for the Critically Ill Surgical Patient (CCRISP) manual.
Recognising the importance of effective study habits, I formed a dedicated study group with five fellow course attendees. We worked together for 1-2 hours daily, aligning our program with the course topics and focusing on practising the MRCS stations. Through repetition and consolidation of knowledge, we made significant progress. We grew more poised and smooth as time went along.
With the wisdom of hindsight from my previous unsuccessful attempt, I understood that deliberate practice, not just reading and writing, was essential to succeed. This was a practical and not a written exam at the end of the day. Thus, I was intentional about improving my communication skills and motor memory. I practised speaking out loud and recording my questions, consistently reviewing the audio to assess my mistakes and refine my technique.
When it came to mastering the skills needed for the clinical exam station, I knew I had to put in hours of practice. And what better practice partner than my wife (a non-medic)? Setting a timer for just five minutes, we methodically worked our way through a suite of over 20 physical exam scenarios that could be tested as per the MRCS curriculum. These ranged from an entire 12 cranial nerve exam to knee joint examinations. Watching YouTube tutorials from the Geeky Medics (https://www.youtube.com/@geekymedics), I developed my own standard process/ checklist.
Still, there was no substitute for a truly hands-on, peer-reviewed experience. This is why I chose to attend further a two-day physical training program delivered by Dr. Salah. At an extra cost of $210, this course cemented the already-established skills with additional practice and refinement. Not only did it help me network with like-minded individuals, but it also took place a week before my exam, an opportune moment to identify and resolve any weaknesses before the big day arrived.
I intensely followed this preparation strategy in the final week leading up to my MRCS exam. Each morning, from dawn until midday, I engaged myself in self-directed reading around areas where my knowledge still needed to improve. In the afternoon, followed a gruelling series of 1 on 1 practical practice sessions with a colleague I met in the MRCS preparation course. These typically started from around 1 pm until 7 or 8 pm. I remained committed and consistent with this routine for the entire week before the exam. For the last two days, we joined efforts with a larger group of four individuals whom we had also met at the MRCS preparation course. Practising together proved formative. Dedication to diligent preparation and systematic repetition significantly improved my comfort and self-confidence.
The most critical, game-changing aspect of my new study routine compared to my 1st time was my daily practice in speaking and physical examination in an exam-style manner with individuals who were either familiar with or preparing for the MRCS exam themselves. This allowed me to acclimate to the examination environment and grow comfortable with the simulated timed, high-pressure scenarios.
The night prior to the exam, I carefully laid out a simple plan for myself – to sleep at least 8 hours and rise refreshed, ready to tackle the challenging day that lay ahead. But as with many things, sometimes even the best-laid plans go awry. Anxiety gripped me overnight, making it difficult to catch a good night’s sleep. Despite this setback, I refused to let it dampen my spirits. Instead, I turned to music to lift my soul and awaken my inner strength. With Kanye West’s ‘Stronger’ playing on my headphones, I set out for the exam centre, feeling energised and ready to take on whatever came my way.
I knew that the exam day would not be easy, but I was determined to face it head-on, armed with the knowledge and skills I had worked hard to acquire. With a clear mind and steadfast determination, I reminded myself of the three keys to success in this exam: staying confident, replicating what I had practised, and maintaining excellent communication.
As I stepped into the exam room, I felt a surge of energy coursing through my veins. I knew I had everything I needed, and there was no room for self-doubt. And indeed, as the hours ticked by and the exam drew to a close, I felt a sense of deep satisfaction and joy wash over me. For I had done all that I could do, and I had done it well. I walked away from the exam centre, head held high and heart filled with hope. No matter the exam’s outcome, I knew that I had given it my all.
Ultimately, I attribute my success on the second attempt at the MRCS exam to my unwavering commitment to a well-defined practice strategy. Combining focused reading, systematic repetition, and daily practice. I would later successfully apply a similar plan on my ST3 application.