Membership examinations are often challenging examinations for those doctors who have not worked in the UK. Academically they are set at the level of a doctor who has completed 3 – 4 years of training after the basic medical degree. They will involve having some knowledge of how patients are treated in the UK. This will involve various real life scenarios with challenging patients, relatives, ethical dilemmas and require you to demonstrate several attributes that make a good doctor.
1. Patient is the main focus
The patient’s welfare is the main concern in the mind of the examiner. A doctor who makes a brilliant diagnosis but dealings with the patient are harsh or lack politeness are likely to raise eyebrows.
2. A holistic approach to the patient
This involves empathetic questioning about aspects of the patients life which might impact on management (e.g. using a spoon in a patient whose hands are deformed with rheumatoid arthritis)
3. Avoiding judgement
A patient might have an illness that may be strongly related to a patient behaviour and may have traits that the doctor may have views on. However in the doctor patient interaction, a professional approach in a non judgemental manner is paramount.
4. Awareness of standards of care
It is important to be aware of standard that are practiced by your peers or by a group of experts. In the UK these are NICE/ SIGN guidelines which cover most common conditions. Doctors are allowed to deviate from protocols but have sound justification for doing so. Using drugs that are off license must be discussed with patients and GP
5. A doctor patient partnership
In an interaction between healthcare professional and a patient, the balance of poser is not equal. The doctor is often in a position of authority and every interaction must try and even out that balance. Patient must be given an opportunity to understand the benefits, risks and must be given the time and confidence to be involved in the decision making process.
6. Equality / Disability
The UK is a country which is very aware of treating everybody equal irrespective of disability whether that be physical or mental. A lot of consideration has taken place to ensure that all are treated equal. A doctor can make decisions about care but must be in the best interests of the patient and an awareness of these principles will score you points.
MRCP Part 1
MRCP Part 2