2)Part B

ON 24/06/2020                                                                                         

BY AFIZA AZMEE

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Resources I used for Part B

Question Bank & Notes

  1. SPMM notes and question bank
  2. MRCPsych Mentor notes and question bank

As I have mentioned before in my Part A page, I only used SPMM and MRCPsych Mentor notes and question bank for the preparation of my Part B. I did not repeat my subscription to Birmingham because:

1) I was not impressed by the misleading answers that the Birmingham Course provided for their questions when I was doing them during my Part A. (But I do feel like their notes could be quite useful even if some of their questions were misleading).

2) I only had 8 months to prepare for my Part B (I passed my Part A in Februrary 2017, and I took my Part B in October 2017). I felt like I must prioritize my time carefully and only do the ones that would be most beneficial to me. I had textbooks to read too for reference. So I felt like SPMM and Mentor should be enough preparation with the limited time that I had.

3)Financial wise, I could only afford two subscriptions. Enough said.

So, really, we can only prepare so much. At the end of the day, we can only do our best within the boundaries of our own limitations and be at peace that this is all we can do and all we can afford and pray that Allah let us pass our exams after we had put in our effort.

Psychiatry Books

I used the same books that I used in Part A. So you can check out what I wrote in Part A.

I mostly used Maudsley this time, though. Because Part B is more clinical. It is about reading CPG, NICE guidelines and Maudsley guidelines. It is more about clinical management.

And there are A LOT of statistics questions. 1/3rd of the questions in Part B are on statistics. Even the Master exam and MRCP do not emphasize on statistics the way MRCPsych does. (60 statistics questions, during my time. The college would give you very long paragraph of studies that you have to evaluate and a few questions would be asked based on that long paragraphs of studies. It was really tough, guys! The statistics questions might be less now because the college has reduced the number of total questions from 200 to 150 while maintaining the same exam duration. Lucky, you guys! Memang tak cukup masa sangat-sangat when I was doing my Part B. Perhaps the college had listened to the constructive comments from previous candidates and decided that it would be fair to reduce the number of questions.)

But I did not use any Statistics books to help me with Statistics. I mostly did a lot of questions from Mentor first, to get a rough idea of what I needed to study. And then I studied SPMM notes and wrote my own short notes where I listed all the formulas I needed to use for each type of study design. You have to memorize all the formulas, of course (Odds Ratio, Relative Risks, NNT, Absolute Risk Reduction, Absolute Benefit Increase, Sensitivity, Specificity, Accuracy, Positive and Negative Likelihood Ratio, Positive and Negative Predictive Values, Pre-test and Post-test Probability and a lot more formulas to remember for your advanced statistics. The most headache-inducing part for me personally was the one where we had to choose which statistical test to use for which type of data in our studies. We have Parametric test and non-parametric tests. And based on the type of data/sample that you are collecting and whether the data are paired or unpaired, you must choose the correct statistical test for them. I hated this part, oh God. Hahaha.)

PART B SYLLABUS

For Part B, it is more imperative that you subscribed to question bank EARLY! As I said before, I only had 8 months to prepare for it. I focused the first four months on mastering Statistics alone. Because I knew that I could cram the clinical part pretty fast should time be limited. Clinical parts are what we do every day, anyway. So, I knew that it was just a matter of memorizing and cramming.

But I knew I could not cram statistics without understanding and mastering the statistics syllabus first. So that was why I only focused on statistics for my first four months. Once I was done covering all the stats syllabus and had moved on to studying the clinical parts, I still allocated one or two sessions per week of doing statistics to avoid memory decay of the statistics skills that I had learned.

This was just what I did. It might not necessarily work for you guys. If you guys are good at stats, then it might not matter whatever strategy you choose to employ and whichever parts you choose to study first.

The syllabus is as follows:

1)Research Methods

  • Epidemiology
  • Study designs
  • Bias, blinding, causality
  • Interventional Studies
  • Economic Studies
  • Secondary Research
  • Intention To Treat Analysis
  • Qualitative Study
  • Quality Improvement
  • N-of-1 trial

2)Evidence Based Medicine

  • EBM principles
  • Evaluating Causation
  • Evaluating diagnosis
  • Evaluating Meta-analysis
  • Evaluating prognosis
  • Evaluating therapy
  • Graphs interpretation

3) Advanced Statistics

  • Choosing statistical tests, correlation regression, multivariate etc etc

4)Adult Psychiatry

5)Emergency Psychiatry

6)Liaison Psychiatry

7)Perinatal Psychiatry

8)Psychotherapy

9)Old Age Psychiatry

10) Child Psychiatry

11) Learning Disability

12) Addiction Psychiatry

13)Forensic Pasychiatry

14)Psychotherapy

15)Psychiatric Services

As you can see, the syllabus is huge. The first three topics alone (Research Methods, Evidence Based Medicine, Advanced Statistics) required 4 months for me to really understand and master all the questions. Only after I am done with those do I properly study the rest of the clinical syllabus. And Alhamdulillah, that strategy worked for me. 8 months of study is sufficient for you to pass your Part B provided that you subscribe early and be methodical in how you cover all  the topics.

You must know yourself, your weaknesses and your strength when you are planning your study. For example, I am pretty good with cramming at the last minute in things that I’ve already understood or have gone through at least once. If all I had to do is remembering/memorizing, then I could keep that at the last minutes provided I already understood the concept in the first place and only needed to refresh my memory. But I am not very good at statistics because I didn’t understand some of the concepts when I first read the notes. So I decided to prioritize statistics first, to understand what I had to understand, and then just repeatedly do the questions over and over again.

EXAM

I found the exam was crazy tough MAINLY because I did not have enough time to properly ruminate and indulge my OCPD-ness to my heart’s satisfaction hahah. Hopefully, now that the college has reduced the number of questions for you guys, you would not have the same difficulty as I did.

The first 60 questions were on statistics alone. Stats questions were so tough. They gave you around 12 studies (of various study designs). For each of the study, they would ask around 4-6 questions based on  that study. The questions were tricky. For example, they didn’t simply ask you in a straightforward manner ‘What is the positive likelihood ratio for this?” Nope! You must first interpret the sentences in the question…. is this question asking for positive likelihood ratio or positive predictive value? So you then would calculate the answer using BOTH formulas and you think you will choose whichever answer is present among the options. But unfortunately, BOTH answers are present among the options. You have no choice but to interpret the question correctly before you can pick the right answer. So if you interpret the question wrongly, you will give the wrong answer.

Some decided to rush through the clinical questions first and leave the tougher statistics questions in the end. They felt that by being able to finish clinical questions early, then they could have plenty of time to spend on statistics.

Well…it depends.

I personally spent my time on statistics first because I was more confident with the clinical questions. I knew that if I ran out of time, I could rush through clinical questions by choosing the answer based on my first instinct alone. But if I had left statistics at the end but ended up still running out of time, I could NOT rush through answering the statistics questions because I MUST analyze the question properly before I could give the right answer.

So my advice is, KNOW YOURSELF.

If you are very good in statistics, then it really doesn’t matter which part you decide to do first. But if you are like me… not very good at statistics…then I suggest you get statistic questions out of the way first. Because chances are you can answer clinical questions faster and can always rush through them if you ran out of time in the end. But if you ran out of time while answering statistics (plus the panic of running out of time) chances are you would not do well in the exam. Because the portion of questions on statistics are HUGE! I spent 2 hours for statistics alone in the exam. I had 140 clinical questions to answer in the one hour that I had left. 30 minutes before the time was up, I had 60 questions left to answer… which meant I had ONLY 30 seconds for each question with barely any time to double check my answer in the end. Thank God I had decided to leave all the clinical questions in the end!

I really thought I would not be able to make it. But Alhamdulillah, Allah is Most Gracious, Most Merciful.

I hope you guys are able to get some idea about Part B after reading this page. I wish all of you the best in your exam. May Allah reward your patience in pursuing His knowledge by bestowing upon you the best of success in this life and the hereafter. Amin. Much love and may Allah bless all of us.

7 thoughts on “2)Part B

  1. williamwilson

    Hi, Dr. Afiza. So glad to have found this blog! And of course, I identify with you when you wrote about the reason you want to be a psychiatrist is because you love stories. I love all these individual stories as well, the study of characters – makes me feel fulfilled…and yeah, since young, I have been lucky enough to be surrounded by books, and encouraged to read and travel by my parents.

    Btw, I’ve just recently cleared Part A…and am thinking of taking Part B sometime next year… I’m in the floating period right now, waiting for my permanent placement. Really hoping that I’d get placed in Psych.

    Regardless, I love what you wrote about the perks of the membership. And yeah, I’m looking forward to all of that and more! And that bit about self-actualization and freedom, I never thought I’d find a fellow colleague who thinks this way, too! (Perhaps, I’m still young haha).

    Anyway, would really appreciate it if you could tell me what else to do now – the next step is always monumental, but honestly, ever since I was a med student, OSCE scares me more than the written papers. Haha.

    I have a few questions. In the criteria for sitting for Part B, we have to be on an approved training programme for Psych for at least 1 year, right? Can you confirm if this means that, in my case for instance, I have to be a Psych MO for, like, 1 year before I can sit for Part B?

    And I read in a comment in your Part A blog entry that Part A has to be retaken even if you have passed it, if you had taken it as an HO? My result came out whilst I’m a floating MO, will that count for or against me?

    Once again, it’s really great to come across this blog. Thank you for your thoughts and I appreciate any advice you can give me.

    Like

    1. Hi there William,

      Yeah, only fellow book readers will understand why psychiatry is such an attractive field for nerds like us. Haha.

      I could not actually remember the criteria for sitting each exam. If I recall correctly, the requirement for sitting Paper B is: being in an approved training program (meaning, if you took your Paper A while you were not an MO in a Psych Dept, then by the time you take your paper B, you must be in a Psych Dept of a training hospital. Eg in Kedah, only HSB and HSAH are approved for training. Even though Hosp Kulim and Hosp Langkawi also have psychiatrists, but these places are not approved for training. So if you plan to take Paper B, you must move to a psych dept of an approved training centre). It is generally RECOMMENDED that you have 1 year of experience before taking Paper B in an approved training centre… not sure if it is compulsory now.

      And about Part A… it is true that you must take your Part A while you are already an MO (not necessarily a psychiatry MO). But since your Paper A result came out when you are a floating MO (but you took Part A when you were a HO), I don’t know how strict the parallel pathway committee would be about this. I think you better ask the committee about this to avoid unnecessary problems in the future.

      All the best in your MRCPsych journey! Thanks for visiting my humble blog!

      Like

      1. Wilson

        Hi, Dr. Afiza! I’m currently in a psychiatric institution – approved for parallel pathway training…I’ve registered with KKM, just not having done the iv yet…plus, new rule change, KKM would be fully in charge of the parallel pathway training, so Ms. Gaya (from the previous committee) said…there should be a change in the way the parallel committee does the iv? Just thinking out loud here. Anyway, they are pushing the iv for registration for the parallel pathway program to some time in May…😅
        I am planning to take Paper B in March (as I’ve registered, so I guess I AM doing it. Haha.) Really cranking down on the stats and all 😵. It’s really good that I was able to transfer to a training psychiatric hospital so, I could be more clinically orientated and all when it comes to the clinical part.
        I have a follow-up question.
        In the event that we think we can flourish our potential outside (just a thought, since you mentioned before that MRCPsych trainees can go overseas and practice) – do you think we need to be in the service here to complete our program? Or the College would still allow us to continue in our journey if we move to a different country? A hypothetical question…since they are saying spaces are limited in the parallel pathway program – not too sure if this is to control output since I think the College would be the better judge in terms of the inclusion criteria of who can or cannot be a psychiatrist 🤭 I’m just wondering what if I passed both my papers but still cannot get into the program because of some rule – like, my SKT was below 85 during my first year of houseman-ship…and this is only my fourth year of service (including the HOship). I just wanna be prepared. Tq in advance for your replies. I wish you a good week ahead. 😊

        Like

        1. Hi Wilson, congrats on finally being able to work in a training-approved psych department. Hope you enjoy yourself in the new workplace you are at.

          To answer your question, the royal college doesn’t care where you practice as long as you fulfil the criteria needed before taking each part. You can always take your exam even if you failed your MOH interview. MOH has its own rules and criteria (and extra syllabus purposefully designed to match the ones in the master program) which you have to follow if you want to be a Psychiatrist IN MALAYSIA.

          But if you don’t want to work in Malaysia, you don’t even need to be registered with MOH for any interview and neither do you need to notify MOH each time you pass your exam. Just pass your exam and clear each part of the exam…then you can spread your wings and fly away…

          However… if that’s the route you wanna go, you might not get the perks that being an MOH-recognized candidate would give you… like study leave (depending on the kindness of your HOD also), extra-grilling/teaching during rounds or CME (this may not be so desirable to some haha), ability to do clinical attachment elsewhere other than in your own department. And also before taking CASC, you need to have done Psychotherapy and Child posting before sitting for CASC… it is difficult to get your HOD to allow you to go for clinical attachment if you are not recognized by MOH as a trainee (of course, you always have the option of taking unpaid leave to go for child attachment elsewhere). Furthermore, before taking CASC, you need to find a supervisor who will ‘sponsor’ you (meaning, a specialist who will verify that you work as a Psych MO, the number of years you have been in Psychiatry, whether or not you have done your child psychiatry posting, your good attitude etc etc. RCPsych will email the document to your sponsor to fill up. I chose my HOD as my sponsor last time.) If you are an MOH-approved candidate, then MOH would already have assigned you your clinical supervisor who will fill up the forms for you. (But that doesn’t mean you cannot find your own sponsor even if you are not approved by MOH. You can just ask any consultant who knows you to vouch for you.)

          In my opinion, just go with the flow. Don’t think too far ahead. Just take your exams and attempt to register with MOH and undergo their requirement. A lot of the requirements by MOH (Like the mini-CEX and case-based discussion) are already part of the MO works that you have been doing anyway. If you are able to meet the MOH requirement, then good. At least you know you can practice in Malaysia if you wish to. If you find that you can’t meet the MOH requirement (because you find the requirement too fussy or complicated or for whatever reason), then you can always rely on your MRCPsych Diploma after passing your CASC to practice elsewhere.

          Royal College only requires you to pass your exam. This is the golden ticket that we all should aim for, first and foremost.
          MOH also has its own requirement – but this is only necessary if you want to be a Psychiatrist in Malaysia. Hope that answers your question.

          All the best!

          Like

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