Sir: Although the forthcoming changes to the Part I and II MRCPsych Examinations are on the whole welcome news (Reference Katona, Tyrer and SmallsKatona et al, 2000), I hold several reservations regarding some of the alterations proposed.
After several years of post-graduate experience in psychiatry I sat an Observed Structured Clinical Examination as part of the Licentiate of the Medical Council of Canada. I had concerns about the inherent validity of the psychiatric section of the examination, which at times was clearly role-play. By including actors in psychiatric examinations, are we not making unnecessary and unwelcome changes?
Experience in the long case is equally if not more valuable to those who fail as to those who pass the membership examinations, and I feel disappointed this will now be subject to screening procedures in Part II, particularly as it has been removed from Part I. Denying experience of a long case until Part II, and lessening the emphasis on history-taking, may delay development of those skills gained in preparing for this aspect of the examination, many of which are fundamental to good clinical practice.
Should changes to our examinations not be moving us closer to rather than further from ‘real world’ psychiatry?
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