7 SKILLS assessed during the PACES exam***
Skill A: Physical examination
This is the easiest skill. As long as you can perform the examination systemically, you will get full marks in this skill.
Tips: Practise daily either with a colleague or friend or even with a pillow. The more you practise, the more natural you will become in performing examinations.
Skill B: Identifying physical signs
This is an important station. It is known that British candidates find this skill a bit challenging. However, with regular examination of the patients, you will be able to pass this skill.
Tips: You need to have PACES oriented mind. Popular cases should be rehearsed well. With proper preparation, this skill is easy to pass. Remember, if you could not identify physical signs, your diagnosis and differentials will not be correct and that will affect other skills (D,E,F).
Skill C: Clinical communication skills
This is one of the challenging skills, especially for non-British candidates. There are only 3 stations (Station 2,4 and 5) which assess this skill, so you need to talk clearly and loudly to deliver your message to the surrogates or patients.
Tips: If you are non-British candidates, you need to practise how to be confident and at the same time, show your sympathy and empathy. This is very important as this skill sometimes can link to skill for managing patient’s concerns (F).
Skill D: Differential diagnosis
Some candidates failed just by one mark in this skill. After you finish your examination, put all the positive and negative findings together to give your provisional diagnosis and sensible differentials.
Tips: You should prepare differentials while you are studying. This is a very crucial advice. However, you should tailor your differentials according to YOUR case in YOUR PACES exam. If you mention differentials which are not relevant to your case, you WILL LOSE marks.
Skill E: Clinical Judgement
If your diagnosis and differentials are not correct, you will lose mark in clinical judgement too. Practise the management plan for each diagnosis before the exam.
Tips: If you are not sure of the diagnosis, your investigations and management plan should cover your differentials. You can always consult your consultant and other specialists. Remember – you are not treating this patient alone! Always remember to admit patients with serious conditions! Consider whether you need to stop the patient from driving. Don’t forget to provide safety netting.
Skill F: Managing patients’ concerns
This is the most difficult skill for candidates. You need to get 11/16 to pass this skill. If you lose marks in communication station (4) and in one BCC, it would be very hard for you to pass.
Tips: Time management is critical for this skill. Candidates find it difficult to finish on time in BCC. They continue to take history or do physical examination and hence they do not have enough time left to address patients’ concerns. This is a fatal mistake! You should always give sufficient time to address patients’ concerns especially in BCC.
Skill G: Maintaining patient welfare
Almost all candidates pass this skill. As long as you behave professionally, you will get full marks in this skill.
Tips: Do not forget to ask about pain before touching the patient. Also, cover up the patient after you have examined him.
Final advice: Remember – PACES is not about how much you know about medicine. It is about how you can correlate the findings, how you behave, your thinking process, your manners, your confidence and whether you are a safe doctor or not.
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