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naderyakoub

Paper 3 Appraisal

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Despite the fact that I have not done well, I liked this Paper very much. I think it is far much better than the old style Part 2. Here are a few things I liked about this exam

1- Many of the Questions are vignette style and relevant to day to day practice

2- Even when the college asked about numbers and fiugures the options made sense for exaple 1 in 10 or 1 in 100 rather than 1 in 10 or 1 in 15. This means that if you have a rough idea of what the risk is, you may be able to answer it

3- Critical Appraisal Questions were mind-stimulating and, in fact, far much better than appraising a single paper. The questions test the understanding of Basic principles of Statistics and how to read a paper and make evidence-based recommendations

4- Surprisingly, the college wrote the whole name of the test rather than the abbreviations. For example Beck's Depression Inventory rather than BDI etc. This is a big move indeed.

On the negative side, there were some repetition in the same Paper, for example copule of questions asking about SSRIs in Premenestural syndrome and copule others about their use post-stroke.

I hope the College has enough questions bank to come with more of these questions the next time. If I fail this exam, I will be very motivated to prepare for the next one. It is a decent exam that worth preparing for rather than a collection of ISQ you have to memorize to pass.

I think any course materials we had were not reflecting the new style questions and they looked very much similar to some American Questions I had.

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Despite the fact that I have not done well, I liked this Paper very much. I think it is far much better than the old style Part 2. Here are a few things I liked about this exam

[highlight]1- Many of the Questions are vignette style and relevant to day to day practice[/highlight]

[highlight]2- Even when the college asked about numbers and fiugures the options made sense for exaple 1 in 10 or 1 in 100 rather than 1 in 10 or 1 in 15. This means that if you have a rough idea of what the risk is, you may be able to answer it[/highlight]

3- Critical Appraisal Questions were mind-stimulating and, in fact, far much better than appraising a single paper. The questions test the understanding of Basic principles of Statistics and how to read a paper and make evidence-based recommendations

4- Surprisingly, the college wrote the whole name of the test rather than the abbreviations. For example Beck's Depression Inventory rather than BDI etc. This is a big move indeed.

On the negative side, there were some repetition in the same Paper, for example copule of questions asking about SSRIs in Premenestural syndrome and copule others about their use post-stroke.

I hope the College has enough questions bank to come with more of these questions the next time. If I fail this exam, I will be very motivated to prepare for the next one. It is a decent exam that worth preparing for rather than a collection of ISQ you have to memorize to pass.

I think any course materials we had were not reflecting the new style questions and they looked very much similar to some American Questions I had.

I think I differ with you NY. The questions were vignettee style but I disagree they were relevant to day to day practice. They are highly hypothetical. I had bought the Kaplan Self study guide 3 days befor the exam. I did some of those questions and they were relevant to day to day practice.

Also the figures they asked are about conditions that are not met with in common day to day practice. They could have asked about schizophrenia, mood disorder, any psychiatric illness for that matter I would have been shattered if I had not known that. I dont feel bad about not knowing Ebstein's anomaly and neural tube defects. I knw that thses conditions happen and that is enough.

The only part I liked in this exam is Critical Appraisal which was stimulating as you rightly say.

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I agree with you NY. It was a more relevant exam. I was going mad beforehand, trying to memorise useless details of neurbiology. This asked questions that patients do ask. As you say, it is more motivating to prepare for a more relevant exam - which, this time, I also failed!

Did anyone else share my slight feeling of shame about not knowing some of the answers that it felt like I really should know, clinically, about evidenced based treatments?

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I agree with you NY. It was a more relevant exam. I was going mad beforehand, trying to memorise useless details of neurbiology. This asked questions that patients do ask. As you say, it is more motivating to prepare for a more relevant exam - which, this time, I also failed!

Did anyone else share my slight feeling of shame about not knowing some of the answers that it felt like I really should know, clinically, about evidenced based treatments?

I felt many times---Wow! who framed this question. Bugger. I should know. otherwise definitely will be wrong. it was easy easy easy to rule out 3 options in 90% of teh questions, problem was with only choosing the best one among 2. I would say these are best of 2 questions.

Whoever is able to read and write english can rule 3 options easily in almost all the questions.

Many questions they have directly asked what will you do if this happens in your clinic,during therapy..or what would you recommend, what would you avoid, what would you advice, what would you warn...

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hi wvery one

i realy do not know how people say that abut the exam 'relevant to day to day practice' realy how is that can any one explain to me

what is

this thing about child i do not even remeber PADINTS f****** IN CHILD ?

ALSO PATHOLOGICAL CRYING

I HAVE BEEN DOING PSYCHIATRY OF 6-7 YRS AND YET u hear about things 1st time in the exam how relevant is that

and so many other questions a i can go on about endlessly ,also wht this obsession with nubers and percentages HAAAAAAA :-X

i realy think the old style was better at least i knew a lot and leart many things by preparing for it which had helped in practice and in passing last time ,but htis style u can do nothing and just go and play the geussing game :lol: :lol: :lol::D

The thing which is realy making me very angry is ,i realy do not feel my studying and all these courses and the money and time we spent had any value or effect in this exame , again it is how good u r in geussing NOTHING MORE

SO WHT THE HILL IS THIS :-/

FURTHER MORE ABOUT THE TIME, THERE WAS NO TIME WHAT SO EVER AND I LEFT MANY QUESTIONS AT THE END BECAUSE IT TAKE SO BLOODY LONG TO READ THE QUESTIONS AND U WOULD GUESS TH ANSWER ANY WAY ::)

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I had been S*&$ng myself before the paper about how hard it was going to be but in the end it really didn't seem so tough. I'm not saying I got them all right (or even passed) but I walked out feeling that it was pretty fair. Sure there were questions I didn't have a clue about (pathological crying?!?) but there have to be some hard ones as differentiators otherwise everyone would get the same mark.

Time I thought was ok, finished in 1hr 45. I know I am generally quick at these sorts of exams and am usually first to go but 3 hours seemed plenty to me.

I think we all worry because we're used to the old exams where we could feel pretty confident because we had seen all the old questions. We are out of practise at doing exams that test our ability to learn the right stuff and remember it rather than just being able to recite all of the old questions.

Saying all that I hope to F*%k I pass cos I don't want to have to do it again.

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I agree with NY: This was a relevant exam.

Of course there are going to be some unusual questions - pathological crying etc but there has to be a range, which there was: some questions were down right simple!!

There was a real sparcity of questions on Scz or BPAD. Nothing on neuroreceptors/ little on findings on scans/ EEG's/ genes etc... which allot of the courses really focussed on!!! Quite a few questions on Perinatal- which threw me... wish I remembered the part 1 stuff I used to know (This was a recurrent theme through out the MCQ's) !!

Critical appraisal was very manageable- standard stuff with simple maths to work out- which if you knew the basic formulae was guaranteed marks.

Id really advised people who sit this exam in future- know your critical appraisal- there is no fluffing about it- pure facts- guaranteed marks.

Disappointing that some of the EMI's were repeated- I know others will disagree with this but- a fair exam should be a fair exam for everyone- new exam should mean all new questions. I may be biased here as I did not pay much attention to past EMI's and feel a bit cheated- my bad you might say.

Overall I thought it was a fair exam- of course there are hard bits- its an exam not a give away.

Best of luck everyone!!

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Has the prevalence of schizophrenia gone down now?????? Don't we see it day to day practice anymore???? Why was there not a single question on Schizophrenia?????

Psychotherapy was only 8 % in the syllabus.

How can people say it is relevant to day to day practice???????? I am amazed. absolutely. >:(

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There was a large emphasis on Schizophrenia and Affective disorders in the old part one- in MCQ's and EMI's and especially in the OSCE: Maybe the college felt that was sufficient? Whats the point in going over old ground?

Also though I spent days on the nuances of SCZ receptors/ genes / scan changes etc- I must say I felt it was totally irrelevant as allot of the info is not fact- e.g. the genes and the extent of their role. Also allot of this stuff changes almost daily.

Psychotherapy is something one is supposed to be doing increasingly through out your training and maybe thats why there were 10 or so questions on it in best of five and One/ Two q's in the EMI's. I suppose we all remember most prominently what we felt we fell down on. Hence me remembering the perinatal stuff as if it made up 30% of the exam (phew it didn't quite) and others focussing on the psychotherapy.

In comparison to the ridiculous MCQ's that featured in the old part 2- these were much more clinical and reasonable in the main.

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I think some of the figures they asked in the exam can be guessed used common sense. For example Neural Tube Defects with Sodium Valproate. The options were 1 in 10 , 1 in 100, 1 in 1000 etc.

They can not be as common as 1 in 10. 1 in 1000 is probably too low to hear about so often in textbooks, so it must be 1 in 100. This is the answer I chosed and in fact I looked it up and it is 1-2 %

I agree that repeating EMIs is UNFAIR. This is one thing I have not done; past EMIs. It is unfair because it turns candidates into machines memorizing the past questions. It also puts those who try to use their mind at disadvantage because they will spend more time thinking about the question. Candidates who know the answer by heart will only take a few seconds to mark it down in the answer sheet. It is UNFAIR and I hope the college will update the question bank frequently so that this does not happen in the future.

In decent well established exams, e.g USMLE, there is always pilot questions to test for future consideration in subsequent exams. I think this should be the case specially with some weired questions like incidence of Ebstein's anomaly. If the college put this question as a pilot first, they will realize that whoever got it right is no more than by chance and it will be taken off future exams!!

I think this is necessary specially when SpRs participate in writing the questions

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Did anyone else share my slight feeling of shame about not knowing some of the answers that it felt like I really should know, clinically, about evidenced based treatments?

Yes. As it's been said, I can imagine patients asking these questions.

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There was a large emphasis on Schizophrenia and Affective disorders in the old part one- in MCQ's and EMI's and especially in the OSCE: Maybe the college felt that was sufficient? Whats the point in going over old ground?

Also though I spent days on the nuances of SCZ receptors/ genes / scan changes etc- I must say I felt it was totally irrelevant as allot of the info is not fact- e.g. the genes and the extent of their role. Also allot of this stuff changes almost daily.

[highlight]Psychotherapy is something one is supposed to be doing increasingly through out your training and maybe thats why there were 10 or so questions on it in best of five and One/ Two q's in the EMI's[/highlight]. I suppose we all remember most prominently what we felt we fell down on. Hence me remembering the perinatal stuff as if it made up 30% of the exam (phew it didn't quite) and others focussing on the psychotherapy.

In comparison to the ridiculous MCQ's that featured in the old part 2- these were much more clinical and reasonable in the main.

The college should have clarified the emphasis. I dont say there shdn't have been psychotherapy but the style of questioning.

What will will you do if someone says 'I have been abusing my children' It will depend on what kind of person that is?Whether it is the first session? Have I previously seen this person???? I will certainly not reassure him that is certain. But if I have a high index of suspicion due to prior knowledge I might do something more proactive.

Also what patient will come and say to you I have recurrent depressive episodes followed by brief periods of hypomania, so will you give me Lithium, Valproate, Olanzapine or bloody some thing else. Is this enough information?????? How was the patient treated until now???? I will base my decision on that.

This was not an exam for first timers. May be repeaters had a advantage. I dont know.

Like somebody posted in this thread their consultant said Perphenazine is an option compared to Quetiapine.for someone not responding to Olanzapine. It depends on individual choice.

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The answer of this particular question was very straightdforward. You should ask the patient what does he/she mean by abusing his/her children. This is the first step in any case and under any circumstances. Any person who understands English could answer this question. Even if you will break confidentiality later on or inform the police or social services, all has to go through this first question. What do you mean by abuse and then get more details.

From Psychotherapy point of view, as I was told by my supervisor, you need to make NO Assumptions. When a patient tells you this sentense, you should not assume anything and get to know what does he / she mean by this. It could be some guilt, thoughts, or real abuse.

Very straightforward question

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Re sex abuse in psychotherapy

...I dont think this was a straight forward question because there werent answers which adequately reflected what you would do in clincial practice and there wasnt enough stand alone information given in the actual question either. This could also be said for the question regarding the dream of having sex with father. The answers were simplistic which is especially inappropriate for psychotherapy!

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Re sex abuse in psychotherapy

...I dont think this was a straight forward question because  there werent answers which adequately reflected what you would do in clincial practice and[highlight] there wasnt enough stand alone information given in the actual question either. [/highlight]  This could also be said for the question regarding the dream of having sex with father.  The answers were  simplistic which is especially inappropriate for psychotherapy!

You just proved that it is a straightforward question. No enough information so all what you need to know is to get enough information. For example what do you mean by abusing your children or what is your interpretation of this dream

VERY EASY QUESTIONs

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[highlight]Did anyone else share my slight feeling of shame about not knowing some of the answers that it felt like I really should know, clinically[/highlight], about evidenced based treatments?

Yes. As it's been said, I can imagine patients asking these questions.

I agree- antidepressants for various situations- I was guessing them, not knowing any of the evidence- and let's face it, depression is not exactly rare :-[ :-[ :-[ :-X

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The answer of this particular question was very straightdforward. You should ask the patient what does he/she mean by abusing his/her children. This is the first step in any case and under any circumstances. [highlight]Any person who understands English could answer this question[/highlight]. Even if you will break confidentiality later on or inform the police or social services, all has to go through this first question. What do you mean by abuse and then get more details.

From Psychotherapy point of view, as I was told by my supervisor, you need to make NO Assumptions. When a patient tells you this sentense, you should not assume anything and get to know what does he / she mean by this. It could be some guilt, thoughts, or real abuse.

Very straightforward question

The English was easy enough even for me but the question was very inadequate for my standards. May be I have very high standards!!!!!!! There were excellent questions in Critical Appraisal which I thoroughly enjoyed even with my supposedly meagre understanding of ENGLISH.

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I'm with NY on this one. That question was one of the most straightforward, it's just common sense. You wouldn't do anything before finding out a bit more info. All the other answers are next steps depending on what you find out.

Sometimes you can overthink things and look for the trap or hurdle where there is none.

But lets face it guys, it really isn't worth fighting about. A bit of discussion and banter is ok but don't take things too personally. It was an exam for gods sake

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overall, i thought the exam was fair and kept telling myself these were questions i really should be getting right. even the critical appraisal, which i think i messed up in ,was bcos i basically did not know the formulae. I also did not do previous EMIs and so was surprised to hear pple saying there were some repeated ones!!!

fingers crossed for the results

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Could anyone please post the answers to the questions given

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