Examination Format

Summary

NEW Change In Time Allocation At Stations 1 And 3 Of PACES

This change affects Station 1 (abdominal and respiratory systems) and Station 3 (cardiovascular and neurological systems) only.

The total time allowed for each system remains the same (ten minutes). After five minutes, the examiners will tell you that you have one minute remaining to complete your physical examination, and after six minutes they will ask you to end your examination so they can question you. This leaves four minutes for questioning by the examiners.

Please note that this is a change from the previous guidelines, which allowed seven minutes for the physical examination with three minutes for questioning. You are recommended to be focussed in your examination to make best use of the time available.

What PACES means for candidates

The PACES carousel

The PACES examination requires five clinical stations, each assessed by two independent examiners. Candidates will start at any one of the five stations, and then move round the carousel of stations, at 20 minute intervals (Figure 1), until they have completed the cycle.

Figure 1 : The carousel of PACES stations

Written instructions

For each case at the clinical stations, the candidate will receive written instructions as to what is required of him/her. (Example - Figure 2)

Figure 2: 

Clinical Stations 1, 3 and 5

These stations aim to assess the candidate's ability to examine the patient, interpret physical signs and discuss the case. The features are as follows:

•  there is a set time limit for each patient (see Figure 1)
• there are written instructions for each case (see Figure 2)
• each examiner has a structured mark-sheet for the case
• every candidate on the carousel will be examined by the same two examiners at each station

Candidates will be expected to differentiate the normal from the abnormal appearances of the optic fundus. Examiners and candidates are reminded that the inclusion of a normal optic fundus in Station 5 is permissible.

Station 2

The history taking skills station aims to assess the candidate's ability to gather data from the patient, to assimilate that information and then discuss the case. The features are:

• written instructions for the case, usually in the form of a letter from the patient's GP are given to the candidate during the five minute interval before the station.
• 14 minutes are allowed for the history taking, 1 minute to gather your thoughts followed by five minutes for discussion (after the patient has left the station)
• the two examiners are present throughout observing the history taking. Each examiner has a structured mark-sheet for the case.

Download sample scenarios 

Station 4

The communication skills and ethics station aims to assess the candidate's ability to guide and organise the interview with the subject (who may be a patient, relative, or surrogate, such as a health care worker), provide emotional support and discuss further management. Other features are as follows:

• written instructions for the case are given to the candidate during the five minute interval before this station
• the two examiners are present throughout
• 14 minutes are allowed for the history taking, 1 minute to gather your thoughts followed by five minutes for discussion (after the patient has left the station)
• each examiner has a structured mark-sheet for the case.

Download sample scenarios

Mark-sheets

Each candidate receives structured mark-sheets for each station prior to the start of the PACES examination. The candidate has to complete the same details (i.e.add his/her personal information) and then hand the appropriate sheets to the examiners at each station. In the event of failing the examination, the mark-sheets will form the basis for feed-back to the candidate.