North West School of Medicine - Exam Support
North West School of Medicine, Exam Support
TPDs for Exam Support Services for Internal Medicine Trainees (IMTs)
What is this service?
This service has been designed to support IMTs (Internal Medicine Trainees) preparing for MRCP Part 1, 2 and PACES. It is especially aimed at trainees who have failed any part of the exam on multiple occasions. A pathway has been developed to support these trainees which is described in more detail below. The service is constantly in development, therefore more resources should be available with time. We also aspire to work with Educational Supervisors and Royal College tutors to provide uniform, high quality local teaching for PACES across our region.
Who are we?
There are two TPDs for exam support for internal medicine:
Dr Diana Chiu is an Acute Medicine Consultant working in the Northern Care Alliance. She has extensive experience in writing MRCP Part 1 and 2 questions for the Royal College of Physicians and online question banks. She actively participates in the local PACES teaching and has a particular interest in medical education with a PG CERT in Postgraduate Medical Education. Her passion is in medical examinations and she gets great satisfaction in helping resident doctors pass the exams. Out of work, she is a mother of three energetic children, so fully appreciates the challenges of having a full time medical job and a young family!
Dr Sushmita Pearce is a Consultant in Diabetes, Endocrinology and General Internal Medicine at Wrightington Wigan and Leigh Teaching Hospitals NHS Foundation Trust.
She has been involved with the MRCP exam for 17 years as both a specialty question writer for Parts 1 and 2, a member and most recently Secretary of the MRCP Part 2 board and has just been appointed as Secretary to the MRCP Part 1 Board. She has been a PACES examiner since 2011. She has a keen interest in medical education, organises her local IMT teaching programme and provides regular PACES bedside teaching. She has a PG Cert in Work Based Medical Education and is the current RCP tutor for her trust.
Her main doctrine when it comes to success in examinations is not that ‘practice makes perfect’, but rather ‘perfect practice makes perfect ‘and she hopes that in this role she will try and pass this wisdom on to as many resident doctors as possible!
She feels privileged to have been able to work part time clinically to allow her to bring up her family and have space to nurture her roles in education and training, culminating in a fabulously rewarding work and home life.
Outside of work she is a keen but very mediocre tennis, pickle ball, piano and guitar player!
If there are any questions relating to TPD for exam support services, please feel free to email:
england.medicine.exam.tpd@nhs.net
Referral Pathways and Support
For trainees who has been unsuccessful in any part of the MRCP after 2 attempts.
They should first have a meeting with their Educational Supervisor (ES). There are many potential reasons for exam struggles for example:
- Lack of time – information from study guide link (see below) may help. If due to work or rota issues, consider addressing locally.
- Due to illness – consider involving IMT TPDs and local services such as Occupational Health, GP services etc.
- Inability to attend a revision course – explore reasons and address appropriately e.g. how to access funding, issues with getting study leave, etc.
- Unable to take adequate private study leave in lead up to exam - need to explore reasons for this and see if they can be addressed locally prior to next attempt
- Issues surrounding availability or access to local PACES teaching – please contact your local Royal College of Physicians (RCP) tutor for further advice.
- Other extenuating circumstances unrelated to the exam itself - need to be discussed on an individual basis.
If there are reasons related to the exam itself the ES should review the presentations provided with the trainee . They have been devised to give helpful exam preparation tips for each section of the exam:
Study Guide
In addition, Health Education North East has produced an excellent trainee pack on exam support which covers a range of topics relevant to improving exam success which ES should review with trainees or direct trainees to access - link
Neurodiversity screening
There is an increasing recognition that neurodiversity plays a part in exam difficulties. Neurodiversity may not always be apparent, therefore screening for dyslexia has been advised for resident doctors who fail any part of the MRCP more than twice. Educational Supervisors are encouraged to ask the resident doctor to complete the dyslexia screening tool
If positive i.e. score over 45, please refer to IMT TPD to complete the referral for formal dyslexia assessment
Westwood coaching
Resident doctors who have been unsuccessful after two attempts in any part of the MRCP exam, particularly if there are wider issues such as exam anxiety, time management issues or organisation etc., can be referred to Westwood Coaching. Please note, Westwood coaching is not medicine specific but will help in generic skills.
If Westwood coaching is felt to be appropriate then ES should refer to IMT TPD to complete the referral form.
After the above interventions, trainees should consider a further attempt at the exam.
Referral to TPD for exam support after more than three failed MRCP attempts
If after three attempts at the MRCP and resident doctor is still unsuccessful and has ongoing issues with exam technique/performance itself, then they should be referred to TPD for exam support for further input and advice . Their consent will need to be obtained.
Please can ES and/or TPDs refer via this link:
What does a TPD for Exam support offer?
TPD for exam support will offer a 1:1 TEAMS session. A pre-meeting questionnaire is sent to trainee which covers:
- Explores why they feel they may have been unsuccessful before
- What have they done to overcome these issues
- How are they preparing for current sitting?
- Have they been screened for dyslexia or received coaching?
- Summarise feedback/previous results and reflect on these
- What kind of support do they feel will benefit them?
- This encourages self reflection, identification of weaknesses prior to meeting us and is returned before we meet so we can tailor meeting accordingly
A 1:1 online session will include:
- Lasts around 90 mins
- Explore reasons for previous exam failure
- Suggestions made regarding
- Preparation - efficient revision/targeted revision/use of question banks
- Approach to questions – cover test/ruling out distractors
- Exploration of different question types/styles/wording with examples do live during meeting for part 1 and 2
- PACES candidates – review the power point presentation and tailor meeting to resident doctor's specific areas of concern
- Ensure that resident doctor is getting adequate local teaching by liaising with ES/RCP tutor, as needed
- Ensure study leave/course attendance has been planned
- Ensure dyslexia screening done
- Consider referral to Westwood coaching if not already done/potentially helpful
- Direct trainees to HENE website if not previously seen this
A summary of the meeting will be recorded in the IMT eportfolio so that TPDs and ES are aware.
A post exam questionnaire will be sent to resident doctor for feedback about TPD for exam support session and we invite resident doctors to let us know the outcome of their next sitting
If the resident doctor is unsuccessful again, they should be referred to PSW for further help by exam support TPD/ES/IMT TPDs. Depending on the circumstances, exam support TPD may refer resident doctor to PSW earlier if felt appropriate (resident doctor will be informed and consent obtained for this).
Summary of current TPD for exam support referral pathway
More information re: TPD for exam support services can be found:
If there are any questions relating to TPD for exam support services, please feel free to email:
england.medicine.exam.tpd@nhs.net
Last updated 14 July 2025