Foreword by Dr. Michael Jones
Acquisition of the diploma of Membership of the Royal Colleges of Physicians is a crucial step in a physician’s
working life that enables them to pursue a career in one of the thirty medical specialties and two subspecialties that are
recognised by the General Medical Council (GMC). The work and training that is required to pass the three parts of the examination
should not be underestimated by anyone. Trying to learn the enormous extent of medicine so that the trainee has enough confidence
to answer the questions that are posed is daunting and there are many theories about the best way to prepare. The changes
that are occurring both in medical training and indeed the MRCP does not obviate the fact that studying medicine will require
a sound grounding in knowledge. It is anticipated, however, that the provision of better training will aid in the acquisition
The main changes that are occurring in medical training in the UK have been driven by the Shape of Training
report which recommended that all new curricula must better serve the patient need, have more generic skills to support the
acute unselected take, provide continuity of care, improve care in the community, support credentialing and provide a
more flexible approach to training. Furthermore, the GMC mandated that all postgraduate curricula must be based on higher
level learning outcomes and incorporate the GMC defined Generic Professional Capabilities (GPCs). In response to this, stage
1 of The Joint Royal Colleges of Physicians Training Board (JRCPTB) designed Internal Medicine Training (IMT) programme was
implemented in August 2019. This is an indicative three-year programme designed to better prepare doctors to become a medical
registrar and provide them with the skills needed to manage patients presenting with a wide range of general medical
symptoms and conditions. Experience in critical care medicine, geriatric medicine and outpatients is mandated and trainees
will receive simulation training throughout the programme.
The use of all sources of information can only be assisted
if there is an adequacy of time and the introduction by JRCPTB of quality standards for registrars in general internal
medicine is now being augmented to cover the whole of internal medicine training.
The MRCP clinical examination
is also changing and 2021 should see the introduction of the updated PACES exam to ensure it remains fair, relevant and fit
for purpose. This has been the subject of a great deal of scrutiny, consultation and deliberation reflecting not only the
place of the examination, but also the importance of the role of excellent clinical skills. Knowing how a disease presents
and how and when to investigate such presentations is at the heart of what physicians do.
The editors for this book have
enrolled an extensive field of authors who are experts in their fields to provide facts which may be assimilated rapidly and
that will be helpful both in revising for the MRCP examinations and also in day to day practice. The consistency of editorship
means that individual conditions are listed according to clinical features, diagnosis and management - a system that will
serve anyone well at the bedside, whether in a clinical or exam setting. It covers aspects of medicine that have been ignored
by the statutory definition of specialty but are enormously important in everyday presentations to the acute hospital, including
obstetric medicine. The inclusion of critical care as a specific aspect for consideration complements well the ambition within
the internal medicine training programme of generating doctors who are more able to manage the acutely ill patient. The editors
have also ensured that there are chapters covering topics that traditionally are ‘Cinderella areas’ and yet are
defined as being important in the new curriculum – these include Statistics and Medical Law and Ethics.
In summary, this work
will help you in studying for the MRCP diploma but if used well will stand the reader in good stead for their future career.
Dr. Michael Jones
Consultant Acute Physician
GIRFT National Clinical Lead for Acute and General Medicine