Friends in Medicine ~ DR. Queenette Akporokah (Member Royal College of Physicians U.K and Member Royal College of Physicians Ireland)

By berrysmotivation - June 03, 2019

DR. Queenette Akporokah is a medical doctor, from Nigeria and currently practicing in the Republic of Ireland. She graduated from Lugansk state medical university Ukraine after which she went to Nigeria for her internship and NYSC. She then returned to Ireland where she had been living prior to medical school to complete the registration exams (PRES) and  during the same period, she got registered with the GMC (UK) and completed her membership examinations -MRCP(UK) and MRCP(Ireland). Over the past 3 years, Dr Queenette has worked as a medical SHO (senior house officer) and also as a medical Registrar.

I spoke to Dr Queenette about sharing some of her experience here on the blog and with no hesitation she agreed to. 
Read on to see what a day at work is like for her, how she passed all exams within a year and still coped with looking after her little one.

What do you like best about being a medical doctor?

The best thing about being a doctor is the fulfillment that comes from seeing, witnessing and knowing that you are making a real difference in people’s lives. It’s amazing how someone can literally transform gradually before your eyes. It could be anything from seeing how the administration of a simple analgesic relieves pain, to seeing someone who was previously unconscious in the ICU, fully recovered and walking out of the hospital. I also just find it satisfying to have an understanding of how the body functions and the basis of disease processes. You never know when the knowledge will be required. One of my memorable experiences was an incident in which there was a medical emergency in an airplane, and I had to step up to the task as there seemed to be no other doctor on the flight. Thankfully, all ended well, and I must say, it felt heroic. There aren’t too many careers that give you that privilege.

What is a typical work day like for you?

My typical day at work usually starts at 9 am with myself and my team meeting up and going through our inpatient list, what we call a ‘’dry round’’. This basically involves having a brief overview of the list to remind ourselves of the current situation with each patient. Then comes the actual ward rounds which usually lasts till late morning/early afternoon. This is where the decisions for the day are made having seen the actual condition of each patient. These decisions could be: to discharge a patient home, change a medication, consult another department, book a new scan etc. By the end of the ward rounds, there would be enough jobs to keep the team going for the day. Teamwork is highly essential. On a day when there is an Outpatient clinic, that could take up the bulk of the afternoon. Otherwise, the rest of the day could be spent doing so many different things; following up on the jobs which emanated from the morning rounds.

What is the secret to succeeding in MRCP and MRCPI?

I’m not sure it is much of a secret and this is probably a little cliche, but I’d say there is no
substitute for hard work, dedication and perseverance. To me, preparing for any exam at all follows the same principles:

a) Understand what the exam entails and know what is expected of the candidates.

This should really go without saying but at times, there could be a temptation to go straight into for instance solving question banks without taking time to understand what the exam requires and covering the basics.

b) Make a schedule.

Whenever I have to prepare for any exam at all, I always start by making a study plan/schedule. This serves as a guide to know what I need to cover, estimate how much time I need, calculate the amount of study hours needed per day to cover the syllables, and finally to help monitor my progress. For instance, If I need to go through a question bank with 3000 questions in 2 months, this means I should have a minimum target of 50 questions per day. Of course, there will be days when you simply can’t meet up with your target because perhaps you are on call. But knowing the target would mean that you can try to make up for it one way or the other.

c) Have a dedicated study time.

I personally find that I love to study in quiet environments with minimum distractions and that for me, means going to the library. In terms of studying, I often say that an hour in the library is worth about 3 hours at home. In essence, I prefer to have a dedicated one or two hours in the library and then give my undivided attention at home. Of course, people are different, but in general I think less distractions = better assimilation = better chance of recall.

d) Keep your eyes on the goal.

Sometimes, it could feel as though your life is consumed by an exam preparation. However, it helps to understand that there are phases to the medical career, and so, at certain points in time like when there’s an upcoming exam you may need to make some temporary compromises like substituting studies for another activity. A thought that keeps me going at such times is reminding myself that it’s only for a while, and really, in no time, it all becomes a thing of the past.

 When is the best time to take both exams?

 Within the first year as a medical SHO is a good time to take the part 1 and part 2 written. As a matter of fact, once you have a minimum of 12 months of postgraduate medical experience you are eligible to take part 1, regardless of whether you are in training or not. Some people prefer to follow up with the clinical straight away, usually by the end of 1st year/early 2nd year while others may prefer to take a little break for a while. I personally recommend getting it over and done with whilst the knowledge of the earlier part is still fresh in your memory as life can quickly get busy and months will turn into years. 

 How long did it take you to prepare for both exams?

Both exams consist of three parts: part 1, part 2 written, and part 2 clinical which is known as PACES in the UK, So, that makes a total of six exams. I took five of them in one year (all parts of MRCPUK and parts 1 and 2 written of MRCPI), and the final one (MRCPI clinical) about a year later as I went on maternity leave. I did both sets of exams almost back to back as the knowledge I get from preparing for one would be used in the other and I wanted to use one stone to kill two birds, even though the stone also kills your finances. 

Why the two memberships (MRCP and MRCPI)

You may wonder. Well, I like to have options in life and not feel constrained to a particular pathway.

What resources do you recommend?

Both Part 1 and part 2 written are in the form of multiple-choice questions. I prepared for these by briefly going through a book ‘’Essential revision notes for MRCP and most importantly by going through question banks.

There a 3 popular question banks that I know of - Pastest, Passmedicine and
Onexamination. I personally used a combination of Onexamination and passmedicine.
It took me about three months to prepare for part 1, two months for part 2 written, and about two months each for PACES and MRCPI clinical.
For the clinicals, the resources I used include;
  •  Pastest online videos which were quite helpful.
  • Courses/tutorials. I found these very beneficial as it exposes you to so many different cases which helps to build your confidence for the exam day. For PACES, I attended a 2-day PACES course, specifically, Ealing Paces course in London. There are however many other good courses
  • available in different parts of UK. For the MRCPI clinicals, I attended tutorials organised locally in the hospital which went on for over a month.  
  •  I also read/glanced through some materials like ‘’Cases for Paces’’, ‘’250 cases in clinical medicine’’, ‘’Pocketbook for Paces’’ to help acquaint myself with the kind of questions asked and the answers expected.
  •  Finally, Practice! PracticePractice with a colleague, a friend, partner etc. Find patients in the ward with good clinical signs and practice. The more you practice, the more natural it becomes.  Depending on your experience, it may also be worthwhile attending some outpatient clinics. For instance, because I had relatively little experience with fundoscopy/ophthalmology, I arranged to attend one or two ophthalmology outpatient clinics. I even ended up buying a small ophthalmoscope which I used to practice fundoscopy at home -Thanks to hubby who always graciously lets me use him as a patient. Not like he has a choice though. That may seem over-the- top, but then, I believe in do the best you can, so that if at all you fail, you’ll have no regrets about what you could have done to improve your chances.

 What is the most common misconception about both exams? Is one more difficult than the other?

Well, I’ve heard many people say that MRCPI has a more difficult part 1, while MRCPUK is tougher for the clinicals. To me, in general, I don’t consider one to be more difficult than the other. There are some variations in the pattern particularly for the clinicals so It’s really a matter of knowing how each station is structured and what is expected. Each exam is unique, so I’d say, even if you’ve done a similar exam, don’t underestimate any exam or you could be setting yourself up for failure. Even though I completed the entire MRCPUK prior to MRCPI clinicals, I still made reasonable effort to attend the tutorials as I didn’t want to take chances.

What were the challenges you were faced with whilst you were preparing for the exams?

The main challenge I had was during my preparations for the MRCPI Clinical, as by then, my daughter was also in the picture, I was readjusting to being back from maternity leave and I also happened to be in a very busy department at the time, so it was quite exhausting finding time to attend tutorials after a stressful day at work and still having to care for a little child . Thankfully, I had great family support which made it easier to cope.

 What are the next steps after passing both exams?

Well, first, I don’t necessarily view the exams as just a step to something else per se. They represent; an objective evidence of one’s knowledge/skills, a sort of professional distinction increasing your ‘’market value’’ in the ever-competitive job market and an internationally valued qualification enhancing one’s career prospects in general. Nevertheless, as a step, they are basically the exit exams from basic specialist training (Ireland) or core medical training (UK), which enables a trainee to move on to Higher specialist training.

 How do you create a work:life balance? (e.g hobbies)

Two words- be intentional!
I believe that regardless of how much you are passionate about your job, there is still need to find a way to unwind outside of work, otherwise, you may eventually burn out and be unable to give your best both at work and other aspects of your life.
I’ve learnt that to achieve most things in life, including a good work-life balance, you have to be deliberate about it. This to me means consciously scheduling a time of the week/day for activities I enjoy, to help me unwind and relax. It could be anything from meeting up with friends, to going for sports events, just sitting out in the park with my family…whatever I’m in the mood for at a particular time.
My hobbies fluctuate from time to time, but at the moment, I enjoy attending guitar lessons and swimming classes some days of the week. These are activities I knew nothing about few months ago but deliberately decided to enroll just for the fun of it and the thrill of learning something new. I also try to be deliberate about my weekends – i.e. have a specific fun activity or sightseeing planned for each weekend if possible.
I do understand that some departments could be quite demanding, but ultimately, the point is unless you are intentional about it, work-life balance will probably remain a fantasy.

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