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GENETICS - Updated information by RCPath for 2004

Author: rcpath, Posted on Tuesday, September 07 @ 02:32:58 IST by RxPG  

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MRCPath Part 1

Part 1 examination

Timing of the examinations

The Part 1 examinations are held once a year in the spring.

Entry requirements

1. Entry qualifications

a) Medical candidates must hold a qualification in medicine that is approved by Council. Candidates holding a medical qualification not accepted by the General Medical Council in the UK must furnish with their application form the document or certificate whereby registration or permission to practise is granted in the country or territory of domicile in which the qualification was granted.

Candidates with a medical qualification must have held suitable clinical appointments for not less than one year; pre-registration appointments are accepted for this purpose.

b) Non-medical candidates must hold a qualification that is approved by Council. For the purpose of this regulation, Council recognises the qualifications in dental surgery and veterinary medicine that are registrable in the UK and 1st and 2nd class Honours degrees or equivalent qualifications granted in the UK and Republic of Ireland in appropriate science subjects. Applications may also be considered on an individual basis from those holding other science degrees granted in the UK and Republic of Ireland and from those holding science degrees from overseas’ universities.

2. Training requirements

Part 1 can be taken following a minimum of three years’ training in departments or laboratories that are recognised by the College for Part 1 training.

For medically qualified candidates, the three years’ training requirement for Part 1 includes two years of higher specialist training.

For clinical scientists, it is recommended the three years’ training requirement for Part 1 includes two years of clinical practice. Thus for clinical scientists in the UK, most candidates will have gained state registration and have undergone four or five years of training in the A and B grades, depending on the route to state registration.

Structure and format of the examination

Candidates must choose either the clinical cytogenetics examination or the clinical molecular genetics examination, depending upon the nature of their training. The examination consists of three components:
· two three-hour written papers
· two three-hour practical papers
· a 30-minute oral examination.

The written examination is taken first. Those who pass are then eligible for the practical and oral examination, which takes place a few weeks later. Candidates will be notified of the time and place of the practical and oral examinations. Those who pass the written examination but fail the practical and oral examination retain a pass in the written examination and only have to retake the practical and oral examination.

The written examination consists of two papers of three hours each, taken on the same day. The candidate must answer four out of five questions on each paper and there is one optional question common to both the cytogenetic and molecular genetic examinations for each paper. The questions may be essays or short answers.

The practical examination lasts for six hours: three hours in the morning followed by a lunchbreak and three hours in the afternoon. Candidates can only sit the practical after passing the written examination.

The practical examination contains a mixture of analytical, problem-solving and interpretative questions. Candidates must answer all questions. The examiners mark the practical examination answer papers the same day and an oral examination is conducted the following day.

Those who pass the written examination but fail the practical retain the pass in the written examination and can retake the practical at a later date.

Those who fail the examination can ask for advice from the College Educational Advisor in Genetics.

Content of the examinations

1. Clinical cytogenetics

The examination will cover all aspects of clinical cytogenetics including prenatal and postnatal diagnosis, cancer cytogenetics (leukaemia and solid tumours) and chromosome breakage syndromes. The Part 1 examination is the major test of a clinical cytogeneticist’s knowledge and analytical and interpretive skills across the whole field of practice, and candidates are advised to prepare themselves accordingly.

A detailed and up-to-date knowledge of the following subjects is required: the structure and function of the human genome; the structure and function of human chromosomes; the clinical relevance of chromosome abnormalities, both constitutional and acquired; the practical techniques used for the preparation and analysis of chromosome preparations; the principles of DNA technology.

A general knowledge of the following areas is required: a general knowledge of the sciences basic to genetics, with particular reference to human genetics; Mendelian inheritance; gene mapping; the fundamental principles of cell biology; aspects of epidemiology and statistics.

Candidates should have experience in the interpretation of results and the compilation of reports.

Candidates should also have knowledge of the administrative aspects of laboratory safety and basic laboratory management principles including audit, quality control, risk assessment, health and safety, and good laboratory practice.

The candidates should maintain awareness of current research and development within the field.
a) Written examination
Paper 1: primarily based on the science of clinical cytogenetics, containing questions on the more theoretical aspects of the subject.
Paper 2: primarily based on the application of the science of clinical cytogenetics, including laboratory management aspects, containing questions of a more applied nature.

b) Practical examination
In the practical examination there will be microscopic and image analysis of chromosomes with various forms of banding. Interphase and metaphase analysis skills will be tested.
The practical examination will contain questions on cytogenetic analysis, interpretation of cytogenetic results, identifying the need for additional investigations and/or using such additional information to revise a cytogenetic interpretation, report writing.
The practical examination may also include: finding suitable metaphases for cytogenetic analysis, data analysis or risk calculation, basic skills in clinical genetics (pedigree interpretation, dysmorphology of common cytogenetic syndromes), molecular genetics, e.g. interpretation of a DNA gel, topics that test awareness of general genetic principles, e.g. meiotic chromosomes, pachtyene or recombinant diagrams, sperm chromomses, non-routine banding paterns, etc.

c) Oral examination
The main purpose of the oral examination is to test the candidate’s knowledge in the areas of the practical in which they have performed badly. The questions may cover any aspect of the material covered in the examination.
The oral examination may enable a borderline candidate to obtain an extra mark or two to reach the pass standard. However all candidates will be tested, even if they have a clear pass on the practical.

2. Clinical molecular genetics

The examination will cover a comprehensive working knowledge of the scientific, clinical and technical aspects relevant to the practice and development of clinical molecular genetics. Candidates should have a sound understanding of human genetics, including some basic aspects of related disciplines such as cytogenetics, biochemistry, immunology, haematology and histopathology. The Part 1 examination is the major test of a clinical molecular geneticist’s knowledge and analytical and interpretive skills across the whole field of practice, and candidates are advised to prepare themselves accordingly.

A detailed and up-to-date knowledge of the following subjects is required: the structure and organisation of the human genome; gene mapping, identification of genes, mutations and polymorphisms, gene expression, DNA diagnostic technology; methods of mutation analysis; patterns of inheritance; simple and complex gene disorders including familial cancer, molecular pathology of genetic disorders, genotype-phenotype relationships and therapeutic interventions applicable to genetic disorders.

A general knowledge of the following areas is required: general principles of human genetics, including principles of gene inheritance; general principles of cytogenetics, including the structure and function of chromosomes; an understanding of cell division and knowledge of common chromosome disorders; relevant aspects of epidemiology and statistics.

Candidates should have experience in the interpretation of results and the compilation of reports, assessment of clinical relevance and the limitations of investigations, risk calculation and assessment, the use of genetic databases.

Candidates should also have knowledge of the administrative aspects of laboratory safety and laboratory management including audit and quality control.

The candidates should maintain awareness of current research and development within the field.

a) Written examination
Paper 1: primarily based on the science of clinical molecular genetics, containing questions on the more theoretical aspects of the subject.
Paper 2: primarily based on the application of the science of clinical molecular genetics, including laboratory management issues, containing questions of a more applied nature.

b) Practical examination
The practical examination will contain questions on data analysis, interpretation of the results of molecular diagnostic tests, report writing.
The practical examination may also include risk calculations using Bayes Theorem with information provided by analysis of linked DNA markers, gene frequency calculations or the Hardy-Weinberg equation, pedigree interpretation, topics that test awareness of general genetic principles, e.g. gene recombination and chromosal translocation, the design of diagnostic tests.

c) Oral examination
The oral examination is held the morning after the practical examination. It will last approximately 20–30 minutes. The main purpose is to test the candidate’s knowledge in the areas of the practical in which they have performed badly. All candidates will be tested, even if they have a clear pass on the practical and the questions may cover any aspect of the material covered in the examination.

Standards and marking methods

Consistency of standards is achieved through the use of two examiners, with one examiner shared between two successive examinations. The examiners mark the questions independently and submit their results to the examination officer. Any discrepancy in marking will be reviewed by a third examiner.

Marks are based on expected main points, agreed by both examiners prior to the examination. Each Part 1 written question carries equal marks. Answers are marked using a ‘closed’ marking system that uses a limited range of marks as follows.

Mark awarded Category
15 (maximum) Excellent pass
14 Clear pass
13 Pass
12 Borderline fail
11 Clear fail
10 (minimum) Bad fail .

Two examiners mark the written papers independently. Their marks for each question are averaged and the average marks for each of the four questions are totalled. The pass-mark for each paper is 50 and marks in excess on 50 from one paper can compensate for a slight underperformance on the other paper, provided the score is 47 or above. A total of 46 marks or below for one paper results in failure of the examination. Candidates are advised to try to obtain an average mark of about 13 per answer, i.e. to manage their time across all four answers per paper and to try to give relevant, informative and balanced answers to each question attempted.

Two examiners also mark the practical papers and oral examinations. The pass mark in the practical examination is 50% of the total marks assigned to all the questions. Parts of questions may be allotted different marks according to the time expected to complete the answer.



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