Abstract
Reviewing this book has been deeply traumatic. Revisiting the body of knowledge required for the UK MRCPsych examinations – from which I am not so distant – reminds me of the bizarre and obscure factoids which one must learn for the qualification. The knowledge base is similar to that of the FRANZCP exams, although both Colleges have moved away from multiple choice questions (MCQs) to extended matching items (EMIs). This appears a good move, as EMIs seem to draw upon better problem-solving strategies, and less ‘cryptic crossword’ analysis. They are certainly believed to discriminate better between candidates. Which begs the question, if the Royal College of Psychiatrists has determined that EMIs are better, why has it commissioned a book of MCQs in 2003?
McNamara has not been phazed by such odd demands. He has produced a stunning, substantial and infuriating work guaranteed to induce bruxism in all readers. I would avoid this book unless in the throes of examinations, or keen to terrify trainees in supervision. It is not that the questions are grossly abstruse nor that the knowledge is unnecessary. Rather, it is the perversity of the MCQ process that this book brings out. One can be wrong by a matter of percentages, failing to pick the double negative, or pedantic misreadings of a stem. It doesn't matter how smart you are or how contemporary your knowledge, MCQs will frequently trip you up. McNamara, keenly attuned to the sadistic possibilities in MCQs, has excelled in developing a glut of difficult questions.
This book is well constructed. Based around the Gaskell Press Seminars series, it covers most areas of psychiatry. It is quite contemporary and offers Internet links to the full text of a few superseded books. The weighting of specialties is appropriate for the MRCPsych Part II, but neglects parts of the curriculum, especially the social sciences and psychology. Many answers refer the reader to another book, rather than expounding on the basis of the answer. There are a small number of typos and factual errors, but not enough to warrant criticism. It may not reflect core curriculum in other exams, as it offers a particularly UK bias. However, exams in Australia are currently in a state of flux and I doubt that candidates can predict the standard of EMIs which will be offered.
There is little currently on the market offering EMIs. Websites offering psychiatry exam questions are limited. Candidates for exit level exams will require both a sophisticated knowledge base and a devious mentality to outwit wily examiners. Even if this book offers candidates a different format, and the core curriculum differs somewhat, it will still develop the competencies sought by the FRANZCP examination.
Some caveats are suggested. Try the MCQs late in study rather than early on, as it may be disheartening to commence by attempting this book. Remember that the book refers to the Gaskell series, most of which are excellent but some of which are not current. Nevertheless, in preparing for exams, this book seems to set a tough standard. It is challenging, comprehensive and appropriately difficult for trainees. I would buy it in preparation for exams. With trepidation.