How to Pass the Critical Appraisal Exam – MRCPsych and RANZCP
Time to read: 4 minutes
Without numerical fluency, in the part of life, most of us inhabit, you are like a one-legged man in an ass-kicking contest. (Charlie Munger)
The word Critical Appraisal /Analysis instils a sense of dread in most psychiatric trainees. It is a crucial component of the MRCPsych and RANZCP exams.
In my opinion, candidates fear critical appraisal because they are not always taught in the right way. When I first started training, I was anxious about critical appraisal; my first critical appraisal presentation was a disaster.
Being a semi-perfectionist and harrowed by this experience, I decided to better myself and read about critical appraisal in more detail.
The approach enabled me to not only pass the MRCPsych Critical appraisal and RANZCP Exams on the first go; it has also enabled me to teach Critical Appraisal in a structured and understandable way.
I thus developed the Psychevidence Critical Appraisal Online Course, which is now the leading psychiatry focused critical appraisal course with users all around the world. For RANZCP Exam trainees – The Psych Scene Online CAP course is an effective and comprehensive course with video lectures, quizzes, reading material and previous exam questions.
IS CRITICAL APPRAISAL DREADFUL?
As many of you have experienced, at the start, I found critical appraisal very dull and dry. By pure chance, I attended lectures by Dr James Warner as part of the London Charing Cross Psychiatric Training scheme, who truly transformed the way I thought about critical appraisal. He connected critical appraisal to the real world. What I realised is that one has to start from the bigger picture. The skills to critically analyse data is a fundamental skill necessary in all aspects of life.
Clinical practice, business, analysing staff performance, patient satisfaction, even buying your first home requires you to evaluate data. Most people have no or little interest in learning how to analyse the data presented to them.
I know I have digressed a bit, but I want to point out that learning concepts of critical appraisal will serve you for life, not just for the exam. I hope that this incentive piques your curiosity the next time you hear the word critical appraisal.
Coming back to the exam, there are 3 main things that you need to do to easily pass the exam:
1. START WITH RESEARCH PAPERS
Most candidates start with a textbook, and while that is fine, most of what you learn can evaporate within a week, if not earlier.
That happens because critical appraisal is like learning a new language; the words you learn need anchors and associations with real-life experiences.
Start with research papers, then go and read the concepts. This way, you have an anchor, and the concepts will start making much more sense.
2. EXPLAIN THE CONCEPTS TO YOUR GRANDMUM or GRANDDAD (NOT IF HE/SHE TEACHES STATISTICS)
(P.S. Apologies for the ageist paragraph title at this point! No offence intended)
My accountancy professor at Melbourne Business School asked us to do this when learning concepts in accountancy. While my grandparents weren’t available, I tried this with my colleagues and friends. This quote sums up the key principle from Einstein.
If you can’t explain it simply, you haven’t understood it well enough.
For me, the only reason I can now teach critical appraisal concepts is that I have done this year on year for the last ten years for over 3500 candidates besides going through the critical appraisal components of the MRCPsych and FRANZCP exam myself.
I continually refine and think of simple ways of explaining concepts while teaching.
As a tip, I would highly recommend presenting at journal clubs. Don’t hesitate; many other people in the room know little about critical appraisal but are too embarrassed to ask, so encourage discussion.
It’s one of those fields where you may be presenting to a whole room thinking that everyone else but you know the concepts, but the reality is anything but that.
3. THINK REAL LIFE
Once the concepts start to sink in, think about how the concepts apply to real life. For example, one can apply the concepts of Absolute and Relative risks to finance and medicine.
I wrote a little piece on pharmaceutical company marketing to show you how the game of numbers can influence minds. In finance, absolute and relative percentages can similarly be used differently when marketing financial products.
Your real estate agent might talk about the median price for property in your area; how does that differ from the average?
Can you predict what happens to property prices when input variables such as area, number of bedrooms, car parks etc., change? In this video, I show how regression analysis can be used in prediction.
There is a whole world of data analytics or big data waiting to explode, and understanding statistics plays a crucial part in it. For example, speech analysis can be used as an objective marker in psychiatry. Digital techniques may be the future of suicide prevention.
Medicine is not immune, and data analytics will feature heavily in performance measurement and may even replace some aspects of clinical diagnosis someday.
In this video, you can see how data analytics conceptualises depression differently.
WHAT DO I DO NOW?
For practice papers go to the British Journal of Psychiatry website and search for words such as case-control studies/ RCT’s; find the papers and get started.
For journal clubs, download the critical-appraisal-worksheets from the Hub to enhance discussion at journal clubs. Use these sheets to dissect various types of research papers.
I wish you luck on your journey in learning this fascinating and life-changing subject. It takes a little bit of effort, and the way you look at the world will be transformed forever.
Learn More:
Psych Scene CAP Online Course for RANZCP Written Exam (MCQ Exam)
Psychevidence course for research and statistics – MRCPsych CAP