Membership of the Royal College of Physicians (MRCP) is compulsory for Internal Medical Trainees (IMTs) moving into higher specialty training. The practical component of MRCP – the PACES (Practical Assessment of Clinical Examination Skills) exam – requires extensive preparation. No structured PACES teaching programme existed at St Helier Hospital, UK. In the authors’ experience, local PACES preparation courses are often organised by those who themselves sat the exam many years ago, whereas trainees with recent exam experience are in an excellent position when it comes to providing preparation support.

The authors, at the time all IMTs with recent PACES experience, designed and delivered a teaching programme over a three-month period. The course consisted of weekly bedside and simulated teaching sessions tailored to candidates’ specific needs, and a pan-London mock PACES exam to give candidates the opportunity to practise their skills in an environment closely resembling the real-life experience.

Direct feedback was obtained both pre and post course, and following each individual session. Questions focussed on such issues as ease of access to PACES teaching and perceived exam preparedness. Pre-course feedback indicated that 86% of candidates felt teaching was difficult to obtain, whereas post course 100% felt this was now easily available. Perceived preparedness across all stations increased from 2.3-3.9 on a 10-point scale pre-course, to 7.8-8.7/10 post-course.

The success of this project stressed the importance of realising that leadership is not so much a matter of seniority as it is of experience. Having only recently sat the exam themselves, the authors were in a unique position to identify the needs of PACES candidates and lead a successful preparation programme. Not only is this beneficial for exam candidates; it offers junior trainees the opportunity to develop and display leadership skills that will prove invaluable throughout the rest of their careers.