PACES Clinical Reasoning Playbook | MRCP(UK) Stations 2 & 5

After failing PACES twice, I realised that knowing the medicine and being able to demonstrate clinical judgement in a consultation aren’t quite the same thing.

You can memorise dozens of differential diagnoses, but when a patient is sitting in front of you, what actually matters?

Take hypertension, for example. Before listing endocrine causes, are you looking for end-organ damage? Have you considered why this patient is hypertensive in the first place? What investigations would actually change your management? Or someone presenting with shoulder stiffness. It’s easy to think PMR, but have you asked the questions that would make you worry about GCA?

These are the kinds of things I started thinking about differently during my PACES preparation.

I’ve since put together a 123-page Clinical Reasoning Playbook focused on Stations 2 and 5. It contains clinical decision maps, short cases with worked explanations, and approaches to multisystem presentations.

It’s not intended to be another textbook or a replacement for the excellent revision resources already available. It’s more about developing a structured way to approach the patient and demonstrate your reasoning.