Preliminary Examination in Medicine

1. A candidate may be admitted to the Preliminary Examination in Medicine provided that his or her name is on the Register of Clinical Students and he or she has been admitted to the Degree of Bachelor of Arts with Honours or has obtained a degree of another university deemed adequate for the purpose by the Medical Sciences Board, and that he or she has satisfied such additional qualifications as the Medical Sciences Board may from time to time prescribe in its regulations.

2. Candidates for the Preliminary Examination in Medicine are required to pursue their studies during a period of: normally 30 weeks in Year 1; normally 39 weeks in Year 2; provided that the Medical Sciences Board shall have power to permit candidates to vary the dates of their studies so long as the overall programme requirement is met.

3. The examination shall be under the supervision of the Medical Sciences Board.

4. The examination shall comprise such subjects and papers as the Medical Sciences Board shall from time to time by regulation determine.

5. The Preliminary Examination in Medicine shall consist of two parts. Part I may be offered not earlier than three terms, and Part II not earlier than six terms, from the date of entry onto the Register of Clinical Students.

6. A core syllabus and an extension syllabus for each of Parts I and II will be published annually at the start of the Michaelmas Term prior to the examination by the Medical Sciences Board.

[For students starting before MT 2018: 7. The examiners may award a Distinction to candidates of special merit in either Part I or Part II of the examination, provided that all the subjects in that Part have been offered and passed at one examination.]

Part I

The examination will assess candidates’ core knowledge and understanding of core material, and clinical skills and critical-appraisal skills.

[For students starting before MT 2018: Candidates must pass all seven components listed below in order to pass the examination.]

[For students starting from MT 2018: Candidates must offer all seven components (eight assessment units) at one examination. ]

[For students starting before MT 2018: Candidates who fail any component(s) of the examination at the first attempt need re-sit only the component(s) that they have failed, provided that all components are passed within a single academic year; except that, where a candidate has been granted leave by the Board to sit a component or components for a third time (under the provisions of the General Regulations for Part I of the Preliminary Examination in Medicine), the Board may also, at its discretion, waive the requirement for the candidate to pass all components within a single academic year.]

[For students starting from MT 2018: The outcomes of Part I of the Examination are as follows:

  • a)    A candidate who has satisfied the Examiners in all seven components will be deemed to have passed Part I of the Examination.

  • b)    A candidate who has failed one or more components will be permitted one further attempt at the components they have failed, within one year of the initial failure.]

The examination will be set at the end of the extended Trinity Term and at the end of the Long Vacation.

Examiners may award Distinctions for outstanding performance in Papers 3, 4 and 5, together with the Submitted Essay and Behavioural Sciences element of the Longitudinal Case Study, by candidates sitting the examination for the first time.

Candidates may be required, at the discretion of the examiners, to undergo an oral examination which may include a further clinical examination.

No candidate may [For students starting before MT 2018: enter for the examination ][For students starting from MT 2018: offer any asessment unit ]on more than two occasions, save in exceptional circumstances[For students starting before MT 2018: at the discretion of the Medical Sciences Board following application from the candidate’s society.][For students starting from MT 2018: . A further exceptional opportunity to offer any assessment unit shall require application to and approval on behalf of the Education Committee of the University.]

  • 1. Core Material

    Candidates will be required to demonstrate their knowledge and understanding of the principles of basic medical science as defined in the core syllabus for Part I. Two papers will be set.

    Paper 1[For students starting from MT 2018: A] (one hour) will be a computer-based assessment consisting of multiple-choice questions.

    Paper[For students starting before MT 2018: 2 ][For students starting from MT 2018: 1B ](two hours) will be in the format of problem-based questions.

    Each question will be marked pass or fail, and a cumulative pass/fail mark will be given for a candidate's overall performance in the two papers.[For students starting before MT 2018: The marks from these papers will not contribute to the award of a Distinction.]

  • 2. Paper [For students starting before MT 2018: 3:][For students starting from MT 2018: 2:] Ethics (one hour)

    Candidates will be required to write one essay in response to a choice of question topics.

  • 3. Paper [For students starting before MT 2018: 4:][For students starting from MT 2018: 3:] Systems of the Body (one and a half hours)

    Candidates will be required to write one essay from a choice of questions, which will relate to extension topics notified to candidates at the start of the academic year.

    [For students starting before MT 2018: Candidates will be given credit for demonstrating their breadth of reading beyond the core syllabus, for their ability to synthesise evidence from different sources and produce a coherent argument, and for discussion of experimental evidence from primary literature.]

    During the examination, candidates will have access to such databases of medical literature as may be prescribed from time to time by the Medical Sciences Board and notified to candidates at the beginning of the academic year.

  • 4. Paper [For students starting before MT 2018: 5:][For students starting from MT 2018: 4:] Critical Appraisal (two hours)

    This paper will assess candidates’ ability to critically appraise primary research material.

    [For students starting before MT 2018: The primary research paper, or extracts from a number of papers, may report laboratory-based or clinical research. The literature will contain experimental, public health or clinical data for interpretation but may also include descriptions of experimental methods.

    Candidates may be required to offer criticism of the experimental method, or of the interpretation of the results, or to draw their own inferences from the published data.

    Candidates must attempt all questions.]

  • 5. Clinical Skills

    Candidates will be required to demonstrate, in a practical examination, their ability to take a clinical history and to perform a clinical examination of the systems of the body specified in the core curriculum and, to apply such practical skills as may be defined in the core syllabus published by the Medical Sciences Board.

    The examination will include an assessment of candidates' communication skills with patients, orally and/or in writing, and of their professional behaviour.

  • 6. Submitted Essay: Systems of the Body

    • (i) Form and subject of the essay

      Candidates will be required to submit an essay on a topic approved by the examiners. The submitted essay shall be of not more than 3,000 words, excluding any tables, figures, diagrams or references. It must be in a format prescribed by the Graduate-entry Education Committee and published in the[For students starting before MT 2018: Notes of Guidance for the Preliminary Examination in Medicine.][For students starting from MT 2018: course handbook.]

      A list of suggested essay titles, and the topics to which they relate, approved by the Chair of Examiners in consultation with the module organisers, shall be published no later than the end of Week 5 of the Michaelmas Term in the academic year of the examination. Candidates may also propose their own titles. The essay may relate to any of the topics set out in the[For students starting before MT 2018: Notes of Guidance for the Preliminary Examination in Medicine][For students starting from MT 2018: course handbook ]except that candidates may not submit an essay that closely relates to work that they have previously submitted for any university examination.

      A candidate wishing to offer an essay with a title not on the approved list must apply for approval of their proposed title by no later than the end of Week 0 of Hilary Term in the academic year of the examination. Application shall be made via the course administrator[For students starting before MT 2018: in the Medical School Office] and shall include the proposed title, a brief outline of the subject matter, and the topic or topics to which it relates. Decision on the application shall be made by the Chair of Examiners in consultation with the module organisers and shall be communicated to the candidate as soon as possible and in any case not later than Week 2 of Hilary Term in the academic year of the examination.

    • (ii) Registration

      No later than the end of Week 0 of Hilary Term in the academic year of the examination, every candidate must register the title of their essay via the [For students starting before MT 2018: Course Administrator in the Medical School Office.] [For students starting from MT 2018: course administrator.]

    • (iii) Authorship

      The essay must be the candidate’s own work. Candidates’ tutors, or their deputies nominated to act as advisors, may discuss with candidates the proposed field of study, the sources available, and the method of treatment, but on no account may they read or comment on any written draft. Every candidate shall [For students starting before MT 2017: sign] [For students starting from MT 2017: submit] a certificate to the effect that this rule has been observed and that the essay is their own work. The certificate[For students starting before MT 2017: , sealed in a separate envelope,] should be [For students starting before MT 2017: addressed to the Chair of Examiners for the Preliminary Examination in Medicine Part I and ]submitted alongside the essay.

    • (iv) Submission

      The essay [For students starting before MT 2017: (two paper copies and an electronic copy)] must be submitted [For students starting from MT 2017: via WebLearn (according to the instructions set out in the notification to candidates from the Chair of Examiners) ] [For students starting before MT 2017: to the Chair of Examiners for the Preliminary Examination in Medicine Part I, c/o the Examination Schools, High Street, Oxford, ]not later than noon on the [For students starting before MT 2018: Tuesday][For students starting from MT 2018: Friday] of Week 0 of Trinity Term.

  • 7. Longitudinal Case Study combined with Behavioural Sciences Commentary

    Candidates will be required to complete a Longitudinal Case Study during their clinical course, details of which will be published each year in the clinical course handbook. This coursework must be submitted to the candidate’s GP Tutor by the first Friday following the end of week 9 of Hilary Term.

    The clinical course organiser will then forward each case study to the Chair of Examiners by the end of Week 0 of Trinity Term, together with a certificate, signed by the relevant clinical supervisor, of satisfactory performance by the candidate in the Longitudinal Case Study.

    Candidates will separately submit an essay covering an aspect of Behavioural Sciences, which will relate to the longitudinal case study. This essay will contribute to the award of a Distinction.

    • (i) Form and subject of the essay

      Candidates will be required to submit a Behavioural Sciences commentary, relating to the patient described in the Longitudinal Case Study, in the form of an essay of not more than 3,000 words, excluding any tables, figures, diagrams or references. It must be in a format prescribed by the Graduate-entry Education Committee and published in the [For students starting before MT 2018: Notes of Guidance for the Preliminary Examination in Medicine.][For students starting from MT 2018: course handbook.]

      The essay must refer to aspects of Behavioural Sciences from a list published at the beginning of the academic year by the Graduate-entry Education Committee and included in the [For students starting before MT 2018: Notes of Guidance for the Preliminary Examination in Medicine .] [For students starting from MT 2018: course handbook. ]The number of such topics to be covered in the essay will be determined from time to time by the Graduate-entry Education Committee and will be published with the list and included in the [For students starting before MT 2018: Notes of Guidance.] [For students starting from MT 2018: course handbook].

    • (ii) Authorship

      The essay must be the candidate’s own work. Candidates’ tutors, or their deputies nominated to act as advisors, may discuss with candidates the proposed field of study as it relates to the patient, the sources available, and the method of treatment, but on no account may they read or comment on any written draft. Every candidate shall [For students starting before MT 2017: sign] [For students starting from MT 2017: submit] a certificate to the effect that this rule has been observed and that the essay is their own work[For students starting before MT 2017: ; and the candidate’s tutor or advisor shall countersign the certificate confirming that, to the best of their knowledge and belief, this is so]. The certificate[For students starting before MT 2017: , sealed in a separate envelope,] should be [For students starting before MT 2017: addressed to the Chair of Examiners for the Preliminary Examination in Medicine Part I and ]submitted alongside the essay.

    • (iii) Submission

      The essay[For students starting before MT 2017: (two paper copies and an electronic copy)] must be submitted [For students starting before MT 2017: to the Chair of Examiners for the Preliminary Examination in Medicine Part I, c/o the Examination Schools, High Street, Oxford, ] [For students starting from MT 2017: via Weblearn (according to the instructions set out in the notification to candidates from the Chair of Examiners) ]not later than noon on the [For students starting before MT 2018: Tuesday] [For students starting from MT 2018: Friday] of Week 0 of Trinity Term.

Part II

[For students starting from MT 2017: No candidate shall be allowed to enter for Part II of the Preliminary Examination in Medicine without first having passed all the assessment units of Part I, save in exceptional circumstances. This shall require application to and approval on behalf of the Educational Policy and Standards Committee of the Medical Sciences Board.]

The examination will consist of seven components. Candidates must [For students starting before MT 2017: pass all seven components listed below in order to pass the][For students starting from MT 2017: offer all seven assessment units at one] examination.

[For students starting from MT 2017: The outcomes of Part II of the Examination are as follows:

  • a) A candidate who has satisfied the Examiners in all seven components will be deemed to have passed Part II of the Examination.

  • b) A candidate who has failed one or more components will be permitted one further attempt at the components they have failed, within one year of the initial failure. ]

[For students starting before MT 2017: Candidates who fail any component(s) of the examination at the first attempt need re-sit only the component(s) that they have failed, provided that all components are passed within a single academic year; except that, where a candidate has been granted leave by the Board to sit a component or components for a third time (under the provisions of the General Regulations for Part II of the Preliminary Examination in Medicine), the Board may also, at its discretion, waive the requirement for the candidate to pass all components within a single academic year.]

The examination will be set towards the end of Trinity Term and at a time to be specified by the examiners during the Long Vacation.

Examiners may award Distinctions for outstanding performance in Papers 2 and 3, and the two extended essays, by candidates sitting the examination for the first time.

Candidates may be required, at the discretion of the examiners, to undergo an oral examination which may include a further clinical examination.

No candidate may enter for the examination on more than two occasions, save in exceptional circumstances[For students starting before MT 2017:  at the discretion of the Medical Sciences Board following application from the candidate’s society.][For students starting from MT 2017: .  A further exceptional opportunity to offer any assessment unit shall require application to and approval on behalf of the Educational Policy and Standards Committee of the Medical Sciences Board.]

  • 1. Paper 1: Medicine (two hours)

    This paper will test core knowledge and understanding through problem-based questions. [For students starting before MT 2017: This material may include basic and applied science, differential diagnosis of common diseases and simple first-line clinical investigations.]

    The paper will be marked pass/fail only. [For students starting before MT 2017: The marks from this paper will not contribute to the overall mark in the examination, nor to the award of a Distinction.]

  • 2. Paper 2: Clinical Science (two hours)

    This paper will relate to extension topics notified to candidates at the start of the academic year and will require candidates to answer two questions.

    [For students starting before MT 2017: Candidates will be given credit for demonstrating their breadth of reading beyond the core syllabus, for their ability to synthesise evidence from different sources and produce a coherent argument, and for discussion of primary literature.]

  • 3. Paper 3: Data Interpretation[For students starting before MT 2017: (two hours)] [For students starting from MT 2017: (two and a half hours)

    ]This paper will assess candidates’ ability to critically appraise primary research material.

    [For students starting before MT 2017: The primary research paper, or papers (normally not more than two), will report clinical research. The literature will contain experimental, epidemiological, or clinical data for interpretation, including public health data.

    Candidates may be required to offer criticism of the experimental method, or of the interpretation of the published data (including epidemiological data), or to draw their own inferences from the published data.

    Candidates must attempt all questions.]

  • 4. Extended Essay on a Public Health topic

    • (i) Form and subject of the essay

      Candidates will be required to submit an essay on a topic related to Public Health aspects of the diagnosis or management of a clinical case they have seen during their clinical attachments in the second year of the course. The submitted essay shall be of not more than 3,000 words, excluding any tables, figures, diagrams or references. It must be in a format prescribed by the Graduate-entry Education Committee and published in the [For students starting before MT 2017: Notes of Guidance for the Preliminary Examination in Medicine.] [For students starting from MT 2017: course handbook.]

      The essay must refer to aspects of Public Health from a list published at the beginning of the academic year by the Graduate-entry Education Committee and included in the [For students starting before MT 2017: Notes of Guidance for the Preliminary Examination in Medicine.] [For students starting from MT 2017: course handbook.] The number of such topics to be covered in the essay will be determined from time to time by the Graduate-entry Education Committee and will be published with the list and included in the [For students starting before MT 2017: Notes of Guidance.] [For students starting from MT 2017: course handbook.]

    • (ii) Validity

      Candidates must submit with their essay a certificate from the Clinical Tutor in Medicine or in Surgery, or from a consultant in charge of the patient, confirming that the student has seen the patient described in the essay.

      As a prologue to the essay, candidates should include a summary of the clinical case to which the essay refers. The summary should not usually exceed 250 words, but will not be included in the overall word count for the essay.

    • (iii) Authorship

      The essay must be the candidate’s own work. Candidates’ tutors, or their deputies nominated to act as advisors, may discuss with candidates the proposed field of study, the sources available, and the method of treatment, but on no account may they read or comment on any written draft. Every candidate shall submit a certificate to the effect that this rule has been observed and that the essay is their own work. The certificate should be submitted alongside the essay.

    • (iv) Submission

      The essay must be submitted via WebLearn (according to the instructions set out in the notification to candidates from the Chair of Examiners) not later than noon on the Tuesday of Week 1 of Trinity Term.

  • 5. Extended Synoptic Essay on a Science topic

    • (i) Form and subject of the essay

      Candidates will be required to submit an essay on a topic approved by the examiners, illustrating a technique or scientific application across several fields of clinical or basic science. The submitted essay shall be of not more than 3,000 words, excluding any tables, figures, diagrams or references. It must be in a format prescribed by the Graduate-entry Education Committee and published in the [For students starting before MT 2017: Notes of Guidance for the Preliminary Examination in Medicine.] [For students starting from MT 2017: course handbook.]

      A list of suggested essay titles, and the topics to which they relate, approved by the Chair of Examiners in consultation with the Chair of the Graduate-entry Education Committee, shall be published no later than the end of Week 5 of the Michaelmas Term in the academic year of the examination. Candidates may also propose their own titles. Candidates may not submit an essay that closely relates to work that they have previously submitted for any university examination.

      A candidate wishing to offer an essay with a title not on the approved list must apply for approval of their proposed title by no later than the end of Week 0 of Hilary Term in the academic year of the examination. Application shall be made via the [For students starting before MT 2017: Course Administrator in the Medical School Office ][For students starting from MT 2017: course administrator ]and shall include the proposed title, a brief outline of the subject matter, and the topic or topics to which it relates. Decision on the application shall be made by the Chair of Examiners in consultation with the Chair of the Graduate-entry Education Committee and shall be communicated to the candidate as soon as possible and in any case not later than Week 2 of Hilary Term in the academic year of the examination.

    • (ii) Registration

      No later than the end of Week 0 of Hilary Term in the academic year of the examination, every candidate must register the title of their essay via the[For students starting before MT 2017: Course Administrator in the Medical School Office.][For students starting from MT 2017: course administrator.]

    • (iii) Authorship

      The essay must be the candidate’s own work. Candidates’ tutors, or their deputies nominated to act as advisors, may discuss with candidates the proposed field of study, the sources available, and the method of treatment, but on no account may they read or comment on any written draft. Every candidate shall submit a certificate to the effect that this rule has been observed and that the essay is their own work. The certificate should be submitted alongside the essay.

    • (iv) Submission

      The essay must be submitted via WebLearn (according to the instructions set out in the notification to candidates from the Chair of Examiners) not later than noon on the Tuesday of Week 1 of Trinity Term.

  • 6. A clinical long case, followed by a viva

    Candidates will be assessed on their clinical history and examination skills, including their communication skills and professional behaviour, and knowledge of differential diagnosis and first-line investigations.

  • 7. An Objective Structured Clinical Examination or similar problem-based clinical assessment

    Candidates will be assessed on their ability to perform a clinical examination of the systems of the body specified in the core curriculum, and on their practical skills, and on their ability to interpret and use clinical data.

  • 8. In addition to the above examination, candidates will be required to have satisfactorily completed the following courses of instruction [For students starting from MT 2017: and associated assessments ]during [For students starting before MT 2017: Year 2:] [For students starting from MT 2017: Year 2 in order to proceed to Year 3 of the course:]

    • (a) practical skills and procedures (defined in the core curriculum) to be assessed in course. A completed checklist of these skills and procedures, signed by the appropriate Clinical Tutor or other representative nominated by the Course Director, is required as a qualification for entry to the examination. These skills may be re-sampled during the [For students starting before MT 2017: end-of-year clinical assessment.] [For students starting from MT 2017: Objective Structured Clinical Examination.]

    • (b) [For students starting before MT 2017: the Laboratory Medicine course ][For students starting from MT 2017: Laboratory Medicine ](as prescribed for the Second Examination for the Degree of BM, Year [For students starting before MT 2017: 1][For students starting from MT 2017: 4]).

    • (c) Medicine (as prescribed for the Second Examination for the Degree of BM, Year [For students starting before MT 2017: 1][For students starting from MT 2017: 4]).

    • (d) Surgery (as prescribed for the Second Examination for the Degree of BM, Year [For students starting before MT 2017: 1][For students starting from MT 2017: 4]).