HOW TO SOLVE QUESTIONS IN THE EXAM

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How to Solve Questions in the MRCPCH Exam

A practical guide to BO5 SBA exam technique, safe thinking, time management and how to avoid common mistakes.

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Understand BO5 SBA Questions

BO5 means Best of Five. You are given five options and you must choose the single best answer.

MRCPCH examination papers are designed in such a way that very little time is left at the end to review all the questions. Many candidates fail not because they lack knowledge, but because they do not complete the paper on time.

My first and most important goal in any examination is to reach the final question. Many times, I found easier questions towards the end of the paper.

Practise as many questions as possible from websites and question banks within a strict time limit and in the manner described below.

Read the question carefully and do not miss key words. Think of the answer first before looking at the options. If you are reasonably confident, mark the answer and move on.

If you are unsure, mark the question and continue to the next one. Once you complete all the questions, return to the marked questions. This time, attempt every remaining question because there is no negative marking.

Important strategy:

Your first aim is to reach the final question before time runs out.

There are some general rules for solving questions:

• a) Read the question carefully. Do not miss important keywords. Look for age, duration, severity, red flags, clinical signs and what the question is actually asking.
  If you misunderstand the question or miss a keyword, your entire reasoning may become incorrect.
• b) Trust your instinct. Your initial answer is often correct, especially if you have prepared well. Avoid changing answers repeatedly without a strong reason.
• c) Be cautious with words such as “always” and “never”. In many medical questions, statements containing absolute terms are often incorrect.
• d) Beware of double negatives. Words such as “not uncommon” or “not infrequently” actually mean “common” or “frequent”.
• e) Pay attention to terms such as “least common” and “most common”. These words completely change the meaning of the question.
• f) Differentiate between “initial management” and “definitive management”. The exam frequently tests whether you understand the safest immediate next step rather than the final long-term treatment.
• g) Questions containing “all of the above”. In older-style questions, if you are confident that at least two of the options are correct, then “all of the above” may also be correct.
• h)Correct vs Best. More than one option may be partly correct, but only one is the best answer in the given clinical situation.
• i)Think Safely. If the child is unstable, the safest answer often involves urgent assessment, treatment or escalation.
• j) Avoid Thinking. Do not invent extra information. Answer based only on the information given in the question.

  
  

The examination is not only a test of knowledge. It is also a test of time management, concentration, and exam technique. Sometimes two answers may look possible. Your job is not to find the correct answer. Your job is to find the best answer for that exact question.

My Step-by-Step Method

Step 1: Read the Last Line First

Check what the question is asking: diagnosis, investigation, treatment, next step, complication or mechanism.

Step 2: Read the Whole Stem

Do not miss key details such as age, fever, duration, vital signs, rash, growth, development or safeguarding clues.

Step 3: Identify the Key Clue

Most questions contain one or two important clues that point towards the answer.

Step 4: Eliminate Clearly Wrong Options

Remove answers that are unsafe, irrelevant, too invasive, too delayed, or not appropriate for the age.

Step 5: Compare the Remaining Two

If two options look possible, ask: which is safest, most appropriate, and most directly answers the question?

Step 6: Choose and Move On

Do not spend too long on one question. Mark it if unsure and return later if time allows.

Simple method: Last line → full stem → key clue → eliminate → compare → choose.

How to Identify the Key Clue

The key clue is the information that changes the answer.

Age

A 2-week-old baby and a 10-year-old child with the same symptom may need different answers.

Severity

Look for shock, respiratory distress, altered consciousness, dehydration, sepsis or seizures.

Timing

Acute, chronic, recurrent and progressive symptoms often lead to different diagnoses.

Red Flags

Safeguarding concerns, non-blanching rash, bilious vomiting, hypoglycaemia and poor perfusion are important.

Safe Thinking in MRCPCH Questions

Many MRCPCH questions test whether you can think safely.

• If the child is unstable, do not choose a delayed outpatient option.
• If there are safeguarding concerns, do not ignore them.
• If there is possible sepsis, think urgent assessment and treatment.
• If there is respiratory distress, think ABCDE and escalation.
• If the answer risks missing a serious diagnosis, be careful.

Time Management

Time management is very important. Do not allow one difficult question to damage the rest of the paper.

First Pass

Answer questions you know confidently. Do not spend too long on difficult questions.

Mark and Move

If unsure, make your best choice, mark the question and move on.

Second Pass

Return to marked questions after completing easier ones.

Final Check

Check unanswered questions. Never leave a question blank.

Practical rule: If you are stuck, eliminate wrong answers, choose the best remaining option and move on.

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Final Message

In MRCPCH exam, exam technique can make a big difference. Knowledge is important, but safe thinking, careful reading, and good time management are equally important.

Remember: read carefully, think safely, choose the best answer, and move on with confidence.