The birth of an impactful PACES tutorials for international medical graduates after '39 pregnant weeks' of virtual PACES sessions

‘There is a loftier ambition than to stand tall in the world. It is to stoop down and raise mankind higher’. Henry Van Dyke. In the Paces Spring Performance Report 2023, the failure rate of International Medical Graduates (IMG) in Paces was alarming compared with British Medical Graduates; Around 60% of IMGs failed the exam- around 700 IMGs in comparison to approximately 30%- approximately 200 UK graduates.1 IMGs are an indispensable component of the UK medical Workforce. Of the new doctors who joined the workforce in 2021, 50% were IMGs. 2,3 Most of these doctors will be at the stage of moving to a higher specialty and success in PACES exams is key. These disparities inspired five IMG registrars to bridge this gap through the free weekly Virtual PACES exam for 39 weeks. 5 IMG registrars- ST4 to ST5, trainees of HEE in Acute Medicine, Neurology, Cardiology, and Stroke Medicine across diverse regions in England facilitated weekly tutorials up to three times weekly since June 2023 through the Zoom Platform. Information regarding the weekly tutorials was disseminated through a WhatsApp platform which has over 300 doctors mainly IMGs. Timetables were created to cover all the components of the PACES exam- Communication, Consultation, Neurology, Cardiology, Abdomen and Respiratory exam. Two registrars were designated to facilitate a 90-min session weekly with two PACES stations discussed. The registrars mostly served as simulators, timekeepers, examiners, and facilitators at each session which has an average range of about 60 attendees. Volunteer candidates were rotated at each session. Constructive feedback was given by the attendees and facilitators for the volunteer candidates using the Sandwich approach. Following this, we then sent a Google survey to candidates to express how impactful these sessions. 53 people responded. More than 96% of the respondents were IMGs. A third of the respondents were Internal Medicine Trainees (IMTs) in the UK. About a third were trainee registrars and a third were in a non-training role. A third of our respondents have attempted paces before. More than about half of the respondents had attended more than five weekly sessions. When asked to ‘rate their strength in the paces content before attending Free PACES teaching’; more than half of respondents rated themselves as either poor or fair across all pace components, especially in Neurology, Communication, and Consultation.4 When asked to rate their improvement in the PACES cont