MBBS4 Tips & FAQ

Welcome to the FAQ page for MBBS4. For other years please look here.

Ask any questions below that you have on the exams! Also leave your tips on the year, for students to come and answer other people's questions.

A full list of useful textbooks used can be found at the bottom of this post. I recommend borrowing them over purchasing them. That said, I get money if you use purchase them through the Amazon links below (which helps fund the website/apps/books). Thanks guys! 

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Questions change year on year, however important topics stay the same. I will give the best advice I can having done the exams in 2015.

Most important to remember is that the number of weeks you spent on a specialty is equal to the number of questions on it. Thus, for example, learn 2-3x as much detail on Obs & Gynae as Orthopaedics! For most things, Oxford handbook of clinical specialties (a.k.a. salt & vinegar) will cover you but it isn't sufficient detail for a lot of the topics! Lectures are also helpful as they are the people making the questions and they also guide you as to which topics are most important.

Obs & Gynae: cannot stress enough how important it is to read the Green Top RCOG guidelines as questions will be based on these guidelines! Just read the bits in bold as questions could be as detailed as asking whether to try assisted delivery or C-section given a certain clinical issue with the baby. Impey offers great explanations but often the information is wrong as it doesn't contain the up to date guidelines.

Sexual health: questions can be difficult, but reading the BASHH guidelines will be lots of help! Know the indications and contraindications for contraception and the way different STIs present: which bacteria, the colour of the discharge and extra features such as foul fishy smell.

Breast: ABC of Breast is more than enough! Triple assessment and breast cancer should be known inside out. For other breast conditions, know how they present (age/history/signs & symptoms) and what to advise patients.

Orthopaedics and Rheumatology: Churchill book covers it in much more detail than you need to know! For orthopaedics, know the topics featured during the lectures very well. This means you should know hip fractures inside out! Also know how different fractures present and how they are managed: open reduction with internal fixation, splints or traction etc. There's a lot of overlap of orthopaedics with emergency medicine and anaesthetics, so expect orthopaedics to potentially feature in other sections. Rheumatology can be studied using the Oxford handbook of clinical specialties or this book and it is all about knowing how each condition presents and is managed. Antibodies should be studied.

Emergency Medicine: Read the Resus council website and the emergency section of Oxford Handbook of Clinical Medicine. Know the order (ABCDE), how to manage an issue at any stage and other common presentations in the Emergency Department such as overdoses.

Anaesthetics: The brief chapter in Oxford Handbook of Emergency Medicine (NOT Oxford Handbook of Anaesthetics, which is way too advanced!) is great. Borrow it though, not worth buying for one chapter! Knowing blocks is too much, but you should know the triad of anaesthesia, briefly about ASA grading, pain management and side effects/what to do in overdose, different anaesthetic agents (when they are used/side effects/contraindications), important parts of the pre-op assessment and finally a very brief amount on the types of induction.

Paediatrics: The Paediatric Society weekend course (and book) covers important things brilliantly e.g. common conditions in paediatrics, paediatric cardiology, paediatric dermatology.

Geriatrics: Lecture notes: Elderly Care Medicine (and Oxford Handbook of Clinical Medicine) covers everything, but you should focus your revision on common topics such as falls, stroke, parkinson's disease, dementia etc. For Child and Elderly Psychiatry Psychiatry PRN is brilliant.

Dermatology: Covered best by the Paediatrics book above but also the free resource from the British Dermatology society is very helpful and more than enough! Important topics are to identify conditions from pictures and manage them.


I recommend using my OSCE Android app which contains mark sheets for many MBBS4 stations (I'm obviously biased) as well as Masterpass for Specialties.

Explaining stations
  • Don't forget to ask a brief history to begin with
  • Ask them what they know already
  • Ask them every step of the way what they want to know and respond accordingly
  • Be reassuring and empathetic
  • Don't forget to explain things they have to know (safety netting)
  • Patient.info is a brilliant website

  • Moulage
    • Most importantly be safe and seek senior help early (however you should be able to ABCDE stabilise the patient first)
    • In the station you usually do have to give an oxygen mask, put on a saturation probe etc.
    • For the purposes of the OSCE, it might be easier to leave your stethoscope off your ears so you can hear what you're meant to be hearing
    • Do ask for Chest X ray/ABGs/ECGs - you may be given a chest x ray for example to interpret
    • Use the Resus website for guidelines
    • Advice for specific scenarios
      • Anaphylaxis - don't forget to take away the allergen
      • Asthma - remember a normal PCO2/decreasing respiratory rate may suggest that things are getting worse as the patient is tiring
      • COPD - if a patient is quite hypoxic start them on high flow oxygen and titrate it down. Hypoxia kills faster than carbon dioxide retention
      • Sepsis - know your sepsis 6 and do them!

  • Breaking bad news
    • Ask a brief history to begin with (ruling out emergencies e.g. shock)
    • If they're in pain, offer painkillers
      • "I'll ask a nurse to get some for you, may we continue whilst we wait?"
    • Try to get an idea of what the patient is expecting/hoping for
    • Break the news in one go in a succinct manner without jargon
    • Silence is unbelievably golden
    • Reassure the patient accordingly - we will be looking after you/giving you the best treatment
    • At the end offer a follow up appointment or the ability to speak to someone

  • Paediatric exams
    • Take your time to actually examine children getting familiar with the difficulties it can present

For information on each book, hover over the book and read my comments!

If you don't see a list of books above, you may need to disable your ad blocker.


12 March 2016 at 20:53 delete

in a ALS moulage station, at what point do you start commenting on looking for reversible causes of a cardiac arrest?

14 March 2016 at 14:35 delete

As soon as really! So this will depend on how many people you have, whether intravascular access has been gained, airways managed and shockable vs non-shockable rhythm. Best would be between rhythm checks.

For the OSCE, usually you're asked towards the end once you have demonstrated for at least one cycle the correct management of shockable or nonshockable rhythms. You may be asked to just talk through after demonstrating one cycle.

Remember the non-shockable e.g. PEA is more common in hospital therefore you will potentially have that.

28 March 2016 at 21:47 delete

for RSH, do we need to learn scores such as the BISHOPS score, CTG and AGPAR?

28 March 2016 at 22:18 delete

It didn't appear in either the OSCE or writtens despite many people fretting about being able to interpret CTGs and analysing scores. For the OSCEs, where you've asked this question, I think it is very excessive. Whereas the writtens, I'd suggest you're aware of it. However the green top guidelines should be what you consider as what you must know inside out. Hope that helps!

30 March 2016 at 19:02 delete

What things do you need to know for anaesthetics? And what is a good resource to use to learn it?

30 March 2016 at 19:07 delete

The exam is split such that you get a series of questions on each topic. Within anaesthetics, the questions were quite simple. Remember that theatre anaesthesia itself is proportionately perhaps 2 days of the entire rotation, which is reflected in the exam. Thus basic things on anaesthetics featured as well as questions on locomotion and emergency medicine.

I recommend using the Anaesthetics chapter in the Oxford handbook of emergency medicine. Don't use the rest of the book it's way too detailed - but I feel that chapter prepared me the best. It might feel like very little, but it was sufficient for me to do well in Anaesthetics.

22 April 2016 at 17:44 delete

what kind of things should we know for palliative care? can you remember what sort of questions came up in this area? thanks

24 April 2016 at 16:51 delete

It's predominantly tested in the OSCE where you have to take a palliative care history. Other than that, you should know symptomatic control. I don't think there really were many, if any at all, on palliative care but if you revise the material from the palliative care lectures and workshops that should be more than sufficient!

4 May 2016 at 21:33 delete

There are so many different ways to do ortho exams- every clinical session we've had on doing them the doctor has mentioned different special tests or techniques. Which source would you recommend that we follow?

4 May 2016 at 21:34 delete

I feel like there is a lot of potential content we could learn in paeds. Illustrated paeds is huge despite being the med student recommended book. Do you recommend we really go through all of it?

4 May 2016 at 21:41 delete

Almost all of my Paediatrics knowledge before the exam came from the Paed Society's crash course. The weekend course and book is brilliant for the exams. Apart from learning on the ward, I didn't use any other resources or books and and scored quite highly. Use it as a reference book through if there's a topic you don't understand. Honestly though, there were a few questions e.g. regarding paediatric cardiology that doesn't even feature in illustrated. Hope that helps!

4 May 2016 at 21:58 delete

There are some tests which you have to do either because it's likely from the rest of the examination that a special test will confirm your diagnosis or because it is such a common condition that you must test for it.

I recommend reading the MBBS5 Orthopaedics Refresher (under Campus Block 3) which has the best summary I think for what tests you should do, but I'll outline them below.

Knee: Anterior drawer (or lachman), effusion tests, posterior sag and drawer, medial/lateral collateral ligaments. NOT McMurray's although be prepared to explain how to do it.

Shoulder: All rotator cuff tests, ACJ. Hawkin's I would ask or do if you have time. Apprehension test definitely not.

Hand: Sensation/Motor for radial/ulnar and median, prayer and reverse prayer and mention tinel's and phalen's (or do if you think carpal tunnel is a possibility). Froment's only mention.

Back: modified schober's and sciatic test are a must. femoral stretch ask the examiner but usually no.

Hip: Thomas and Trendelenburg only.

If you feel I've missed any tests or need more detail please ask.

4 July 2016 at 17:32 delete

How useful would you say resources like PassMedicine are? Are the questions representative?

4 July 2016 at 18:43 delete

Just comparing to past papers, you can see that the questions on PassMedicine are way more difficult. Personally I didn't ever find doing questions useful as my way to study is to read and digest rather than to do questions. I feel the above resources were what led me personally to do really well at MBBS4. Feel free though to ask if you have any more questions =)