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Pres Handbook 2023

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34 views34 pages

Pres Handbook 2023

Uploaded by

Camila Ehonwa

We take content rights seriously. If you suspect this is your content, claim it here.

Available Formats

Download as PDF, TXT or read online on Scribd

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Medical Council

Upper Ground Floor and 5th Floor

Block 9 (Europa House)
Harcourt Centre
Harcourt Street
Dublin 2
D02 WR20

Phone 00353 1 4983100

Email [email protected]
Website www.medicalcouncil.ie

PRE-REGISTRATION EXAMINATION SYSTEM HANDBOOK

THE PURPOSE OF THIS DOCUMENT IS TO PROVIDE INFORMATION REGARDING

LEVEL 3
OF THE PRE-REGISTRATION EXAMINATION SYSTEM (PRES)

THIS DOCUMENT SHOULD BE READ IN CONJUNCTION WITH THE

MEDICAL COUNCIL REGISTRATION RULES 2011
AND
THE GUIDE TO THE APPLICATION PROCEDURE AND REGISTRATION RULES FOR REGISTRATION.

IMPORTANT:

• PLEASE READ CAREFULLY BEFORE SUBMITTING AN APPLICATION AND/OR TAKING AN EXAMINATION

EFFECTIVE: OCTOBER 2018

THIS HANDBOOK WAS LAST UPDATED IN JANUARY 2023

PLEASE ENSURE YOU READ THE MOST UP-TO-DATE INFORMATION REGARDING EXAMINATIONS
MEDICAL COUNCIL PRE-REGISTRATION EXAMINATION HANDBOOK
Contents

1. What is PRES and who can apply for it? ............................................................................................. 4

1.1. Introduction ........................................................................................................................................ 4
1.2. What is PRES? ................................................................................................................................... 4
1.3. What is the process for applying for Registration? ............................................................................ 4
2. How does one know if one is eligible to sit the PRES Examination? .................................................. 5
2.1. Applying for Registration .................................................................................................................. 5
2.2. Changes to the Pre-Registration Examination System ...................................................................... 5
3. Eight Domains of Good Professional Practice ..................................................................................... 6
4. Level 3 .................................................................................................................................................. 7
4.1. General Information ........................................................................................................................... 7
4.1.a. What is Level 3? ......................................................................................................................... 7
4.1.b. Where can Level 3 be taken? ..................................................................................................... 7
4.1.c. How does one apply for and find out about Level 3 dates? ....................................................... 7
4.1.d. Level 3 Validity .......................................................................................................................... 7
4.2. Before the Level 3 ............................................................................................................................. 8
4.2.a. How does one book a place in the Level 3? ............................................................................... 8
4.2.b. What happens if there are no available places to sit the exam that I want? ............................... 9
4.2.c. Examination cancellation ......................................................................................................... 10
4.2.d. Fees for the PRES Level 3 ....................................................................................................... 10
4.2.e. How does one withdraw/cancel their place? ............................................................................ 10
4.2.f. Late withdrawal or absence on the day of a Level 3 ................................................................. 11
4.3. The Level 3 ...................................................................................................................................... 12
4.3.a. What is the format of the Level 3? ........................................................................................... 12
4.3.b. Pass Mark ................................................................................................................................. 14
4.3.c. Time .......................................................................................................................................... 15
4.3.d. Common mistakes that candidates for Level 3 make ............................................................... 16
4.4. On the Day of the Level 3 ................................................................................................................ 18
4.4.a. What time should one arrive at the Examination Venue? ........................................................ 18
4.4.b. What should one bring to the Examination Centre? ................................................................ 18
4.4.c. What happens at Examination Registration? ............................................................................ 19
4.4.d. What should one wear to the Level 3? ..................................................................................... 20
4.4.e. The holding of candidates before/after their Level 3 ............................................................... 20
4.4.f. Information about the examination centre ................................................................................ 21
4.4.g. Complaints ............................................................................................................................... 22
4.4.h. Adverse Circumstances which affect the Conduct of the Examination ................................... 23

PLEASE NOTE: This information may be subject to amendment/changes in whole or in part at any time at the discretion of the
Medical Council. You should ensure that you read the most up-to-date information regarding examinations in this Handbook.
Page 2 of 34
MEDICAL COUNCIL PRE-REGISTRATION EXAMINATION HANDBOOK
4.4.i. Cheating and misconduct .......................................................................................................... 23
4.4.j. Sanctions/enforcements............................................................................................................. 24
4.5. After the Level 3 .............................................................................................................................. 25
4.5.a. Results ...................................................................................................................................... 25
4.5.b. Breakdown of Results .............................................................................................................. 25
4.5.c. Appeals ..................................................................................................................................... 26
4.5.d. How many times can one attempt Level 3? ............................................................................. 27
4.5.e. Re-apply for eligibility having not passed Level 3 within time allowed ................................. 27
4.5.f. Re-apply for eligibility having failed Level 3 three times ........................................................ 27
4.5.g. Reference Number and Change of Address ............................................................................. 27
5. Is there exemption from the PRES? ................................................................................................... 28
5.1. Details of Exemption from the PRES .............................................................................................. 28
5.2. Changes to the PRES ....................................................................................................................... 28
6. English Language Requirements and Exemptions ............................................................................. 29
7. Frequently Asked Questions (FAQs) ................................................................................................. 30
7.1. Reference Number ........................................................................................................................... 30
7.2. Change of Address ........................................................................................................................... 30
7.3 Changes to Passport .......................................................................................................................... 30
7.4. Can the Medical Council help with Visa Applications? .................................................................. 30
7.5. Can the Medical Council recommend a hotel? ................................................................................ 30
7.6. Where can one obtain information about living and working in Ireland? ....................................... 31
7.7. Where can one obtain information about transportation in Ireland? ............................................... 31
7.8. Does the Medical Council provide any Past Papers? ....................................................................... 31
7.9. Does the Medical Council recommend any preparation courses? ................................................... 31
7.10. Does the Medical Council recommend any Textbooks? ............................................................... 31
7.11. What is the syllabus for the PRES? ............................................................................................... 32
7.11.a. Medicine ................................................................................................................................. 32
7.11.b. Surgery ................................................................................................................................... 32
7.11.c. Obstetrics & Gynaecology ..................................................................................................... 32
7.11.d. Paediatrics .............................................................................................................................. 32
7.11.e. General Practice...................................................................................................................... 32
7.11.f. Psychiatry ................................................................................................................................ 33
8. Contacting the Medical Council about the PRES Examination ......................................................... 34

1.1. Introduction

The Medical Practitioners Act 2007 and the Health (Miscellaneous Provisions) Act 2007 replace the Medical
Practitioners Acts 1978-2002; Part 6 of the Medical Practitioners Act 2007 deals with registration matters. The
Medical Council has made Registration Rules under Section 11 of the Act, and the Register of Medical
Practitioners is established under section 43 of the Act.

The Registration application process comprises of FOUR Levels.

LEVEL 1 Document Examination For all applicants

LEVEL 2 Clinical Examination Where applicable
LEVEL 3 Evaluation of internship Where applicable
LEVEL 4 An assessment of the applicant’s postgraduate education, training, Applicants for specialist
qualifications and experience to establish the applicant’s eligibility for registration only
specialist registration.

The Register of Medical Practitioners comprises four Divisions. General Registration is the only form of registration
available for medical practitioners who do not practise in individually numbered, identifiable training posts, who
have not been proposed for a post in the Supervised Division, and who have not completed recognised specialist
medical training. As part of the Trainee Specialist Division, Trainee Specialist Registration is specifically for medical
practitioners who practise in individually numbered, identifiable postgraduate training posts which are recognised
by the Medical Council for training, while they are completing all or part of their medical specialist training in Ireland.

1.2. What is PRES?

All applicants for Registration will be required to undergo a Level 1 assessment and verification of their
documentation. Eligible medical practitioners will then be required to sit Level 3, known as the Pre-Registration
Examination System (PRES).

Since January 2016, the Medical Council no longer requests that new applicants complete the previously known PRES
Level 2 examination, instead applicants are required as part of their application to provide documentary evidence
that they have completed an alternative exam which the Medical Council has deemed to be an acceptable equivalent.
Please see Section 2.2. for more detail.

PRES Level 3 is an assessment of doctor's clinical skills through a data interpretation exam and an Objective
Structured Clinical Examination (OSCE).

1.3. What is the process for applying for Registration?

If you wish to apply for registration, you should follow this link to ascertain which division of the register you
would be eligible for and to access the relevant application form.

You should also refer to the information available on the Medical Council’s website relating to First Time
Applications: http://www.medicalcouncil.ie/Registration-Applications/First-Time-Applicants/

2.1. Applying for Registration

If you wish to apply for registration and this is your first contact with the Medical Council, you should refer to 1.3.
What is the process for applying for Registration? for further information. If you have further questions in relation
to registration with the Medical Council, you should contact the Registration Section using the Registration Contact
Form.

If you are in the process of applying for registration, and are at present having your documentation examined by
the Registration section, you are not eligible to sit the PRES until Level 1 (documentation examination) is complete
and you have been declared eligible for the exam. If you have further questions in relation to your application for
registration with the Medical Council, you should contact the Registration Section using the Registration Contact
Form.

If you have recently been declared eligible to sit the PRES, the Medical Council has emailed you an email
confirming you are eligible to sit the Level 3.

2.2. Changes to the Pre-Registration Examination System

Since January 2016, the Medical Council no longer requests that new applicants complete the PRES Level 2
examination, instead applicants are required as part of their application to provide documentary evidence that they
have completed an alternative exam which the Medical Council has deemed to be an acceptable equivalent.

Accepted Alternative to PRES Level 2 Evidence Required

Professional and Linguistic
Assessment Board (PLAB) A pass will be accepted as valid for the same Copy of Results Email
period considered by the awarding body.
Part 1
United States Medical Licencing
A pass will be accepted as valid for the same Official Examination
Exam (USMLE)
period considered by the awarding body. Transcript
Step 1 and 2
A pass will be accepted as valid for the same
Medical Council of Canada
period considered by the awarding body. The Certified Copy of Statement
Evaluating Examination
exam must have been completed through of Results
(MCCQE 1)(MCCEE)
English.
Copy of AMC Results Letter
Australian Medical Council A pass will be accepted as valid for the same and Candidate Feedback
MCQ (AMC) period considered by the awarding body. Sheet

Applicants who provide this evidence will then be made eligible for the PRES Level 3, and will have two years or
three attempts from the date they are declared eligible to complete the Level 3 examination.

There are Eight Domains of Good Professional Practice as devised by the Medical
Council. They are the following:

Patient Safety and Quality of Patient Care

Patient safety and quality of patient care should be at the core of the health service delivery that a doctor provides. A
doctor needs to be accountable to their professional body, to the organisation in which they work, to the Medical
Council and to their patients thereby ensuring the patients whom they serve receive the best possible care.

Relating to Patients
Good medical practice is based on a relationship of trust between doctors and society and involves a partnership
between patient and doctor that is based on mutual respect, confidentiality, honesty, responsibility and
accountability.

Communication and Interpersonal Skills

Medical practitioners must demonstrate effective interpersonal communication skills. This enables the exchange of
information, and allows for effective collaboration with patients, their families and also with clinical and non-clinical
colleagues and the broader public.

Collaboration and Teamwork

Medical practitioners must co-operate with colleagues and work effectively with healthcare professionals from other
disciplines and teams. He/she should ensure that there are clear lines of communication and systems of
accountability in place among team members to protect patients.

Management (including Self-Management)

A medical practitioner must understand how working in the health care system, delivering patient care and how
other professional and personal activities affect other healthcare professionals, the healthcare system and wider
society as a whole.

Scholarship
Medical practitioners must systematically acquire, understand and demonstrate the substantial body of knowledge
that is at the forefront of the field of learning in their specialty, as part of a continuum of lifelong learning. They must
also search for the best information and evidence to guide their professional practice.

Professionalism
Medical practitioners must demonstrate a commitment to fulfilling professional responsibilities by adhering to the
standards specified in the Medical Council’s “Guide to Professional Conduct and Ethics for Registered Medical
Practitioners”.

Clinical Skills
The maintenance of Professional Competence in the clinical skills domain is clearly specialty-specific and standards
should be set by the relevant Post-Graduate Training Body according to international benchmarks.

You should be aware of these, as they are the key skills and values that the Medical Council expects of doctors
who practise in Ireland.

4.1. General Information

4.1.a. What is Level 3?

Level 3 is a clinical based assessment of Communication, Interpretation and Practical Skills, and takes the form of
an OSCE and a data interpretation exam. Level 3 is the second part of the PRES examination.

The Level 3 is primarily a test of clinical skills in the main clinical disciplines of Obstetrics & Gynaecology, Paediatrics,
Psychiatry, Surgery, and Medicine/General Practice. It is based on the Eight Domains of Good Professional Practice
as devised by Medical Council. A blueprint has been designed which establishes the scope of content for each Level
3 examination. Further information can be found on our website here.

4.1.b. Where can Level 3 be taken?

Level 3 is usually offered in a centre in Ireland, either in Dublin or in a major provincial centre i.e. Cork, Galway or
Limerick. There are currently no overseas centres for Level 3.

4.1.c. How does one apply for and find out about Level 3 dates?

The Council will provide information about Level 3 dates as soon as it becomes available. The dates will be posted
on the Medical Council website under PRES dates. The Medical Council endeavours to give as much notice as
possible prior to the date of the Level 3. The Level 3 is usually held two to three times per year depending on
demand. Click here for the current Level 3 dates.

Candidates must pass one of the acceptable alternative examinations before being permitted to sit Level 3. These
candidates will also be informed by email at the same time as dates are posted on the Medical Council website.
Therefore, it is important to keep the Medical Council informed of any changes in email address. The Level 3
application form and further information is also available on the Medical Council’s website.

4.1.d. Level 3 Validity

Candidates must pass Level 3 within two years from the date of eligibility. If a candidate DOES NOT pass Level 3
within two years or fails Level 3 THREE times, they should refer to Sections 5.5.e. and 5.5.f. for further information.

4.2.a. How does one book a place in the Level 3?

i) Notification of Level 3 dates

Notification of Level 3 dates is emailed to every eligible candidate along with the Level 3 application form and
further information. The Level 3 application form and further information is also made available on the Medical
Council’s website.

Once an eligible candidate has received their Level 3 notification they should read and follow the instructions
in the email, the Important Notice about the Level 3, and the Level 3 application form.

Candidates are advised to read, note and understand the most up-to-date version of the following
documentation (available on the Medical Council’s website) prior to completing the Level 3 application form:

• The Guide to the Application Procedure and Registration Rules;

• This, the Pre-Registration Examination Handbook; and,

• The Guide to Professional Conduct and Ethics for Registered Medical Practitioners.

The specified closing date is clearly stated on the application form and on the Medical Council website. Only in
exceptional circumstances will the Medical Council, at its discretion, accept applications beyond the specified
closing date.

ii) Allocation of places

The numbers of Level 3 places available are limited for each examination.

Candidates should note that, since April 2014, scheduling for the Level 3 is prioritised on a first-come-first-
served basis in order of:

1. First attempt candidates at Level 3 who have never sat Level 3 before;

2. Candidates whose eligibility is due to expire before the next Level 3 examination session;

3. All other applications.

It should be noted that candidates being awarded priority status does not guarantee that they will be allocated
a place for a particular exam sitting.

The aim of this approach is to ensure that all candidates have an opportunity to complete the Level 3 as quickly
as possible within their eligibility period.

iii) If the candidate wishes to sit the Level 3

Level 3 places are allocated on a strictly priority and first-come-first-served basis on receipt of a fully completed
Level 3 application form AND confirmation of payment being accepted. It is advisable that eligible candidates
submit their Level 3 application to the Medical Council without delay. Candidates risk not being allocated a
place in the Level 3 if their application is received after allocations for places have been made, if a candidate’s
application form is not fully completed or is illegible, or if their payment does not go through. Candidates should
ensure that they complete the application form carefully and accurately.

scanned and emailed to: [email protected] with the subject heading of PRES Level 3 Application form followed
by their Medical Council Reference Number

You can, if you wish, send the Level 3 application form by post addressed to: PRES Level 3 Examination,
Examinations Section, Medical Council, Kingram House, Kingram Place, Dublin 2, Ireland. However, you should
be aware that your Level 3 application form may be received by post after allocations for the Level 3
examinations have been made.

When an application is received, it is reviewed before being sent to the Finance Department for the payment to
be processed.

Once received back from the Finance Department the candidate will be contacted by email to confirm whether
or not they have been allocated a place.

If a candidate has been allocated a place, they will be emailed their Level 3 admission letter and other relevant
details i.e. examination venue information or other important notifications with their confirmation email. If a
candidate has recently renewed or obtained a new passport, they will be required to provide the Medical Council
with a notarised copy of their passport prior to sitting their Level 3.

The confirmation of a place usually takes 10 working days. We would request that candidates please refrain from
telephoning or emailing the Medical Council regarding confirmation of receipt of their application as this will delay
the processing of the Level 3 applications.

4.2.b. What happens if there are no available places to sit the exam that I want?

The Medical Council cannot guarantee a place in the Level 3(s) being held.

Due to the demand and supply of Level 3 places, places may be filled up before the Level 3 deadline.

If a candidate’s complete Level 3 application is received after allocations for the Level 3 have been made, the
candidate may be:

a) Placed on a standby list (if there are no more places available for the one Level
3) OR
b) Allocated a place in the list for their second or subsequent preference (if there is more than one day for
sitting the Level 3). This does not guarantee an automatic place in the other Level 3 venues. The candidate
may also be placed on a standby list.

i) Standby places

Occasionally, due to the supply and demand for Level 3 places, the Level 3(s) may be filled before the deadline. If
this is the case, all applicants who have NOT been allocated a place will be contacted by email to notify them of this
situation and they will be placed on a standby list for any places that become available.

Please be advised that a candidate having their name on the standby list does not guarantee that the candidate will
be offered a place at the Level 3. If there are withdrawals/cancellations at the Level 3, it may be possible to offer
doctors on the standby list a place. The Medical Council cannot predict if or when withdrawals/cancellations may

If a candidate is offered a place from standby, they will be given a limited period of time, usually 24 hours, but less
as the Level 3 approaches, to respond.

If the candidate wishes to accept the offer of a place, payment of the Level 3 fee will be taken immediately; a
candidate’s examination place is not guaranteed until payment has been processed. If a candidate is offered a place
and fails to respond within the specified time or does not wish to accept the place, the place will be offered to
another doctor on the standby list.

ii) Second or subsequent preference

If there are a number of different Level 3 dates, the Medical Council cannot guarantee that a candidate will be
placed in their first preference of the Level 3. If the candidate is not allocated a place in their preferred Level 3
date/venue, they will be placed in the list for their second and then subsequent preference (only if there is more
than one date/venue for sitting the Level 3). They may also be placed on a standby list. This does not guarantee an
automatic place in the other Level 3 dates/venues. It is very unlikely that there will be any vacant places in the Level
3 venues.

4.2.c. Examination cancellation

The Medical Council also reserves the right not to hold an examination at the listed date if there are insufficient
candidate numbers or if there are circumstances beyond our control. Should this occur, candidates will be notified
at the earliest possible opportunity and will be allocated a place in the next available examination date.

4.2.d. Fees for the PRES Level 3

Click here for the current Level 3 fee and further details regarding payment. The Level 3 fee should be made payable
to the Medical Council in Euro either by credit or debit card (Visa or Mastercard). CASH AND/OR CHEQUES CANNOT
BE ACCEPTED AS A MEANS OF PAYMENT.

Each time a candidate attempts Level 3, the current Level 3 fee will apply.

In the event of a third party paying the fees for the Level 3 on a candidate’s behalf, and the fees being refunded,
the candidate will be issued with the refund and not the third party.

4.2.e. How does one withdraw/cancel their place?

If a candidate is allocated a place in Level 3 but they are unable to attend, they SHOULD formally withdraw/cancel
their place from the Level 3. This will allow other candidates who are on a standby list to have the opportunity to
apply to sit the Level 3.

Candidate’s wishing to withdraw/cancel should complete the Level 3 Withdrawal Form available on the Medical
Council’s website, and return it to the Medical Council either by post or email at the details located on the Level 3
Withdrawal Form. Emails or telephone conversations with the Medical Council is NOT a sufficient means of
withdrawing and will NOT be accepted as such. The Level 3 fee (less service charge) will be forfeited unless the
Medical Council receives prior notification on or before the specified closing date. Please note that the Medical
Council cannot assist candidates with their visa applications.

Transfers to another Level 3 in another venue/session or the next Level 3 are not permitted. Candidates must
formally withdraw and re-apply with the Level 3 application and fee when they wish to take the Level 3.

Withdrawing from a Level 3 does not constitute an attempt at the Level 3.

If a candidate withdraws after the deadline for withdrawal of a Level 3 they will forfeit the full Level 3 fee paid. The
Level 3 fee paid will not be transferred to another Level 3.

Should the candidate arrive late and is not admitted to sit the Level 3 at the time/group stated on their admission
letter, they will not be able to sit in a Level 3 later that day/next day (if applicable/available). The Level 3 fee paid
will not be transferred to another Level 3.

If a candidate is absent on the time and date of the Level 3, they will forfeit the full Level 3 fee paid. Absence from
a Level 3 does not constitute an attempt at the Level 3.

4.3.a. What is the format of the Level 3?

Level 3 is primarily a test of clinical skills, knowledge and attitude in the main clinical disciplines of Obstetrics &
Gynaecology, Paediatrics, Psychiatry, Surgery, Medicine and General Practice. The Level 3 is based on the Eight
Domains of Good Professional Practice as devised by Medical Council. A blueprint for the Level 3 examination has
been established which sets out the scope of content that can appear for each diet of the PRES Level 3. Further
information on this can be found on our website here.

The cases used in the PRES Level 3 represent the kinds of patients and medical conditions normally encountered
during medical practice in Ireland. Most cases are specifically designed to elicit, through the process of examining a
candidate’s practical, communication, and interpretation skills, the examinee's clinical ability.

There are three types of skills being assessed namely Practical, Communication and Interpretation.

In the current Level 3 format, Practical and Communication Skills are being held together and the
Interpretation Skills are being examined as one exam either on the same day or on another separate day.

The Level 3 is split into TWO:

• Practical and Communication Skills are examined in ONE clinical examination, where candidates rotate
through a series of clinical scenarios or skill stations

• Interpretation skills are examined in ONE examination, which may be a paper based written exam or
a computer based exam.

Practical
and Interpretation
Level 3
Communication skills
Skills

Further details are available in the following pages.

i) Practical skills

This assesses the candidate's practical skills ability, such as performing a physical examination, demonstrating a
practical procedure, using diagnostic/therapeutic instruments, or examination of a patient’s mental state.

Practical skills will usually be assessed using a simulated patient or anatomical model in a variety of simulated
clinical situations. However, on occasion, genuine patients may be used.

Please note: the scenarios below are given as examples of practical skills and may or may not be part of the
examination.

Assessment of a patient’s The candidate will be assessed performing this.

mental state
Clinical Procedural skills The candidate will be will be expected to demonstrate clinical procedural skills
which may include to perform /take/use auroscope, blood pressure (BP), an
electrocardiogram (ECG), ophthalmoscope, peak flow rate, etc.
Injection Techniques The candidate will be assessed performing these skills correctly and safely.
Inserting a cannula The candidate will be assessed performing these skills correctly and safely.

Candidates MUST use the hand gel provided if they have contact with patients or are performing practical skills.

If a candidate finishes a practical skills station before the time is over, they should not engage in small talk
with their examiner/simulated patient/invigilator.

ii) Communication skills

This assesses the candidate's ability to obtain a history, to demonstrate interviewing and communication skills
and/or to apply clinical management skills with patients/relatives/children/healthcare professionals from a
wide variety of demographic/ cultural/religious/socio-political and ethnic dimensions/backgrounds.

On occasion, genuine patients may be used.

Please note: the scenarios below are given as examples of communication skills and may or may not be part of the
examination.

Breaking bad news to a The candidate will be asked to convey “bad news” (such as an unfavourable
patient outcome, unsatisfactory care or poor prognosis) to the patient demonstrating not
only a knowledge of the subject but also an ability to communicate with empathy.
Communication skills The candidate will be expected to demonstrate an ability to show their written
(Written) communication skills through medical records, discharge letters, investigation
request form or clinical letters to medical colleagues.
Ethics The candidate should understand and apply the general principles as outlined in the
Guide to Professional Conduct and Ethics for Registered Medical Practitioners.
Explaining diagnosis, The candidate will be given information about a specific condition or the result of
investigation and an investigation and will be expected to communicate this information to the
treatment patient in the context of a clinical situation. The candidate may also have to explain
options available i.e. the option not to treat, and the opportunities available for
further information including a second opinion. It may also include an assessment
of a patient’s mental state.
Patient management With a patient, relative or colleague.
plan/ education
exercises/health
education promotion/
PLEASE NOTE: This information may be subject to amendment/changes in whole or in part at any time at the discretion of the
Medical Council. You should ensure that you read the most up-to-date information regarding examinations in this Handbook.
Page 13 of 34
MEDICAL COUNCIL PRE-REGISTRATION EXAMINATION HANDBOOK
preventive strategies
Seeking/obtaining The candidate will be advised as to the specific procedure the patient is to undergo.
informed consent for The candidate will be asked to obtain consent from the patient for the procedure.
standard procedures
Taking a history The candidate will be expected to demonstrate an ability to obtain a focussed
medical history with relevant key points, in a variety of clinical situations,
appropriate to the clinical case i.e. fit for purpose.
Working in a team The candidate will be expected to provide information to the simulated patient
who is acting as a member of the team (nurse, paramedic, other colleague, senior
medical colleague (i.e. registrar or consultant)) providing appropriate information
for the clinical scenario presented.

While the communication skills stations last seven minutes and candidates are assessed on their interaction with
simulated patients, we do not suggest that tasks such as breaking bad news would be completed within the time
allowed in the real clinical environment.

When a candidate enters the communication skills stations they should give their exam label to the examiner who
will place it on their answer sheet.

If a candidate finishes a communication skills station before the time is over, they should not engage in small talk
with their examiner/simulated patient/invigilator.

iii) Interpretation skills

This assesses the candidate's ability to be able to interpret results from tests and procedures. This may involve the
candidate interpreting:

Please note: these are given as examples of Interpretation skills and may or may not be part of the examination.

An Electrocardiogram (ECG) The candidate will be assessed to interpret this correctly.

Pharmacology and Prescribing Medication The candidate will be assessed to interpret this correctly.
Laboratory tests The candidate will be assessed to interpret this correctly.
Paediatric growth charts The candidate will be assessed to interpret this correctly.
Photographs The candidate will be assessed to interpret this correctly.
X-rays The candidate will be assessed to interpret this correctly.

Candidates are being examined on the same issues as either a paper based written exam or a computer based exam.
If a candidate finishes before the time is over, they should not engage in small talk with other
candidates/examiners/invigilators.

4.3.b. Pass Mark

Each station/question is marked out of a total of 20. Each skills component (communication, interpretation and
practical) is marked out of 120 marks. A candidate must achieve a minimum level of competence (marks) as
determined by the Modified Angoff or Borderline Regression in each of the three types of skills (communication,
interpretation and practical) to be awarded a pass in the Level 3.

However, candidates should note the following:

• If a candidate has been deemed to have made a clinical error that compromises the patient (e.g. not properly
clearing the airway at the start of a resuscitation procedure) or that endangers themselves, their patient, or
their surroundings (e.g. not disposing of hazardous material e.g. sharps in the correct manner), it will result in
the candidate FAILING THAT SKILL STATION.

• This exam is NOT negatively marked.

• There is NO compensation BETWEEN interpretation skills, practical skills and communication skills.

• There IS compensation only WITHIN the range of the interpretation skills, practical skills and communication
skills.

• To pass the Level 3, candidates must pass (i.e. minimum mark or above) each of the three types of skills
(i.e. Communication, Interpretation and Practical).

4.3.c. Time

The Level 3 is split into TWO format of examination which examines clinical skills.

Practical and
Level 3 Interpretation skills
Communication Skills

(Total examination time (Total examination

(Total examination time
= 3 hours 40 minutes) time = 1 hour)
= 2 hours 40 minutes)

Practical and Communication Skills are examined in ONE clinical examination.

Interpretation skills are examined in ONE data interpretation examination.

i) Practical and Communication Skills

• This consists of ONE practical examination.

• The examination will last 2 hours 40 minutes.
• This consists of 12 “active” stations, rest stations and preparatory stations. At a preparatory station
candidates have to read instructions/information regarding the next station.
• Each station is seven minutes in duration. A period of up to one minute transfer time between stations will
be given.

Station 1 Station 2 Station 3 Station 4 Station 5 Station 6

Communication Communication Preparation for Communication RE S T Communication

Station 4

Station 7
Station 20
REST Communication

Candidates must continue around the

Station 8
Station 19 circuit from station to station in
Practical consecutive order. A candidate at the Preparation for
last station i.e. (station 20) proceeds Station 9

on the station 1, and continues

around the circuit in consecutive
Station 18 Station 9
fashion, until they have completed all
Preparation for the stations. Communication
Station 19

Station 10
Station 17
Practical RE S T

Station 16 Station 15 Station 14 Station 13 Station 12 Station 11

Practical RE S T Practical Preparation for Practical Practical
Station 14

ii) Interpretation skills

• This consists of ONE examination which may be either a paper based written exam or a computer based
exam.
• The examination will last 1 hour
• This consists of 6 questions.
• Each question is marked out of 20 marks.

4.3.d. Common mistakes that candidates for Level 3 make

• Not reading the stations/exam question instructions carefully or misinterpreting the instructions. Candidates
should not assume that they know what the station/exam question is about. Candidates should read the
instructions carefully and respond in the correct manner. If candidates are asked to take a patient’s history,
they will not gain any marks from discussing a management plan or explaining a diagnosis with a patient.

• Not listening to or understanding a patient’s response and therefore missing important information from the
patient.

• Asking too many questions, talking too much or talking at the patient. Candidates are expected to speak to the
patient in language that the patient will understand and the manner that they would expect. The way a
candidate communicates with the patient tells both the patient and the examiner a lot about the candidate’s
approach with the patient. It is also important to allow the patient an opportunity to ask questions to make
sure they understand.

• Giving generic information or set phrases. If candidates are asked to provide a patient with information or
advice relevant to their specific problem, they should not give general statements regarding that problem.
Candidates also use set phrases designed to show understanding but use them in the wrong context.

• In practical stations, candidates sometimes do not take into account the standard precautions which would
endanger themselves, their patient or their surroundings (i.e. not disposing of hazardous material e.g. sharps).
This is a serious matter and will result in the candidate FAILING THAT SKILL STATION.

• Leaving or attempting to leave the communication/practical station early. If the candidate is finished early at
the station they should sit down/stand by the side and wait for the end of station bell to ring.

• Incidents of unprofessional behaviour identified by the examiners (examples of unprofessional behaviour

include: lack of respect for patient or examiner, inappropriate utterances or actions, rough or inappropriate
treatment/handling of patient).

It is in the interest of the candidate to avoid these mistakes.

4.4.a. What time should one arrive at the Examination Venue?

Candidates are required to present themselves at the Examination venue for registration AT THE TIME STATED ON
THEIR LEVEL 3 LETTER. Candidates who are late may be excluded from the examination at the discretion of the exam
coordinator.

Candidates may be asked to arrive or remain at the Examination venue for a short period of time before/after their
Level 3 starts/concludes in order to ensure security of the examinations process. This is because candidates are not
permitted to meet/have any form of contact with, the group of candidates that took the examination in
another/earlier group.

The Level 3 itself normally lasts for approximately 3 hours 40 minutes

• Practical and Communication skills = 2 hours 40 minutes
• Interpretation skills = 1 hour

In total the candidate may be at the examination venue for approximately five and a half hours.

Exact details of the Level 3 will be given to candidates in their admission e-letter. The Level 3 examinations are
expected to run to time, however it is suggested that candidates allow time for unforeseen delays when booking
tickets for a return journey.

4.4.b. What should one bring to the Examination Centre?

On the day of their Level 3, for admittance into the Level 3, candidates must bring with them the following:

• their admission letter (which will be sent to candidates by email once they have been allocated a place), and,

• Their current, valid Passport, which is the same evidence of identity as shown on the admission letter. Only
candidates who have refugee status may use their Garda National Immigration Bureau (GNIB) Card along with
their valid Travel Document, as a form of identity for this examination. No other evidence of identity is
acceptable and candidates presenting without the correct evidence of identity and in date will not be
permitted to sit the exam.

IT IS THE CANDIDATES RESPONSIBILITY TO ENSURE THAT THEY HAVE THESE ITEMS WITH THEM FOR ADMITTANCE
TO THE EXAMINATION.

Candidates presenting without these documents will not be permitted to sit Level 3. In that event, they must pay
the full Level 3 fee again to reschedule their Level 3.

On the day of their Level 3, for sitting the Level 3, candidates must bring with them the following:

• their own pens/pencils (and eraser if considered necessary) and,

• their own watch (showing seconds)

• their own stethoscope(which they may use during this examination); and,

• depending on the venue, candidates may also be requested to bring their own white coat which they will
wear during this examination. Candidates will be notified on this requirement in their admission letter.

All equipment necessary for the Practical and Communication skills stations will be provided for use should
equipment be required.

Mobile phones, notes, textbooks, dictionaries, laptops, palm pilots and all other electronic devices are STRICTLY
PROHIBITED from the examination centre. Mobile phones or other electronic communications devices should NOT
be left powered on within the vicinity of the examination centre and should be left SWITCHED OFF in the holding
room for registration.

4.4.c. What happens at Examination Registration?

Candidates are required to present themselves at the Examination venue for registration on time at the time
stated on their Level 3 admission letter.

Candidates are usually advised to meet at the reception at the venue. Information and directions to the
Registration Room may be shown at reception, in which case the candidate should go to that room at the time
stated for Registration. If not, they should remain at reception at the time stated for Registration.

At the time stated for Registration on their admission letter, candidates will be brought to a holding room for
registration.

At registration, candidates are asked to present to the registration staff:

• admission letter, and

• current, valid Passport

They are also asked to sign the Level 3 Register and non-disclosure agreement. The non-disclosure agreement
confirms that the candidate will NOT disseminate or reveal to others the content of the Level 3. This means that
they CANNOT discuss or disclose the Level 3 content even after the examination is over including sharing Level 3
content with future candidates and posting of Level 3 content and questions online.

Mobile phones, other hand held electronic devices and laptop computers will be given to the Medical Council
staff member immediately when they are in the Registration Room. They will be given back to candidates only
after the Level 3 and only when they are released at the end of their Level 3 session.

Candidates will be given:

• exam labels (which has their name, Level 3 number and Medical Council reference number on it)

• their starting place number (for the Communication/Practical Skills)

• a form showing the candidate’s current postal address that the Medical Council has. Candidates are asked
to confirm their most up-to-date details on this form. Failure to notify the Medical Council of a change in
address may result in unnecessary delays in sending out their Level 3 results

Candidates may be given:

• a map/layout of the circuit (which shows the Type of Station e.g. Communication and Specialty of
Station e.g. Psychiatry)

Candidates will be asked to attach one of their examination labels (which contains their starting place number for
the Communication/Practical Skills) onto their clothing as a means of identification for the duration of the Level
3.

Candidates will be given brief instructions on how to complete the examination by a member of the Medical
Council staff, and usually the Examination Coordinator, prior to the commencement of the Level 3. It is very
important that candidates listen carefully to the information that they are given at the briefing and also follow
any instructions that they are given by the invigilators during the Level 3.

In an effort to minimise disruption candidates are requested to visit the toilets before the Level 3 commences.
Candidates may be permitted to use the toilets escorted to the toilet by an invigilator and only when given
permission to do so.

Once a candidate has been registered for their Level 3, they cannot leave the examination premises.

Candidates will then be escorted to the examination centre where they will be asked to stand in front of a
seat/station to await further instructions.

The Registration (signing in) process usually takes approximately 40 minutes. The instructions take approximately 5
minutes. Approximately and usually around 10 minutes before the start of the Level 3, as a group, the candidates for
that group will be escorted to the examination centre where they will be asked to stand in front of a station/their seat
to await further instructions. IT IS THEREFORE EXTREMELY IMPORTANT FOR CANDIDATES TO ARRIVE AT THE TIME
STATED ON THEIR LEVEL 3 LETTER, TO ENSURE THE SMOOTH RUNNING AND TIMING OF THE EXAMINATION.

4.4.d. What should one wear to the Level 3?

Candidates should wear clothes which are appropriate for the clinical/hospital environment and for the treatment
of patients. Candidates should bear in mind that it may be much colder than they are used to and should dress
accordingly.

Please note: Do not wear neck ties, jeans, shorts or sandals.

If an examination centre has a specific dress code, for example – the wearing of white coats, or being bare below
the elbow, then candidates will be advised of this in their admission letter.

4.4.e. The holding of candidates before/after their Level 3

• To ensure confidentiality and security of the Level 3, candidates may be requested to remain in a holding room
for a period of time before or after their Level 3, until the next group have all arrived and have registered in the
Registration Room or until the earlier group have completed their Level 3. This is because candidates are not
permitted to meet/have any form of contact with the group of candidates that took the examination in an earlier
group or have yet to take the examination.

• Candidates may be asked to remain at the Examination venue for a short period of time (usually 30 to 60
minutes) after the Level 3 concludes in order to ensure security of the examinations process.

• In some circumstances, candidates may be asked to arrive at the Examination venue more than one hour in
advance of their Level 3 starts.

• Details of whether candidates are being asked to remain on the holding room before/after their Level 3 can be
found in the timings of their admission letter.

• Candidates may be permitted to use the toilets escorted to the toilet by an invigilator and only when given
permission to do so.

• No electronic devices may be used whilst in the holding room, such as mobile telephones, palm pilots, laptops,
etc.

• Candidates should not ask Medical Council staff/invigilators that they have to leave immediately after their Level 3
and that they cannot wait or that they wish to have their electronic device returned before or during their stay in
the holding room, as Medical Council staff/invigilators will NOT accede to the request by the candidate.

4.4.f. Information about the examination centre

i) Travel arrangements

Candidates must make their own provisions in relation to travel arrangements. Candidates are advised to allow for
any transportation delays (i.e. heavy/rush hour traffic and delays in public transport) and unfamiliarity of the
surroundings when planning their journey and time of arrival at the Examination centre. Public parking spaces
(limited) may be available at/nearby certain examination venues. Further information regarding transportation is
found in Section 8.

ii) Refreshment arrangements

Drinking water will be provided during the Level 3 wherever possible, though this will depend on the examination
venue. It will usually be located at the Communication and Practical skills “rest” stations.

At certain examination venues/times, candidates may be asked to arrive early/remain at the Examination venue
for a period of time before/after the Level 3 starts/concludes in order to ensure security of the examinations
process. If this is the case, light refreshments such as tea/coffee/biscuits/sandwiches may be provided, though this
will depend on the examination venue.

iii) Toilet facilities

In an effort to minimise disruption candidates are requested to visit the toilets before the Level 3 commences. As
candidates are under examination conditions from when they are in the registration holding room until after the
end of the Level 3, they will be escorted to the toilet by an invigilator. Toilet breaks may be permitted during the
Level 3 at the discretion of the invigilator and only when candidates are at a Communication and Practical skills
“rest station”.

iv) Smoking arrangements

Smoking is forbidden in enclosed places of work (e.g. office blocks, various buildings) in Ireland. Smoking is NOT
permitted in the exam hall or adjacent areas (e.g. toilets). Candidates will NOT be permitted to leave the building
for a smoke break during the exam. It may be possible to smoke in a designated outdoor smoking area outside the
examination venue, but this facility is solely at the discretion of the examination venue provider.

v) Storing of personal belongings

Mobile phones, blackberry, notes, textbooks, dictionaries, laptops, palm pilots, USB, memory sticks, tablets and all
other electronic devices are STRICTLY PROHIBITED from the examination centre. Ideally candidates should not
bring such devices with them. Mobile phones or other electronic communications devices should NOT be left

At registration, candidates will be asked to deposit any such devices to staff of the Medical Council. Although staff
of the Medical Council may store these personal belongings for the candidate, please note that no responsibility
can be taken for lost or stolen items.

Where Examination halls do not have secure areas to store personal belongings, any coats, bags or other item(s)
brought into the Examination hall should be deposited as directed by the invigilator(s). Please note that no
responsibility can be taken for lost or stolen items.

vi) Waiting arrangements

Candidates are advised that it will not be possible for the Examination centre to facilitate waiting spouses, relatives
or friends before, during or after the Level 3. Candidates sitting the Level 3 should plan to meet them elsewhere
after the examination.

vii) Emergency Evacuation of the examination centre

In the event of an emergency evacuation of the building, the Level 3 will be terminated with immediate effect. All
stations already completed will be null and void and candidates will be re-booked to a future date.

4.4.g. Complaints

i) Before the examination

Temporary personal circumstances (such as illness or pressing domestic circumstances) which occur close to, or
during the examination which might affect a candidate’s performance cannot be taken into account.

ii) Problems encountered on the day of the examination

If a candidate feels that he or she has been disadvantaged during the examination (e.g. through equipment failure,
human error, or otherwise), the candidate must make a complaint to the Examination Coordinator or Medical
Council representative during or immediately after the examination, and before leaving the premises. All such
complaints should be recorded in writing on the “Complaint/Remedy form” (available at the Level 3 venue) and
signed by the Examination Coordinator and the candidate.

Complaints of this nature made at a later date are difficult to investigate or validate and therefore will not be
entertained.

There are, however, certain complaints that will not be entertained and may not be further investigated. These
include:

• Not being able to find the examination centre location/delay in arriving at the examination centre location.

Candidates are informed of the exam venue and times for the exam well in advance of their exam date. If they are
unsure as to the location of the examination centre, they should make sure that they allow ample time to arrive at
the examination centre at the correct time, bearing in mind heavy/rush hour traffic and delays in public transport.

Candidates are required to present themselves at the Examination venue for registration ON TIME AT THE TIME
STATED ON THEIR LEVEL 3 LETTER, TO ENSURE THE SMOOTH RUNNING AND TIMING OF THE EXAMINATION. A
candidate who arrives late for the Level 3 may only be allowed sit the Level 3 at the discretion of the Examination
Coordinator. It is HIGHLY UNLIKELY that if a candidate arrives late that they will be allowed sit the examination. Due
to the nature of the examination, the examination once started cannot stop until the completion of the whole
examination.
PLEASE NOTE: This information may be subject to amendment/changes in whole or in part at any time at the discretion of the
Medical Council. You should ensure that you read the most up-to-date information regarding examinations in this Handbook.
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• Not reading the instructions of the stations/exam questions fully and carefully

Instructions for each station/exam question are clearly stated. Candidates should read the instructions carefully and
ensure that they understand what they are being asked to do. If it is a history station and the candidate performs a
physical examination they will not be given marks. If an answer sheet has two pages/sides, instructions will be given
to the candidate to “turn over the page/turn to the next page/P.T.O.”.

• “Running out of time”

The communication and practical skills stations are designed to be completed in seven minutes. Candidates should
be conscious of the time constraint of a skills station. Candidates need to maintain a courteous manner while
ensuring that they complete the essential features of the task in the available time. The interpretation skills
questions are designed to be completed within the time allowed.

4.4.h. Adverse Circumstances which affect the Conduct of the Examination

If any adverse circumstances affect the conduct of the examination for any candidate(s), the Examination
Coordinator with agreement of the Medical Council representative, will take such action as they think fit. After the
Level 3, the Examination Coordinator and/or the Medical Council Representative will report to the Examinations
Sub-Committee. The Examinations Sub-Committee will consider the effect of the circumstances and take any
further action they think appropriate.

In such cases of immediate notification of a complaint, and at the discretion of the Examination Coordinator and
Medical Council Representative, the candidate may be permitted to immediately re-attempt a maximum of two
Level 3 Communication and Practical skills stations once the examination centre has been vacated.

4.4.i. Cheating and misconduct

It is important to note that cheating in all its forms and misconduct is deemed to be a major disciplinary offence in
the Medical Council’s Pre-Registration Examination System (PRES), and as such serious penalties may be imposed.
Cheating in an examination is defined as the use, possession, or attempted use, of unauthorised material,
unauthorised collaboration or attempted collaboration, copying or attempted copying. Misconduct in an
examination is defined as unacceptable or immoral behaviour that is not in accordance with accepted moral or
professional standards.

Please note the following are STRICTLY PROHIBITED and are deemed a DISCIPLINARY OFFENCE:

Cheating

a) that a candidate brings one or more of the following with them to the examination centre - mobile phone(s),
notes, textbooks, dictionaries, laptops, palm pilots and all other electronic devices;

b) that a candidate’s mobile phone(s) or other electronic communications devices is left powered on within the
vicinity of the examination centre;

c) that a candidate removes from the examination venue, any examination rough work paper/“scratch paper”,
whether used or unused, or other supplied material;

d) that a candidate writes down or copies details of questions, by any means, to take out of the examination
venue;

e) that a candidate consults any materials or mobile phones or other electronic communications devices outside
the examination room during periods of absence (i.e. toilet break) while the examination is in progress;

Misconduct

g) that a candidate aids, or attempts to aid, another candidate, or obtain, or attempt to obtain, any assistance from
another candidate, or communicate in any other way with another candidate in the examination venue;

h) that a candidate uses, attempts to use, assists another to use or attempts to assist another to use any other
unfair, improper or dishonest method to gain advantage in any part of the PRES;

i) that a candidate obtains information about Level 3 skill stations from any source including other candidates;

j) that a candidate is rude or abusive towards any member of Medical Council staff;

k) that a candidate communicates with the examiners, simulated patients, invigilators, Medical Council staff or other
administrative staff either during or after the examination regarding the possible outcome of their grades;

l) that a candidate whose conduct or behaviour at an examination is thought to cause disturbance to other
candidates or affecting the proper running of the Examination;

m) that a candidate is involved in the theft or concealment of any material which is the property of the Medical
Council or the Medical School/Examination Centre venue;

n) Any attempt to reproduce examination materials will be considered a breach of examination procedures and
will be reported to the Registration and Continuing Practice Committee of the Medical Council

o) any other form of cheating and/or misconduct not outlined above.

If a candidate does any of these things they will be reported to the Medical Council by the examination
coordinator/Medical Council representative (apart from f). The Medical Council reserves the right to withhold
publication of the results of an examination candidate suspected of having been involved in any irregularity or
misconduct in connection with a Level 3, pending the completion of investigations into the alleged irregularity or
misconduct.

4.4.j. Sanctions/enforcements

During an examination;

• if any candidate is found to be in possession of any material/electronic aids, the candidate will be issued
immediately with a verbal warning from the invigilator/examiner and have the material/electronic device that
the candidate brings into the examination room confiscated.

• a candidate may be removed from the examination room if by their conduct they disrupt the examination.

A written report will be drafted and signed by the invigilator/examiner and countersigned by a witness to the event.
This report will be forwarded to the Examination Coordinator and Medical Council representative immediately and
without delay. They will jointly decide if the misconduct is severe enough to call a meeting of the Examinations
Sub-Committee after the examination.

The Examinations Sub-Committee may, in its absolute discretion,

• decide not to take any action in relation to the alleged offending conduct;
PLEASE NOTE: This information may be subject to amendment/changes in whole or in part at any time at the discretion of the
Medical Council. You should ensure that you read the most up-to-date information regarding examinations in this Handbook.
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• request explanation, comments and/or further information in writing or in person by the Candidate;

• ask that the Registration and Continuing Practice Committee impose penalties on the Candidate. The penalties
that the Registration and Continuing Practice Committee may recommend to impose on a candidate include,
without limitation:

• no penalty;

• awarding the candidate a zero mark (or failure) for the station/exam question or the whole Level 3;

• expulsion from the examination process; for a certain period as decided by the Committee;

• informing the Council of the Medical Council who will decide if further disciplinary/registration action may be
taken.

Within a reasonable period after the Examinations Sub-Committee and/or Registration and Continuing Practice
Committee meeting, the candidate will be given a written notice of the decision concerning the alleged offending
conduct. The candidate may, within one calendar month of the issue of the notice, appeal in writing to the
Examinations Sub-Committee and/or Registration and Continuing Practice Committee against the decision. The
appeal should be supported with relevant information or evidence.

4.5. After the Level 3

4.5.a. Results

The Medical Council will notify all candidates about their results in Level 3 as soon as possible after the examination
(approximately four to six weeks after the exam). An announcement will be made on the Medical Council’s website
as to when the results will be issued. They will NOT be issued before the date specified.

Candidates must not telephone the Medical Council regarding their result, as this will create unnecessary work for
staff and may delay the process further. The results are issued as a Pass or Fail. No diploma or certificate will be
issued to successful candidates. Results will not be given over the telephone.

The results of candidates who were successful in their Level 3 will be placed on the Medical Council website, using
the Medical Council reference number, at the same time as the results e-letters are issued.

All enquiries about the Level 3 results must be made in writing to the Examinations Section. The Level 3 results will
NOT be given or discussed over the telephone or in person. All correspondence regarding a candidate’s Level
3 appeal will be dealt with in writing only to the candidate and the outcome will be given to the candidate in
writing.

Successful candidates
Provided a candidate’s application for Registration is complete and satisfactory, those who are successful in the
examination will receive their eligibility e-letter which explains the next step in the registration process.

Unsuccessful candidates
Unsuccessful candidates are issued with a breakdown of their results. Further details regarding their examination
are enclosed in their results e-letter.

4.5.b. Breakdown of Results

All Level 3 results are verified at least three times before being sent to the candidates. Borderline results (i.e. within
close range of the passing score) undergo increased scrutiny. Candidates who were unsuccessful will receive a

The breakdown of the Level 3 results will NOT be given or discussed over the telephone or in person. All
correspondence regarding a candidate’s Level 3 appeal will be dealt with in writing only to the candidate and the
outcome will be given to the candidate in writing.

Candidates who are successful will not receive a breakdown of results but will instead be issued with details on how
to complete their registration.

4.5.c. Appeals

If a candidate remains dissatisfied after they have received and reviewed the breakdown of their results, they may
appeal their results.

The Level 3 appeal of results will NOT be given or discussed over the telephone or in person. All correspondence
regarding a candidate’s Level 3 appeal will be dealt with in writing only and the outcome will be given to them in
writing.

The “Level 3 Appeal Form” (available on the Medical Council’s website from the day that the Level 3 results are
announced) MUST be completed if a Level 3 candidate wishes to appeal their Level 3 result. The current
administration fee which should be made payable to the Medical Council, by way of credit or debit card payment
must accompany all requests for an appeal.

The “Level 3 Appeal Form” MUST be received by the Medical Council within one calendar month of the date of
issue of the results.

On the Level 3 Appeal Form, the candidate should write their personal details and the grounds and reason upon
which the appeal is being made. The three grounds are as follows:

(a) That the candidate believes that there is evidence of substantive irregularity in the conduct of the Level 3.

(b) That the candidate believes that the Level 3 mark awarded was incorrect and/or that the checking of the Level
3 results was not properly carried out (in particular, an appeal will not be upheld under (b) if the only evidence
produced is the opinion of the candidate that they performed better than the final mark indicates i.e. “I am
disappointed/surprised at my result” is not a ground for appeal).

The appeal may be accompanied by such evidence as may be relevant for consideration.

On receipt of a request for an appeal, the Examination Coordinator will personally recheck the examination scripts.
The Examination Coordinator will inform the Medical Council, in writing, of the results of the appeal.

The appeal may be:

• Dismissed as not an appropriate grounds with 5.5.c (a) or 5.5.c (b) or 5.5.c (c) as above

• Dismissed because out of time or incomplete

• Upheld

All correspondence regarding an appeal, including the Examination Coordinator’s response, will then be considered
by the Medical Council’s Examinations Committee. The Committee’s decision in the matter will be final.

The Medical Council will then provide a written response to the appellant, as soon as possible after the Registration
and Continuing Practice Committee meeting.

(a) In the event of a successful appeal on the grounds of (a), some form of redress will be offered to the candidate
at the discretion of the Medical Council.

(b) In the event of an appeal on the grounds of (b), if the review of the appeal shows that the candidate did reach
the required pass mark in each of the three types/domains of skills stations and overall then the fail may be
declared void and a pass mark awarded.

(c) In the event of a successful appeal on the grounds of (c), some form of redress will be offered to the candidate
at the discretion of the Medical Council.

4.5.d. How many times can one attempt Level 3?

The Medical Council currently imposes a limit of three attempts at any Level of the examinations. Candidates
attempting Level 3 have a two years period of eligibility from the date when they were declared eligible for the PRES
Level 3. If a candidate is unsuccessful in the Level 3, they may attempt the examination up to and including a
maximum of three times, within the two years allowed, until they either pass the examination, they fail three times
or their eligibility expires.

4.5.e. Re-apply for eligibility having not passed Level 3 within time allowed

If a candidate does not pass the Level 3 exam within the two years allowed, and still wishes to attempt the exam,
they must make a new application for Registration. Information in relation to submitting an application can be found
on the Medical Council website under “Registration Applications”.

4.5.f. Re-apply for eligibility having failed Level 3 three times

The Medical Council currently imposes a limit of three attempts at the Level 3 examination. If a candidate does not
pass the Level 3 exam within three attempts, and still wishes to sit the PRES exams for the purpose of obtaining
Registration, they must make a new application for Registration. Information in relation to submitting an application
can be found on the Medical Council website under “Registration Applications”.

4.5.g. Reference Number and Change of Address

The reference number allocated by the Medical Council must be quoted in all telephone calls, emails and other
correspondence relating to PRES.

The postal address specified by the candidate on the application form for PRES/Level 3, may also be used for
correspondence. Any subsequent change of address must be immediately notified online on the Medical Council
website, in writing or by email to the Medical Council. If the address is changed by email or letter, the candidate’s
date of birth and mother’s birth surname must be included as a security measure. Failure to notify the Medical
Council of a change in address may result in unnecessary delays in candidates receiving their results.

5. Is there exemption from the PRES?

5.1. Details of Exemption from the PRES

Refer to this link for further information regarding exemption from the PRES.

5.2. Changes to the PRES

Since January 2016, the Medical Council no longer requests that new applicants complete the PRES Level 2
examination, instead applicants are required as part of their application to provide documentary evidence that
they have completed an alternative exam which the Medical Council has deemed to be an acceptable equivalent

The Medical Council will consider an alternative exam pass as valid for two years from the date of completion, and
will not accept evidence of exams completed outside of this time frame.

Accepted Alternative to PRES Level 2 Evidence Required

Professional and A pass will be accepted as valid for the same Copy of Results Email
Linguistic period considered by the awarding body.
Assessment Board
(PLAB) Part 1
United States A pass will be accepted as valid for the same Official Examination
Medical Licencing period considered by the awarding body. Transcript
Exam (USMLE) Step
1 and 2
Medical Council of A pass will be accepted as valid for the same Certified Copy of Statement of
Canada Evaluating period considered by the awarding body. Results
Examination
Australian Medical A pass will be accepted as valid for the same Copy of AMC Results Letter
Council MCQ period considered by the awarding body. and Candidate Feedback
Sheet

6. English Language Requirements and Exemptions

Refer to this link for further information regarding English Language Requirements and English Language
Exemptions.

7.1. Reference Number

The reference number allocated by the Medical Council must be quoted in all telephone calls, emails and other
correspondence relating to PRES.

7.2. Change of Address

Where possible, the PRES section use email to contact exam candidates so that information can be communicated
as quickly and efficiently as possible.

The postal address specified by the candidate on the application form for PRES may also be used for correspondence.
Any subsequent change of address must be immediately notified online on the Medical Council website, in writing
or by email to the Medical Council. If the address is changed by email or letter, the candidate’s date of birth and
mother’s birth surname must be included as a security measure. Failure to notify the Medical Council of a change of
contact details may result in unnecessary delays in candidates receiving correspondence from the Medical Council.

7.3 Changes to Passport

The Medical Council use passports as a form of identification for doctors sitting the and Level 3 exams. If you renew
or replace your passport while you are eligible for the PRES exam, you must provide the Examination Section with a
notarised/attested hard copy of your passport either by post, or by presenting the original passport to the Medical
Council offices.

All copy documents must be notarised by a Notary Public or attested by a Justice of the Peace/ Commissioner for
Oaths/ Member of An Garda Síochána (documents signed by a Police Officer from another State are not acceptable).
They should confirm that the copy is a true copy of the original document, provide their full name and sign, date and
officially stamp each copy document. Documents which are not stamped clearly or have not been properly
notarised/attested cannot be accepted and will cause a delay in the processing of an application. Documents which
are not stamped clearly or have not been properly notarised/attested cannot be accepted and will cause a delay in
the processing of an application.

7.4. Can the Medical Council help with Visa Applications?

The Medical Councilare unable to assist candidates with visa applications. The Medical Council is not involved with
any stage of a visa application and cannot enter into discussions with the Irish Naturalisation and Immigration Service
on any candidate’s behalf. THE MEDICAL COUNCIL HAS NO ROLE TO PLAY IN THE GRANTING OR REFUSING OF
VISAS.

The Irish Naturalisation and Immigration Service has further details in relation to visa applications and requirements
on their website www.inis.gov.ie. The Irish Naturalisation and Immigration Service (INIS) recommend that
candidates should allow as much time as possible when applying for a visa and a minimum time of 8 weeks is
recommended. Candidates should be aware of the documents required for visa applications. Candidates should also
ensure that they contact the Visa Office in time to get an indication as to whether they have time to apply and get
the visa to be able to sit the Level 3. The onus is on you, the candidate, to allow enough time to complete all necessary
processes to enable you to sit the Level 3.

Public service information is found on the Citizens Information website. Information regarding employment permit
applications is available on the Department of Jobs, Enterprise and Innovation website.

7.5. Can the Medical Council recommend a hotel?

7.6. Where can one obtain information about living and working in Ireland?

Although the Medical Council cannot provide this information directly to PRES candidates, there are many
informative websites about Ireland’s culture, tax system, housing, citizenship, health service, etc., such as,
www.gov.ie or www.citizensinformation.ie or www.immigrantcouncil.ie

7.7. Where can one obtain information about transportation in Ireland?

Information regarding transportation in Ireland can be found at this Citizens Information link. The National
Journey Planner provides journey planning and timetable information from all licensed public transport
providers across Ireland.

7.8. Does the Medical Council provide any Past Papers?

The Medical Council does NOT provide any past papers in relation to the PRES. Information in relation to the
subjects covered in the PRES exam is provided in 8.10. Does the Medical Council recommend any Textbooks?.

7.9. Does the Medical Council recommend any preparation courses?

The Medical Council does NOT provide and does NOT endorse any preparation courses in relation to the PRES.

7.10. Does the Medical Council recommend any Textbooks?

The Medical Council does not require candidates to purchase or use any specific textbooks for the PRES
examinations. Candidates may find it useful to review the major textbooks in the main clinical disciplines of
Obstetrics & Gynaecology, Paediatrics, Psychiatry, Surgery, Medicine and General Practice. Journals can also
be used as a way to keeping up-to-date. The examinations are designed to be a test of a candidate’s clinical
skills, knowledge and attitude. The Medical Council does not authorise or endorse any books/papers
specifically about passing the PRES.

General Practice
Stephenson A: A textbook of General Practice (Hodder Arnold Publication 2011)

Psychiatry
Puri, Laking, and Treasadon: Textbook of Psychiatry (Churchill Livingstone 2011)
Cowen, Harrison, and Burns: Shorter Oxford Textbook of Psychiatry (Oxford University Press 2012)
Katona and Robertson: Psychiatry at a Glance (Wiley Blackwell 2012)

Obstetrics and Gynaecology

Collins, Arulkumaran, Hayes, Jackson and Impey: Oxford Handbook of Obstetrics and Gynaecology (Oxford
University Press 2013)

Paediatrics
Lissauer and Clayden: Illustrated Textbook of Paediatrics (Mosby 2011)
Marcdante, Kliegman, Behrman, and Jenson: Nelson Essentials of Paediatrics (Saunders 2010)
Rudolf, Lee and Levene: Paediatrics and Child Health (Wiley Blackwell 2011)
Bernstein and Shelov: Paediatrics for Medical Students (Lippincott Williams and Wilkins 2011)
Gill and O’Brien: Paediatric Clinical Examination Made Easy (Churchill Livingstone 2006)
Stephenson, Wallace, and Thomson: Clinical Paediatrics for Postgraduate Examinations (Churchill Livingstone 2003)

General Internal Medicine

Kumar and Clarke: Clinical Medicine (Saunders 2011)
PLEASE NOTE: This information may be subject to amendment/changes in whole or in part at any time at the discretion of the
Medical Council. You should ensure that you read the most up-to-date information regarding examinations in this Handbook.
Page 31 of 34
MEDICAL COUNCIL PRE-REGISTRATION EXAMINATION HANDBOOK
Longmore, Wilkinson, Baldwin, and Wallin: Oxford Handbook of Clinical Medicine (Oxford University Press 2014)
Boon, Colledge, Walker and Hunter: Davidson’s Principles and Practice of Medicine (Churchill Livingstone 2006)

Surgery
Townsend, Beauchamp, Evers, and Mattox: Textbook of Surgery: The Biological Basis of Modern Surgical Practice
(Saunders 2012)

Ethics and Professional Conduct

Guide to Professional Conduct and Ethics for Registered Medical Practitioners
(Medical Council 2016)

7.11. What is the syllabus for the PRES?

7.11.a. Medicine

Candidates are required to have a comprehensive general knowledge of the key elements of accurate history taking;
the interpretation of symptoms; the analysis of cardinal physical signs; proficient bed side examination and the
competent interpretative skills necessary for clinical diagnosis. Additionally they should have adequate background
knowledge of genetics, immunology, pharmacology, nutrition, social and environmental factors, occupational
influences and the impact of environmental hazards due to physical and chemical agents.

Candidates will be expected to have a broad knowledge of the therapeutic principles of drug action, prime drug
indications, side effects of pharmaceutical agents and reasonable knowledge of the drugs used for common acute
and chronic medical conditions.

7.11.b. Surgery

Candidates will be expected to be familiar with the basic physiology and biochemical processes in health and disease
and to apply the underlying concepts, in association with anatomical and pathological principles, for the
identification, investigation and treatment of surgical illnesses.

Candidates are expected to have sufficient knowledge of surgical problems in the gastrointestinal tract, vascular
system, endocrine system, genitourinary system, neurological and locomotor systems, chest, head and neck, skin,
connective tissue and limbs. The ability to discuss pre and postoperative care of the patient will be assessed and
particular emphasis will be placed on surgical infection, wound healing, nutrition, food and electrolyte balance,
haematological investigation and the planning of further investigations and management.

7.11.c. Obstetrics & Gynaecology

Candidates will be expected to have adequate knowledge of the physiology of normal pregnancy, labour, delivery
and the puerperium, together with an insight into common diseases states of the pregnant woman and the newborn
infant and their investigation and treatment. Candidates will be expected to have adequate knowledge of
disturbance of reproductive function, including menstrual disorders, infertility, contraception and family planning,
and genital infections. In addition, an understanding of the presentation, investigation and management of
gynaecological malignant diseases will be required.

7.11.d. Paediatrics

This syllabus will include congenital malformations, normal growth and development of children, assessment of
handicap, nutrition, common infectious diseases, accidents and poisoning, non-accidental injury, function and
diseases of the heart, lung, gastrointestinal tract, genitourinary tract, blood, central nervous system and skin.

7.11.e. General Practice

7.11.f. Psychiatry

Candidates will be expected to have a broad knowledge of the theoretical and practical aspects of psychiatry
including the clinical approach to the patient. The ability to elicit a comprehensive history and adequately assess the
patient’s mental state will be necessary.

Assessment may include personality development, organic psychiatric syndromes, schizophrenia, the affective
disorders, the clinical neuroses, personality disorders, alcoholism and drug abuse, eating disorders, mental handicap,
common childhood psychiatric disorders, psychosomatic disorders, forensic psychiatry, psychosexual problems and
community psychiatry.

An adequate knowledge of current treatment and management approaches to psychiatric illness, including physical,
psychopharmacological and psychological treatments will be required.

SEE ALSO “HOW TO USE THE DRAFT BLUEPRINT FOR THE PRE-REGISTRTAION EXMINATIONS (PRES) LEVEL 3”

8. Contacting the Medical Council about the PRES Examination

If you have any queries regarding the PRES examination itself, please contact the PRES Officers at the Examinations
Section by email to: [email protected]

If your query relates to registration with the Medical Council, please contact the Registration Section using the
Registration Contact Form.

The Medical Council’s address is:

Medical Council
Upper Ground Floor and 5th Floor
Block 9 (Europa House)
Harcourt Centre
Harcourt Street
Dublin 2
D02 WR20

The main telephone number is: 00353-1-4983100

The website address is: www.medicalcouncil.ie

This information may be subject to amendment/changes in whole or in part at any time at the discretion of the
Medical Council.

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