MFPH part A tips

Introduction

This page contains some tips for people taking the MFPH Part A exam. A few of them are obvious, but hopefully they'll still be a useful reminder. Any feedback/additional tips gratefully accepted!  Good luck!

General tips

You might want to bear the following in mind, roughly in order of when they may be useful to you:

As soon as you know you want to take the MFPH part A

• Check the dates of the next sitting - see the FPH timetable page - and apply for the exam (sounds obvious, but some people forget!)
• Size up the job - have a quick look at the syllabus and some recent past papers (2001 on) so you get an idea of how much you know already, and how much work you've got to do.  (Quick warning on the syllabus: some of the descriptions are quite concise and clear, others aren't - don't be put off - but by the end you should try to know a bit about every item on the list.)  You can then work out when you want to start revising properly 
• Check dates for revision courses (see below for more information) if you're able/want to go on one.  I found Ed Jessop's course invaluable and brilliant value, and also a useful barometer for how my revision was going. Again, make sure you apply early for any course
• Find out if anyone else you know is taking the exam; some people find it helpful to revise together (though this is really personal taste) but it's definitely useful to have a sympathetic ear when you're frustrated with revision!

When to start revising

• How much revision you need to do, only you can decide. However, I reckon if you start too early you'll only forget it all!
• Your decision will also depend on whether you are 'revising' or just 'vising' (sorry for the obvious pun) - if you think there's a lot you're not sure about, or you've not got MSc or MPH experience, then you might want to think about starting earlier too
• Whether you are doing a full-time day job just before the exam, or if you have the luxury of some revision leave, will also impact upon how long before the exam you should start your exam work

Start of revision period

• Get together your revision material
  • print out a copy of the syllabus
  • print out some of the past papers (if you're only doing a few, go for the most recent, but only from 2001 onwards in any case)
  • buy/borrow any textbooks you think you might need (see below)
  • make sure you know where any notes are from any relevant MSc, MPH or other course
• Divide up the work. You may want to do this by syllabus section, or your own headings (I used: General [random bits of information that didn't seem to fit in elsewhere], Specific topics [e.g. obesity, environmental health], health protection [e.g. HIV, TB], epidemiology & stats, health economics, organisations & management)
• Make a revision timetable.  You may feel like you're about to take your GCSEs again, but I find a bit of discipline (and reward - I try to make sure I have regular days or half-days off) helps.  It also means you can force yourself to concentrate on areas you know you are weak on, and divide up big topics into manageable portions.  I like to keep my timetable 'dynamic' - I'll update it to reduce the time on areas I'm comfortable on, and increase the time on more difficult topics

Main revision period

• Do the work!
  • It may seem tempting to try to 'wing it' on little revision, or 'bin' topics - but both these strategies (especially the latter, given that there are very few optional elements to the exam) are pretty high risk, and you'll kick yourself if you fail without trying properly.  Also, remember how much it's costing you to take the exam!
  • Most of my 'main' work consisted of making notes from books (see below), looking up topics on the internet (see below), doing a bit of data manipulation, and regularly (every day) testing myself on stuff I'd already revised (initially just topic by topic, then later on by practising past paper questions), to make sure it stayed in my head!
• Use basic memory/education theory to boost your recall
  • 'Active' learning is better than simply reading information - try to use or manipulate the information while revising - e.g. by testing yourself after reading some text, or simply making notes from a book rather than just reading it.  Some people like to revise in groups, with other colleagues who are also taking the exam, although I find I usually work better 'solo'
  • Recall is improved if you revise the same information a few times, at longer intervals each time
  • Different people learn in different ways: if you remember things more easily if you draw a diagram, then draw diagrams; if you like mnemonics, then use these; etc.
  • Don't work too hard.  Attention span is always said to be about an hour maximum, so try to have a short break after this time, otherwise you'll not be working efficiently
• Practise exam questions from past papers (or similar ones set by yourself)
  • Don't feel compelled to do this early on in your revision if you think it'll knock your confidence - better to get a bit of general knowledge under your belt, then try
  • Practising questions will help make sure your revision is relevant to the exam you'll be sitting (no point in revising lots of stuff which you won't be asked), and that you get used to the style of answer the examiners are looking for
  • Although some questions are reused, it's probably a waste of time trying to learn set answers
  • Some people like to write full essays during their revision; I prefer to write none before the exam at all - just do lots of essay plans, then mark them according to the Examiners' comments given in the past papers. Remember, though, there is no exactly 'right' or 'wrong' answer for each question, so don't be put off if yours isn't identical to that given - but it should be in the same ball-park
  • Make sure you're reasonably cognizant of major public health reports and legislation (see Public health policy and legislation) - in particular the Black, Acheson and Wanless reports
  • 'Trendy' topics (e.g. smoking, climate change) may turn up, but don't bank on it.  Remember too that the exam is set (principally) for the whole of the UK - so questions requiring knowledge of policies specific to one area/country (e.g. Practice-based commissioning, England only) are not likely to appear, although there's no reason why you can't use them as examples in your answers
• Use the syllabus as a guide
  • Don't be intimidated by the size of the syllabus (unless the 'fear factor' helps you!), but you may find it helpful to keep a note of which topics listed you still have to cover
• Practise critical appraisal
  • Some people hate this, for others it's not such a problem.  Either way, it's probably best to practise at least one or two appraisals (e.g. from the past papers) before the real thing. See resources, below for some useful websites
  • Some advocate trying to read through all the BMJ articles from the year preceding the exam to guess which might turn up for critical appraisal; this might work, but there are so many possible articles that you're probably better off practising general technique, or doing general revision
  • You might find my critical appraisal framework (pdf, 11kb) adapted and extended from CASP) useful as an example
• Practise data handling
  • Again, a bit of an individual thing how comfortable you are with this,   but you should make sure you're not too phased by being asked to calculate directly or indirectly standardised mortality ratios, numbers needed to treat (NNT), population attributable risk, sensitivities, specificities, likelihood ratios, chi-squared etc.

The last few days before the exams

• If practising exam questions, make sure your timing works.  You should be able to do a complete essay plan in about 5 minutes, and full essays (if you're doing them before the exam) in the allocated time
• Remind yourself of the structure of the papers, how long they are, and how long you have for each question in the exam.  Currently this is:
  • Paper 1A - 2½ hours, 6 questions (=25 mins/question)
  • Paper 1B - 1½ hours, 4 questions (=22½ mins/question)
  • Paper 2A - 2½ hours, critical appraisal and some other questions
  • Paper 2B - 1½ hours, data manipulation and summary
  • Papers 1A and 1B are on day 1; Papers 2A and 2B on day 2
• Work out some basic 'frameworks', if you find this helpful
  • By frameworks, I mean outline structures for questions of a certain genre - e.g. 'what is the epidemiology of disease x?'
  • They are useful to make sure you don't forget to put information in your answer which you know, but will otherwise not score points for
  • If you decide to use such frameworks you should be careful to apply them judiciously, and always make sure you answer the question - don't put in everything you've remembered from your framework just because you can - you risk not gaining any extra points, and worse, annoying the examiner.  The FPH specifically advises on this point in their exam blurb, so be warned!
• Remember that everyone's good at remembering some things and not others.  Therefore this may be the time to forcibly insert into your head - however temporarily - those things you just can't get to stay in your brain for more than a day or so (for me, the formulae for confidence intervals had a habit of slipping away if not regularly used...)
• Work out how you're going to get to the exam hall!  Remember that the exams are spread over two days, so if you've got a very long journey to the exam you may want to stay over at least one night

During the exams

• Relax!  Spend two minutes at the start of each exam reading through the paper, instead of rushing headlong into writing your answers
• Answer the question (and all of the question)!  However tempting it is to answer a question you know the answer to, rather than that in front of you, stick to the latter
• Write a brief essay plan for each essay question prior to writing the answer, to ensure you cover all points and the essay flows reasonably
• Aim to write roughly 1 side of A4 per 10 minutes of exam time (the paper you are given is wide ruled, just so you know). This will obviously vary depending on your handwriting size, but I think mine's about average, so if yours is extra large or small you should adjust this accordingly.  If you're writing's normally illegible, tidy it up!
• Make sure you answer every question - you can't afford to score a low mark on any question - so even if you've not written everything you know about your favourite topic, if you're running out of time, skip to the next question
• Your literary style is not marked, so don't get overly worried about fancy sentence construction, so long as you can get the point across clearly
• Number each sheet according to the instructions given in the exam
• Show all working for data manipulation questions - you may get some credit for your working even if the end result is incorrect
• Your answers will be farmed out to different examiners to mark, so write the question number, subsection, and the question itself, at the top of each answer, so that if the pages get muddled up you still get the credit you deserve
• Structure your answers with appropriate underlined headings - this makes it easier to read, and means (i) it shows the examiner you've understood the question; (ii) it's easier to see where you've made points which deserve marks; and (iii) puts the examiner in a better mood, thus predisposing them to give you the benefit of the doubt elsewhere in the paper!  Bullet lists are also acceptable and useful when used appropriately
• Define how you interpret key terms used in the question at the start of your answer, e.g. "In this answer I will take 'diabetes' to mean types 1 and 2 diabetes mellitus (not diabetes insipidus), and 'local interventions' to mean those appropriate to the level of the Primary Care Trust (population ~300,000) in England"
• Take a diplomatic/polite tone when answering questions where you have to write a letter, press statement, etc.  Whilst you should be honest, and clearly state any facts relevant to the question, you should also acknowledge other people's opinions or stances, e.g. if you are responding to an inaccurate press story or pressure group opinion.  Note this is not the same as sitting on the fence - you should still express your own opinion, just not be unnecessarily rude or inappropriate when criticising others
• Similarly, use lay language where appropriate, e.g. if writing to a non-scientific audience
• Give relevant examples in your answers where possible.  This shows breadth of knowledge and confirms you understand the question
• Write what you would do in practice - e.g. if an answer concerns managing a disease outbreak, you might write that in addition to everything else you would do, you would still check in a textbook/look up the disease on the internet, and consult colleagues with experience in handling such an outbreak if it's one you're unfamiliar with

After the exams

• After the first day's exams, try to get a reasonable night's sleep before the next day - try not to do too much extra revision that night, and especially don't worry about how you did in the first two papers - there's nothing you can do about it now
• After the last paper - congratulations!  Your hand stayed in one piece (just), and now you can relax (at least until the results are nearly out)
• The results come out about 6 weeks after the written paper.  At the time of writing, these were only available by post - not by phone or internet.  Also, the estimated date for publication was put back on about 3 occasions, so don't get too nervous before the results are first 'supposed' to be out - they may not arrive in the post that day!

Recommended courses

I'd recommend Dr Jessop's course without hesitation.  It lasts a couple of days and is a rapid review of the majority of topics you'll need to know.  There's no intimidating picking on people (if you've had bad revision course experiences before!) and he's very pragmatic.  The notes which are available on his website are very good, but make more sense after you've been to the course.

A local one for me, but the Oxford University HERC one-day course was an excellent introduction to health economics.

Please let me know of any other courses you've heard of, or been on, which are good.

Recommended textbooks

Everyone will have their favourite textbook for different subjects, but these are some of the books I found useful.  Unfortunately there are no textbooks which purport to cover all of the Part A syllabus yet (although see Not yet published..., below). Most books here are good to dip in and out of - don't feel compelled to read each in its entirety. Also, remember that textbooks date quite quickly, so you may want to complement your reading with a bit of internet surfing for updated information.

(I've given the link to the Amazon.co.uk page for each text for convenience.)

General topics

Pencheon, D et al. Oxford Handbook of Public Health Practice (2e). ISBN: 0198566557  Very useful short, pragmatic chapters on a wide variety of public health topics.  I've got the first edition, but assume this second edition is as good if not better

Donaldson LJ & Donaldson RJ. Essential Public Health (2e). ISBN 190060387X  I was initially quite sceptical about the relevance of this book - the cover is quite old-fashioned - but it has very readable, in-depth chapters about lots of useful topics including fertility rates, mental health, care of the elderly and environmental health

Farmer, R and Lawrenson R. (Lecture Notes on) Epidemiology and Public Health Medicine (5e). ISBN: 1405106743  Okay, so maybe quite a lot of it is basic, but the chapter on health targets gives very concise summaries of the epidemiology of major diseases over time

Detels R et al. Oxford Textbook of Public Health (4e). ISBN: 0198509596  For my money slightly erratic, but still useful for reference. The chapters are very detailed, perhaps a bit too detailed for this level - I found it often took too long to distil out the relevant material - but the contributors are usually leaders in their field.  I didn't use this as much as I thought I might, but it does look good on your shelf!

Health economics

I didn't (and don't) have one!  I found a combination of notes I had taken on the Oxford University HERC one-day course and Ed Jessop's revision course sufficient

Statistics and epidemiology

Kirkwood BR, Sterne JAC. Essential Medical Statistics (2e). ISBN: 0865428719  Very approachable, but later chapters are probably too in-depth for the MFPH

Sociology

Scambler G. Sociology as Applied to Medicine (5e). ISBN: 0702026654  Not all relevant, but useful introduction to concepts such as the sick role and deviance

Organisations and management

Handy, C. Understanding Organizations (4e). ISBN: 0140156038  Perhaps not as good as some evangelists make out, but a useful reference for looking up specific terms, and surprisingly cheap by 'textbook' standards. I found the chapters on power particularly helpful

Health protection

Hawker, J et al. Communicable Disease Control Handbook (2e). ISBN: 1405124245  Excellent summaries of all the diseases you could ever want (so to speak!)

Not yet published...

Lewis et al, Mastering Public Health ISBN: 1853157813  Not published yet (due Dec 2007) - so I'm afraid I can't say whether it's any good.  However, I plan to review the book shortly for the site. In theory, this may be the answer to Part A candidates' prayers!

Recommended websites

For most topics you're probably best off doing a Google search, but these are some specific sites I found useful.

Statistics

Jason Newsom's stats notes (Portland University) - absolutely fantastic (in my view!), very readable introduction to basic and intermediate stats
Statistics at square one (BMJ, 1997) - whole book online
Statsoft electronic textbook of stats (StatSoft) - good reference site
Jonathan Marchini's notes (University of Oxford)

Health protection

HPA - obvious perhaps, but gives good overviews of loads of diseases
Chemical and other incident checklists (HPA) - useful reference

NHS Policy

National Service Frameworks (DH)
NHS Screening - good current information on screening programmes

Occupational health

RIDDOR - information on RIDDOR
COSHH - information on COSHH (HSE)

Organisations and management

Strategy survival guide (Cabinet Office) - useful overview of strategy development
Managing change in the NHS (SDO) - change management documents - quite long, but principles useful

Critical appraisal

Critical Appraisal Skills Programme (CASP) tools (PHRU) - good frameworks for critical appraisal; adapt, extend and personalise them as necessary

My critical appraisal framework (pdf, 11kb) - based initially on CASP, but with added extras

Topical issues

Try to look at some of the sites linked to on the news sources page when you get a chance, to keep up-to-date with major public health stories.  Some of these stories can also be found in the Public Healthy news archive

General

Wikipedia - general encyclopedia, good for health economics terms
Edmund Jessop's site - some good revision notes, and includes details of Ed's courses
Health Knowledge - slightly variable, but some good articles nonetheless
Howard J, MFPH Exams (BMJ Career Focus, 2008)
Revision advice from Catherine Heffernan  'Top ten' Part A tips

 

Any other suggestions?  Please drop me a line.