Four weeks before PACES, the most useful plan starts with your confirmed allocation, available bedside teaching and the skills that still need observation. Put scarce supervised sessions into the calendar first, then use independent study to prepare for and learn from them. Do not build an ideal online timetable and hope the essential clinical practice will fit around it.
The Federation's PACES dates page, checked on 3 October 2026, distinguishes examination diets and locations; your allocation determines the actual countdown. This is a suggested final-stage framework, not an official programme or a claim that four weeks is sufficient preparation from any starting point.
Establish what has and has not been observed
Review recent feedback and ask which skills have been assessed directly. A colleague may have heard a good summary without seeing the examination. You may have recognised a sign in a video without eliciting it on a patient. Record those distinctions rather than grouping everything under a topic marked complete.
Choose a small number of priority gaps. These might concern a particular examination technique, the interpretation of uncertain findings, an unfocused presentation or difficulty responding to patients' concerns. The plan should state how each will be tested again.
Use the current PACES format, checked on 3 October 2026, to retain breadth. Concentrating on a weakness should not make other encounter types disappear from the month.
Week one: obtain an honest baseline
Arrange representative observed practice early. Ask the observer to distinguish what you performed, what you found and how you interpreted it. If the findings differ, discuss the reason rather than immediately memorising the observer's conclusion.
After each session, select one correction that can be acted on. A technical problem needs a demonstrated and observed repeat. A knowledge gap needs a focused source check followed by a new explanation. A communication problem needs another interaction, not merely a better written model answer.
A fictional trainee, Ben, discovers that his long summaries do not identify which findings support his preferred diagnosis. He initially plans to read a larger case book. His observer instead asks him to present the same information in a way that separates observation from interpretation, then test that approach on another case.
Reserve bedside access before adding more independent tasks
Clinical teaching depends on appropriate patients, consent, supervision and local arrangements. Agree sessions realistically and respect the clinical workload. Do not assume every missed session can be replaced immediately or that access to a ward alone provides useful feedback.
When a planned session is cancelled, choose an activity that advances the same learning question where possible. Ben might practise summarising a de-identified teaching case or revisit the relevant physiology. He should not record this as an observed examination if none occurred.
The Federation's preparation guidance, checked on 3 October 2026, provides an authoritative anchor for seeking senior observation. Use the source to calibrate your plan while keeping the actual requests specific to your needs.
Week two: alternate examination and discussion
Pair a suitable examination session with a later case discussion. The first asks whether you can gather and recognise the information. The second asks whether you can explain what it means and respond to questions about alternatives or next steps.
Do not repeat only the same case. Change the task: after discussing a finding, explain it to a patient rather than an examiner, or compare it with a related but different presentation. The purpose is to test whether the reasoning survives a change in context.
Maintain some communication practice even when the most visible weakness concerns physical signs. A reasonable clinical interpretation still needs to be conveyed in a way that fits the person and the task.
Use solo practice for the interval between observers
As described in iatroX's September 2026 simulation announcement, its PACES track supports conversational rehearsal, transcript-linked feedback and Tutor-led remediation. This can provide a bounded activity between supported sessions, particularly when the unresolved problem is explaining a clinical distinction.
For Ben, the exercise is not to produce a memorised speech about the earlier patient. It is to explain why particular findings support one interpretation while leaving a relevant alternative open. After the discussion, he checks questionable clinical claims against an appropriate source.
The simulation does not replace physical examination practice or establish a pass probability. Where transcript feedback conflicts with a defensible explanation, inspect the exchange and seek appropriate clarification. A number on a report should not decide which evidence you ignore.
Week three: test integration and unfamiliarity
Use a suitable mock or series of unfamiliar observed tasks to examine whether the different skills hold together. Match the purpose to the current format without assuming that a locally organised circuit reproduces the official marking process.
Reserve a debrief before choosing the size of the mock. Identify errors that recur across encounters and distinguish them from isolated uncertainty. A poor performance in one case should lead to analysis, not an immediate replacement of every resource.
Ben's next mock shows a clearer opening summary, but his answers become unfocused when the observer challenges an alternative diagnosis. The next task is therefore a discussion of competing explanations, not another generic presentation exercise. This is a fictional illustration of adapting a plan, not measured improvement from a product.
Make the rota part of the design
Place demanding integrated practice in periods when you can engage with the feedback. Use shorter sessions around work for a defined source question, a focused explanation or review of a previous observation. Do not make every evening depend on access to another person.
When the week changes, retain the highest-value next action rather than adding every missed activity to the following day. A workable reduced plan is preferable to a growing backlog that no longer reflects the available time.
If important competencies remain unobserved or substantial gaps persist, discuss this with an appropriate supervisor. A revision calendar cannot establish readiness simply because all its boxes are complete.
Week four: narrow the plan and confirm the day
Choose the final activities from the most recent evidence. Revisit a recurrent technical issue in an appropriate setting, rehearse a difficult explanation and review the small set of knowledge gaps that materially affect your reasoning. Avoid beginning a new comprehensive resource unless it solves a clearly defined problem.
Confirm the centre, travel, identification and current candidate instructions. Practise moving attention to the next encounter after an imperfect one, using mock transitions rather than spending every break reconstructing the previous case.
According to iatroX's product information dated 3 October 2026, one complete simulation is free and ongoing access is part of its learning bundle. Use additional digital practice only when it contributes to this plan. The final month should leave you with clearer evidence about what you can demonstrate and which limitations still need support, not merely a larger count of completed cases.
Frequently asked questions
Should I count four weeks from the start of the PACES diet?
No: plan backwards from your own confirmed allocation. Diet dates and other candidates' appointments do not establish your examination day.
What should I do when bedside teaching is cancelled?
Choose a useful related activity, then rearrange the observation that remains necessary. Do not treat a video or conversation as evidence that physical technique has been assessed.
Does completing this plan mean I am ready for PACES?
No: readiness depends on the skills and knowledge you can demonstrate, not timetable completion. Use current official information and appropriate supervisor feedback to assess remaining needs.