Communication Skills

1. Please provide your contact information below: *

First Name:	*
Last Name:	*
Email Address:	*
Contact Mobile Number:	*

2. When did you start studying medicine?

3. Which option best describes yourself:

UK Graduate
IMG (International Medical Graduate)
Other (please specify):

4. When are you planning to sit the PACES exam?

5. How many time have you attempted the PACES exam?

This will be my first time
Twice
More than twice

If you failed, why do you think you failed?

6. What is your biggest fear about the Communication station?

7. What holds you back the most when it comes to the communication (skills/belief)?

8. On a scale of 1-5, how would you rate the following statement:

I have COMPLETE clarity and have a STRUCTURED framework on HOW to communicate effectively e.g. breaking bad news, DNAR discussions and counselling for a procedure.

9. Please confirm you are happy for an initial call to discuss one to one tutoring in “PACES communication”. *

I confirm

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