My ERPM Journey – It’s Easier Than You Think

The Examination for Registration to Practise Medicine (ERPM) in Sri Lanka is conducted by the Sri Lanka Medical Council (SLMC) for citizens of Sri Lanka who obtained their medical qualification from medical schools overseas


Summary

ERPM exam consist of two components

  • Part A and D 
  • Part B and C
For more details, click here


I was able to pass ERPM in my first attempt (ERPM Part A, D in July 2019 and ERPM Part B, C in December 2019) as I managed to find the proper guidance, motivation and support from the people around me. That is why I decided to write this article, to direct you on a brighter path which I believe is right. Everything I have mentioned here, is my personal opinion based on my personal experience.  


Get Degree Approval Letter
This is the first thing you need to do, to get the eligibility to sit for ERPM.
Visit SLMC and follow the procedure that they advice you to do. (This procedure changes frequently)
After submitting all documents, they will provide you the degree approval letter in about 1 month.
 
 

Do The Research 
Find out the ERPM classes that you want to attend. 
Classes are held at….

  • Sipna Institute – Colombo 4
  • Sigma Institute – Kirulapone
  • Ideal Academy – Wallawatte 


Remember to spend less time in classes and more time in self studying.

Sigma institute, Kirulapone conducts comparatively more number of classes than Sipna institute, Colombo 4 which I think is a huge disadvantage.
Therefore I attended classes at Sipna Institute and Ideal Academy


Find An Apartment 

This is highly recommended for the ones who lives far away from the institute, to reduce the time wasted because of traveling.
I stayed in Colombo – 4, as majority of the classes I attended was at Sipna Institute


Avoid Locums Or Any Other Part-time Jobs (Research Assistant, Medical Assistant or Demonstrator)
Unless you are having severe financial difficulties, try to avoid them. For the time being you may think that it’s a cool way of earning, but this will minimize the effort that you put into the exam or may eventually be carried away by the money.


Attend Classes – ERPM Part A and D

Attend classes regularly, because all the stuff that they teach is not included in their handouts. 
Write down the additional stuff that they teach, as it will come handy when attempting questions later on.
Become familiarized to the exam pattern and questions. This does not mean you have to attempt a ton of questions, remember to study smarter, not harder 

  • Medicine 
    • I attended classes of Dr. Lalindra Dias
    • Classes frequency – 2 classes / week and occasionally 3
    • His past paper classes are very beneficial 
    • It is essential to be prepared for paper classes to get the most out of it. So at least read all theory notes before attending paper classes
 
  • Paeadiatrics
    • I attended classes of Dr. Ruwanka De Livera 
    • Class frequency – 1 class / week
    • He will discuss questions at the end of each topic
    • He did only 5 papers classes including a class covering all SBAs – More than enough for the exam
 
  • Surgery
    • I attended classes of Dr. Rohana Gamage 
    • Class frequency – 1 class / week
    • He will teach a very concise version of surgery, which is enough to get through the exam
    • He will tell directly what to study and what to leave
    • I only attended his revision and paper classes, and I had a quite good knowledge in Surgery after finishing the exam
 
  • Gynaecology and Obstetrics 
    • I attended classes of Dr. Wasantha Kumara 
    • Class frequency – 1 class / week
    • He will finish the syllabus quickly and start revision soon after that
    • His revision will overlap most important topics over and over again, so even if you don’t study you’ll be able to remember by listening to it
 
  • Community Medicine 
    • Classes are conducted by a group of teachers (Dr. Mahesh KambukageDr. Ashan pathiranaDr. Chathura WijesundaraDr. Himan GalappaththiDr. Kumudu Nanayakkara
    • Class frequency – 1 class / week
    • Will not teach any unnecessary stuff just to scare the students 
    • They are a very dedicated group of teachers looking from the students perspective and trying to make the boring subject more enjoyable 
    • You can download my Community Medicine notes from here.
 
  • Forensic Medicine 
    • I did not attend any class
    • I followed the model papers and answers given by Dr. Christy Rajeev‘s.
    • To clarify my doubts that I came across while doing the papers, I refered the book called “Forensic Medicine And Medical Law” written by Dr. Hemamal Jayawardena
 

ERPM Part A and D – Exam Day 
  • Prepare all documents and stationary (pen, pencil, eraser, sharpener) prior to the exam date
  • Have adequate sleep, to aid better judgement
  • Take something to eat in the middle and water to refresh yourself before the second paper begins 
  • Medicine, Paediatrics, Surgery papers can be finished at least 40 mins prior to the finishing time (Personal opinion)
  • Give the paper and leave to get more time to study for the next day exam 
  • I marked the mark sheet initially with a pencil, then marked with a pen while reviewing the questions 
  • Remember that there is negative marking in MCQs and avoid marking doubtful MCQ stems, unless you haven’t marked enough MCQs to get the pass mark or you do not know the whole MCQ
 
 
Allocate hospitals for clinical practices 
You should do this soon after the exam, as everyone is in a rush to do this. So if you don’t do this early, you want be able to get the desired hospital.
For this you have to go to Office of Provincial Director of Health Services at Maligawatta and follow the instructions provided from the office.


Attend classes – ERPM Part B and C
Classes will start soon after finishing the written exam before the results are published. I attended the same set of classes.
You will feel like you have studied less than ERPM part A, that’s because they assess your clinical skills. communications and cooping with emergencies in this chapter of the exam.
Do not study a lot of theory parts as they would not question about it. 
All classes that I attended, covered all histories with related questions, the art of questioning patients, examination technique, case presentation
For emergency viva – Be more practical and always try to imagine yourself working as a HO and then you will be able to answer questions more easily 

  • Medicine
    • The clinical exposure under the guidance of Dr. Lalindra Dias at Nuwara Eliya District General Hospital was very beneficial 
    • I strongly advice to go for these clinic visits with him (Twice is more than enough) because you will be able to identify your weaknesses and gradually strengthen them
 
  • Paediatrics 
    • The sole reason that I passed the CVS short case in my exam was because I attended his cardiovascular clinical visit
    • Attending Dr. Ruwanka De Livera’s practical sessions are ultra important to brush up the inadequate paediatric exposure 
 
  • Surgery 
    • He does not conduct practical sessions, but his teaching and demonstration is enough to apply the knowledge on a patient
    • Dr. Rohana Gamage will do role play, him acting as the patient and you have to take the history from him
    • My communication skills are so bad, this method helped me to improve my communication skills
    • I also attended one practical session arranged by Dr. Dileepa Banagala where I was able to examine a lot of patients at a shorter duration (If you have adequate hospital exposure, no need to attend for this)
    • I referred the app “Short Cases In Surgery” developed by RER MedApps, which was very beneficial 
 
  • Gynaecology and Obstetrics 
    • Dr. Wasantha Kumara taught examination techniques on actual patients which was helpful
    • He covered all topics very quickly which left us time to attend hospitals 
    • I added some extra points for the histories, just to make it complete, but his teaching is enough to pass
 
  • Emergency Viva
    • Finish studying this part as soon as possible as it contain most of the theory parts that we studied for part A
    • Find the notes from someone who attended the class before, get their notes and go through them
    • In classes, this part is done at the very end, sometimes you might not have enough time to go through them if you wait that long


Go For Hospital Visits

After you get the letter from the Ministry, go to hospital visits
This is the most crucial element in passing the exam
After you practice examination techniques at home, perform on patients to achieve perfection. 
Always concentrate on time (6 mins) when performing examinations
Take histories from patients
Try to present both long and short cases (Equally important as problem identification, as you can strike the examiner with a good impression just by talking)More effective when going along with a small gang (2 – 4 friends) and them to assess your performance and criticize on the mistakes 


Waiting for the letter from SLMC

Till you receive this letter, you will have no idea on the exam date
Mostly you will receive the letter mentioning your exam station two weeks prior to the exam
Therefore you have to be prepared by then, as you will not have time to cover everything, if you are doing all four subjects
If the station that you got is far away from where you live, you’ll have to reserve a hotel as well


ERPM Part B and C – Exam Day

  • Prepare all documents required prior to the exam
  • Ensure that you have all instruments prepared prior to the exam
  • Get adequate amount of sleep 
  • I have no special advise here, because the exam depends on multiple factors (Patient, examiners, language barriers, what you give as answers, etc…)


Hope this helped and wishing you good luck! 



My ERPM Journey


This journey began the day I left Bangladesh completing the one year internship on 21st February, leaving my ever loving fiancée (Dr. Janani Rajamanthri) in Bangladesh all alone. She asked me only one thing the day I was going back to my hometown, that was to pass ERPM at one go, to compensate the loneliness that she will endure from our temporary parting. This is the main reason that kept me motivated throughout the exam.


After submitting all documents to SLMC to get the degree approval, the first and most important thing was to decide on what classes I was planning to attend. For this I contacted some of my friends who passed the exam in their first attempt and the ones who failed the exam in their first attempt. I specially asked about the amount of classes and the study time that we have for ourselves. 


Final verdict on the classes was most of the students were attending the Sigma institute at Kipulapana which will hold classes the whole week and on most days there will be classes the whole day leaving us neither time to review our notes nor to attend in self study. Most of the guys from my batch was attending those classes, whom I did not wish to see again. 

There were another set of classes held at Sipna Institute at Milagiriya which will have less amount of classes (Paediatrics, Gyn and Obs, Surgery – 1 class per week, medicine 2 – 3 classes per week). I was really impressed with that schedule and further reassured by my friends Dr. Sanjeewa Weerasinghe and Dr. Shanuka Dilshan, therefore I decided on perceiving these classes. 

Then I inquired about Community medicine and Forensic medicine and left me with doubtful thoughts. I myself decided to attend community medicine classes held at Ideal academy at Wallawatta which will have only one class per week and for Forensic medicine Dr. Sanjeewa Weerasinghe convinced me to go through the past papers and prepare by myself without attending for any classes.


I will consider this as the second most important decision that I made for my success in the exam, that was to rent an apartment at Colombo 4, close to the academic institution. I would recommend this to anyone who is residing far away, to rent out an apartment close to the institute, so that you can avoid unnecessary travel time as this is one of the crucial elements of passing the exam even though it doesn’t sound like much of a big deal.


When I started attending classes, I was already too late.



ERPM – Part A and D


Medicine classes were conducted by Dr. Lalindra Dias who is almost always late. He had completed up to Endocrinology when I joined the class. I took the previous notes from my friend Dr. Sanjeewa Weerasinghe who attended all the classes since day 1. He will conduct past paper revision classes covering all the exam questions and this will prepare you to handle any medicine question that would be given to you at the exam. He will also give an answer script which will provide additional information. He took me to a level where I would believe that I would pass Medicine even before appearing the exam.


Paediatric classes was conducted by Dr. Ruwanka de Livera, the youngest of all teachers who will teach you from the scrap covering all the basic to the much more advance stuff, with the intention of teaching all students at all levels of education. His teaching was quite slow paced, but helped me to catch up as I began late. He had finished two systems when I started attending classes. His notes are precise, straight to the point without unnecessary stuff. This saved me a lot of time, because I wasn’t trying to remember unwanted stuff. He did not pay much attention in doing past papers. The only thing he kept on telling was to keep the basics solid and then you can handle any question that they throw at you. 
He will also asked questions from previous lessons, which will help you to keep in touch with the past topics. We did only 5 past papers before the exam and this kept me a bit worried. But ultimately it turned out what he said was true all along even though I didn’t realize it at that moment.


Surgery classes were conducted by Dr. Rohana Gamage. When I was going to attend his lectures all of the theory classes have been finished and I was going to attend for his revision classes. My friends told me to follow his revision, even that is enough to pass the exam and he had only passed surgery on his first attempt which provided me enough evidence to trust his statement. So I did not try to find the older theory notes, instead I followed only the revision classes. He taught us a concise edition of Surgery, directly exam based covering almost all questions that would appear in the exam. 
He will straightaway tell what to study and what not to study. 18 questions (Same model) that were discussed in the class were there in the ERPM surgery SBA paper.


Gyn and Obs classes were conducted by Dr. Wasantha Kumara who is always late to finish the class. Sometimes I left the class early because I wanted to have a rest before attending Community medicine classes. He had also completed a lot of topics when I started to attend for his classes. Got the notes from the same person and started studying them. I was really scared of Gyn and Obs because most of my friends had failed in this subject. I studied the notes and attended the revision classes, but a totally different paper was there in the exam. ERPM SBA questions were mostly practical questions which you would learn by working in a ward. 

He is jovial person, I can still remember the jokes that he makes during his class

Community Medicine were conducted by a group of teachers (Dr. Mahesh Kambukage, Dr. Ashan pathirana, Dr. Chathura WijesundaraDr. Himan Galappaththi
Dr. Kumudu Nanayakkara) who will deliver lectures on their specialties. These teachers will try to do the best for the student. The only aim of them is to try and get us passed by at least getting 45 marks. I was terrified the first the I attended to that class. I did not understand a single word they said. Most of the terms they used were abbreviation which I did not understand. There were no one in the class that I knew, all were strangers to me. Immediately when I came to my apartment, I called my friends and asked who had attended that class previously. Luckily there was some people that I knew attended that class, even though they were absent on the day that I went. Then I called Dr. Himesh Kasthuriaarachchi and got all the note. This was the other subject I was scared about. But these teachers made that fear go away. They will arrange revision classes close to the exam. I strongly recommend you to attend for those classes, where they will discuss all the relevant questions from past papers.


Forensic medicine, I just heeded my friends advice and I also followed a book called “Forensic Medicine And Medical Law” written by Dr. Hemamal Jayawardena who happened to be my apartment owner and he provided me with a free copy of his book. His book helped me clarify all the doubts that I came across while going through the papers of 
Dr. Christy Rajeev‘s.

I would like to thank Dr. Dulaj Weerasekara for providing me with the latest papers which were done in his class. 

I always remembered to complete the latest note and one previous note to eventually get me back on the right track. It did not take me much time to caught all up, because I wasn’t disturbed by a lot of classes.


I’m not a study freak who studies all day. I played PUBG mobile till the last moment, so if I can do it anyone can. Always remember that you can pass this and hold on to something to keep you motivated.


Our exam was held without any gaps in the middle. 

Keep the required documents prepared without waiting till the last moment. It is crucial to have adequate amount of sleep, so that you can have a clear judgement when answering questions. This duration may differ from individual to individual, so do what suits you the best.

Take two pencils along with a sharpener, two pens and an eraser.

I initially marked all answers using a pencil, so that you don’t have to suffer for your mistakes. Then I went through the paper again marking all with a pen, this will reduce the room for error. 
You will have enough time to do this except for Community medicine and Forensic medicine. Therefore remember to be swift during those two exams. 

The most important thing is to only mark the MCQs stems that you know. If there is any doubt, mark it on the paper (not the answer sheet) and count the ones that you are certain, and see if it’s enough to get you through the exam. It’s better to leave that stem rather than risking for a negative marking. I marked only 64 stems in Gyn and Obs MCQs. 


In the evening paper, I always left 30 mins before the exam ends, to get a time advantage for the next days paper. 


After completing the exam, I was anxious about Gyn and Obs because I only marked 64 MCQs and I did not know whether the SBAs was correct or not. 

Out of ERPM Part A and D, I think Gyn and Obs was the most difficult paper in July 2019 followed by Forensic Medicine, may be it’s because I did not attend any classes for it. 


ERPM – Part B and C

 

After ERPM part A and D exam was finished, classes were started for part B and C. I attended the same classes. Classes were held at the same schedule, so I had enough time to attend the wards.

Medicine – He taught us the art of taking histories and sample presentations of short cases. Sometimes I had my doubts whether his teachings were enough or not. After appearing at the exam I realized that I was total fool of doubting myself. He took us for clinic visits at District General Hospital Nuwara Eliya where we heard a lot of murmurs and both short cases that I got for my exam was covered during that visit to Nuwara Eliya. I will recommend you to go there and get the appropriate clinical exposure under proper guidance. Only downside was that he conducted the classes at mid night, so you would have to bear with that.

But in emergency viva, I encounter a question which he didn’t teach, but I remembered what he taught for part A and I managed to survive that question. It was about Addisonian Crisis.

Paediatrics – He will provide you with everything that you need to pass the exam. He will provide you with a proper theory note, history taking pattern, all short cases with proper art of presentation. I would recommend you to attend his practical sessions, specially the cardiovascular session, which is extremely beneficial to brush up the inadequate clinical exposure.
He will also give the list of all instruments that is needed for the exam and this was very beneficial for me at the last moment.

I had extra help from my mom and sister who is a paediatrician and a paediatric registrar respectively. But even without the additional help anyone who follows him will pass without any doubt.

Surgery – Same as part A, a concise version of surgery was taught. All long cases were discussed along with the pattern of taking the history and the clinical questions. He taught us the pattern of examining short cases and the relevant questions which are going to be asked from them. He tried to remove the fear by asking us to take the history from him where he played the role of the patient. 

I also attended one practical session which was arranged by Dr. Dileepa Banagala, where one of my friends provided me with a registration number to enter the Sigma Institute, but if you have a good hospital exposure no need to attend for this. 
But for the short case I got a AV fistula at the elbow which was not taught before, luckily I somehow managed it.
I’m also grateful for the surgeon at District General Hospital Gampaha who taught us about short cases during our hospital visits
I also referred the app “Short Cases In Surgery” developed by RER MedApps which I would recommend to all.

Gyn and Obs – He taught us how to take obs histories and gynae histories and the pattern of answering questions. For some histories, I myself added few extra points to make it look complete. He requested us to come to his hospital to learn how to insert a speculum. But I did not go as it was too far. 

I also had help from Dr. W. H. A. Semasinghe who taught me the  practical method of handling Gyn and Obs cases.
In the exam, I screwed up the Gynaecology case, but I managed to pass because I aced the obstetric case.

Keep the required documents and instruments prepared without waiting till the last moment. After appearing for the exam, what I understood was that, clinic visits are truly beneficial. So it is ultra important to go to the hospitals and to see the patients. 

Try to practice clinical examinations initially with a pillow later perfect it by doing it on a patient. Always keep track of time when doing these examinations. 
It is equally important practice your presentation skills, because this is an area where you can impress the examiner by showing your confidence and to gain more marks. 
Take histories and see what points you miss often. Pairing up with a friend or a small gang would be more beneficial as it would help to improve the communication skills and to the find out the errors that you do. 
Most examiners would not ask you sophisticated post grad stuff, they will try to assess whether you have the knowledge of a house officer that would not harm / kill the patient.

Emergency viva – They will provide you with a scenario in all subjects. You can study and answer for the questions in Paediatrics and Medicine emergency vivas. But for Surgery and Gyn and Obs, they expect you to give practical answers based on the ward set up. They will not assess your theory knowledge here. So try to improve your logical thinking, by imagining that you are a house officer working in the ward. 

And most importantly do not forget to study about blood transfusion.

To be honest, I hated hospital visits, I just went because my friends are asking my to come there. So a special thanks to Dr. Deeptha Pathiranage, Dr. Sanjeewa Weerasinghe and Dr. Dinath Diyasena for including me in their gang and motivating me to attend those clinic visits.

I would like to thank Dr. Deeptha Pathiranage and his fiancée Dr. Dulashi Uluwaduge who provided me the instruments (Stethoscope, X-Ray tube, Building blocks, Torch, Illuminating light) which I did not prepare prior to my exam. 
I would also like to thank Dr. Kasun De Alwis who taught me blood transfusion without even having his dinner and telling us the important Paediatric cases when we went for hospital visits. 
I should also mention Dr. Shanuka Dilshan  who provided me guidance which lead to a success in facing ERPM exam.

My preparation for Part B and C was terrible, maybe it’s because I hate dealing with patients. 

You don’t have to study 24/7 to pass part B and C. Improve your communication skills and develop a clinical eye to tackle short cases. They expect you to approach cases in the practical way. 
I did not study a lot of theory stuff for part B and C, because I was disturbed by COD mobile which I recommend you all to try out. 

I’m truly grateful for all the teachers that I have mentioned above, all my friends who was with me during this journey, my fiancée (Dr. Janani Rajamanthri) who kept me motivated and my family (Mom, Dad and Sister) who provided me with knowledge and support to pass this exam in my first attempt. 


Latest posts by Dr. Pasindu Suriapperuma (see all)
4.6 14 votes
Article Rating
Subscribe
Notify of
guest
4 Comments
Oldest
Newest Most Voted
Inline Feedbacks
View all comments
Deeptha
1 year ago

Lit bro ❤ & way to go
Congratulations!!!!

Deeptha
1 year ago

Lit bro ❤ & way to go
Congratulations!!!!

Pasindu Suriapperuma
Reply to  Deeptha
1 year ago

Thanks mate

Chamath Nanayakkara
Chamath Nanayakkara
5 months ago

Congratulations, thankyou for the advices.