OnExamination vs. Pastest for UK Medical Finals

by thethug on October 27, 2009

Picking a question bank for UK Medical Finals isn’t an easy task. There a many options available, but the two most popular are OnExamination and Pastest. I used both of these sites for studying, but it’s time for a hardcore review. I could not find a good comparison of OnExamination vs. Pastest, so here it goes…


Overview: At £44.03 for 3 months it’s the more expensive option (as discount is available if you’re a BMA member). OnExamination offers over 4000 questions in a variety of styles e.g EMQs (extended multiple choice), MCQs and short answer questions. In total, OnExamination has 800 more questions than Pastest.

User Interface: OnExamination has a user intuitive interface which allows questions to be selected by speciality or randomly. I didn’t notice any faults with the system and it ran smoothly. One minor point is that the user is not able to search for specific questions e.g if I wanted to do some questions on warfarin, there is no “question search” feature.

Questions: This is OnExamination’s biggest weakness. The questions are very repetitive and often test fact recall rather than clinical reasoning. Considering most medical finals do not test fact-recall, many of the questions did not seem applicable. UK medical schools are using more and more Extended Matching Questions (EMQs) in exams, OnExamination has 2000 of these. There was a mixture of quality with these EMQs, some tested facts, while others involved some clinical reasoning.

There is a big question quality discrepancy between specialities, for example, the cardiology section is much more challenging than the general surgery section. Hard questions are a great way to learn, but the cardiology section was too advanced.

The quality of the question explanations is apauling with OnExamination. The explanations were short, poorly structured and had spelling errors. The explanations didn’t address the questions, they were often facts regarding the conditions. However, my biggest disapointment came when I noticed some of the explanations had been copied directly from Wikipedia. Don’t get me wrong, I love Wikipedia, but a ‘copy pasted’ article from wikipedia as an explanation to a question is unacceptable.

The poor quality of explanations is the main reason why I would not recommend OnExamination to any student revising for medical finals.

Value for Money: £44.03 may seem a little expensive compared with Pastest, it is resonable considering there are almost 4000 questions. If you did every single question, the site might be worth the money, but most students only get through 1000-2000.


Overview: £27.39 for 6 Months. Over 3200 questions and 91 OSCE scenarios. Pastest is an established company within medical revision. They have many books available and the online question bank reflects their maturity as a organisation.

User Interface: This is Pastest’s weakest area. They recently released a new interface which improves matters slightly, but it isn’t as flawless as OnExamination’s. At times Pastest’s website lacks stability e.g it says “an error occured, please check back later”. This only happened 3-4 times for about 10 minutes in the months that I was using the site.

The best part about Pastest’s user interface is the “search” function. This allows a user to search for specific questions using a keyword search. I found this very useful if I studied an obscure topic and wanted to find some questions related to it or if I wanted to find a question I had done previously.

Questions: The questions on Pastest are better than OnExmination’s. Pastest’s questions are mostly at the level appropriate for a final year medical student. The explanations are short yet give the necessary information (there are occasional spelling mistakes). I used these explanations are part of my revision on multiple occasions. Pastest seems to understand what medical students are supposed to know. In contrast OnExamination sometimes felt like the questions were not based on medical school learning outcomes.

Pastest also features 91 OSCE scenarios. The site presents a scenario and you can think about it before looking at an explanation. The explanations for these scenarios are excellent. The scenarios are clinically relevant and are very helpful for revision (although you will still need a dedicated OSCE book).

There are some additional multi-media features such as eLectures or audio revision guides, however, I didn’t use these.

Pastest isn’t perfect. There are almost 900 True/False questions which are not useful, especially due to the wording e.g “it is not uncommon for..” – a double negation makes it uncessarily complicated. Additionally, the paediatric section is weak, after having completed all of the paediatric questions I didn’t feel confident. Therefore, you’ll need another resource for paediatric questions.

Value for Money: £27.39 is an amazing deal for 6 months, especially because it includes the 91 OSCE scenarios.

ThugMed’s Recommendation: Pastest is the overall winner. Great value for money,  excellent search function and good explanations. I wouldn’t hesitate for a second to recommend Pastest as the question bank of choice for UK Medical Finals.

The main reason why I signed up to OnExamination also was because I felt like I should do as many questions as possible. The closer to exams I got, I realised this approach wasn’t necessary, stick to one question bank (hint: use Pastest). OnExamination is expensive and has low quality explanations – avoid it.

{ 3 comments… read them below or add one }

kiran sodha 12.08.09 at 3:31 pm

Hi, that was extremely useful. im enjoying the thugmed revolution and ur approach to med

LH 11.24.13 at 9:44 am

Pas test has good lectures and content esp for mrcp but the video lectures NEVER work which is a massive waste of time and very irritating considering MRCP subscription is £150! They have no helpdesk and seemingly no interest in helping you once they have your money! I would not buy it again.

Khalid 11.15.15 at 7:16 am

I do agree with the comments above. I had similar experience with MRCS A. Hopefully you can get advantaged by my experience that onexamination. com is not a good option.

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