Recently we travelled up to the highlands of Scotland to catch up with Pastest founders Nigel and Freydis Campbell to celebrate Pastest's 50th birthday, back in 1972 they kick-started the company from the kitchen of their home, oversaw the company grow from a small publisher to running courses for doctors across the world. When they retired in the early 2000's they left a company just embarking on online content and it's continued to evolve ever since. They reflect on the early days of the company and how it has evolved to become the modern, online test prep provider it is today.

Q: 50 years is a long time, the world has changed significantly. What change has impacted Pastest the most? 

A: I think really the biggest change has been to move from books and courses to move to online learning. That's been the biggest change. Also, the doctors used to be given some help with paying for a course, and then that all stopped. Health Authorities used to pay something towards the courses and they didn't any longer. So we had to develop the material, which would be easier for the doctors to prepare themselves when paid study leave was withdrawn. And that had a big impact on our courses because if you couldn't get time out, didn't have a colleague who could cover for you, and you weren't being paid for study leave.  Both that and the fact they had to pay for their own course had a huge impact. 

Q: Would you like to see any changes to how we train and test medical professionals going forward? 

A: Well, I think there will be changes because medicine is always changing. So the way of teaching it and presenting it to students will change and we have to change with that. The thing for us to do is to keep in touch with the students and junior doctors to make sure that we maintain the standard of giving a high-quality product, which they can help to train from. We must be the best at what we can do.  We realized over the last 50 years that it's no good just being an addition to the market, that we've really got to shine. 

Q: What are your hopes for Pastest in the next 50 years? 

A: Well, I think we hope we will continue to provide the excellent help that it provides at the moment for junior doctors. To enable them to gain the knowledge they need to be good doctors, therefore, to pass exams. And we may find new fields to investigate, when there's a need, because exams for sure are here to stay. So maybe we'll find some new pastures to add to medicine. 

Q: How has Pastest changed over the years? 

A: Well, it's obviously changed a lot as the exams have changed, and because we started off by publishing books and then we started running courses and the staff in the office built up and we became better at looking after the whole business. Then the technology came in and of course, that has been a big change. Cause we originally didn't have even, even computer knowledge, let alone apps and things like that. I mean, 1972 when the first computers came in, it was a big learning curve that everybody, for doctors and for, and for us, keeping abreast of that technology. And it's still racing ahead. 

Q: What were your initial aspirations when you founded Pastest? 

A: Well, I think we discovered that the UK doctors taking MRCP had a pretty raw deal that the pass rate was very low. Even with a lot of very bright doctors. Some of those bright doctors were going to fail, and I think we really felt there was something we could do by providing practice exams. Just like your friend. Yeah, that's what we wanted to do. Provide practice exams to help people pass the MRCP. 

Q: What struggles did you face when building Pastest? 

A: Well the difficulty really was finding suitable doctors to write the exams for us, and to collect questions by going to some exams and talking to the customers. One of the things we implemented was going to the Royal College exam venue and by collaring doctors as they came out of the exam venue saying, if you'll come opposite to the pub, I'll give you a beer, an exchange for telling me some of the questions.

Needless to say, the Royal College was not at all happy and sent me two letters at various points, which we totally ignored because there was no legal reason why we couldn't chat to doctors afterward and find out what they'd remembered, but it was a struggle getting high-quality questions. 

Q: What has been the hardest part of running Pastest? 

A: Changes in the exam, that were horrendous. Just when we had a very large question bank, for example, MRCP questions, the Royal College changed to the American system. The UK questions were one out of five, one was accurate out of five, and the American system was each item, each question item could be true or false. So we had to change the total question, a bank of thousands of questions, and get competent doctors to alter the questions so that they could be, the answers were clearly true or false. That was quite a big struggle!

Q: What are the values at the heart of Pastest and do they still hold true 50 years later? 

A: Well, I think the values are providing good quality material, providing a good quality course or a good quality book, and making sure that we respond to any problems that occur. Those were the key values. Looking after the customer in every way.

Q: What drove you to create Pastest? 

A: Well, we, I was fortunate to have an American friend who was a doctor at Yale and he'd already started the business, which he called Pretest, and we thought we could do something similar to what he was doing in the States, in the UK, and that's what got us going. It was lucky that I was working as a physio at St. Toin City Hospital, so I was then on maternity leave, which was wonderful because it gave us time to research the situation with MRCP exams in Britain. 

Q: What has been the most memorable Pastest moment? 

A: One of my memorable note moments was entirely due to Nigel. He said, what are these horrible biscuits, these hardworking doc doctors are getting?

We were on tea breaks in a  hospital at the time, and he said, why don't you treat them to some wonderful sticky buns? So we contacted the local Swiss baker, who made them at half past six every morning for a seven-day course. I went in and collected the trays of sticky buns and took them to Bart's hospital for the beginning of the course and they were a  great success. And the word went round. If you go to a Pastest course, you'll get sticky buns instead of biscuits. So that was certainly one big memorable moment.

Another one was when I got a letter from a doctor saying, there are so many wrong answers in your book. You are encouraging doctors to fail, and we are going to report you to the British Medical Journal. So they never take another advertisement. So I thought, oh, what am I gonna do with this letter? Nigel comes back from the office saying "what's wrong with this letter? You are very lucky that somebody cares". And I said, "Well I'll write a letter in the morning." "No, you won't," said Nigel. "Get on the phone straight away and talk to this doctor. Explain how it could have happened, and ask for his help."

And this junior hospital doctor went through the book for which we paid him, went through the minutia, pointing out all the problems. And that lovely doctor worked for us freelance for the following two years. And the word must have got around that, you know, Pastest was reliable and reacted quickly to any problems. 

Q: What has been your proudest Pastest moment? 

A: Well, I think we were very excited to have over 200 junior hospital doctors taking an MRCP course at one of London University's lecture theaters. It was a lot of people to organize, and hand out books and course notes. We had great feedback, and we felt very proud that we'd been able to keep so many ambitious young doctors satisfied and impressed with what we were doing. 

Q: What was your biggest mistake? 

A: I think my biggest mistake and it was definitely all down to me, was for our first courses. We thought the people that would be the best teachers were the really knowledgeable senior consultants. I couldn’t have been more wrong.

The senior consultants arrived at these courses and in those days they were weekend courses with consultants in every subject that you needed. But the consultants, instead of keeping to the straight and narrow how to pass MRCP in cardiology or urology etc, set off on their research results and their research topics It went down like a lead balloon and I had complaints that they were completely off-target. London, Manchester, Glasgow. They all got their money back. And we learned from them.

The people that you need to teach, are young senior registrars. Try and choose registrars who have already failed once or twice because they will know exactly why they failed. So from then on, the course took off and any senior registrar who was lecturing, who didn’t get 10/10 was never invited back. And one rather nice detail is that if you had that you taught for Pastest on your CV, then it was a big plus point. 

A huge thanks to Nigel & Freydis for welcoming us into their home, and we too look forward to seeing how Pastest continues to evolve in the next 50 years!