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Overview of MRCP (UK)

• July 06, 2022

The Royal College of Physicians provides specialty examinations that are globally recognised as excellent quality benchmarks of medical knowledge and clinical skills. This examination is the best route to GMC Registration for any international Doctor wanting to work within the NHS as a Medicine or Acute Medicine physician. The federation is a partnership of:

• The Royal College of Physicians of Edinburgh
• The Royal College of Physicians and Surgeons of Glasgow
• The Royal College of Physicians of London

 

To obtain Membership of the Royal College of Physicians you will have to sit three exams:

1. MRCP(UK) Part 1 - £608: Please note that the application process/fee for the Hong Kong and Singapore centres are different.
2. MRCP(UK) Part 2 Written - £608: Please note that application process/fee for the Hong Kong and Singapore centres are different.
3. MRCP (UK) Part 2 Clinical (PACES) -£1202

MRCP(UK) Part 1

At a glance:

• One-day examination
• Two three-hour papers
• 100 multiple-choice (best of five) questions
• No images
• Sat in an examination hall OR online

 

Exam Format

Part 1 is designed to assess your knowledge and understanding of the clinical sciences relevant to medical practice and of common or important disorders to a level appropriate for entry to specialist training.

The exam has two test papers and each paper is 3 hours long and contains 100 multiple-choice questions in the ‘best of five’ format. You must choose the best answer from the five possible answers. Each correct answer is awarded one mark and there is no negative marking.

You will be tested on a wide range of common and important disorders in General Medicine which are set out in the Specialty Training Curriculum for Core Medical Training.

The following table outlines the topics of questions across the 2 papers (200 questions).

Specialty	Number of Questions
Cardiology	14
Clinical Pharmacology and Therapeutics	15
Clinical Sciences	25
Dermatology	8
Endocrinology, Diabetes and Metabolic Medicine	14
Geriatric Medicine	8
Gastroenterology and Hepatology	14
Haematology	10
Infectious Diseases	14
Neurology	14
Oncology	5
Medical Ophthalmology	4
Palliative and End of Life Care	4
Psychiatry	9
Renal Medicine	14
Respiratory Medicine	14
Rheumatology	14

Please note that the above table is merely an indication, the questions may alter slightly in each examination sitting.

What does the clinical sciences module comprise of?

1. Cell, molecular and membrane biology (2 questions)
2. Clinical anatomy (3 questions)
3. Clinical biochemistry and metabolism (4 questions)
4. Clinical physiology (4 questions)
5. Genetics (3 questions)
6. Immunology (4 questions)
7. Statistics, epidemiology and evidence-based medicine (5 questions)

Please visit the Royal College’s site to note the available test centres and dates and to access sample questions please click here.

MRCP Part 2

At a glance:

• Two papers to be taken in one day
• Each paper is three hours long
• 100 multiple-choice questions (best of five)
• Questions include images
• Sat in an examination hall

 

Part 2 of the MRCP(UK) diploma can only be taken once you have passed the MRCP Part 1 examination. Part 2 builds on your knowledge that was assessed in Part 1 and will test your acquisition of medical knowledge, skills and behaviour specific in the Specialty Training Curriculum for Core Medical Training.

From the beginning of 2018, the Part 2 exam moved to a single day format. The exam now consists of two, three-hour papers each with 100 questions each. Part 2 will test the ability to apply clinical understanding, make clinical judgements and will test your ability to:

• Prioritise diagnostic or problem lists
• Plan investigations
• Select a plan for immediate management
• Select a plan for long-term management
• Assess prognosis

 

Exam Format

The questions in this exam will typically have a clinical scenario, it may include the results of investigations and may be illustrated with images such as clinical photographs, pathology slides, inheritance trees, ECGs, X-rays, CT and MR scans and echocardiograms.

The questions will ask you about the diagnosis, investigation, management and prognosis of patients using multiple-choice questions in ‘best of five’ format. This format, in addition to testing core knowledge and comprehension, will also assess your ability to interpret information and to solve clinical problems. You must choose the best answer from the five possible answers. Each correct answer is awarded one mark and there is no negative marking.

Specialty	Number of Questions
Cardiology	19
Dermatology	9
Endocrinology and metabolic medicine	19
Gastroenterology	19
Geriatric Medicine	9
Haematology	9
Infection Diseases and GUM	19
Neurology	17
Nephrology	19
Oncology and palliative medicine	9
Ophthalmology	3
Psychiatry	3
Respiratory Medicine	19
Rheumatology	9
Therapeutics and Toxicology	18

Please note that the above table is merely an indication, the questions may alter slightly in each examination sitting. A proportion of these questions will also be Paediatric cases.

To access sample exam questions please click here.

MRCP(UK) Part 2 Clinical (PACES)

At a glance:

• Half-day examination
• Takes place in a clinical setting (hospital or clinical skills centre)
• Assesses seven core skills
• Five stations
• Eight patient encounters
• Two independent examiners at each station

 

The MRCP(UK) Part 2 Clinical Examination (Practical Assessment of Clinical Examination Skills – PACES) sets rigorous standards to ensure that candidates are competent across a range of skills and ready to provide a high standard of care to patients.

To take PACES you must have passed MRCP Part 1 within the last 7 years.

What are the seven core skills?

1. Physical Examination – Demonstrate correct, thorough, systematic, appropriate and professional technique of physical examination
2. Identifying Physical Signs – Identify physical signs correctly and not find signs that are not present
3. Clinical Communication – Elicit a clinical history relevant to the patient’s complaints, in a systematic, thorough and professional manner.
4. Differential Diagnosis – Create a sensible differential diagnosis for a patient that the candidate has personal clinically assessed.
5. Clinical Judgement – Select an appropriate management plan for a patient or clinical situation. Select appropriate investigations or treatments for a patient that the candidate has personally clinically assessed.
6. Managing Patients’ Concerns – Seek, detect and acknowledge and address patients’ or relatives’ concerns, confirm their understanding and demonstrate empathy.
7. Maintaining Patient Welfare – Treat a patient or relative respectfully and sensitively and in a manner that ensures their comfort, safety and dignity.

 

Stations

At each station, you will encounter a patient or surrogate patient. Stations 1, 3 and 5 will have two encounters and stations 2 and 4 involve one. There is a total of eight encounters throughout the exam.

Station	Encounter	Duration of examiner-to-candidate contact
1	Respiratory system examination Abdominal system examination	10 minutes 10 minutes
2	History-taking skills	inutes
3	Cardiovascular system examination Nervous system examination	10 minutes 10 minutes
4	Communication, skills and ethics	20 minutes
5	Integrated clinical assessment a) Brief clinical consultant 1 b) Brief clinical consultation 2	10 minutes 10 minutes
Total Time		125 minutes (including five minutes between each station)

PACES Exam Structure:

• The PACES examination works in a carousel format
• You will be marked at each of the 5 stations, assessed by 2 independent examiners
• You can start at any one of the stations and move to the next every 20 minytes until you have completed the cycle
• There is a 5 minute period between each station.

 

Please visit The Royal College website to gain access to sample clinical scenarios.

When should I take each MRCP(UK) exam component?

The Royal Colleges of Physicians has analysed previous candidate result statistics to reveal the points in time when pass rates tend to be the highest.

MRCP(UK) Part 1

• First attempt with 12-24 months after graduation – 70% pass rate
• 36 months after graduation – 50% pass rate
• 36-48 months after graduation – 40%
• The guidance states “you should not apply before you feel you know enough to pass, the data implies that trainees who are well prepared can expect to pass at the first attempt and should not delay this beyond 24-months without good reason.”

 

MRCP(UK) Part 2

• The data reveals that your best chance of passing Part 2 is to attempt it within 36 momths after graduating.
• Candidates who take the exam at an earlier stage are slightly less likely to be successful, although the pass rate is still above 85%

MRCP(UK) Part 2 Clinical (PACES)

• The data reveals that you should delay attempting PACES at least 36 months after you have graduated
• Those who take the exam between 12-24 months after graduation are “very unlikely to pass” as they have had no time to develop the necessary knowledge and skills in a clinical setting.
• 24-36 months after graduation – 50% pass rate
• 36-48 months after graduation – 77% pass rate
• The data also reveals that candidates have the best chance of passing PACES if they have already successfully completed the part two written examination.

Tips for passing MRCP

1. Register early – There is a high demand for sitting the MRCP(UK) exams, especially PACES as spaces are limited. If you register early you can plan your revision to fit the exam schedule and reduce the risk of missing out on your perfect time slot.
2. Start revising early – We advise you to start revising at least six months in advance of each exam to prepare adequately. Although some doctors pass with less preparation time, do not risk it. If you start your exam revision as early as possible you will increase your chance of passing.
3. Use a varied range of revision resources – do not just stick to one big textbook for your revision. The additional use of online courses, discussion forums and online tests will increase your knowledge and confidence when it comes to the exam itself.
4. Try to cover all topics evenly – Excellent knowledge of smaller topics such as statistics, ophthalmology and psychiatry will allow you to collect extra marks for only a short period of study.
5. Check the Royal College’s exam regulations - https://www.mrcpuk.org/mrcpuk-examinations/regulations

 

If you are an IMG who wants to relocate to the UK and work within the NHS send your CV to [email protected] and we will be happy to help you. And head over to our Facebook Group: IMG Advisor for an online support network of IMG’s who want to K relocate to the UK.