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Changes to the MRCP PACES Examination

  • August 19, 2020

As you may know, the MRCP PACES Examination was due to change in September 2020. However, due to the ongoing global COVID-19 situation, the introduction of the new PACES has been delayed by the Royal College of Physicians until 2021 – (specific date yet to be confirmed).

This blog article aims to outline the aspects of the examination that will be changing, how to best prepare for the new examination and why these alterations are being implemented.

Why is the examination changing?

The changes to PACES are the product of a 12 month review of the examination by MRCP(UK) to ensure that it remains fair, relevant and fit for purpose.

The changes build on the current format but develop some elements to make them more realistic for examiners and trainees. It now better reflects the new Internal Medicine stage 1 curriculum, developed by the JRCPTB on behalf of the Federation.

What parts of the examination are changing?

The PACES Examination will still test the same clinical skills, and there will be five stations.

The table below outlines the three stations that are being removed from the PACES Examination and the reasons for their removal:

Station 2

The History- taking station was considered to be artificial and not representative of modern practice

Station 4

20 Minutes for a single communication and ethics encounter was felt to be rather long and the 5 minute examiner/candidate interaction added little value to the overall assessment

Station 5

Testing all seven skills in an integrated manner was very realistic but applied large amounts of pressure in 10 minutes

To replace the above stations, the following three aspects will be being introduced:


Two 10-minute communication encounters. These will not include a question and answer section with the examiners, but instead the encounter will be judged on observation alone.


Two 20-minute clinical consultations will assess candidates across all seven skills in a realistic and integrated manner. Candidates will have 15 minutes to take a structured history, examine the patient, explain the likely diagnosis and management and address any qu3stions or concerns raised. There will then be a 5 minute question and answer section with the examiners.

Encounter Sequencing across the Carousel

The new carousel will alter the sequencing of the encounters through the carousel. Some stations will include physical examination and communication encounters. This will ensure that examiners at each station contribute more judgements in each of the skills for each candidate, improving the reliability of the exam.

How do I best prepare?

The Royal College of Physicians have stated they will be providing “a comprehensive range of resources for candidates and examiners to ensure that they are prepared” for this new PACES format and structure. These will include informative videos of the new encounters, an examiner webinar, written guidance and attendance at events and training days. Look out for these on the MRCP(UK) website, Facebook and Twitter, as well as their newsletters and emails in the coming months.

We would advise all candidates that will be sitting PACES under the new format in 2021, to register for any preparation courses that are run by the three Colleges that make up the Federation of Royal Colleges: RCP Edinburgh, RCPS Glasgow and RCP London.

References 2020. PACES 2020 | MRCPUK. [online] Available at: <,3%20diet%20in%20September%202020.> [Accessed 28 July 2020]. 2020. Preparing For PACES Exams | Royal College Of Physicians Of Edinburgh. [online] Available at: <> [Accessed 28 July 2020]. 2020. Get Ready For PACES 2020 | Royal College Of Physicians Of Edinburgh. [online] Available at: <> [Accessed 28 July 2020].


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