PassMrcp

Part 1

Defined by the Royal College seeks to: “…identify those physicians in training who, having satisfied the entry criteria, possess a broad knowledge and understanding of common and important disorders as well as clinical science.”*

Format & Entry

Part 1 consists of 2 papers, each consisting 3 hours and 100 MCQs in the Best of Five (BOF) format. The 2 papers are usually held on the same day. To sit for Part 1, you will need at least 12 months in medical employment. You can an unlimited number of attempts at Part 1.

Question breakdown

As a guide, the Royal College* has determined that the combined questions will be composed of :

15 Cardiology
15 Haematology & oncology
20 Pharmacology, therapeutics and toxicology
4 Cell, molecular and membrane biology
3 Clinical anatomy
4 Clinical biochemistry and metabolism
4 Clinical physiology
3 Genetics
4 Immunology
5 Statistics, epidemiology and evidence-based medicine
8 Dermatology
15 Endocrinology
15 Gastroenterology
15 Neurology
4 Ophthalmology
8 Psychiatry
15 Nephrology
15 Respiratory medicine
15 Rheumatology
15 Tropical medicine, infectious and sexually transmitted diseases

The detailed syllabus is available through a lengthy and cumbersome document entitled Specialty training curriculum for general internal medicine for August 2009 by Joint Royal Colleges of Physicians Training Board**.

We’ve done all the hard work, gone through the document and derived the full syllabus. You can access that document with a MRCP part 1 written subscription. Sign up now!

The Low Down

Past experience has shown that MRCP Part 1 is primarily on clinical sciences and the disorders which highlight basic mechanisms and principals. For example, the appropriate use of anti-arrythmics in Wolff-Parkinson-White syndrome and why certain agents and contra-indicated.

This means that the preparation for Part 1 is based on Book knowledge and past paper questions. It also means that the questions tend to be stereotypical with several favourite topics the Royal College repeatedly test candidates on. With a definitive syllabus to start from, comprehensive lecture notes and experience in past papers, you can be well on the way to clearing these exams! Why not try out ours?

Part 2a

Defined by the Royal College seeks to identify: ” attainment of the minimum level of knowledge expected at the completion of General Professional Training and the ability to apply this knowledge to clinical problem solving and clinical practice.”***

Format & Entry

Part 2a written consists of 3 papers, again 3 hours each usually spread over 2 days. Each paper consists of approximately 90 questions in the MCQ- BOF or  N from many format. The Royal College states that:

“Candidates can apply to sit the MRCP(UK) Part 2 Written Examination after they have been awarded a pass in the MRCP(UK) Part 1 Examination. They do not require any additional medical experience. You can make unlimited attempts within your 7-year eligibility period.”***

Question breakdown

As a guide, the Royal College*** has determined that the combined questions will be composed of :

10 Cardiology
5 Dermatology
10 Endocrinology and metabolic medicine
10 Gastroenterology
5 Haematology/Immunology
10 Infectious diseases and GUM
10 Neurology/Ophthalmology/Psychiatry
5 Oncology and palliative medicine
10 Renal medicine
10 Respiratory medicine
5 Rheumatology
10 Therapeutics and toxicology

The Low Down

Unfortunately, a proportion of the questions will be on adolescent medicine, medicine for the elderly and psychiatry. And there is no set syllabus, unlike in Part 1. To give you an idea however, the Royal College has stated that part 2a seeks to:

“test the ability to apply clinical understanding, make clinical judgements and take responsibility for:

• prioritising diagnostic or problem lists
• planning investigation
• selecting a plan for immediate management
• selecting a plan for long-term management
• assessing prognosis.”***

Which is frankly, not very helpful. Experience has shown that the questions are based primarily on Grey cases and management scenarios. For example, the most appropriate intervention in say pulmonary embolus.

Usually these questions have several layers of complexity, to further the example above, the patient in question may present with dyspnoea, tachycardia, mild basal crepitations after minor surgery so you will have to diagnose PE. The patient may be hypotensive or pregnant. The answers may all be sensible choices: high flow oxygen, spiral CT, heparin.

These questions pose a great challenge as the history and lab results can often be misleading (deliberately!) or the correct answer is based very closely on the question: the best initial management vs. next best management.

The examiners also like to throw in questions out of the Part 1 exams- like statistics or statistics like questions and the examination itself is constantly evolving- several stereotypes (eg. sailors and Sexually Transmitted Diseases) previously used are now being phased out and in the more recent diets, a trend towards strict BOF and away from n from many has been noted.

All of this makes Part 2a particularly challenging to revise for as the questions can be out of sync with daily clinical practise. Clinicians order a battery of tests not just one and management, as we are taught in med school should be holistic not just based on the single best treatment.

Still, a good working knowledge of clinical diagnostic and management guidelines along with experience in the style and wording of past questions will improve your chances of progressing to PACES!

Our comprehensive revision notes are updated regularly with the latest trial data and guidelines and our database of past questions are updated to reflect the current exam trends. Why not try it out?