The differences between MRCP 1 & MRCP 2 exams

Loyal Pastest MRCP user Dr Jemma Mickleburgh highlights the key differences between the MRCP Part 1 and MRCP Part 2 exams.

To gain the MRCP(UK) qualification, you will need to pass three separate parts of the exam:

  • MRCP Part 1
  • MRCP Part 2 Written
  • MRCP Part 2 Clinical (PACES)

People often wonder what the differences are between the two written exams – Part 1 and Part 2. This differences will be explored in this blog post.


Part 1

Part 2


Two papers

·         3 hours duration each

·         100 multiple choice questions

·         Best of 5 format


Two papers

·         3 hours duration each

·         100 multiple choice questions

·         Best of 5 format



20% basic medical and clinical science

Greater emphasis on clinical scenarios


No clinical images

Clinical images included

MRCP Part 1

At times, revising for Part 1 feels like being transported back to the early days of undergraduate medical training. There is a much greater emphasis on the basic medical sciences and basic clinical science: 20% of the paper! This means refreshing your knowledge of anatomy (based on these clinical signs, where is the lesion causing the foot drop?), biochemistry (what’s going on in acute porphyria?) and genetics (what’s the inheritance of haemochromatosis?). Other areas of basic science included in the exam are pharmacology (CYP450 inducers vs inhibitors), immunology (what antibodies are implicated in autoimmune hepatitis?) and statistics (what kind of study does this describe?). Linking the underlying physiological processes to pathology and the basis for treatment is also a key part of Part 1. For example, you may be tested on your understanding of the pathophysiology of HIV and how this relates to the mechanism of action of available treatments.

The remaining exam questions are focussed on different specialities. On the MRCP(UK) website, there is a detailed breakdown of the exam format, including what proportion of the exam is allocated to the various specialties. This can help to inform the foundations of your revision plan.

Once you have succeeded in passing Part 1, you have the joy of progressing to Part 2.

MRCP Part 2

In Part 2, there are more questions aligned with day-to-day clinical experience. Questions may include familiar scenarios related to the management of common conditions such as asthma, diabetes or atrial fibrillation. Knowledge of NICE guidelines is important, and the NICE clinical knowledge summaries are an invaluable source of information to start with. However, be sure to set aside some revision time for some of the less commonly encountered, but examinable conditions. A little information on glomerulonephritis, Whipple’s disease and syringomyelia, amongst others, will go a long way!

Part 2 also includes clinical images for interpretation. These could vary from tests you may be used to seeing daily, such as chest x-rays, ECGs and CT scans, so plenty of exposure to these on the wards will stand you in good stead; to investigations you may be less familiar with interpreting, such as spirometry, audiograms and photographs of dermatological findings. These all build upon knowledge gained from Part 1. Practise via a good question bank is the best way to become more familiar with this type of question.

The main similarity between the exams is the need to practise as many questions as possible, with some practise done under timed conditions. The Pastest resources are accessible, extensive and reflective of the exam. Easy access to materials via the handy Pastest app means that fitting 5 quick-fire questions in ‘on the go’ is possible, optimising time efficiency. The short ‘Ask the Experts’ videos are succinct and pre-empt those all-important questions which may loom as the exam day approaches. The detailed feedback and explanation provided in the answers equips you well for sitting these challenging written exams.

 So, hope that summary of the two written exams helps a little as you progress through MRCP. Good luck!


Jemma Mickleburgh 15/06/22

Pastest MRCP user Dr Jemma Mickleburgh

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