MRCP Part 1, Jan 2021 Exam: Instant Insights

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Check out our latest insights about the MRCP Part 1 January 2021 exam. We’ve been busy collecting candidate feedback, and we’re already using this to inform the development of our MRCP Part 1 resources over the coming months. Here’s a summary of what we’ve found out so far:

Due to the UK national lockdown, and subsequent announcement from the Royal College just five days prior to the exam, many UK candidates had their exam deferred until March. The online version of the exam still took place for UK candidates, and many international centres were still open.

From the results of our post-exam survey around 38% of Pastest customers sat the exam online, up from only 15% in September 2020.

MRCP Part 1 January 2021 Exam Content

Candidates reported that the MRCP Part 1 exam got progressively more difficult as they worked through it and that the second paper, in particular, was problematic. We often hear that Paper 2 is more difficult, though remember that at this point you’ll likely be experiencing some exam fatigue, so make the most of your break to re-energise and take a break from your screen.

We heard about a range of question types in the exam, from pure knowledge-based questions with no vignette, to one-liners about genes and mutation, to brief vignettes which offered very few clues about the answer, to lengthy neurology questions with vignettes spanning four to five lines of text.

Don’t expect a straight recall test though, candidates also struggled with complex patient scenarios involving challenging clinical reasoning.

It’s worth noting that there were no negatively-phrased questions (e.g. “which of the following options is NOT…”) and the majority of questions asked you to select the “most likely” answer from several plausible options.

Tricky topics

We asked candidates which topics they found the most challenging in the exam. The most frequently mentioned were Neurology, Respiratory, Pharmacology and Statistics.

Other topics of note included:

  • Psychiatry
  • Drug mechanism of action
  • Glomerulonephritis
  • Sudden cardiac death (Long QT syndrome)
  • Diabetic patients with underlying health conditions


There were no questions relating to COVID-19 in this exam.

The Online MRCP Part 1 Exam Experience

If you’re sitting an online exam for the first time, we’ve got a great blog to help you prepare, which includes a video from a previous MRCP Part 1 online candidate: How To Prepare for an Online Exam

While candidates did report some technical issues, 77% of the online candidates that we spoke to said that they would prefer to sit future exams online.

Here’s some advice and insight from candidates who sat the exam in January:

  • Try not to let your gaze wander around the room, it could be just for a few moments whilst you gather your thoughts, but the proctor may ask to see your room again.
  • Ensure that all other household members are aware that you aren’t to be disturbed. Candidates with home-schooling children reported that this was easier said than done!
  • You are allowed toilet breaks, but when you return you’ll have to show the proctor around the room again. One candidate suggested that he had to go through rigorous checks which took almost 10 minutes of his exam time.
  • To avoid stress on exam day, make sure that you’ve received your personal id as well as the exam id and password via email. If you haven’t, check your spam/junk folders.
    • In addition, be sure to read the emails carefully, one candidate was confused because they received the link for the second paper before the first paper, and struggled to start the exam.
  • Inform neighbours that you will be sitting an exam; candidates reported being disrupted by hedge trimming and drilling through walls while trying to concentrate!
  • Some candidates found it difficult to pick up their laptops and show the proctors around the room with the built-in webcam. If you have the option of using an external webcam, that might be easier.

Are you preparing for the MRCP Part 1 exam? We can help! Take out our free MRCP Part 1 trial today, and see what it’s like to get the Pastest Advantage.

Read on to see more insights from previous exam sittings...

Insights from the September 2020 MRCP Part 1 exam:

  • Paper 2 was considered much more difficult, with long vignettes and a lot of data interpretation.
  • The toughest topics as voted by our customers were:
    • Dermatology (lots of rashes!)
    • Basic Sciences
    • Neurology
  • Clinical Sciences formed a large part of Paper 1, with a high number of Mechanism of Action (MoA) questions coming as a surprise to candidates.
  • As well as difficult topics, many candidates said that choosing between two plausible options was the most difficult aspect of the exam.
  • Ensure you read the question thoroughly as some deviated away from the vignette to catch you out.
  • Paper 1 contained a number of short vignettes testing basic science, especially genetics, biochemistry and anatomy.

Pastest Customer Outcomes

  • 65% of candidates who answered our survey passed the September 2020 exam.
  • On average, successful candidates answered over 4800 questions in our Part 1 question bank. Unsuccessful candidates answered around 2400 on average. Questions, questions, questions... Volume really is key to passing this exam!

Common Topics from recent exams

The following topics were present in three consecutive sittings of the MRCP Part 1 exam – September 2020, January 2020 and September 2019:

  • Skin manifestations of systemic disease
  • Hypertension management
  • Blood gas interpretation
  • Type 2 diabetes management
  • Bleeding disorders
  • Site of action of diuretics
  • Calculating sensitivity
  • Asthma management
  • Dementia
  • Ankylosing spondylitis

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