MRCP(UK) Diploma Guide: Part 1, Part 2 Written and PACES

The Membership of the Royal Colleges of Physicians of the United Kingdom (MRCP(UK)) Diploma is a single diploma shared by the three Royal Colleges of Physicians of the UK. Examination organization is devolved to MRCP(UK), a division of the Federation of the Royal Colleges of Physicians of the UK.

The diploma consists of three required examinations:

• Part 1
• Part 2 Written
• Part 2 Clinical, formally the Practical Assessment of Clinical Examination Skills (PACES)

Candidates must complete all three examinations; the current regulations make no exemptions from individual parts. Passing one written component does not confer the diploma. After the final examination is passed, the candidate must complete the membership process, including submission of the Form of Faith to the chosen Royal College. The diploma and the post-nominal MRCP(UK) cannot be claimed until the three examinations have been passed and the required Form of Faith process has been completed satisfactorily.

This is an initial diploma examination pathway. The same qualification family includes UK and international delivery arrangements, but the available centers, application procedures, and delivery options can vary by location.

Part 1 and Part 2 Written each use five answer options with one best answer. Part 2 Written focuses on applying clinical understanding to diagnosis, investigation, immediate and long-term management, and prognosis.

PACES is conducted in a clinical setting such as a hospital or clinical skills center. Stations 1 and 4 contain communication and physical-examination encounters; Station 3 contains cardiovascular and nervous-system examinations; Stations 2 and 5 are integrated consultations. The consultation encounters last 20 minutes, while the other encounters last 10 minutes.

Part 1 written blueprint

The Part 1 page publishes likely question counts rather than fixed percentages. The actual number may vary slightly between diets.

The Part 1 clinical-sciences allocation comprises cell, molecular and membrane biology; clinical anatomy; clinical biochemistry and metabolism; clinical physiology; genetics; immunology; and statistics, epidemiology and evidence-based medicine.

Part 2 Written blueprint

The current Part 2 format page also publishes likely counts. Actual numbers may vary by up to 2%, and a proportion of questions concerns adolescent medicine.

Part 2 Written questions usually use clinical scenarios and may test diagnosis, investigation, management, and prognosis. Image interpretation is an explicit preparation priority.

PACES station map

The seven PACES skills are physical examination, identifying physical signs, clinical communication, differential diagnosis, clinical judgment, managing patients’ concerns, and maintaining patient welfare. PACES marking uses encounter-level ratings and requires both an overall standard and a minimum standard in each skill.

The current regulations distinguish formal entry requirements from preparation recommendations.

• Primary medical qualification: Candidates must hold a medical qualification awarded by an institution that awards primary medical degrees and is recognized by the UK General Medical Council or listed in the World Directory of Medical Schools. Candidates who are or have been registered with the GMC or an equivalent regulator must provide the relevant registration number. Candidates without such registration must provide a copy of the primary medical qualification.
• Part 1 timing: Admission to Part 1 is not permitted until 12 months after the graduation date shown on the primary medical qualification. A specific alternative applies where the graduation date is substantially later than completion of the first year of training, provided documentary evidence is supplied.
• Progression: Part 1 must be passed before applying for Part 2 Written or PACES. Once Part 1 has been passed, Part 2 Written and PACES may be taken in either order.
• PACES readiness: The regulations recommend attempting PACES after completing a two-year foundation program and entering Internal Medicine Training or an equivalent period of training. They also recommend at least four months during those two years in posts involving continuing care of emergency medical patients. This is preparation guidance, not a universal requirement to have followed the UK training pathway.
• Language: All components are conducted in English. The Colleges advise that candidates’ English ability should be equivalent to IELTS Level 7.5, but IELTS or another language examination is not required for entry. The diploma cannot be used as proof of English-language competence.
• Attempts: Candidates have a maximum of six attempts at each component. After six attempts, an exceptional additional attempt may be requested through the specified process and must be supported by additional education or training. The previous requirement to complete Part 2 Written and PACES within seven years of passing Part 1 has been removed.
• Practice restrictions: Erasure or suspension from practice can prevent entry. Warnings, interim orders, undertakings, or practice conditions must be declared and may be reviewed before the candidate is permitted to sit.
• Diploma completion: After all three examinations are passed, the candidate must complete the membership formalities, including the Form of Faith, before the diploma and post-nominal can be claimed.

1. Establish Part 1 breadth

Use the Part 1 blueprint to organize a broad first pass through clinical sciences and the major medical specialties. Prioritize understanding of common and important disorders, clinical physiology, pharmacology, statistics, epidemiology, and evidence-based medicine. Practice best-of-five questions under timed conditions and use the absence of negative marking to develop a consistent answering and review process.

2. Convert knowledge into decisions for Part 2 Written

Part 2 Written is not simply a larger recall test. Practice moving through each case by prioritizing the problem list, selecting appropriate investigations, choosing immediate and long-term management, and assessing prognosis. Add deliberate image practice for ECGs, radiographs, CT and MR scans, echocardiograms, pathology slides, clinical photographs, and inheritance trees.

The larger Part 2 blueprint areas deserve sustained attention, particularly cardiology, endocrinology and metabolic medicine, gastroenterology and hepatology, renal medicine, respiratory medicine, infectious diseases, and neurology.

3. Rehearse PACES as observed performance

Practice the actual station architecture rather than relying only on written questions:

• Communication encounters: structure the interview, explain information clearly, identify concerns, show empathy, apply relevant ethics, and close safely.
• Physical examinations: use a systematic or appropriately focused sequence, identify positive and negative findings accurately, construct a sensible differential, and propose investigations or management.
• Consultations: combine history-taking, focused examination, communication, clinical reasoning, and examiner discussion within the 20-minute format.
• Every encounter: make patient welfare, dignity, comfort, and safety visible in your behavior.

Written question banks can support clinical knowledge, but they do not reproduce the observed patient interaction, timing, or examiner assessment of PACES. Use repeated bedside practice with patients or surrogates and obtain structured feedback against the seven PACES skills.

4. Diagnose errors by type

After each study block, classify mistakes as knowledge gaps, interpretation errors, failure to prioritize, unsafe management reasoning, communication problems, examination-technique problems, or time-management failures. This produces a more useful remediation plan than tracking only a total question score.

5. Plan the sequence around readiness

After Part 1, Part 2 Written and PACES can be taken in either order. Choose the sequence according to readiness: Part 2 Written requires applied clinical decision-making and image interpretation, while PACES requires repeated observed practice across respiratory, cardiovascular, neurologic, abdominal, communication, and consultation encounters.

As of September 17, 2026, candidates should check the current component pages and regulations before selecting a sitting.

• Written delivery: The April 2026 regulations state that Part 1 and Part 2 Written use in-center computer-based testing from June 2026, with remote online proctoring potentially permitted in specific circumstances by advance agreement. The Part 2 overview separately identifies Myanmar and Sudan as continuing with remote online proctoring. UK candidates may request a pencil-and-paper version when required as a reasonable adjustment.
• Applications: The regulations state that current fees, application periods, and examination dates are published on the MRCP(UK) website. Applications must be complete, paid, and received by the advertised deadline; late applications are not accepted. Part 1 applications require a primary medical qualification copy or verified GMC registration, and all outstanding requirements must be completed before sitting.
• Location planning: Written examinations are delivered through test centers, and PACES takes place in a clinical setting. Confirm the available location, delivery mode, travel requirements, and any local administrative instructions for the component and sitting being entered.
• Reasonable adjustments: Candidates who need an adjustment should follow the current MRCP(UK) procedure and submit supporting information within the required process rather than assuming that an adjustment will be arranged automatically.
• Scoring: Part 1 and Part 2 Written results use equated scaled scores, so a raw percentage from one diet is not a universal pass target. PACES requires a minimum overall standard and a minimum standard in each of the seven skills. Preparation should therefore target consistent performance across the assessment rather than a single estimated percentage.
• Membership formalities: Passing the final examination is not the last administrative step. Complete the Form of Faith and disclose any relevant practice restrictions when applying for election to membership.