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 common diploma of the three UK Royal Colleges of Physicians. The colleges delegate examination organization to MRCP(UK), a division of the Federation of the Royal Colleges of Physicians of the UK.

The initial diploma pathway has three required examinations: Part 1, Part 2 Written, and Part 2 Clinical, formally the Practical Assessment of Clinical Examination Skills (PACES). Candidates must pass all three; the regulations provide no exemptions from individual parts. UK and international sittings belong to this examination family, although local arrangements vary.

Passing all three examinations completes the examination requirement for the diploma. The Form of Faith is a separate step to be submitted to the candidate’s chosen College for election to membership; the regulations do not make it a fourth examination.

PACES stations combine the following encounters:

The seven PACES skills are physical examination, identifying physical signs, clinical communication, differential diagnosis, clinical judgment, managing patients’ concerns, and maintaining patient welfare. The written papers use five answer options with one best answer; each correct response earns one mark, with no negative marking.

Part 1

The official Part 1 blueprint gives likely question counts; actual counts may vary slightly by examination diet. Clinical sciences include 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

The current blueprint applies through the 2027.2 diet. Its likely counts may vary by up to 2%, and a proportion of questions concerns adolescent medicine. A revised blueprint applies from the 2027.3 diet; the two columns below distinguish the current and announced future counts.

Part 2 Written scenarios may assess diagnosis, investigation, management, and prognosis. Images may include clinical photographs, pathology slides, inheritance trees, ECGs, X-rays, CT and MR scans, and echocardiograms. Check the official revised blueprint when planning for a 2027.3 or later diet.

PACES station content

PACES includes communication encounters, focused physical examinations, and integrated consultations. The consultations assess all seven skills. The physical-examination encounters focus on examination, sign identification, differential diagnosis, clinical judgment, and patient welfare; the communication encounters assess communication, judgment, patients’ concerns, and welfare.

The September 2026 regulations distinguish formal entry requirements from preparation recommendations:

• Primary medical qualification: Candidates must hold a medical qualification from an institution that awards primary medical degrees and is recognized by the UK General Medical Council (GMC) or listed in the World Directory of Medical Schools. Candidates who are or have been registered with the GMC or an equivalent body provide the relevant registration number; candidates without such registration provide a copy of their qualification.
• Part 1 timing: Candidates may not sit Part 1 until 12 months after the graduation date shown on their primary medical qualification. A documented alternative may apply when that date is significantly later than completion of the first year of training.
• Progression: Part 1 must be passed before applying for Part 2 Written or PACES. After passing Part 1, candidates may take Part 2 Written and PACES in either order.
• PACES preparation recommendation: The regulations recommend completing a two-year foundation program and entering Internal Medicine Training or an equivalent period before attempting PACES. They also recommend at least four months in those two years in posts involving continuing care of emergency medical patients. This is preparation guidance, not a universal requirement to have followed a particular UK training pathway.
• Language: The examinations are conducted in English. The Colleges advise English ability equivalent to IELTS Level 7.5, but candidates do not need IELTS or another language examination to sit the diploma examinations.
• Attempts and completion period: Candidates are limited to six attempts at each examination component. After six attempts, they may request an exceptional additional attempt through the specified process, supported by evidence of further education or training. The former seven-year period for completing Part 2 Written and PACES after passing Part 1 has been removed.
• Practice restrictions: Erasure or suspension from practice can prevent entry. Candidates must declare applicable warnings, interim orders, undertakings, or practice conditions for review.

After passing all three examinations, candidates should submit the Form of Faith to their chosen College for election to membership. The regulations distinguish this membership step from completing the three examination parts for the diploma.

Build breadth for Part 1

Use the Part 1 blueprint to plan coverage of clinical sciences and the broad medical specialties. Give study time proportionate to the likely question counts while retaining coverage of smaller areas. Practice timed best-of-five questions and review why the best option is preferable to the distractors. Since Part 1 does not include images, align practice with its published format.

Practice applied decisions for Part 2 Written

Work through clinical scenarios by prioritizing problems, choosing investigations, selecting immediate and longer-term management, and assessing prognosis. For a sitting through 2027.2, give sustained attention to the larger-count areas, including cardiology, endocrinology and metabolic medicine, gastroenterology and hepatology, infectious diseases, renal medicine, and respiratory medicine. For 2027.3 or later, re-plan from the revised blueprint: its largest allocations include cardiology, endocrine and metabolic medicine, gastroenterology and hepatology, renal medicine, and respiratory medicine. Add deliberate practice interpreting the image types listed in the official format.

Rehearse PACES directly

Practice the actual station tasks rather than relying on written questions alone:

• Communication: organize the interaction, explain information clearly, respond to concerns, and show empathy and respect.
• Physical examination: use a systematic, appropriate examination; identify signs accurately; and explain a sensible differential and clinical judgment.
• Consultation: integrate history, focused examination, communication, and clinical reasoning within the 20-minute encounter.
• Across stations: demonstrate patient comfort, safety, and dignity in your conduct.

Use timed bedside or simulated-patient practice that reflects the station structure, with feedback against the seven assessed skills. Review errors by type—knowledge, image interpretation, examination technique, sign recognition, prioritization, communication, or timing—and direct subsequent practice toward those gaps.

After passing Part 1, choose the order of Part 2 Written and PACES according to readiness for their different formats: applied written decisions and image interpretation for Part 2 Written, and observed clinical performance for PACES.

Delivery and location: As of October 18, 2026, the Part 1 and Part 2 Written dates-and-fees pages describe in-center delivery for most sittings and identify Myanmar and Sudan as remote-online-proctoring exceptions. The regulations state that remote proctoring may be permitted in certain circumstances when agreed in advance. PACES takes place in a clinical setting; center availability and administrative arrangements vary by location.

Applications and dates: Consult the official Part 1, Part 2 Written, and PACES dates-and-fees pages for current application windows, deadlines, fees, and location availability. These details can change. The regulations require applications to be complete and paid by the advertised deadline; late applications are not accepted. International candidates should check the center-specific instructions before applying or making travel plans.

Adjustments and scoring: Candidates who need a reasonable adjustment should follow the current MRCP(UK) procedure and observe the component’s published timing. Written examination results use equated scaled scores, so a raw percentage is not a universal pass target. PACES requires both an overall standard and minimum standards in each of the seven skills.