MRCPI in General Medicine: Exam Guide

The Royal College of Physicians of Ireland (RCPI) awards Membership of the Royal College of Physicians of Ireland in General Medicine through three separately taken examinations: Part I Written, Part II Written, and Part II Clinical. Candidates normally pass each part before progressing; RCPI permits specified exemptions.

Part I and Part II Written assess medical knowledge through single-best-answer questions. Part II Clinical assesses observed history-taking, focused examination, clinical reasoning, communication, and investigation and management planning. Passing Part II Clinical completes the examination sequence required to be eligible for conferral as an MRCPI in General Medicine.

In Ireland, MRCPI is part of the General Internal Medicine training pathway. RCPI describes Basic Specialist Training as preparation for Higher Specialist Training, a later stage; MRCPI alone is not completion of Higher Specialist Training.

Part I and Part II Written questions are equally weighted and have no negative marking. Part II Written is scored as a combined examination: candidates do not have to pass each paper separately.

For each long case, the candidate is observed taking a history and performing a focused examination for 20 minutes, then discusses problems, investigations, management, and aftercare for 5 minutes. The short cases typically comprise four patient-based cases and one communication and ethics interaction with a simulated patient or role player. The clinical cases use 6 minutes for examination and 4 minutes for discussion; the communication interaction uses 6 minutes followed by 4 minutes of discussion.

RCPI’s October 2025 regulations state that the Basic Specialist Training curriculum serves as the examination blueprint. RCPI describes that curriculum as a framework, not a comprehensive list of everything that may be examined. Part I publishes typical question-count ranges by specialty and separate ranges for cross-specialty skills; Part II Written publishes subject percentages. These are distinct blueprint dimensions.

Part I Written: published ranges of questions by subject

Part I also publishes ranges for skills tested across specialties: managing emergencies (5–20); applying knowledge of disease (5–25); understanding disease mechanisms (5–20); interpreting clinical information (5–30), data (5–20), and images (0–10); planning investigations (5–20); and planning non-drug and drug therapy (5–20 each). RCPI states that at least 75% of Part I questions concern direct clinical care of hospital inpatients and outpatients.

Part II Written: published subject allocation

For Part II Clinical, RCPI identifies cardiology, respiratory, abdominal, endocrine, dermatology, neurology, and rheumatology cases, alongside a communication and ethics case. The seven marking skills are clinical communication, relationships with patients, physical examination, identifying physical signs, differential diagnosis, clinical judgment, and patient safety and quality of care. Passing requires passing at least one long case and three short cases, meeting the pass mark in each of the seven skills, and meeting the overall minimum pass mark set by the Board.

Part I Written: Candidates may apply six months after receiving their primary medical degree. For a first application, RCPI requires the documentation it specifies, including an attested or certified copy of the degree and a passport-style photo. Proof of registration with the Medical Council in Ireland or the UK may be submitted instead of the degree. A degree in another language requires an official translation that meets RCPI’s requirements.

Part II Written: The standard route is a pass in MRCPI General Medicine Part I or MRCPI Paediatrics Part I within the preceding six years. If that period expires, Part I must be retaken. Paediatrics Part I is an alternative entry route, distinct from RCPI’s qualification-based exemptions. The regulations list specified qualifications that may be considered for exemption from Part I, including full MRCP(UK), MRCPath, MRCPCH, FRACP, and other named qualifications. Partial completion of a listed qualification is not sufficient. FRACP is separately listed as a possible exemption from Part II Written. Exemptions require supporting documentation and RCPI approval.

Part II Clinical: The standard route requires a pass in Part II Written within the preceding three years. If that period expires, Part II Written must be retaken. Candidates relying on an applicable exemption should confirm their individual route with RCPI before applying.

Attempts and time limits: The standard limit is six attempts for each component. Part I has no stated completion time limit; Part II Written must be passed within six years of passing Part I; and Part II Clinical within three years of passing Part II Written. The October 2025 regulations allow candidates to apply for one final additional attempt after six attempts, subject to a minimum interval of six months or one examination diet and completion within three examination diets of the sixth attempt.

Part I: build breadth, then apply it. Organize revision around the published subject ranges, including foundational sciences. Separately practise the listed skills: managing emergencies, interpreting clinical information and data, selecting investigations, and planning treatment. Because RCPI states that at least 75% of questions concern direct clinical care, combine science review with clinical SBA practice.

Part II Written: rehearse clinical decisions and data interpretation. Use the published subject percentages to plan coverage. Practise longer vignettes by identifying the main problem, prioritizing a differential, interpreting investigations, and selecting a management step. Timed practice with two 75-question papers can help you rehearse pacing across the stated paper and break structure.

Part II Clinical: practise observable performance. Rehearse long cases from rapport and focused history through examination, problem summary, differential, investigations, management, and aftercare. Practise short-case examinations followed by concise presentations of physical signs and reasoning within the station time. Use live, observed practice for patient-facing examination and communication; written questions or discussion alone do not reproduce that assessment format.

Use feedback to separate knowledge gaps from interpretation, examination technique, communication, prioritization, safety, and timing issues. Treat the published blueprint as a study framework, not a prediction of individual questions.

The written examinations use remote invigilation. RCPI requires a quiet, secure setting and a suitable computer with reliable internet, webcam, and microphone. The current remote-invigilation guidance prohibits multiple screens, headphones, and earbuds; review the full current technical instructions before exam day. The regulations state that examinations are conducted in English and that drugs are generally referred to by UK-approved names and measurements use SI units.

Part II Clinical is center-based. RCPI’s clinical format page lists centers in Ireland and internationally, but locations and places are subject to change. The RCPI examination schedule carries a notice dated September 18, 2026, stating that clinical examinations were postponed until further notice following advice against staff and College representatives traveling to the Middle East. The notice does not clarify the status of every listed location. Verify the status of your specific sitting with RCPI before applying or making travel arrangements.

Candidates who need a visa are responsible for applying in sufficient time; RCPI states that a visa-related inability to attend does not entitle a candidate to a refund or transfer. Check RCPI’s current Exam Applications and Examinations Schedule pages for application information, current availability, dates, fees, and deadlines.