Sitting the MRCP 1 Exam

Written by: Dr Joseph Parker (FY2)

Introduction

Royal College membership exams are one of the major hurdles in progressing through training, whether in medicine or otherwise. For those intending to enter Internal Medicine Training (IMT) and later higher specialty training, the Membership of the Royal College of Physicians (MRCP) remains a necessary requirement.

MRCP Part 1 is the first of three exams that make up a full membership. You must complete MRCP Part 1, Part 2 and PACES before you start a job at ST3 (if in a group 2 specialty) or ST4 (if in a group 1 specialty).

I decided to take Part 1 during my FY2 year, aiming for the September sitting. This felt like a natural point in training: I had a full year of clinical experience behind me, some insight into my preferred career path, and enough stability in my rota to commit to a regular revision pattern.

Timing

Unlike MRCS Part A or some other membership exams, MRCP Part 1 can only be sat once you have completed 12 months of post-graduate work. This enforced delay has its benefits, given FY1 is busy enough without trying to squeeze in major exams! It also allows you to settle into clinical work, build confidence, and focus on your portfolio areas: teaching, quality improvement and research.

The first sitting typically available to most trainees is therefore September of FY2. If you are planning to take it at this point, some forward planning is helpful. Booking usually opens around two months before the sitting (e.g., July for a September exam).

There are several advantages to sitting the exam in FY2:

1. Shorter time from medical school: helpful because Part 1 includes a substantial amount of pre-clinical science (physiology, pharmacology, pathology) alongside clinical medicine.

2. Evidence of commitment to a specialty: while you do not gain points directly in IMT shortlisting, exam progress is viewed positively at interview.

3. Less pressure during IMT: passing early can significantly ease the workload in an already demanding training programme.

4. Higher pass rates early post-graduation: candidates within 12–24 months of graduating tend to perform best (although there will undoubtably be confounding factors to this).

   
   

From a practical standpoint, I would strongly recommend aligning the exam with a rotation that is less strenuous. Jobs like GP and psychiatry often allow more consistent evenings/weekends free and tend not to involve on-calls.

Cost and Booking

The 2026 UK fee for sitting the MRCP Part 1 is £502. Because the exam is now delivered via online proctoring, you can sit it at home on your own laptop, removing travel costs but adds the burden of ensuring your equipment and internet connection are reliable. I have heard that there are plans to re-introduce in-person exams if this would be your preference in the coming year!

I unfortunately had a rocky start to my exam: technical issues meant I could not initially log in to the platform. The MRCP exam team were thankfully extremely helpful, and after a phone call and a reset of my login, I was eventually able to start the exam (albeit slightly delayed).

The wider cost of the exam can be prohibitive, so I would recommend budgeting ahead of time. Don’t forget you can claim tax relief on Royal College exam fees if they are necessary to your progression in training.

Exam Format and Content

MRCP Part 1 consists of two papers sat on the same day:

• Paper 1: 3 hours, 100 SBAs

• Paper 2: 3 hours, 100 SBAs

• 1-hour break between papers

  
  

Questions cover all major specialties within general medicine including cardiology, gastroenterology, respiratory, neurology, renal, endocrinology, haematology, infectious diseases, oncology, psychiatry, dermatology, clinical pharmacology, statistics, and the key scientific foundations underpinning them.

The style is very similar to medical school finals but significantly more detailed, and the breadth is far wider. Often people comment that the exam feels less about esoteric knowledge and more about recognising common patterns, applying guidelines, and understanding basic pathophysiology.

Revision Strategy

Revision approaches vary widely, but for MRCP Part 1 my strongest piece of advice is simple: do lots of questions.

The exam covers a huge breadth of medicine, and while reading around topics can be useful, pure content-heavy revision is low-yield. It is far more effective to expose yourself to hundreds of questions, learn the patterns, and identify your knowledge gaps.

My personal approach was:

• Work through a single question bank systematically.

• Flag questions or topics I consistently got wrong.

• Use targeted summaries (I used ChatGPT to generate concise revision notes, which was helpful for specific conditions).

  
  

Remember that any information you eventually rely on in clinical practice should be cross-referenced with official guidelines or textbooks, rather than AI-generated notes.

Question Banks

The two most widely used question banks are Pastest and Passmedicine. Each has advantages:

• Pastest: more difficult, some find the style closer to the exam.

• Passmedicine: excellent explanations and a well-organised structure.

I won’t recommend a specific one here as both are good, and it’s more important to be consistent with whichever platform you choose.

The MRCP also publishes an official specimen paper, which I found extremely useful. I would suggest sitting this 2–4 weeks before the exam. It’s an excellent barometer of progress and helps familiarise you with how MRCP phrases its questions.

On the Day

Treat the day like you would any major exam. The official start time is 9:30am, which usually gives you a comfortable morning routine.

If sitting from home:

• Make sure you have a quiet, well-lit environment.

• Test your webcam, microphone, and internet connection.

• Have your ID ready.

• If possible, a wired internet connection is best

There is an hour between the two papers. Use it to step away from the screen, have something to eat, and reset mentally. The papers are long, and pacing yourself makes a significant difference.

Conclusion

Sitting MRCP Part 1 during FY2 is entirely achievable with some planning, a consistent revision strategy. It is a demanding exam, not because any single topic is impossibly difficult, but because of the sheer breadth of medicine. Regular question practice and early engagement are key.

Passing Part 1 gave me a real sense of progress and made the idea of entering IMT feel much more tangible. If you’re considering sitting it early in your foundation years, I’d encourage you to go for it, and I wish you the very best of luck!