How to Pass MRCP Part 1

The MRCP Part 1 exam is tough. Preparation methods are constantly evolving, as is the exam. I am going to share some best practice: from my own experience of teaching countless exam candidates over the years, from recent candidate experiences, and that obtained through analysis of Pastest utilisation data.

While many doctors are currently facing incredibly challenging circumstances battling the COVID-19 Pandemic, we do know that some candidates are still looking ahead to the upcoming application window in June, and on to the MRCP Part 1 Exam sitting this September. At the point of writing this, the September exam is still scheduled to take place (in the UK at least).

Look out for regular updates on Pastest’s COVID-19 resource page, where you can find the latest on MRCP Part 1 announcements and cancellations. To those doctors who are too busy for exam preparation right now, it is rewarding to know that the general public around the globe are hugely grateful for your efforts to combat and curtail the COVID-19 Pandemic.

To those of you who do find yourselves with enough time to study, I hope you find the following information helpful in your preparation.

So where should you even start?!

Make a plan for how you’re going to tackle your MRCP Part 1 preparation. There are a variety of methods that candidates employ to prepare for this exam. Having spoken to many exam candidates, and from my own experiences, the three most common strategies are:

  1. Answering Practice Questions at RandomCandidates answer a large volume of MRCP Part 1 practice questions completely at random. This is how questions will be presented in the exam, so it helps you to get into the mindset of quickly switching from one specialty to the next.
  2. Taking a Specialty-Based ApproachAnother, more methodical approach is to plan a study schedule, and to answer questions on each specialty in bespoke sessions, before reviewing all of them a few weeks out from the exam date.
  3. Taking a Comprehensive, Syllabus-Based ApproachIf time and inclination allows, some candidates prefer to study the medical syllabus more comprehensively, providing a thorough knowledge base for a future career in Medicine. This entails methodical study of individual specialties using reputable textbook chapters and accompanied by answering many relevant questions as in (2) above.

How many questions should you answer?

There’s no magic number of practice questions that will guarantee you a pass in the exam, but Pastest utilisation data suggests that successful candidates answer well over 4,000 questions before sitting the exam.

It’s not as easy as A, B or C…

Answering questions is a great way to ensure that you’re learning to recognise patterns. It’s a key skill that you’ll need in order to pass the exam. However, pattern recognition alone will only get you so far. If you know WHAT the answer is, but don’t fully understand WHY, then you may not be in a position to work out a similar, but differently worded question.

While answering questions, make sure that you’re engaging in active learning; that is to say, make sure you take the time to understand WHY a question is right or wrong. Pastest’s Dynamic Explanations are a great tool to achieve this, as each possible answer has its own explanation, unique to the context of the vignette.

Supplement your learning by doing further reading. Pastest are working on an exciting development called “Expanded Explanations” which is coming soon. This feature will offer a topic overview, as well as information on Clinical Presentation, Differential Diagnosis, Diagnosis/Intervention, Management and Prognosis, and links out to external resources, all available as further reading after each question.

You would be surprised if I didn’t also recommend the Essential Revision Notes for MRCP textbook (!), which offers a comprehensive explanation of almost everything you need to know before taking the exam.

MRCP Part 1 Exam Content

Whether you’re answering questions at random, following a study plan, or undertaking comprehensive study tied to answering questions in each sub-specialty of medicine, make sure that you’re studying smart, and spending the right amount of time on each topic.

From January 2020, the MRCP Part 1 exam breakdown changed. Pastest have produced a handy infographic to help you plan your time. If you’re unsure how much of the syllabus you’ve covered, the Pastest performance data can help you to spot areas where you need a little extra focus.

Common MRCP Part 1 Topics

There are several reoccurring themes in the MRCP Part 1 exam. Pastest have analysed recent exam themes reported by candidates, and have listed topics that have been present in the last three consecutive exam sittings. These topics are highly likely to appear again in future sittings, so ensure that you cover these well in your revision.

Check out the latest commonly occurring topics from the May 2019, September 2019, and January 2020 exams.

Past Papers are Perfect Practice!

Here’s another great way to make sure that you’re preparing with relevant exam material. After each exam sitting, Pastest produces an MRCP Part 1 Past Paper, which includes similar proportions of specialty questions and similar themes to those tested in the exam. Analysis of Pastest users clearly shows an advantage to the candidates who use these papers.

Pastest users who answered none of the Past Papers had a pass rate of 22% less than the average. Users who answered 10+ Past Papers had a whopping 67% pass rate! It’s important to note though, that these users also answered many questions from the main question bank. Users who ONLY used Past Papers tended not to perform so well in the exam.

MRCP Part 1 Exam Technique

Know your Trigger words

Many MRCP Part 1 questions will contain trigger words or phrases. Understanding how each one of these is employed in a question can help you identify some of the nuances behind each question, and ultimately select the correct answer.

Watch this useful video on MRCP Part 1 Exam Trigger Words for an explanation:

ALWAYS attempt the question

Remember, there’s no negative marking in the MRCP Part 1 exam, so you should answer every question, even if it’s a guess.

Read the question upside-down

Yes, that’s right. Several MRCP Part 1 questions in recent exams have had long, complex vignettes which lead the candidate in one direction, before asking something unrelated. For this reason, it can be helpful to read the last line of the question first to contextualise the vignette, especially if it’s a long one.

Prepare for a Marathon Effort

Candidates reflecting on the exam were universal in their view that mental fatigue affected performance in the afternoon paper, due to the overall length of the exam (two x three-hour papers of 100 questions over the course of the day). Do everything that you can to ensure that you’ve still got plenty left in the tank to tackle Paper two. One really important thing to note is that lunch is not provided! Make sure to bring your own food, and adequate fluids, to keep you going through the afternoon.


The MRCP Part 1 exam is arguably one of the most important exams that you’ll take in your medical career. Stay calm, try to start your preparation early, and practice consistently, and you should find yourself well prepared come the exam day.