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MRCP Part 1 Exam format

  • MRCP Part 1 exam is designed to assess a candidate’s knowledge and understanding of the clinical sciences relevant to medical practice and of common or important disorders to a level appropriate for entry to specialist training.
    • Knowledge is an essential base for the practice of clinical reasoning and vital as a basis for learning during postgraduate training to develop understanding of disease and their treatment.
  • MRCP Part 1 exam has a two-paper format.
    1. Each paper is 3 hours in duration and contains
    2. 100 multiple choice questions in the ‘best of five‘ format.
    3. This format, in addition to testing core knowledge and comprehension, also assesses the ability to interpret information and to solve clinical problems.
    4. There will be five options – one correct answer and four alternatives to the correct answer. The four distractors will be closely related to the preferred option but less correct, therefore acting as plausible alternatives.
    5. The candidate chooses the best answer from the five possible answers.
    6. Each correct answer is awarded one mark; there is no negative marking.

The content of MRCP Part 1 Exam format

  • The content of the examination is based on a blueprint.
  • This outlines the composition of the papers, including the likely number of questions under each broad clinical topic heading.
  • This has been updated to reflect the new terminology used in the new UK Internal Medicine curriculum, and it will be used from the 2020/1 diet of the examination.
Specialty Number of questions
Cardiology 14
Clinical Pharmacology and Therapeutics 15
Clinical sciences (Pre-para clinicals)** 25
Dermatology 8
Endocrinology, diabetes and metabolic medicine 14
Gastroenterology and Hepatology 14
Geriatric medicine 8
Haematology 10
Infectious diseases 14
Neurology 14
Oncology 5
Medical ophthalmology 4
Palliative medicine and end of life care 4
Psychiatry 9
Renal medicine 14
Respiratory medicine 14
Rheumatology 14
200
  • NB: This should be taken as an indication of the likely number of questions – the actual number may vary slightly.
  • *Clinical sciences comprise (Pre-para clinicals):
Cell, molecular and membrane biology 2
Clinical anatomy 3
Clinical biochemistry and metabolism 4
Clinical physiology 4
Genetics 3
Immunology 4
Statistics, epidemiology and evidence-based medicine 5
  • NB: A detailed explanation of the marking system adopted for the MRCP(UK) Part 1 Examination can be viewed in the MRCP(UK) Regulations.

Sample MRCP Part 1 Questions

1. A 65-year-old woman presented with a 12-hour history of sudden-onset gait unsteadiness, vomiting and headache, followed by increasing drowsiness. What is the most likely diagnosis?

A: acute cerebellar haemorrhage
B: acute subdural haemorrhage
C: frontal subdural empyema
D: herpes simplex encephalitis
E: pituitary apoplexy

2. A post-marketing observational study of a new drug was conducted on 5000 patients following clinical trials. What best describes the data generated from this type of study?

A: comparative efficacy
B: cost–benefit
C: cost effectiveness
D: potency
E: profile of adverse effects

3. A 79-year-old woman was admitted for elective hip-replacement surgery. On examination, she was pale. There was 2-cm splenomegaly and there were small discrete axillary lymph nodes. Investigations:

haemoglobin 107 g/L (115–165)
white cell count 34.5 × 109/L (4.0–11.0)
platelet count 183 × 109/L (150–400)

What is the most likely diagnosis?

A: acute myeloid leukaemia
B: chronic lymphocytic leukaemia
C: chronic myeloid leukaemia
D: myelodysplasia
E: myelofibrosis

4. A 17-year-old boy presented with a non-blanching rash over his legs, a swollen knee and painless, visible haematuria. Urinalysis showed blood 3+, protein 1+. Investigations:

serum creatinine 210 µmol/L (60–110)
urine culture negative
ultrasound scan of kidneys normal

What glomerular abnormality is most likely to be present at renal biopsy?

A: focal segmental sclerosis
B: foot process fusion
C: linear deposition of IgG on the basement membrane
D: mesangial deposition of IgA
E: thickening of basement membranes

5. A 28-year-old man presented with a 1-month history of weight loss, abdominal distension, flatulence and foul-smelling diarrhoea following a visit to India. Investigations:

anti-tissue transglutaminase antibodies negative
stool cultures and microscopy negative

What is the most likely diagnosis?

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