Failing MRCP Part 1 – What Next?

The current UK trainee pass rate for MRCP Part 1 is an abysmal 50.4% so don’t beat yourself up too much if you’re finding it difficult. If you include all candidates, the picture is even more grim and our collective pass rate falls to 42.1%. One thing for sure is that failing MRCP Part 1 is quite common unfortunately, and in some cases several times.

If you’re a UK medical graduate, the statistics above tell us your chances of passing are a coin-flip. But we know statistics can be very misleading. The pass rate can easily be skewed towards the right by some very high achievers that diet or conversely left by candidates who are only attempting MRCP Part 1 as a box-ticking exercise for CT1 applications.

Regardless of your current circumstances, here’s what you should do if you find yourself failing MRCP Part 1.

Failing MRCP Part 1

Firstly, I know I know, after a 6-hour exam, the last thing you want to do is to sit down and reflect on what the hell happened! But stay disciplined, grab yourself a coffee and at least consider the specialty or specialties that really let you down.

Confirm this when you get your exam result three weeks later as MRCPUK usually send out a specialty breakdown that looks something like this:

Clinical Haematology & Oncology20
Clinical Pharmacology, Therapeutics & Toxicology54
Clinical Sciences20
Geriatric Medicine90
Infectious Diseases & GUM60
Respiratory Medicine40


At first glance, that score isn’t terrible – could it maybe even scrape a pass? Unfortunately probably not.

When we examine the score a little more closely, we realise that the 90% mark we’re really proud about for geriatrics is only worth about 1.5% of the entire exam! The key is to understand that geriatrics is only worth 4 out of the 200 marks available in the exam. The other piece of bad news is that our low score in clinical sciences actually cost us 10% of the entire exam.

It’s natural to read and work on subjects you’re already strong at but try and stay disciplined.

The specialty that has the most impact on your score and the one that is your weakest subject should be the target of your focussed study if you find yourself failing MRCP Part 1. Then focus your efforts on your second weakest and the one that impacts secondarily on your total score and so on.

That means that using the above example, I would focus a lot more effort on clinical sciences, haematology/oncology, respiratory, rheumatology and maybe ophthalmology before attempting the exam again.

The next step is to decide when you would reapply. Assuming you’ve worked relatively hard for your initial attempt, I would always recommend immediately booking yourself onto the exam at the next earliest opportunity.

Just like a driving test, it would be wise to continue with driving lessons and book another test immediately. The longer you wait without driving, the less likely you are of passing the next time round.

The only caveat, of course, is if you were completely unprepared on your initial attempt. In that case I would perhaps delay it until the diet after.

If you enjoyed this article make sure you get your own copy of my MRCP Part 1 & 2 Written Guide. In this guide, I explore the above and other concepts such as time allocation and the most preferable resources for the written exams in much more detail.