How to Pass MRCP Part 1

MRCP Part 1 is invariably referred to as the bane of a core medical trainee’s (CMT) working life. Some medics even argue that it’s the most difficult hurdle to overcome as it’s the first exam since medical school finals. And if you’ve done no studying since then, boy are you in for a wake-up call. I certainly woke up. Here’s my guide on how to pass MRCP part 1.

Speaking to many consultants during my CMT made me realise just how many times most people fail this exam.

However, I feel that with careful planning, MRCP Part 1 doesn’t necessarily have to be a bad dream. Not that it’ll ever be a good dream either though. Now you’re pushing your luck…

How To Pass MRCP Part 1

The first thing is to decide when considering how to pass MRCP Part 1 is how long you should dedicate to this exam. If you’re aiming for financial independence and early retirement (FIRE) then we could be really good friends but now probably isn’t the time to accept those extra locum shifts from your rota coordinator. Remember that each unsuccessful attempt will set you back £419 plus another subscription fee on your favourite practice question bank so in reality, you’re trading pounds for pennies.

In hindsight I’d probably set aside a good 3 months for MRCP Part 1, bearing in mind you’ll be juggling a busy medical rota consisting of evenings, weekends and night shifts. Be realistic and out of those 90 days, calculate how many hours you going to dedicate to studying.

The key word is realistic so during your 0900 – 1700 days, you cannot really expect to study more than 2 hours after commuting, dinner, relaxing and sleeping. And during your 0900 – 2200 shifts, you probably won’t get to study when you get home at so obviously discount those days.

On your occasional weekends off, you should maximise your study time whilst keeping that realistic attitude. If you can do 4 hours each day of the weekend then you’re doing really well.

The next step is to examine the MRCP Part 1 format.

It consists of two 3-hour papers separated by a 1-hour lunch break. Each paper comprises approximately 100 questions, totalling 200 questions in 6 hours. The question generally contains a stem followed by five options. And because you’re expected to pick the best answer, it’s called the best-of-five (BOF) format.

A typical question could be:

You are the cardiology CT1. An 82-year-old lady attends clinic with longstanding confirmed hypertension. Blood pressure today is 182/95. Her medication history includes amlodipine 10mg OD. Assuming she is fully compliant with her medication and this is a true reading what advice would you give her?

  1. Add doxazosin
  2. Add ramipril
  3. Ignore the reading and reassure her
  4. Add bendroflumethiazide
  5. Add bisoprolol

Each year MRCPUK dedicates a specific number of questions to each specialty to ensure coverage of the entire CMT curriculum. Recently this has been divided as follows:

SpecialtyMarksPercentage of exam
Clinical Haematology & Oncology157.5%
Clinical Pharmacology, Therapeutics & Toxicology168%
Clinical Sciences2512.5%
Geriatric Medicine42%
Infectious Diseases & GUM157.5%
Respiratory Medicine157.5%


The clinical sciences section is further subdivided:

Cell, Molecular & Membrane Biology2
Clinical Anatomy3
Clinical Biochemistry & Metabolism4
Clinical Physiology4
Statistics, Epidemiology & Evidence-based Medicine5


One of the main reasons why candidates are unsuccessful is because they fail to effectively manage their time. It’s prudent to remember that not all specialties are equal. For example, everyone knows respiratory medicine is where all the fun is at.

Have a look at the above allocation again. Clinical sciences are worth 25 marks whilst only 4 marks are related to geriatric medicine. This is of utmost importance when deciding how much revision time you’re allocating to each specialty.

So how much time can you afford?

Knowing you have 50 days until the exam isn’t very useful if you’re on a busy MAU placement with night shifts and long days coming up. A much more useful and accurate measure of time in this case is how many hours you have.

Divide the total number of marks in the exam by the total number of hours you have. For example, Part 1 is worth 200 marks and if you can realistically fit 100 hours of studying in the next 3 months then you should allocate 1 hour to every 2 marks in the exam. Or 30 minutes for every mark.

Referring back to the first table, gastroenterology roughly comprises 15 of the total 200 marks and therefore you can theoretically afford to spend 7.5 out of your 100 hours on this subject. That’s not a lot of time for one specialty when you factor in the number of practice questions available and that big blue book everyone recommends.

But despite this, 100 hours seems a very long time to study. Unfortunately, that’s the paradox of MRCP.

This means that even if becoming a gastroenterologist has been your lifelong dream since childhood you should spend no longer than 7.5% of your time on this specialty. And you must stay disciplined otherwise you may find you’ve left other specialties completely uncovered.

The only caveat to this is that all this information should act as rough guidance and you may wish to adjust your time allocation depending on your own personal strengths and weaknesses.

Finally, if you find yourself approaching the exam date with very little time then I’d recommend spending all or the vast majority of your time on the specialty that offers the most points first. For example, if you find clinical sciences and psychiatry uncovered in the last day, consider spending all of your time on clinical sciences.

Hopefully you’ve found my guide on how to pass MRCP Part 1 helpful and all the best!

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.