This is authored by Gavin Brittain, Neurology Registrar at the Royal Hallamshire Hospital in Sheffield and MRCP Medical Advisor for Pastest. 

In this blog we’ll give you a quick overview of the MRCP Part 2 exam, and, more importantly, we’ll share our top 10 tips on how to pass with flying colours!

About the MRCP Part 2 exam

The MRCP Part 2 exam is the second of two written papers that you need to pass to become a Member of the Royal College of Physicians. Candidates must have passed MRCP Part 1 before attempting Part 2. The final MRCP exam is the Part 2 Clinical, known as PACES.

The MRCP Part 2 Written exam takes place three times a year – normally in March, June and October. There are test centres in a number of UK cities and in over 20 countries around the globe.

The exam is made up of 2, 3-hour papers of 100 questions, both taken on the same day – one in the morning, and one in the afternoon. The questions are in the same Multiple Choice format as MRCP Part 1, commonly referred to as “Best of Fives”.

Unlike MRCP Part 1 questions which prioritise clinical science knowledge, Part 2 exam questions are more complex, often structured in two steps, covering investigations, diagnosis and management of conditions. For this reason, there are commonly around 15-20 questions per paper containing images and interpretations of results.

MRCP Part 2: Top 10 Tips

1. Sit the exam at the right time in your training.

UK graduates, for example, have the best chance of passing the exam within 3 years of graduation (usually at the end of the year after completing Foundation year two).

2. Familiarise yourself with the curriculum.

The Royal College website provides a breakdown of questions per speciality.  Knowledge of this from the start of your prep, will help you to prioritise areas according to their weighting. For example, ophthalmology and statistics questions may seem hard but there are only a handful of these in the exam.

3. Review your Part 1 score.

This will help to ensure that you focus on subjects that you were weaker in. Once you’ve done this, you can effectively plan out how you will approach your revision. You can keep track of your progress by specialty using online question banks. While getting through as many practice questions as possible is key, don’t forget to read through the explanations to fully understand why you may have got a question right…or wrong!

Even if you were correct there can be gems of valuable information in each explanation. As a guide, successful Pastest users tend to answer well over 3000 questions before the exam. However, if you are struggling for time, concentrate on the specialities highlighted as your weak areas in combination with those which are tested most often.

4. Give yourself plenty of time.

Don’t rely on squeezing in revision every evening after a full day at work. Put time aside for rest and exercise. Revising on a tired brain is ineffective. Some candidates take a holiday in the week before the exam, but cramming the night before is a big ‘no no’. Just relax before the big day, at that point you’re as ready as you’ll ever be!

Check with your employer to see if you are eligible for study leave. Certain deaneries in the UK, for example, permit a small amount of self-study for MRCP examinations, but don’t count on this.

5. Make use of ‘dead time’.

As a change from answering practice questions, listening to podcasts while running or driving can boost your knowledge in weaker areas and add a bit of much-needed variety to your revision. If you have access to practice questions on your mobile phone you can turn a boring commute or rare night shift lull into a quick-fire revision session.

6. Get to grips with the latest guidelines.

Investigation and management of conditions in the exam is based mainly on national guidelines, for example NICE and SIGN, rather than cutting edge medicine. Don’t just rely on what you may normally do on the wards in case it isn’t entirely compliant with the appropriate guideline!

7. Practise against the clock.

In the final weeks leading up to the exam attempt practice papers so that you get into the mindset of answering questions under timed conditions. In the exam, don’t be afraid to skip a tricky question and come back to it if you’ve been staring at it for an eternity.

Also, be prepared for long vignettes which can certainly use up valuable time.  A trick that works for some is to read the question back to front, starting with the final part of the question and the answers.  Sometimes reading the vignette isn’t always necessary, but take care not to miss valuable clues!

8. And this is a big one – practise as many image-based questions as you can!

Candidates are often surprised by the high number of image questions in the MRCP 2 exam; these can range from chest and joint x-rays, to ECGs, photos of skin lesions, eyes and facial appearances, basic MRI and CT images, such as an obvious brain haemorrhage, to family trees and flow volume loops. There is also the potential for questions to contain multiple images, for example a pre and post contrast scan.

These images are typically distributed across both papers and between all specialities. Some questions may be based purely on the image provided, for others it will form just part of a long vignette.

If you aren’t immediately sure what the image signifies spend some time analysing the image and try to interpret what it shows in isolation from the vignette. Then use this information in conjunction with the remainder of the question.

Alternatively, use the vignette to discount as many of the four distractors as possible. Then revisit the image armed with the remaining possible answers and see if it fits with the remaining options.

9. Look for clues in the vignettes.

If you are struggling with a question, look back over the vignette and highlight any clues in the history or patterns in the results to discount a few of the distractors to narrow down your options. A normal result, or an absence of a clinical sign or symptom is just as important as the presence of one when discounting the incorrect answers.

Remember that there is no negative marking so guessing from the remaining options is not going to harm your score.

Also, while interrogating the vignette, watch out for negative phrasing. There are commonly a handful of these in each paper, such as “Which of the following is the LEAST likely diagnosis.”

10. Get organised for exam day.

Arrive at the exam hall in plenty of time; the last thing you want is to be stressed out by running late. The exam centre may also not be the same one where you sat MRCP Part 1. There aren’t always facilities to buy food in every venue so take some water, consider a mid-examination snack and don’t forget your lunch.

Another practical piece of advice is to mark your answers on the answer sheet to start with; do not answer on the question paper with the plan to transcribe at the end. One simple mistake when rushing to transfer the answers could knock all your answers out of sync – you could easily flunk the exam without realising!

We hope you’ve found this advice useful. Thanks – and good luck in the exam!