Since the MRCP Part 2 exam in September 2023 we’ve been gathering feedback about the sitting, so that we can analyse the key information, and help future candidates get The Pastest Advantage. Once again, UK candidates sat the MRCP Part 2 exam online – and we’ve gathered some instant insights about this experience. We’ll continue to update this blog as we find out more, but here’s what we know so far:

MRCP Part 2 September 2023 exam content

• A complete reverse from the previous diet when the vignettes were rather short, this diet saw very detailed vignettes but with ambiguous questioning, especially in Paper 2.
• As a result, candidates felt the exam contained several Red Herrings within the options, ensure you read the question carefully.
• Time management was key with the longer question length, don't get consumed with one question, flag it and move on.
• There was a heavy focus on different syndromes such as Gaucher disease and Mcardle disease.
• Neurology was once again considered the trickiest topic with 19% of candidates rating it the hardest, this was followed by Endocrinology at 14% and Renal Medicine at 13%.

Customer comments

Here's a selection of comments and advice provided by candidates who sat the September 2023 MRCP 2 exam:

• "MRCP Part II is heavily clinically based. Clinical judgement and management of conditions are more applicable as opposed to heavy memorization of key facts in Part 1. Hence, practice as many questions to get a feel of the themes and with equal diligence; you must practice completing the exam within the time limit otherwise your hard work will become insignificant."
• "It is very important to get the very core concept of each topic (solid theory background) step by step."
• "Read widely but also in depth. Things that you see in practice at work rarely come up. Uncommon things appear on the exam."
• "The data interpretation is heavily relied on here. The body of history not useful in concluding answers"
• "Part 2 is about thinking like a doctor - getting the diagnosis right and knowing treatment guidelines incl. drug allergy alternatives."
• "Practice picking up points from topics. Focus on recurring themes. Make sure you time yourself and pace yourself. Its a long exam and requires effective time management"

Common topics

According to Pastest users, questions on the following topics have appeared at least twice in the last three MRCP Part 2 exams:

• Chronic headache management.
• Dysentery differentials.
• Diabetes complications.
• Prescribing in pregnancy.
• Epidural haematoma - image interpretation.
• Hospital acquired infections.
• Drug interactions.
• ECG interpretation of SVT.

Sitting the MRCP Part 2 Exam Online

Most candidates felt that the online remote experience was more convenient and less stressful than attending a physical exam centre. However, taking the exam at home didn't make for a perfect experience. Some candidates mentioned eye strain from staring at the screen all day; this is hardly surprising as it's a long day filled with two, three-hour papers so fatigue can set in, especially after lunch.

Distractions in the home environment were cited as an issue, so ensure family and friends are aware that you cannot be interrupted. Pets also need to be considered, so make sure they've been fed and watered as required.

We've also had reports of inconsistencies between different proctors regarding whether you were allowed to use scrap paper to make notes.

A few technical issues have been reported in recent sittings, including the second paper failing to load for some candidates, screen sharing regularly disconnecting, connection dropouts during the exam and proctors taking a long time to reply regarding toilet breaks. When sitting the exam online, you may also have to deal with interruptions from the invigilators, especially to share your screen.

Advice from Exam Candidates

We asked our customers what advice they would give to future online candidates. Here’s what they suggest:

• Check you have a stable internet connection – an ethernet cable helps with this.
• Make sure that you won’t be disturbed during the exam.
• Use the rear camera on your phone for the remote invigilation so that you don’t get disturbed by the screen.
• Ensure that you’ve checked your internet speed before registering for an online place.
• Prepare for the exam in the same way you would normally, as the content is the same.
• Get a good night's sleep beforehand, your eyes will get tired.
• Check with the proctor regarding rules on toilet breaks and note-taking on paper, as this did vary.
• Make sure you've got a relaxed environment, that your chair is comfortable (as you're going to be sat on it for several hours), your monitor is at the right eye level and the lighting in the room is good.
• If you're fasting during Ramadan etc., make sure you're pre-loading on foods rich in complex carbohydrates and protein, fruit and vegetables...and drink plenty of water!
• Use Pastest to prepare, as the experience is very similar!

Attending the Exam Centre (overseas)

Candidates reported that despite infection control measures being in place, this did not add any stress to their exam experience. Candidates were well spread out during the exam, and could leave the exam hall once finished, which reduced the traffic filing out at the end.

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Keen to find out more about the exam? Read on for more insights from recent exams...

MRCP Part 2 May 2023 exam content

• Compared to previous papers the question length was considered shorter, although Paper 2 still contained some lengthier vignettes.
• Neurology-related questions were more prominent in this diet, while expected topics like chest X-rays and CT were less represented.
• Ethnicity was relevant when mentioned in the question as well as travel history.
• No negatively phrased questions were included in the exam.
• Neurology was considered the trickiest topic (probably due to the surprise number of questions included) with 30% of candidates rating it the hardest, this was followed by Endocrinology at 13% and Infectious Diseases at 10%.

MRCP Part 2 September 2022 exam content

• The first paper was considered the trickier of the two. A number of questions contained within it had patients with multiple symptoms and diagnoses then would go off on a tangent.
• Questions, in general, were 4-5 lines in length, although this varied and a few went to 8 lines long, sometimes augmented with tables and pictures so ensure you pace yourself with your timings, it's a long day!
• Ethnicity was relevant when mentioned in the question as well as travel history.
• No negatively phrased questions were included in the exam.
• Endocrinology, diabetes and metabolic medicine was once again considered the trickiest topic in the exam with 21% of candidates, this is the 2nd diet running where this topic came top. Renal medicine and Neurology followed with 13% and 11% respectively.

MRCP Part 2 June 2022 exam content

• Question length was varied across the two papers, many questions were quite brief with little clues provided within the vignette, which made it difficult to pick between two choices for the answer.
• On the flip side there were also a number of questions, especially in Paper 1, that were extremely long and packed full of information to dissect.
• Candidates reported a large number of MRI and CT scan images throughout the papers, including several new ones not seen in previous papers.
• Red herrings were included so look out for these so you don't get tricked!
• Endocrinology, diabetes and metabolic medicine was considered the trickiest topic in the exam with 26% of candidates, followed by Neurology at 12% and Respiratory at 11%.
• Timing was an issue for many candidates, it's a really long day so pace yourself!

Customer comments

Here's a selection of comments and advice provided by candidates who sat the June 2022 MRCP 2 exam:

• "There were vague symptoms with urinalysis finding. Questions required figuring out diagnosis and than appropriate investigations or management."
• "When completing the question bank try to read the guidelines and understand not only how to diagnose but what they test and what is the first line, second line, and any other management."
• "Focus mainly on diagnosis and immediate investigations and simple 1st line management rather than going deep in managing options."

February 2022 exam content

• Question stems were considered longer than usual with lots of information to digest. As a result many candidates struggled with time keeping and fatigue towards the end of each paper.
• There was a large number of questions on different types of vasculitides, so swot up on your autoimmune diseases.
• Topics were bunched together, i.e. there were groups of questions around a single topic, testing the same point a couple of times. 
• Renal Medicine and Rheumatology were considered the trickiest topics in this exam, this is in contrast with the October exam which saw Neurology deemed the hardest area.

December 2021 exam content

• There were more red herrings in this sitting than usual, especially in paper 2.  
• There wasn’t a lot of Dermatology or Ophthalmology, and there was only one question on Therapeutics. The main focus was Cardiology, Respiratory, Infectious Diseases and Renal, with quite a few Oncology questions about prognosis, such as knowing the level of treatment to give in T stages.
• The questions required a lot of deep medical knowledge. Extensive data analysis was a required element.
• Topics were bunched together, i.e. there were groups of questions around a single topic, testing the same point a couple of times. 
• Time management was an issue for several candidates, many reported fatigue and a struggle to concentrate towards the end of each paper.
• Neurology was once again considered the trickiest specialty in the exam, narrowly ahead of Cardiology, Endocrinology, Infectious Diseases and Oncology. This is in contrast to the March exam which saw Endocrinology deemed the hardest area.

October 2021 exam content

• The questions varied in length in both papers, some vignettes were composed of a couple of sentences whilst others were particularly long with several twists. As a result of this, some candidates struggled to keep up a consistent pace and manage their time well, especially during the first paper.
• Timekeeping, in general, was also a real issue for many candidates who referenced finishing the exam with only a couple of minutes to spare and not having time to check answers.
• There were not as many Basic Science or Pathophysiology questions as expected, but there were lots of 'red herring' style questions and a huge amount of data and tables to work through.
• A number of 'niche' questions about kidney pathology appeared in the exam.
• Several 'new' images were included in the exam that were difficult to interpret especially in Dermatology.
• Neurology was considered the trickiest specialty in this diet, narrowly ahead of Cardiology and Nephrology. This is in contrast to the March exam which saw Endocrinology deemed the hardest area.

June 2021 exam content

• Around half of the Respiratory questions included images, with no definitive hint to help you pick up a correct diagnosis.
• There were a number of 'most important investigation' questions with clues throughout the vignette provided to eliminate incorrect answers.
• Endocrinology was considered the most difficult specialty, followed by Cardiology, Neurology, and Nephrology.
• Causes of haemolytic and/or microcytic anaemia and/or low platelets in the context of different clinical scenarios were referenced in the exam.
• Paper 2 was considered the harder paper with several red herring-style questions which led candidates in one direction with the vignette, before asking an unrelated question.
• Questions that include a country of origin or patient’s occupation tend to include these clues for a reason. They aren’t just peripheral facts, they may lead you to the correct answer!

Here’s another vital comment that one candidate mentioned:

"Ensure that the signature on your application matches your ID that you present on the day!" One candidate said that they were pulled up on this on the morning of the exam. Don’t let a simple admin faux-pas add to your pre-exam stress!