MRCP(UK) Part 1 is the first of the three examinations that lead to Membership of the Royal Colleges of Physicians, and for most doctors it is the first postgraduate exam they sit after foundation training. It is broad, it is sat under time pressure, and roughly four in ten candidates fail at each diet. This guide sets out what the exam is, who can sit it, how it is marked, when it runs, and how to prepare for it in a way that gets you through at the first attempt.
What MRCP Part 1 tests
Part 1 checks that you have the core knowledge of general medicine and the basic sciences that underpin it. The paper covers every specialty of internal medicine, from cardiology and respiratory medicine through gastroenterology, nephrology, endocrinology, neurology, haematology, oncology, infectious diseases, rheumatology and dermatology, together with clinical pharmacology, genetics, immunology, cell and molecular biology and medical statistics. Most questions are written as a short clinical scenario, but a good number test straight science: the mechanism of a drug, the inheritance of a condition, the interpretation of a likelihood ratio.
The weighting between specialties is fixed by a published blueprint, and it is worth knowing. Cardiology, respiratory medicine, gastroenterology, neurology, endocrinology and nephrology each carry a substantial share, and clinical pharmacology is consistently the single largest topic in the paper. Candidates who revise their favourite specialty in depth and skim the rest are the ones who come up short.
Format of the exam
The exam is taken on one day as two papers, each lasting three hours and each containing 100 questions, which gives you under two minutes a question. Every question is best of five: a stem, a single question, and five options of which one is the best answer. There is no negative marking, so an unanswered question is simply a lost mark and you should answer everything. The exam is delivered on computer at test centres in the UK and in many countries overseas.
Who can sit it
You need at least twelve months of postgraduate clinical experience by the date of the exam. For UK graduates that means completion of Foundation Year 1; international graduates need the equivalent period of supervised clinical practice after their primary medical qualification. You do not need to be working in the UK, and you do not need to be in a training post. Registration is through the MRCP(UK) website, and you will need your primary medical qualification certificate to hand when you first create an account.
How it is marked
The two papers are combined into a single score, which is then scaled and compared with a pass mark set by standard-setting for that particular diet. The pass mark is therefore not a fixed percentage, and it is published after each sitting rather than before. In practice it sits a little above 60 per cent of questions correct, but you should aim higher than that in your practice bank, because exam-day performance is usually a few points below practice performance.
You are allowed six attempts at Part 1. After that you can only apply again with evidence of further educational experience, so it is worth preparing properly for the first attempt rather than treating it as a trial run. Results are released around four to five weeks after the exam.
When the exam runs
There are three diets a year, usually in January, May and September, with the application window opening roughly three months before each sitting and closing several weeks before the exam date. Places at popular centres fill early, so apply as soon as the window opens. Current dates, fees and centre lists are published by the Federation of the Royal Colleges of Physicians at mrcpuk.org, and you should check there rather than relying on any secondary source.
How long to allow for revision
Most first-time passers describe three to four months of steady preparation, with a final month of intensive question practice. Shorter works if you have a strong recent knowledge base, for example straight after a medical school with a heavy final-year emphasis on medicine, but the breadth of the syllabus catches out candidates who leave it to six weeks. If you are working full time, an hour a day on weekdays and a longer session at the weekend across three months adds up to roughly 150 hours, which is enough.
How to revise: questions first
The single most reliable predictor of passing Part 1 is the number of practice questions you have worked through and understood. Reading a textbook cover to cover feels productive but tests nothing; answering a best-of-five question and reading the explanation tells you immediately what you did not know. Aim to complete between 2,500 and 4,000 questions before the exam, and read the explanation for every one, including the ones you got right, because a right answer for the wrong reason is a wrong answer next time.
A simple structure works well. In the first two months, work through the bank by specialty, one specialty at a time, in the proportions of the blueprint. Keep a short list of facts you got wrong, in your own words, and reread it weekly. In the final month, switch to mixed-specialty blocks of 100 questions against the clock, so that you are practising the pace and the switching between topics that the real paper demands. Repeat your two weakest specialties in the last fortnight.
Explanations matter more than the questions themselves. A good explanation tells you the mechanism, says why each wrong option is wrong, and leaves you with a single memorable point. That is how one question teaches five facts, and it is the reason to choose a bank by the quality of its explanations rather than by the raw number of questions.
The topics that decide the result
Some areas carry more marks than their size suggests. Clinical pharmacology appears throughout the paper, not only in the pharmacology section: mechanisms of action, adverse effects, interactions and prescribing in renal and hepatic impairment are tested in every specialty. Medical statistics is a small section that candidates routinely neglect, yet its questions are formulaic and quick marks once learned. Genetics and immunology reward a few hours of focused revision because the question styles repeat. In the clinical specialties, the questions cluster around diagnosis from a pattern of results, the first-line investigation, and the first-line treatment under current UK guidance, so knowing the NICE and Royal College position on the common conditions is worth more than rare-disease detail.
Common reasons for failing
Candidates who fail Part 1 usually give the same reasons afterwards. They revised the specialties they liked and under-revised pharmacology and the sciences. They read rather than practised, and so never found out what they did not know until the exam. They ran out of time in the second paper because they had never practised at the real pace. And they changed answers: in best-of-five questions, the first instinct is right more often than the second, so change an answer only when you can say exactly why the first one was wrong.
Preparing with License Medical
Our MRCP Part 1 question bank holds more than 2,600 best-of-five questions written to the current blueprint by a UK consultant physician, each with an explanation that gives the mechanism, works through the wrong options and ends with a Clinical Tip. You can try free MRCP Part 1 questions first and judge the explanations for yourself. Once you have passed, the next step is the MRCP Part 2 Written question bank.
Frequently asked questions
Is Part 1 harder than Part 2? Part 1 has the lower pass rate of the two written papers, partly because it is the first filter and partly because it tests basic science that many candidates have not revisited since medical school. Part 2 has longer stems but is closer to everyday clinical work.
Can I sit Part 1 outside the UK? Yes. Centres run in many countries, and there is no requirement to hold a UK post or GMC registration to sit the written papers.
How many questions should I do in a day? Fifty to a hundred, with the explanations read in full, is a realistic daily target alongside clinical work. Volume without reading the explanations adds little.
Do I need a textbook as well as a question bank? A reference to look things up in is useful, but it should be used to answer the gaps that questions reveal, not read front to back.