MRCP Part 1

More than 2,600 best-of-five questions for the MRCP(UK) Part 1 examination, written by a UK consultant physician and mapped to the current exam blueprint.

Each explanation gives the mechanism, says why the other four options are wrong and ends with a Clinical Tip you can carry into the exam. Sat it before and missed the pass mark, or sitting for the first time? Either way, start with the free sample questions and judge the explanations for yourself.

What you get

• Exam-matched questions. Short clinical stem, one lead-in, five options, one best answer. Weighting across specialties mirrors the official blueprint, so you spend most time where the marks are.
• Teaching explanations. The pathophysiology in a sentence or two, then every distractor worked through so you learn five facts from one question.
• Revision notes. Topic-by-topic notes sit beside the questions, so a wrong answer links straight to the reading you need.
• Progress by specialty. See your score in each specialty, revisit flagged questions and reset the bank for a second pass before exam day.
• Website and app. Use the website or the License Medical app on iOS and Android; progress syncs between them.
• Current guidance. Management answers are checked against the NICE and Royal College guidance the examiners use, and new questions are added free during your subscription.

Which plan?

• 1 month. Tried another bank and did not get through? One focused month to close the gaps before you resit.
• 3 months. The plan most first-time passers use: one full pass of the bank and a second pass of your weak specialties.
• 6 or 12 months. Working full time or on nights? Spread it out at under an hour a day and still finish the bank twice.

Sample question

A 34-year-old woman presents with a three-month history of fatigue, pruritus and dry eyes. Examination shows xanthelasma. Blood tests show alkaline phosphatase 410 IU/L, ALT 48 IU/L, bilirubin 14 µmol/L and a raised IgM. Antimitochondrial antibody is positive at a titre of 1:640. Ultrasound of the liver and biliary tree is normal.

Which of the following is the most appropriate first-line treatment?

A. Azathioprine
B. Cholestyramine
C. Obeticholic acid
D. Prednisolone
E. Ursodeoxycholic acid

Answer: E. Ursodeoxycholic acid. Cholestatic liver tests, a high-titre antimitochondrial antibody and a raised IgM in a middle-aged woman are diagnostic of primary biliary cholangitis without biopsy. Ursodeoxycholic acid at 13 to 15 mg/kg/day is first-line in all patients because it slows histological progression and improves transplant-free survival. Obeticholic acid is reserved for patients whose alkaline phosphatase stays above 1.67 times the upper limit after a year of ursodeoxycholic acid, and is not used in decompensated disease. Cholestyramine treats the itch but not the disease. Prednisolone and azathioprine treat autoimmune hepatitis, which would show a raised ALT and IgG rather than a cholestatic picture with raised IgM. Clinical Tip: a positive antimitochondrial antibody with a cholestatic pattern is primary biliary cholangitis until proven otherwise, and the first drug is always ursodeoxycholic acid.

About the MRCP(UK) Part 1 exam

What does Part 1 test? Part 1 is the first of three MRCP(UK) examinations and checks that you have the core knowledge of medicine and the basic sciences behind it. Questions cover the whole of internal medicine, from cardiology and respiratory medicine to clinical pharmacology, genetics, immunology and statistics, and most stems are written as a short clinical scenario.

What is the format? Two papers on one day, each lasting three hours and each containing 100 best-of-five questions. There is no negative marking, so answer every question.

Who can sit it? You need at least twelve months of postgraduate clinical experience by the exam date (for UK graduates, completion of Foundation Year 1). You do not need to be working in the UK; the exam runs at centres in many countries.

How is it marked? The two papers are combined into one scaled score and compared with a pass mark set by standard-setting. Check the current pass mark on the MRCPUK website before you sit.

How many attempts are allowed? Six. After that you can only re-enter with evidence of additional educational experience, so it is worth preparing properly for the first attempt.

When are the sittings? Three diets a year, usually January, May and September, with applications opening about three months earlier. Dates and fees are published by the Federation of the Royal Colleges of Physicians at mrcpuk.org.

How many questions should I do before the exam? Most candidates who pass first time have worked through 2,500 to 4,000 questions and read every explanation, including the ones they got right. Our bank gives you a full first pass plus a second pass of your weakest specialties.

How is License Medical different from the big banks? The bank is written and kept up to date by one UK consultant physician rather than a rotating pool of authors, so the style and depth of the explanations are consistent from the first question to the last. It is also considerably cheaper, and you can try it free before paying.

Written by a UK consultant physician. Every explanation follows current NICE and Royal College guidance and is reviewed when guidelines change. Next step after Part 1: the MRCP Part 2 Written question bank.