MRCP Part 2

More than 2,000 best-of-five questions for the MRCP(UK) Part 2 Written examination, written by a UK consultant physician around the longer, data-rich stems of Part 2: results, images, ECGs and the decision you would make on the ward.

Every explanation ends with the management step the examiners are looking for. Passed Part 1 and want Part 2 done at the first attempt? Start with the free sample questions and judge the explanations for yourself.

What you get

• Part 2-style stems. Longer scenarios with a full set of results, so you practise finding the one abnormal value that changes the answer, exactly as in the real paper.
• Interpretation practice. Blood gases, ECGs, spirometry, bone profiles, liver screens and genetic results appear as they do in the exam, with the reasoning spelled out.
• Decision-based explanations. The differential, why the diagnosis fits, the next investigation or treatment by current UK guidance, and a Clinical Tip.
• Progress by specialty. Scores broken down by the exam blueprint, so you know whether it is nephrology or neurology that needs the next week.
• Website and app. Revise on a laptop at home or on the License Medical app between patients; progress syncs.
• Timed practice. Answer in exam-length blocks against the clock, because Part 2 leaves under two minutes a question. 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 58-year-old man with a 20-year history of ulcerative colitis attends for surveillance colonoscopy. He is in clinical remission on mesalazine. Colonoscopy shows quiescent pancolitis; a 12 mm sessile polypoid lesion in the sigmoid colon is removed en bloc, and histology reports low-grade dysplasia with clear margins. Four targeted biopsies from the flat mucosa around the resection site show no dysplasia.

What is the most appropriate next step?

A. Refer for panproctocolectomy
B. Repeat colonoscopy in three months
C. Repeat colonoscopy in one year
D. Repeat colonoscopy in five years
E. Start azathioprine for chemoprevention

Answer: B. Repeat colonoscopy in three months. A visible, well-circumscribed dysplastic lesion in colitis that has been completely resected, with no dysplasia in the surrounding flat mucosa, does not need colectomy. The risk is incomplete removal or synchronous invisible dysplasia, so UK and European guidance recommend an early surveillance colonoscopy with chromoendoscopy at around three months, then a return to annual surveillance if that is clear. Colectomy is reserved for invisible dysplasia confirmed by a second pathologist, multifocal dysplasia, or a visible lesion that cannot be completely removed. A five-year interval is for low-risk colitis with no dysplasia. Azathioprine is an immunomodulator for active disease and is not used for chemoprevention. Clinical Tip: in colitis, complete endoscopic resection of a visible dysplastic lesion means intensified surveillance, not surgery.

About the MRCP(UK) Part 2 Written exam

What does Part 2 test? Part 2 Written moves on from the knowledge tested in Part 1 to how you use it: making a diagnosis from a full set of findings, choosing the next investigation, prioritising treatment and recognising when a result does not fit. Stems are longer and often include images or tables of results.

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

Who can sit it? You must have passed MRCP Part 1 within the previous seven years. You do not need to have passed PACES first; the two Part 2 components can be taken in either order.

Is Part 2 harder than Part 1? Pass rates for Part 2 are usually a little higher than for Part 1, partly because candidates have already been selected by Part 1 and partly because the questions are closer to everyday ward work. The difficulty is time: 200 long stems in six hours leaves under two minutes per question.

How many attempts are allowed? Six, as for Part 1, after which further attempts need evidence of additional educational experience.

When are the sittings? Three times a year, usually March, July and November. Application windows and fees are published by the Federation at mrcpuk.org.

How should I revise? Part 2 rewards pattern recognition under time pressure, so the most useful preparation is a high volume of exam-length questions answered against the clock, followed by reading the explanation in full. Finish the bank once, then repeat your two weakest specialties in timed blocks in the final month.

Written by a UK consultant physician. Every explanation follows current NICE and Royal College guidance and is reviewed when guidelines change. After MRCP: the Specialty Certificate Exam question banks.