Overview — UK Examination Landscape
UK postgraduate medical examinations are run by the Royal Colleges. Most exams have a written (MCQ/SBA) component and a clinical/practical (OSCE/viva) component. Passing membership exams is typically required to progress in specialty training.
MRCS — Membership of the Royal Colleges of Surgeons
MRCS is required for progression in surgical training in the UK, run jointly by the four UK Royal Colleges of Surgeons (RCS England, RCS Edinburgh, RCPSG Glasgow, RCSI).
MRCS Part A
- Two papers: Applied Basic Sciences and Principles of Surgery in General
- 180 questions (1.5 hours each paper)
- Sittings: January, April, September
- Pass mark is scaled; typically ~60–65%
- Can be sat from CT1 onwards
MRCS Part B (OSCE)
- 18-station OSCE covering anatomy, clinical skills, communication and operative surgery
- Must pass Part A before sitting Part B
- Sittings: April/May and October/November
- Pass rates historically 50–65%
Recommended Resources
- Get Through MRCS Part A (Pastest)
- Intercollegiate Surgical Curriculum (ISCP)
- OSCEstop.com for Part B OSCE practice
- Surgical Anatomy by Applied (Lumley)
MRCP — Membership of the Royal Colleges of Physicians
MRCP is required for Internal Medicine Training (IMT) and progression to most physician sub-specialties. Run by the Federation of Royal Colleges of Physicians (RCP London, Edinburgh, Glasgow).
MRCP Part 1
- 200 best-of-five questions over two papers
- Sittings: January, May, September
- Can be sat from CT1/IMT1 onwards
MRCP Part 2 Written
- Best-of-five and extended matching questions
- Includes data interpretation and clinical images
PACES
- Practical Assessment of Clinical Examination Skills — OSCE format
- Five stations: respiratory, abdomen, cardiovascular, neurology, history/communication
- Must pass Part 2 Written before PACES
Recommended Resources
- Passmedicine.com — most popular online question bank
- OnExamination (BMJ)
- Oxford Handbook of Clinical Medicine
- PACES for the MRCP (Ryder/Mir)
MSRA — Multi-Specialty Recruitment Assessment
The MSRA is a computer-based assessment used as a longlisting/shortlisting tool for multiple specialty applications via NHS Oriel. It tests:
- Professional Dilemmas (PD): Situational judgement questions
- Clinical Problem Solving (CPS): Best-of-five clinical questions
Used for: GP, Psychiatry, Obstetrics and Gynaecology, Ophthalmology, Radiology, Anaesthetics, Core Medical Training and others. High MSRA scores can compensate for a weaker interview.
Preparation Tips
- Start 6–8 weeks before the assessment
- Use GP-focused question banks for CPS (e.g. Passmedicine, Quesmed)
- Practice Professional Dilemmas using GMC Good Medical Practice as your framework
MRCGP — Membership of the Royal College of General Practitioners
- AKT (Applied Knowledge Test): 200 MCQ questions — clinical, administrative and evidence-based
- RCGP CSA / WPBA: Workplace-based assessments throughout GP training
- RCA (Recorded Consultation Assessment): Replaced the Clinical Skills Assessment (CSA)
Other Key UK Exams
| Exam | Specialty | College | Format |
|---|---|---|---|
| MRCPsych | Psychiatry | RCPsych | Papers 1, 2, 3 + CASC OSCE |
| FRCA Primary | Anaesthetics | RCoA | MCQ + OSCE |
| FRCA Final | Anaesthetics | RCoA | Written + SOE Viva |
| FRCEM Primary | Emergency Medicine | RCEM | MCQ |
| FRCEM Intermediate | Emergency Medicine | RCEM | Short Answer Questions |
| FRCR Part 1 | Radiology | RCR | Physics + Anatomy MCQ |
| FRCR Part 2 | Radiology | RCR | Rapid Reporting + FRCR |
| FRCS | Surgery (Higher) | Intercollegiate | Written + Viva |
General Exam Strategy
- Question banks: The single most effective revision tool for MCQ components
- Spaced repetition: Use Anki or similar for high-yield facts
- Start early: Aim for 3–6 months of preparation for major exams
- Peer revision: Study groups significantly improve retention and motivation
- Past papers: Practice under timed conditions from 4 weeks out