About the exam
MRCP(UK) Part 1 Exam structure
An independent study guide aligned to the current Federation MRCP(UK) Part 1 blueprint, April 2026 regulations and Internal Medicine Stage 1 curriculum.
Issuer and path
MRCP(UK) Part 1 Study Guide is administered through Federation of the Royal Colleges of Physicians of the UK. Check official resources before booking, retesting, or relying on a stale requirement.
MRCP(UK) Part 1 Written Examination
200 scored + 0 pretest
One assessment delivered as two three-hour computer-based papers of 100 best-of-five questions; the current blueprint does not publish a paper-specific specialty split.
Before your examination diet
Recheck the current Federation pages, regulations, admission document and direct communications for venue, delivery route, identification, timings, reasonable adjustments and any updated standard.
Official Outline Coverage Map
Coverage is mapped to official outline item counts so content depth can be checked without hard-coding a single exam.
| Topic | Official outline items | Your questions | Your flashcards | Confidence |
|---|---|---|---|---|
| Cardiology | 14 | 42 | 10 | Strong |
| Clinical Pharmacology and Therapeutics | 15 | 45 | 10 | Strong |
| Clinical Sciences | 25 | 76 | 15 | Strong |
| Dermatology | 8 | 24 | 10 | Strong |
| Endocrinology, Diabetes and Metabolic Medicine | 14 | 42 | 10 | Strong |
| Gastroenterology and Hepatology | 14 | 42 | 10 | Strong |
| Geriatric Medicine | 8 | 24 | 10 | Strong |
| Haematology | 10 | 30 | 10 | Strong |
| Infectious Diseases | 14 | 42 | 10 | Strong |
| Neurology | 14 | 42 | 10 | Strong |
| Oncology | 5 | 15 | 10 | Strong |
| Medical Ophthalmology | 4 | 12 | 10 | Strong |
| Palliative Medicine and End of Life Care | 4 | 12 | 10 | Strong |
| Psychiatry | 9 | 27 | 10 | Strong |
| Renal Medicine | 14 | 42 | 10 | Strong |
| Respiratory Medicine | 14 | 42 | 10 | Strong |
| Rheumatology | 14 | 42 | 10 | Strong |
How to use this guide
How to prepare for MRCP(UK) Part 1
Use the official likely question distribution to plan breadth, then connect mechanisms, patterns and investigations to one most appropriate answer.
1. Identify the task
Decide whether the item asks for mechanism, diagnosis, investigation, immediate management, definitive treatment, adverse effect or prognosis.
2. Extract discriminators
Use age, tempo, pattern, physiology, medicine exposure and key positive or negative findings.
3. Apply mechanism and probability
Link clinical science to the disease pattern and rank options by fit rather than familiarity.
4. Apply current UK practice
Check urgency, contraindications, national guidance, monitoring and the level expected at entry to specialist training.
5. Commit to the best answer
Select the option that most completely answers the exact stem, then move on because there is no negative marking.
Official blueprint
Cover all 17 specialties in published proportions
The official likely counts total 200 and apply across both papers; live counts may vary slightly.
Cardiology
Ischaemic, structural, rhythm, heart-failure, vascular and preventive cardiovascular medicine.
Choose a topic to open below
Clinical Pharmacology and Therapeutics
Pharmacokinetics, interactions, adverse effects, poisoning and safe evidence-based prescribing.
Choose a topic to open below
Clinical Sciences
Cell biology, anatomy, biochemistry, physiology, genetics, immunology, statistics and evidence-based medicine.
Choose a topic to open below
Dermatology
Inflammatory, infective, autoimmune, drug-related and malignant skin disease.
Choose a topic to open below
Endocrinology, Diabetes and Metabolic Medicine
Diabetes, pituitary, thyroid, adrenal, calcium, bone and metabolic disease.
Choose a topic to open below
Gastroenterology and Hepatology
Luminal, hepatobiliary, pancreatic, nutritional and gastrointestinal emergency medicine.
Choose a topic to open below
Geriatric Medicine
Frailty, falls, cognition, multimorbidity, medicines and person-centred care of older people.
Choose a topic to open below
Haematology
Anaemia, malignant haematology, thrombosis, haemostasis and transfusion.
Choose a topic to open below
Infectious Diseases
Sepsis, antimicrobial choice, organ-specific infection, HIV, travel and infection prevention.
Choose a topic to open below
Neurology
Vascular, epileptic, inflammatory, degenerative, peripheral and neuromuscular disease.
Choose a topic to open below
Oncology
Cancer presentation, diagnosis, treatment principles, complications and acute oncology.
Choose a topic to open below
Medical Ophthalmology
Visual loss, painful red eye, retinal disease and ocular manifestations of systemic disease.
Choose a topic to open below
Palliative Medicine and End of Life Care
Symptom control, communication, decision making and coordinated care near the end of life.
Choose a topic to open below
Psychiatry
Mood, psychosis, anxiety, substance use, cognition, risk and mental-health law.
Choose a topic to open below
Renal Medicine
Acute and chronic kidney disease, fluid, electrolytes, acid-base disturbance and renal replacement.
Choose a topic to open below
Respiratory Medicine
Airway, parenchymal, pleural, vascular, sleep and respiratory-failure medicine.
Choose a topic to open below
Rheumatology
Inflammatory arthritis, connective-tissue, vasculitic, crystal, bone and soft-tissue disease.
Choose a topic to open below
Ischaemia, Heart Failure and Valve Disease
Link symptoms, examination, ECG, biomarkers and imaging to acute and chronic cardiovascular decisions.
Key rules
Rule 1
Cardiac presentations require early recognition of instability and time-critical treatment before diagnostic refinement.
Exam cue: Separate immediate stabilisation from definitive investigation.
Rule 2
Structural disease management depends on severity, ventricular effect, symptoms and intervention threshold.
Exam cue: Use physiology and trajectory rather than one isolated test.
Common traps
Excluding acute coronary syndrome after one normal early test.
Prevention: Do not select an option merely because it is true; choose the one that best answers the exact stem and fits the full pattern.
Treating congestion without identifying the precipitant.
Prevention: Do not select an option merely because it is true; choose the one that best answers the exact stem and fits the full pattern.
Memory anchors
What frames acute chest pain?
Stability, ECG, serial biomarkers, dangerous alternatives and reperfusion or specialist pathway.
What belongs in heart-failure assessment?
Congestion, perfusion, cause, trigger, cardiac function, renal status and medicines.
How is valve severity interpreted?
Symptoms, examination, imaging measurements, ventricular response and complication risk.
What follows an acute coronary syndrome?
Secondary prevention, rehabilitation, risk-factor control and medicine monitoring.
What makes cardiogenic shock urgent?
Hypoperfusion from cardiac failure requiring rapid cause-directed support and specialist escalation.
Next best moves
Quick check-up
Use a short quiz to confirm the rule pattern is actually sticking.
Check-up Questions
A 62-year-old man has 40 minutes of crushing central chest pain. ECG shows 2 mm ST elevation in leads II, III and aVF. His nearest primary PCI centre can accept him immediately with an estimated diagnosis-to-wire time of 90 minutes. What is the most appropriate reperfusion strategy?
A 70-year-old woman presents with chest pain and diaphoresis. ECG shows horizontal ST depression in V4-V6. High-sensitivity troponin is above the assay's 99th centile and rises on repeat testing. What is the most likely diagnosis?
Answer all questions to submit.
Next step personalized recommendations
Open another topic next
Official resources
Verify the details with the official sources
Use these links for eligibility, scheduling, handbook rules, and issuer updates. Our guide helps you study; official sources tell you what the testing partner currently requires.
Federation: MRCP(UK) Part 1
The current purpose, curriculum relationship, entry-level scope and examination-at-a-glance page.
Federation: Part 1 format and blueprint
The authoritative two-paper format, best-of-five marking and 17-specialty likely question distribution.
MRCP(UK) Regulations, April 2026
Current delivery, eligibility, progression, attempt and conduct rules.
Internal Medicine Stage 1 curriculum
The current curriculum linked from the Part 1 pages, including clinical presentations, conditions and capabilities.
Federation: pass marks explained
Current Part 1 equating method and scaled pass score of 450 from the 2026/1 diet.
Federation: Part 1 preparation
Current centre-based preparation, admission and examination-day guidance with access to the online practice interface.
Federation: UK and international centres
Current centre and delivery information; candidates should confirm the location and format for their diet.
FAQ
Common MRCP(UK) Part 1 questions
Is this an official Federation resource?
No. This is an independent study guide. The current Federation website, regulations, curriculum, admission document and direct candidate communications remain authoritative.
What is the current MRCP(UK) Part 1 structure?
Part 1 is a one-day examination with two computer-based papers. Each paper lasts three hours and contains 100 best-of-five questions, giving 200 questions in total.
Are the specialties split between Paper 1 and Paper 2?
The current Federation format page publishes one 200-question specialty blueprint and no paper-specific specialty allocation. This module therefore uses one 200-item assessment section while recording the exact two-paper delivery.
Are the published specialty counts exact?
No. The Federation describes them as the likely number of questions and says the actual number may vary slightly. They are still the authoritative planning weights and total 200.
What is included in the 25 Clinical sciences questions?
The official breakdown is Cell, molecular and membrane biology 2; Clinical anatomy 3; Clinical biochemistry and metabolism 4; Clinical physiology 4; Genetics 3; Immunology 4; Statistics, epidemiology and evidence-based medicine 5. These seven component counts total 25 and are included in, not additional to, the 200-question blueprint.
What level does Part 1 assess?
It tests clinical sciences and common or important disorders at a level appropriate for entry to specialist training. Candidates are also expected to know relevant current UK national guidance.
Does every item have a clinical vignette?
Not necessarily. The Federation says clinical-science questions will use a clinical stem where appropriate, but a stem may be omitted when it would not be justified by the subject.
Are images used?
The current Part 1 overview states that the examination has no images. Visual diagnostic reasoning can still be studied conceptually, but this guide does not claim image-based live items.
How is Part 1 marked?
Each correct answer receives one mark and there is no negative marking. Results use Item Response Theory equating to account for differences in question difficulty and report an overall scaled ability score.
What is the current pass mark?
The Federation states that the Part 1 scaled pass score is 450 from the 2026/1 diet. Because of equating, this is not a fixed raw score or percentage and the pass rate can vary.
How many attempts are allowed?
The April 2026 regulations permit a maximum of six attempts at each part. After six attempts, an exceptional additional attempt may be requested on the basis of relevant additional education or training with supporting evidence.
When can a doctor first sit Part 1?
The regulations state that candidates are not admitted until 12 months after the graduation date on their primary medical qualification, subject to the detailed alternative evidence rule in the regulations.
Are the 601 planned questions an official blueprint?
No. The official blueprint totals 200 likely live-exam questions. The 601-item map is an internal future-authoring plan allocated proportionally as three times each specialty count, with one rounding remainder added to Clinical sciences.