About the exam
MRCP(UK) Part 2 Written Exam structure
An independent study guide aligned to the current Federation MRCP(UK) Part 2 Written format, 16-specialty blueprint and April 2026 regulations.
Issuer and path
MRCP(UK) Part 2 Written 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 2 Written Examination
200 scored + 0 pretest
One assessment delivered as two three-hour computer-based papers of 100 image-capable 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 | 19 | 58 | 10 | Strong |
| Clinical Pharmacology and Therapeutics | 18 | 54 | 10 | Strong |
| Dermatology | 9 | 27 | 10 | Strong |
| Endocrinology, Diabetes and Metabolic Medicine | 19 | 57 | 10 | Strong |
| Gastroenterology and Hepatology | 19 | 57 | 10 | Strong |
| Geriatric Medicine | 9 | 27 | 10 | Strong |
| Haematology | 9 | 27 | 10 | Strong |
| Infectious Diseases | 19 | 57 | 10 | Strong |
| Medical Ophthalmology | 3 | 9 | 10 | Strong |
| Neurology | 17 | 51 | 10 | Strong |
| Oncology | 6 | 18 | 10 | Strong |
| Palliative Medicine and End of Life Care | 3 | 9 | 10 | Strong |
| Psychiatry | 3 | 9 | 10 | Strong |
| Renal Medicine | 19 | 57 | 10 | Strong |
| Respiratory Medicine | 19 | 57 | 10 | Strong |
| Rheumatology | 9 | 27 | 10 | Strong |
How to use this guide
How to prepare for MRCP(UK) Part 2 Written
Use the official likely question distribution to protect breadth, then practise extracting decisive clinical and visual evidence before selecting one best answer.
1. Identify the clinical task
Decide whether the item asks for diagnosis or problem priority, investigation, immediate management, long-term management or prognosis.
2. Establish urgency and time point
Identify instability, organ threat and what must happen now before considering definitive or long-term care.
3. Extract clinical and visual discriminators
Use age, tempo, pattern, physiology, medicines and the modality-specific image abnormality.
4. Rank options in context
Apply current UK practice, contraindications, test sequence and patient factors to eliminate answers that are true but mistimed.
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 16 specialties in published proportions
The official likely counts total 200 and apply across both papers; a live distribution may vary by up to 2%.
Cardiology
Clinical judgement in ischaemic, structural, rhythm, heart-failure, vascular and preventive cardiovascular medicine.
Choose a topic to open below
Clinical Pharmacology and Therapeutics
Individualised therapeutics, interactions, adverse effects, monitoring, poisoning and safe prescribing.
Choose a topic to open below
Dermatology
Inflammatory, infective, autoimmune, drug-related and malignant skin disease using clinical images where relevant.
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
Cytopenias, malignant haematology, thrombosis, haemostasis and transfusion.
Choose a topic to open below
Infectious Diseases
Sepsis, antimicrobial therapy, organ-specific infection, HIV, travel and infection prevention.
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
Neurology
Vascular, epileptic, inflammatory, degenerative, peripheral and neuromuscular disease.
Choose a topic to open below
Oncology
Cancer diagnosis, staging, treatment, prognosis, complications and acute oncology.
Choose a topic to open below
Palliative Medicine and End of Life Care
Symptom control, communication, treatment limits and coordinated care near the end of life.
Choose a topic to open below
Psychiatry
Mood, psychosis, anxiety, substance use, cognition, risk, capacity 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
Acute Coronary and Rhythm Decisions
Use symptoms, ECGs, biomarkers and haemodynamics to prioritise acute coronary, rhythm and pericardial care.
Key rules
Rule 1
Stability, symptom tempo, ECG pattern, serial biomarkers and dangerous vascular or respiratory alternatives.
Exam cue: Shock, ongoing ischaemia, malignant arrhythmia, tamponade physiology or aortic catastrophe.
Rule 2
Stabilise, activate the appropriate reperfusion or rhythm pathway, address contraindications and plan secondary prevention.
Exam cue: Choose serial ECG and biomarkers, targeted imaging and invasive assessment according to pre-test probability and urgency.
Common traps
Excluding acute coronary syndrome after one early normal ECG or biomarker.
Prevention: Do not interpret a visual pattern without the modality, clinical context and the exact task in the stem.
Selecting an option that is true in isolation but does not best answer the exact clinical task.
Prevention: Do not interpret a visual pattern without the modality, clinical context and the exact task in the stem.
Memory anchors
What frames Acute Coronary and Rhythm Decisions?
Stability, symptom tempo, ECG pattern, serial biomarkers and dangerous vascular or respiratory alternatives.
Which acute coronary and rhythm decisions findings change urgency?
Shock, ongoing ischaemia, malignant arrhythmia, tamponade physiology or aortic catastrophe.
How should investigations be chosen in acute coronary and rhythm decisions?
Choose serial ECG and biomarkers, targeted imaging and invasive assessment according to pre-test probability and urgency.
What guides management in acute coronary and rhythm decisions?
Stabilise, activate the appropriate reperfusion or rhythm pathway, address contraindications and plan secondary prevention.
What common error should be avoided in acute coronary and rhythm decisions?
Excluding acute coronary syndrome after one early normal ECG or biomarker.
Next best moves
Quick check-up
Use a short quiz to confirm the rule pattern is actually sticking.
Check-up Questions
A 63-year-old man has ongoing chest pain and 2 mm horizontal ST depression in V1-V3 with tall R waves. The first troponin is pending. Which additional ECG recording most directly tests the leading diagnosis?
A 71-year-old woman has NSTEMI, recurrent pain despite treatment, transient ST depression and a calculated GRACE 2.0 mortality risk above 3%. She is haemodynamically stable. What is the most appropriate strategy?
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 2 Written
The current purpose, Part 1 progression requirement, clinical application scope and examination-at-a-glance page.
Federation: Part 2 Written format and blueprint
The authoritative two-paper format, image types, marking and 16-specialty likely question distribution.
MRCP(UK) Regulations, April 2026
Current delivery, progression, attempt, conduct and administrative rules.
Part 2 Written March 2026 performance report
The latest available official diet report used here to cross-check the two-paper structure, specialty reporting and scaled pass score.
Federation: pass marks explained
Current Part 2 Written equating method and scaled pass score of 444 from the 2026/1 diet.
Federation: Part 2 Written preparation
Current centre-based preparation, admission and examination-day guidance with access to the online practice interface.
Federation: UK and international centres
Current test-centre delivery information and the specified locations retaining remote online proctoring.
FAQ
Common MRCP(UK) Part 2 Written questions
Is this an official Federation resource?
No. This is an independent study guide. The current Federation website, regulations, admission document and direct candidate communications remain authoritative.
What is the current Part 2 Written structure?
It is a one-day computer-based examination with two papers. Each paper lasts three hours and contains 100 best-of-five questions, giving 200 questions in total.
Who can take Part 2 Written?
A candidate must have passed MRCP(UK) Part 1 before applying for Part 2 Written. Candidates should check all current eligibility and administrative rules in the regulations before booking.
How does Part 2 Written differ from Part 1?
Part 2 builds on Part 1 knowledge and emphasises application and clinical judgement: prioritising diagnoses or problems, planning investigations, selecting immediate and long-term management, and assessing prognosis. Its questions usually use clinical scenarios and may include images.
Are 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. They are the likely numbers of questions across the examination. The Federation states that the actual number may vary by up to 2%, so the counts are planning weights rather than a guaranteed diet-level tally.
Is adolescent medicine assessed?
Yes. The current format page states that a proportion of questions will be on adolescent medicine, but it does not publish a fixed adolescent-medicine question count.
What images can appear?
The Federation lists clinical photographs, pathology slides, inheritance trees, ecgs, x-rays, ct scans, mr scans, echocardiograms. Interpret each image with the clinical scenario rather than as an isolated recognition test.
How is the examination 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 2 Written scaled pass score is 444 from the 2026/1 diet. Because of equating, this is not a fixed raw score or percentage and the number of scored items can be adjusted after post-examination quality review.
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.
Can I use a calculator?
No. The current centre-based preparation guidance says calculators and personal stationery are not permitted. A pen and paper are supplied for note making.
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 at about three times each specialty count, with one rounding remainder added to Cardiology.