About the exam
MRCPsych Paper B Exam structure
An independent guide aligned to the current RCPsych Paper B clinical and Critical Review syllabuses, 2022 Core Psychiatry Curriculum crosswalk and June 2026 MRCPsych regulations.
Issuer and path
MRCPsych Paper B Study Guide is administered through Royal College of Psychiatrists. Check official resources before booking, retesting, or relying on a stale requirement.
Section A: Critical Review
50 scored + 0 pretest
Fifty marks covering evidence retrieval, epidemiology, biostatistics, economics, qualitative methods, appraisal, application and performance evaluation.
Section B: Clinical Topics
100 scored + 0 pretest
One hundred marks across eight clinical syllabus sections, from service delivery and general adult psychiatry to forensic and intellectual-disability practice.
Confirm the syllabus and delivery for your diet
Check the RCPsych preparation page, calendar, current regulations and Pearson VUE instructions for your date, venue or OnVUE route, identification, equipment, adjustments and whether the January 2027 syllabus has taken effect.
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 |
|---|---|---|---|---|
| Organisation and Delivery of Psychiatric Services (8 marks; 5.5%) | 8 | 32 | 15 | Strong |
| General Adult Psychiatry (30 marks; 20%) | 30 | 120 | 25 | Strong |
| Old Age Psychiatry (14 marks; 9%) | 14 | 56 | 15 | Strong |
| Psychotherapy (8 marks; 5.5%) | 8 | 32 | 15 | Strong |
| Child and Adolescent Psychiatry (14 marks; 9%) | 14 | 56 | 15 | Strong |
| Substance Misuse/Addictions (10 marks; 6.5%) | 10 | 40 | 10 | Strong |
| Forensic Psychiatry (8 marks; 5.5%) | 8 | 32 | 10 | Strong |
| Psychiatry of Learning Disability (8 marks; 5.5%) | 8 | 32 | 10 | Strong |
| Critical Review and Evidence-Based Practice (50 marks; 33.5%) | 50 | 201 | 40 | Strong |
How to use this guide
How to prepare for MRCPsych Paper B
Integrate clinical formulation, safety and current UK practice with disciplined appraisal of design, bias, estimates and applicability.
1. Identify section and lead-in
Decide whether the item asks for a clinical decision or evidence appraisal, then answer the exact lead-in rather than the broad topic.
2. Structure the evidence
For clinical content, build a timeline, formulation, physical differential and risk picture. For Critical Review, identify PECO(t), design and variables.
3. Find the decisive discriminator
Use onset, course, impairment, safety or treatment phase clinically; use bias, denominator, effect measure or assumption in appraisal.
4. Apply current boundaries
Use the relevant UK jurisdiction, current guidance and respectful terminology clinically, and judge internal validity before generalising evidence.
5. Match the item form
For an MCQ, choose the single best of five. For an EMI, apply the shared option list and lead-in consistently to each vignette.
6. Check the closest alternative
State why the selected answer fits better than its nearest competitor, verify direction and denominator for calculations, then commit because there is no negative marking.
Official clinical blueprint
Balance eight clinical domains across 100 marks
General Adult carries 30 marks; Old Age and Child and Adolescent carry 14 each; the remaining five domains complete the clinical two-thirds.
Organisation and Delivery of Psychiatric Services
Multidisciplinary care, prevention, physical treatments, service planning, rehabilitation, rights, capacity, medico-legal and cultural practice. Official Paper B allocation: 5.5% (8 marks).
Choose a topic to open below
General Adult Psychiatry
Adult disorders and their epidemiology, aetiology, presentation, assessment, treatment and outcomes, including liaison, emergencies and perinatal care. Official Paper B allocation: 20% (30 marks).
Choose a topic to open below
Old Age Psychiatry
Later-life services, assessment, physical and cognitive illness, major disorders, suicide, bereavement, sleep, relationships and adapted treatment. Official Paper B allocation: 9% (14 marks).
Choose a topic to open below
Psychotherapy
Psychodynamic, family, cognitive-behavioural, group and other therapeutic models, indications, cultural fit and evidence of effectiveness. Official Paper B allocation: 5.5% (8 marks).
Choose a topic to open below
Child and Adolescent Psychiatry
Developmental and family context, services, safeguarding, physical health, assessment, disorders, evidence-based interventions and transition. Official Paper B allocation: 9% (14 marks).
Choose a topic to open below
Substance Misuse/Addictions
Substance pharmacology and epidemiology, dependence, withdrawal, complications, dual diagnosis, prevention, treatment and behavioural addictions. Official Paper B allocation: 6.5% (10 marks).
Choose a topic to open below
Forensic Psychiatry
Mental disorder and offending, victimisation, criminal-justice assessment, reports and evidence, secure care, risk management and human rights. Official Paper B allocation: 5.5% (8 marks).
Choose a topic to open below
Psychiatry of Learning Disability
Person-centred services, epidemiology, aetiology, communication, assessment, diagnostic overshadowing, behavioural phenotypes and treatment. Official Paper B allocation: 5.5% (8 marks).
Choose a topic to open below
One-third of Paper B
Trace question, design, estimate and application
Retrieval, epidemiology, statistics, economics, qualitative methods, synthesis, guidelines and improvement form one connected 50-mark domain.
Critical Review and Evidence-Based Practice
Clinical questions, evidence retrieval, epidemiology, biostatistics, economics, qualitative methods, appraisal, shared decisions, audit and PDSA. Official Paper B allocation: 33.5% (50 marks).
Choose a topic to open below
Clinical safety
Turn risk into a proportionate action plan
Emergency, physical-health, safeguarding, legal and forensic decisions require explicit mechanisms, ownership and review.
Organisation and Delivery of Psychiatric Services
Multidisciplinary care, prevention, physical treatments, service planning, rehabilitation, rights, capacity, medico-legal and cultural practice. Official Paper B allocation: 5.5% (8 marks).
Choose a topic to open below
General Adult Psychiatry
Adult disorders and their epidemiology, aetiology, presentation, assessment, treatment and outcomes, including liaison, emergencies and perinatal care. Official Paper B allocation: 20% (30 marks).
Choose a topic to open below
Old Age Psychiatry
Later-life services, assessment, physical and cognitive illness, major disorders, suicide, bereavement, sleep, relationships and adapted treatment. Official Paper B allocation: 9% (14 marks).
Choose a topic to open below
Child and Adolescent Psychiatry
Developmental and family context, services, safeguarding, physical health, assessment, disorders, evidence-based interventions and transition. Official Paper B allocation: 9% (14 marks).
Choose a topic to open below
Substance Misuse/Addictions
Substance pharmacology and epidemiology, dependence, withdrawal, complications, dual diagnosis, prevention, treatment and behavioural addictions. Official Paper B allocation: 6.5% (10 marks).
Choose a topic to open below
Forensic Psychiatry
Mental disorder and offending, victimisation, criminal-justice assessment, reports and evidence, secure care, risk management and human rights. Official Paper B allocation: 5.5% (8 marks).
Choose a topic to open below
Psychiatry of Learning Disability
Person-centred services, epidemiology, aetiology, communication, assessment, diagnostic overshadowing, behavioural phenotypes and treatment. Official Paper B allocation: 5.5% (8 marks).
Choose a topic to open below
Service Coordination, Prevention and Care Models
Multidisciplinary case management, the psychiatrist's role, integrated physical, psychological and social treatment, prevention and culturally responsive care.
Key rules
Rule 1
Effective psychiatric care coordinates biological, psychological and social interventions through clear multidisciplinary roles, shared formulation and continuity across service boundaries.
Exam cue: Identify the person's need, the professional best placed to address it and how information and accountability pass between teams.
Rule 2
Prevention can be universal, selective or indicated and can act before illness, during early disorder or after established illness to reduce disability and relapse.
Exam cue: Classify a preventive intervention by its target population and point in the illness pathway.
Common traps
Treating multidisciplinary working as parallel professional activity without an integrated plan.
Prevention: Do not choose an option because it is merely familiar or associated; show why it best answers this lead-in.
Assuming one service model fits every population without considering need, access, culture and local resources.
Prevention: Do not choose an option because it is merely familiar or associated; show why it best answers this lead-in.
Memory anchors
What makes a multidisciplinary plan integrated?
A shared formulation, agreed goals, explicit roles, coordinated interventions and planned review.
What is universal prevention?
An intervention offered to a whole population regardless of individual risk.
What is selective prevention?
An intervention aimed at a subgroup whose risk is higher than that of the general population.
What is indicated prevention?
An intervention for people showing early signs or high-risk features without an established target disorder.
What protects continuity at a service transition?
Named responsibility, timely information transfer, medication and risk reconciliation, and a clear follow-up plan.
Next best moves
Quick check-up
Use a short quiz to confirm the rule pattern is actually sticking.
Check-up Questions
A community mental health team has parallel plans from several professions, but the patient receives conflicting advice. What is the most useful first correction?
A patient is discharged from an acute ward with two days of medication and no confirmed community appointment. Which intervention best protects continuity?
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.
RCPsych: Preparing for Paper B
The current format, clinical and Critical Review split, exact domain allocations and 2027 syllabus transition.
RCPsych: Current syllabic curriculum
The live February 2021 syllabus PDF; Paper B occupies sections 6 to 14.
RCPsych: Current Critical Review syllabus
The separate current-linked Evidence-Based Practice Syllabic Content PDF, labelled updated May 2011.
RCPsych: Preparation FAQs
The two blueprint sections, three-part delivery, navigation, item construction and ICD-10/ICD-11 boundary.
RCPsych: Papers A and B marking scheme
Five-option SBA and EMI marking, no negative marking, modified Angoff criterion referencing and SEM adjustment.
RCPsych: Core Psychiatry Curriculum 2022
The CT1-CT3 curriculum and HLO capabilities used only as a study crosswalk here.
RCPsych: 2022 curriculum documents
The GMC-approved curriculum set and official list of nine HLOs and 16 themes.
RCPsych: MRCPsych examinations
The examination hub and current June 2026 regulations notice.
MRCPsych eligibility criteria and regulations
The 27 May 2026 rules for Paper B experience, order, attempts, six-year validity, delivery and conduct.
RCPsych: Applying and examination dates
Current fees, application process, changeable 2026 diet dates and theory-validity information.
RCPsych: Online Paper A and B guidance
Candidate guidance for the Pearson VUE online assessment environment and technical preparation.
RCPsych: Exams reading list
The College reading-list entry point, to use alongside rather than instead of the current syllabus.
FAQ
Common MRCPsych Paper B questions
Is this an official Royal College of Psychiatrists resource?
No. It is an independent study guide. The current RCPsych syllabus, regulations, exam pages, candidate guidance and direct communications remain authoritative.
What does the mrcpsych-paper-b slug cover?
It covers MRCPsych Paper B only: current syllabic curriculum sections 6 to 14, comprising eight clinical domains and the separate Critical Review syllabus. It does not cover Paper A, CASC or the whole training pathway.
Which Paper B syllabus is current in July 2026?
RCPsych directs candidates sitting through the end of 2026 to use the live syllabic curriculum last updated February 2021. Paper B is sections 6 to 14.
Why is the Critical Review source dated May 2011?
The separate seven-page Evidence-Based Practice Syllabic Content PDF is labelled updated May 2011, but it remains the document directly linked as the current Critical Review syllabus from the RCPsych Paper B page on the review date. This guide records both facts.
When does the revised syllabus take effect?
RCPsych plans to publish a revised Papers A and B syllabus in September 2026 and bring it into effect from January 2027. This guide does not substitute that unpublished future syllabus for a 2026 sitting.
What are the two Paper B blueprint sections?
Section A is Critical Review for 50 marks, approximately one-third. Section B is Clinical Topics for 100 marks, approximately two-thirds.
Are those the same as the three online parts?
No. RCPsych describes two blueprint sections but three online delivery parts that roughly correspond to thirds. The number of questions in each delivery part varies with the paper's makeup, while the whole paper always has 150 questions.
What are the eight clinical domains?
Organisation and Delivery of Psychiatric Services; General Adult Psychiatry; Old Age Psychiatry; Psychotherapy; Child and Adolescent Psychiatry; Substance Misuse/Addictions; Forensic Psychiatry; and Psychiatry of Learning Disability.
How are the 100 clinical marks distributed?
Organisation and Delivery 8, General Adult 30, Old Age 14, Psychotherapy 8, Child and Adolescent 14, Substance Misuse/Addictions 10, Forensic 8, and Psychiatry of Learning Disability 8.
What does Critical Review cover?
It covers answerable clinical questions, evidence retrieval, epidemiology, study design, bias, measurement, biostatistics, health economics, qualitative methods, systematic review, guidelines, application, audit and PDSA.
How do MCQ and EMI formats differ?
An MCQ presents one stem and five options for a single best answer. An EMI set provides a theme, a longer ordered option list and a common lead-in, followed by several vignettes that each require the best option.
Is there negative marking?
No. Each correct response earns one mark and incorrect responses do not lose marks, so RCPsych advises attempting every question.
Is there a fixed pass percentage?
No fixed percentage is published in advance. RCPsych uses modified Angoff criterion referencing and adds two standard errors of measurement to the Angoff-derived mark before approval.
How does the 2022 Core Psychiatry Curriculum relate to Paper B?
The Core Curriculum has nine High Level Outcomes and 16 themes. The clinical syllabus crosswalks broadly to clinical skill, complexity, law, services, prevention, teamwork, safety and safeguarding, while Critical Review links most directly to HLO 9.1 and quality improvement. The curriculum does not replace the examination syllabus.
Which ICD version should candidates know?
RCPsych states that ICD-11 knowledge may be examined and ICD-10 may also be examined while it remains in common use. Candidates should identify the system and use current terminology and guidance.
Who may sit Paper B?
Current regulations require full registration as a medical practitioner and at least six months' whole-time-equivalent psychiatry experience. The College recommends 12 months before attempting Paper B.
Can Paper B be taken before Paper A?
Yes. The theory papers may be taken in either order, subject to each paper's separate eligibility requirements.
Does passing Paper B confer MRCPsych membership?
No. Paper B is one component. Candidates must meet current training requirements and complete the remaining examination and membership requirements, including Paper A and CASC as applicable.
Are the 601 practice items an official number?
No. The live paper contains 150 questions. The 601-item original practice bank is a repository allocation proportionally mapped to the official domains.
Does this guide provide a full mock?
No. It provides independent five-option practice questions. It does not reproduce shared EMI option sets, Pearson VUE delivery or the locked three-part workflow.