How I ranked top 10% in MRCP Part 1: Preparation and Planning

In this article, I talk about how I devised my strategy for tackling the exam, and the key learning points I found in the process.

To find out more about MRCP Part 1, click here.

What is MRCP?

The Membership of the Royal College of Physicians (MRCP) examinations are a set of three exams for certification of the Royal College of Physicians. This is an essential part of progressing as a doctor in a medical specialty in many countries including the United Kingdom, Hong Kong, Singapore, India and Pakistan.

I took MRCP Part 1 – the first of the three examinations - in 2020 and received a scaled score of 732/1000, ranking me in the top 10% of candidates worldwide. It was certainly a rewarding experience albeit a challenging one.

I did a lot of research before deciding to take the exam and frustratingly couldn’t find a good source of information in how to prepare for it. Most of my insight came from word of mouth. I thought to myself: If I was struggling to find the key information, surely others would be too?

I think it’s important that candidates know what they’re getting into when they begin their preparation. In the vast world of medicine, we all have the same objective: improving the way we treat patients and help others. We should all be trying to help one another achieve our goals. I wanted to create something that future candidates could refer to, in a format that I wish I’d been able to learn from before studying for the exam.

I created a video to share my study process. I wanted to break it down into even more detail including how I devised a thorough strategy in preparing for the exam and managed my time and resources. Hence, this series of articles on MRCP on my website!

I’ll share my insight in 3 sections:

1. Preparation and Planning
2. The Study Process
3. The Online MRCP Part 1 Process

I like to be strategic in my exam preparation and thoroughly research anything I do to save myself time. I carefully selected my resources and study method to optimise memory retention. These were the approaches that worked for me, but your preferences may be different. Everyone studies slightly differently which is completely fine! I hope these articles will at least serve as a framework for those who are looking for some study guidance.

As always, feel free to let me know what you think. I’d love to hear from you!

Overall Study Duration

In total, I revised for a rough total of 3 months, 2-4 hours a day on average. I did this while working full time as a foundation doctor in the UK.

I answered ~4500 questions on questionbanks which comprised of:

• 3500 questions
• 800 mock paper questions
• 300 questions that I redid as I’d gotten them wrong

I also supplemented my learning with self-made flashcards which I reviewed daily.

Looking on other forums, it appears the average study duration of candidates is around 2-4 months. I only completed my question bank once (Passmedicine) because I integrated it with other techniques and resources, but I’ve noted that several candidates completed multiple question banks with varying degrees of success.

Realistically, I could’ve slashed 25% of my total revision time and have still felt able to pass. It’s definitely doable in much less time. Despite this, I worked by the philosophy ‘better safe than sorry’. I simply asked myself: ‘What would I regret more? Overworking or failing?’ The answer was easy.

The Importance of Planning

I can’t stress how important planning is for an exam like this. Studying for MRCP Part 1 is a HUGE commitment of your next few months, and a lot of your free time. Many of you will be working full time in medical employment alongside your revision. You need to understand the task at hand, your personal situation and motivations, and the most efficient ways to study.

If you don’t go in with a game plan, you’ll drown.

“If I had an hour to solve a problem I'd spend 55 minutes thinking about the problem and five minutes thinking about solutions.” - Albert Einstein

Doing your Due Diligence

Doing research is undoubtedly as important as the studying process itself. Understanding the exam requirements, format and syllabus lets you tailor the most relevant approach to revision. After all, if you don’t know what the question is, how do you come up with an answer?

I comprehensively researched the exam to understand the task that i was getting into. The key sources and resources I obtained my information from included:

• MRCPUK Official website
• MRCP official exam reports, statistics
• Word of mouth: Colleagues and seniors
• Youtube videos
• Forums: Studentroom, Reddit

These are the key points of MRCP Part 1 which I also highlighted in my last article:

• Exam Format: One day examination consisting of 2 papers, 3 hours each. Each paper has 100 multiple choice (best of five) questions per paper.
• Timing: All doctors in one sitting take the same paper worldwide simultaneously.
• Marking: The examination is pass/fail, with no opportunities for distinction/merit. There is NO negative marking (you will not be penalised for wrong answers).
• Content: Basic sciences and clinical information from 17 specialties. Questions per specialty varies.
• Question style: Most questions have a clinical stem. There are no images (and therefore no questions on subjective interpretation of imaging, ECGs etc.)

From statistical reports, I also found that:

• Candidates tend to do better if they take it sooner after medical school
• The more attempts, the lower the overall proportion of successful candidates. Better to pass it first time around!
• The scaled pass mark was 540/1000
• Opthalmology was consistently the worst performing specialty among all candidates

MRCPUK do not release the raw pass mark for papers. However, from looking at results from previous sittings I calculated it to be between 59-63%. On average, only 40% of candidates pass MRCP Part 1. Certainly a difficult exam!

The allocation of questions varied per specialty:

Learning from other people’s experiences, I found that:

• Average study durations varied from 2-4 months. The most extreme cases were 1 month (I deduced that it was therefore doable, but not ideal)
• Every single person used a question bank as the main source of revision, with the number of questions done by successful candidates ranging from 3500 to 10000
• A study partner was not necessary for Part 1 as much of the work was self-revision and memorisation
• Preclinical sciences were the biggest source of misery. Many people required supplementary resources for revision of immunology and biochemistry.

Determining Your Motivations

Revising for the exam is a huge commitment. Before signing up, it’s important to understand several things: why the exam is necessary, whether it’s logistically feasible, and your motivation for working hard to pass.

I asked myself a few questions:

• Reason: Will this exam help me get to where I want to be in my career?
• Cost: Can I afford the application fee at this point in time?
• Time: Am I willing to dedicate 2-3 hours a day to study in the next few months?
• Result: What are the consequences of failing?

For me, I was hoping to pursue a career in cardiology so MRCP qualification was essential. I was lucky to be in a financially stable position and going onto a less busy rotational job so could commit time to studying. Although the consequences of failing weren’t huge because I didn’t have any urgent application deadlines, I hated the thought of failing. I’d managed to get through medical school without failing any exams and knew I’d work hard to keep my record intact (many of us as doctors have huge egos – it works for and against us at times!).

If you’re looking to take the exam, I’d recommend doing something similar as it’s important to establish 1) Whether you really need to take the exam, and 2) If your circumstances will allow you to take it.  It may be that you find now isn’t a great time, or you have outstanding personal commitments. That’s complete fine! You can always take it several months later when you’re in a better position to study to give yourself a higher chance of success.

By considering the consequences of failing, you learn to value your efforts now. This will establish your motivational driver for your revision process.

Doing well on an exam is 90% about the mindset, and 10% about the execution.

Strengths, Weaknesses, Opportunities, Threats

Equally as important to the planning process is awareness of yourself and your abilities. This allows you to dedicate revision time according to your strengths and weaknesses. How did you perform in medical school? How confident are you in your preclinical foundations of immunology, biochemistry, physiology, and pathology?

Let’s take a chapter out of the entrepreneurial book to do this by performing a SWOT analysis (Strengths, weaknesses, opportunities, threats). This technique is normally used to assess business opportunities, but the principles apply in our situation.

• Strengths: Themes that you are familiar with. Conditions that give you a favourable environment for productive revision.
• Weaknesses: Less confident specialties or areas that you will likely need to spend more time on.
• Opportunities: Logistical changes that would make your revision smoother e.g. hiring childcare over the weekend so you can focus on studying, or allocating every Saturday morning as quiet time for revision
• Threats: things that would subtract from your revision process. In this context, it includes things like a busy work schedule, holidays and family events.

I identified my weak specialties that I would need to brush up on such as haematology and ophthalmology, and also went through the subsections of each specialty to determine the amount of work I'd need to do for each one.

Planning a Study Strategy

You’ve heard me say it several times already. Planning is essential! I was working full time while maintaining other commitments, so it was important that I had a time-efficient and structured approach to revision.

The 2 things in particular I determined were my study METHOD, and SCHEDULE.

Study Method

My study strategy was based off 5 key principles of learning:

1. Exposure
2. Understanding
3. Learning
4. Spaced Repetition
5. Application

In my opinion, how you facilitate your learning is equally as important as the content that you are learning. Understanding the flow of information has been key to my medical career. What I mean by that understanding the WAY you learn: taking a fact or concept, breaking it down into comprehendible information, learning it and practicing it repeatedly to instil it into your memory.

Having a strategy to achieve this lets you learn maximal content, most effectively, in less amount of time. I won't go into too much detail about this, but if you’re interested in understanding your learning you can find out more here.

I chose my resources and sequenced my study process based on these 5 steps.

Study Schedule

I created a study schedule for several reasons:

1. To keep track of my progress
2. To maintain consistency
3. To hold myself accountable to tasks I was setting myself

Subtracting 2 weeks for final revision to do mock papers, I allocated the remaining time from my 3 months to revising specialties. My study time per specialty was proportional to its number of questions. Larger specialties worth more marks like cardiology and respiratory medicine were allocated more revision time than smaller specialties like ophthalmology.

I created a spreadsheet with the specialties, number of questions and details about my studying. I then created sub-sheets for each specialty and listed key topics to ensure I would comprehensively track progress.

Having a central point of organisation kept me helped me stay on top of revision throughout. It was also satisfying to tick off boxes as I went along!

With all the planning in mind, I moved on to my revision process.

In the next section, I’ll take you through my resources and how I used them to pass MRCP Part 1.

Next: My Revision Strategy and Resources