MRCP Part 2: Everything You Need To Know

You can watch the video above or read the written guide below.

With MRCP Part 1 out of the way, you're now faced with 2 remaining exams to obtain your full MRCP. These are Part 2 and PACES.

🚀 I've just released my MRCP PACES Strategy and revision guide with Pastest, which takes you through revision timelines, key skills, station-specific strategies, flashcards, and so much more! To read more, click here.

Still working on MRCP Part 1 and want to go back to the guide? Click here.

The focus of this guide is to give you the information you need about MRCP part 2. I'm a huge believer of early planning and really understanding the exam that you're signing up for, having a very early and strong revision strategy, and doing everything you can to maximise the chances of passing. I’ll discuss:

• Key logistical information you need to know about booking and taking the exam
• What exactly the exam entails in terms of content
• How you can start preparing a revision strategy for your own revision

I sat the exam in 2023 and achieved a scaled score of 681. In this guide, I'll share some tips on my revision strategy.

What is MRCP Part 2?

MRCP is an internationally recognised exam around the world, crucial in the journey to becoming an internal medicine physician.

The MRCP part 2 exam is the second of two written papers that you need to pass to become a member of the Royal College of Physicians. Unlike MRCP part 1 which comprised of questions focusing on pre-clinical scientific knowledge, MRCP part 2 assesses the clinical aspect of care including differentials, investigations and acute management decisions. Interestingly, the pass rate for part two is actually a bit higher than Part 1 - around 60 to 80% - which suggests the clinical components may be more approachable to study for.

To be able to take MRCP Part 2 you'll have had to pass Part 1. If this is something you're unfamiliar with or you simply want to learn more about what the exam is or what the revision materials and strategy is like, click here.

Exam Format and Logistics

The format of the paper is two sets of three hour papers taken on the same day. Each paper consists of 100 best of five questions. This tends to be split across a morning and afternoon session with a small gap in the middle for a lunch break.

Logistically you need to book the exam on the official website of mrcp.uk, typically at least 2 months in advance. There tends to be four sittings each year and more or less all sittings now are done online (if you're curious to know what the online exam experience is like, watch this video here).

In terms of when is best to take the exam, there’s no hard and fast rule. Statistics show that candidates have the highest rate of passing if they attempt part 2 within 36 months of graduating. The general opinion is that the best time is either right after part 1, or just before you plan to sit MRCP PACES. So in other words, paired with one of the other exams. This is because there is significant overlap in knowledge you need for either Part 1 or PACES so it’s advisable to take it at a roughly similar time, although of course not mandatory - it just saves you revision effort.

Understanding Exam Focus

What this means for revision is that a lot more of your time will be spent applying and consolidating knowledge, rather than learning and understanding new content.

Similar to Part 1, the exam covers a wide range of medical topics including cardiology, respiratory medicine, infectious disease, endocrinology and so on. It's designed to test your clinical knowledge and your ability to make safe and accurate clinical decisions. However, the key thing to know about part 2 is that it has a clinical focus which completely changes how you study for this versus MRCP Part 1. Whereas Part 1 was about ensuring you had a good theoretical basis behind disease pathology, Part 2 is about assessing your clinical judgement. This is done through scenarios that requiring judgement calls, like 'what would you do next as the medical SHO’, ensuring your decision making is safe as a medical doctor.

For example, when testing you about asthma exacerbation, a typical Part 1 question may ask you about the pathophysiology of asthma or beta agonists, while Part 2 questions would ask you what criteria you would look for to escalate to intensive care. So although there are still questions about pathology that require some further understanding and reading,  questions are now much more clinical-focused.

What this means for revision is that a lot more of your time will be spent applying and consolidating knowledge, rather than learning and understanding new content. And this is a really important point because it means your study focus is very different from Part 1 - you won’t be memorising the pathophysiology of diseases and specific molecule pathway of drugs, you’ll be thinking about how to manage these conditions when you’re the on-call doctor.

Another important point is that whereas in Part 1 questions were purely text-based, in Part 2 image and data interpretation form a core part of the exam, just like they would be in your assessment of a patient in the hospital. So make sure you are confident in interpreting things like ECGs and common imaging like X-Rays!

You probably know from your revision which specialties you are stronger at and which ones you’re weaker at, and this is vital information because identifying your weaker specialties will allow you to tailor your revision. You can use your MRCP Part 1 breakdown score will guide you on how you did in each specialty, and which ones might need a bit more of your time. Make sure you are accounting for the number of marks each specialty is worth. For example, there are far more questions in the exam cardiology than oncology, so if you are weak at both then focus on the one with more questions proportionally!

Developing Your Revision Strategy

When you develop your revision strategy, you need to think about 3 aspects:

•      What resources and tools do I plan to use?

•      How much time do I realistically have or want to spend?

•      How much work do I need to do to feel ready?

Resources

There are a number of  resources available including books, question banks, and courses. There are tons of guides out there advocating different approaches. The reality is that everyone learns slightly differently - however from my own personal study experience and speaking to tens of UK trainees, everyone does a bulk of the revision is with a question bank - which is also what I'd recommend.

Passmedicine and Pastest are undoubtedly the 2 best resources. Each have thousands of questions that are modelled from years of candidate feedback, previous questions, and core curriculum, packed with explanations for candidates to consolidate your knowledge. Without a doubt, this HAS to form a core part of your revision  if you want to pass. The knowledge bank and past papers of these online resources are invaluable for access to high quality and relevant materials.

In terms of tools, you probably already know what works for you. For example, I’m a huge advocate for Anki repetitive learning for memorisation, but some people don’t like it. Other people are visual learners and like mind maps. Some people just like doing question banks over and over again. I’d suggest sticking to what’s worked for you in part 1.

How much time do I need for revision?

The general rule is approximately 2-4 months. I’d advise first thinking about what resources you want to use, and based on resources chosen, see how much time each will take. For example, think about whether you want to do 1 or both question banks, the number of questions on your question bank, how many questions you can realistically do in a week plus any extra time to revise materials, and then estimate how much time you’ll need for this. Remember to be realistic and account for any life or family events, and study breaks. Then think about how that fits into your schedule and whether it is realistic.

Finally, what you want to do is create a revision schedule that fits with your work schedule. Divide the number of weeks you have available by the specialty allocations you've made, and number of questions you plan to do. Block off the last 2 weeks before your exam if you can afford to, allocating them for consolidation, mock papers, and final review of things like flashcards.

My personal revision strategy

Finally, if you are interested, here is my study strategy that I used to pass MRCP Part 2.

I studied over 3.5 months, with the 2 weeks prior to the exam blocked off for mock papers and consolidation, and used Passmedicine and Pastest question banks, with self-made flashcards on Anki.

I did the Passmedicine question bank once, and then moved over to Pastest where I did approximately 15 past papers, which was equated to a total of around 4000 questions answered. On top of this, I made 1650 flashcards which I went through each approximately 2-3 times at intervals.

The core of my revision revolved around Passmedicine and Pastest. I personally recommend using BOTH question banks, and here’s why:

• The phrasing of questions in both banks are different even though they are both based on exam content and previous questions. Using both ensures you remain impartial to the way questions are phrased, and are focusing on learning the key content
• They  bring slightly different points of value. Passmedicine has a comprehensive questionbank but their searchable knowledge base was extremely helpful, and I learned a lot along the way from my peers in the comments section. Pastest has a HUGE past paper section that was super helpful in consolidating my knowledge after going through the question bank once, and questions in these mocks did end up coming up in the real exam which I thought was super helpful.

All in all, Both have huge question banks and if you're looking for revision via repetition, you can do both. Otherwise, you can just do one.

As I progressed in my revision using the questionbanks, I utilised tools to consolidate my knowledge. I wrote notes for each core condition as a generalised summary that I could go back and search through whenever needed. This was useful because it created a summary of key points for each condition, allowing me to search for it quickly through digital means.

As I finished each specialty’s questions, I would then go back through these notes and highlight any key points I felt unfamiliar with. For any really important facts I needed to memorise, I turned it into a flashcard to revise with Anki.

This goes on to my next method - Anki with repetitive learning has always been a go-to resource for revision for all my exams. I won’t go into detail about phrasing and how I structure my cards, but I basically created a deck for each specialty and put important facts in. The key thing is to be doing them consistently every day - I started doing them in my second month of revision and usually did around 20-30 cards per day whenever I had time whilst commuting or before bed, before increasing the number of cards per day just before my exam.

I also made sure to complete my question bank well before the last 2 weeks as I saved this period for consolidation and mock papers. I had time to do approximately 10-15 mock papers, going back to review any topics I felt unconfident with.

At the end, my revision paid off! I was grateful to pass comfortably and attribute a huge amount of my success to proper planning and keeping a disciplined revision strategy.

Conclusion

In conclusion, it’s definitely possible to reliably pass MRCP Part 2 with a good revision strategy, and I hope this guide has helped you take the first steps in devising your own plan for the exam. Remember that MRCP Part 2 has a much larger clinical emphasis - but because of this, it also has a much higher pass rate than MRCP Part 1.

As always, please feel free to reach out if you ever have any questions.