Membership of the Royal Colleges of Physicians of the United Kingdom

The three Royal Colleges of Physicians have been holding membership examinations for many years. In the London College the Censors, helped by other examiners, had the duty to carry out the assessment of candidates and advise the College. The MRCP (London) examination began in 1859 with a numerical marking system devised in 1893. In the late 1960s the need to have a single recognized membership examination throughout the United Kingdom was recognized. Such an examination made it unnecessary for junior doctors to enter several membership examinations and removed the suggestion that the standards of the examination at the three Colleges were different.

The exam incorporates both examination of the candidate's knowledge of basic medical sciences as well as testing the clinical skills required for the diagnosis and management of disease. Changes to the exam in recent years have put more emphasis on communication skills and professionalism. Obtaining the "MRCP(UK)" is a prerequisite to anyone wishing to go on to a specialist training post as a Physician in the United Kingdom. Various companies, including the Royal Colleges themselves, have developed preparatory courses that focus on the nature of the questions and the required background knowledge.

In partnership with the relevant specialist societies, the three UK Royal Colleges have set up the MRCP Specialist Examinations Unit responsible for the organization of new knowledge based assessments. The ultimate objective is to ensure that NHS consultants have demonstrated their acquisition of sufficient knowledge in their chosen specialty to practice safely and competently. This will bring the assessment of physicians in training in the UK into line with those training in North America, where most specialist trainees sit a specialist examination as a further test of excellence, usually after having acquired certification in Internal Medicine.

The MRCP exam has three parts: MRCP Part 1 (written paper); MRCP Part 2 (written paper); and MRCP Part 2 Clinical Examination (PACES).

The MRCP part 1 examination consists of multiple choice questions in the best of five format. Starting from September 2019 MRCP part 1 exam will be available in USA.

The MRCP part 2 examination consists of multiple choice questions in the best of five format.

The MRCP PACES examination consists of a carousel with 5 stations that were updated in 2023.^[1]

• Station 1: Tests the candidate's communication and ability to examine the respiratory system.
• Station 2: Tests the candidate's consultation skills.
• Station 3: Tests the candidate's ability to examine the cardiovascular system and perform a neurological examination.
• Station 4: Tests the candidate's communication skills and the ability to perform abdominal examination.
• Station 5: Comprises a brief clinical consultation requiring the candidate to take a focused history and examination, formulate a differential diagnosis and management plan, and communicate the plan to the patient.

The MRCP PACES examination is held not only in the United Kingdom, but also in many other parts of the world. Hosting sites include Brunei, Dubai, Al Ain, Egypt, Kuwait, Oman, Qatar, India, Pakistan, Singapore, Malaysia, Malta, Hong Kong, Myanmar, Sri Lanka, Kenya and Sudan.^[2] Examination fees at centres outside the UK are significantly higher than at UK centres.

In Singapore, the MRCP(UK) and MMed are often taken together. In Hong Kong, MRCP(UK) is taken with MHKCP intermediate examination.

At present, the examination cost is £1495 from start to finish if all parts are taken in the UK and £2390 if are taken overseas^[3][4][5] - assuming each examination is passed in a single attempt without attending any courses. Candidates may elect to participate in any of a number of training courses, online revision websites or use mobile applications as revision aids to improve their chances of passing.

• Official website