How I Scored in the Top 5% for MRCP Part 1 & 2

Preparing for the MRCP Part 1 and 2 written exams is a demanding journey. Achieving a score in the top 5% involves not only knowledge but strategy, discipline, and a targeted approach to revision. In this post, I will share my own approach, focusing on effective strategies, question banks, and specific tips that helped me excel in these exams.

Recognise What You Already Know

The MRCP covers an extensive range of topics, but most of this material should already beat least vaguely familiar to practising doctors; we’ve all passed finals and see pathology every day. It stands to reason that one should recognise that studying for these exams is not about starting from ground zero, rather it is about deepening knowledge in targeted areas. Everyone will come at this with different levels of experience in different areas. Maybe you’ve done a cardiology job, maybe you haven’t. Either way, the MRCP doesn’t care. The key lies in identifying areas that need refreshing rather than attempting to relearn everything from scratch. By focusing on these weaker areas, one can study more efficiently, building on an existing knowledge base while filling in the gaps.

Prepare Over 3–4 Months, Flexibly

I recommend a 3- to 4-month preparation window for each of these exams. This will of course depend slightly on work schedule and life commitments. During this time, I committed to using any free evening or downtime for study, fitting revision around my schedule to avoid burnout (in other words, don't put the rest of your life on hold for the sake of this exam).

The flexibility of mobile apps for question banks and sources of knowledge makes it easier to keep studying while on the go, with the caveat that revising on the go should involve 'lighter' revision (such as going over key facts) rather than digging into the depths of new or complex topics.

Another helpful tip is to apply what you're studying to your working life. See a patient with Ulcerative Colitis; remind yourself - What is the HLA association? What are the characteristic histopathological features? And so on. Remember this is exam is at least supposed to be relevant to the jobbing physician, so being able to apply this seemingly obscure knowledge to real life will help it sink in.

Use Quality Question Banks Strategically

Now to the meat of the discussion and the part you were probably expecting: which question banks to use. There is no denying that this is a numbers game; simply put, if you do enough questions you should pass. I don't necessarily think any one question bank is essential for this exam, rather how one uses the banks to revise.

To get this out the way: my primary resources were the Passmedicine and Pastest question banks. Instead of creating comprehensive notes, I approached these question banks directly from the outset, using them to expose me to a wide array of topics. Attempting questions from the start allows you to identify areas where you need further study without the pressure of extensive note-taking. Yes, this feels painful in the beginning as your failure rate will be high, but as I mention above, there simply isn't time to go over everything from scratch and this will be the most efficient way to sieve out what you do and don't know.

With this said, I think there is a way to use these banks effectively. I structured my revision by topic, setting aside each day for a different specialty, such as cardiology or neurology, and aimed to complete between 50 and 100 questions daily. I would rotate through each topic, ensuring that I had a good coverage of each of the key areas in proportion to their representation in the exam. With time, you will notice patterns and become more able to differentiate conditions if you cover similar questions in close succession; this I believe is the advantage of having a topic for each session as opposed to doing it randomly.

Reflect and Review Consistently

Passmedicine and Pastest both provide explanations with each answer - this is where the real gold dust lies. Instead of simply aiming to get through as many questions as possible, spend time analysing each answer option, reflecting on why you were correct or incorrect and committing that understanding to memory.

For any question I got wrong or found unfamiliar, I would pause, review the feedback thoroughly, and, if necessary, make brief notes on the topic. For example, I distinctly remember the first time I encountered a question on chikungunya fever - something which I'd never even heard of before. Topics like tropical diseases are not common in UK medical school curricula, so naturally I took time to read around these unfamiliar areas. Although the question just wanted me to match the signs and symptoms with the disease, I didn’t just stop at memorising that particular answer—I explored the aetiology, clinical presentation, diagnostic criteria and management, which reinforced my understanding beyond just a superficial level. This meant that when I inevitably came across another question on the condition, this time asking about its transmission, I was well placed to attempt an answer. For these new areas, I continued to review the specific notes I made on weaker areas over time, ensuring retention.

Quality Over Quantity

Contrary to popular belief, I don't think you don’t need to complete every question in each bank. I didn’t, and instead prioritised a deeper understanding of the areas I found challenging. Targeted, deliberate practice yields far more benefit than blitzing through questions without thoughtful review. This exam likes to test knowledge of the minutiae therefore knowing most topics well rather than all topics superficially is an advantage. In addition to reading around incorrect answers to better assimilate topics as whole, I also made an effort to revisit the questions I initially answered incorrectly helped solidify my knowledge.

Another habit of this exam is demanding mastery of many esoteric facts which sadly one needs to just sit down and memorise. For this, I kept a separate document for key facts, like autoantibody associations and rare drug side effects, divided by topic, which required quick recall. This resource became a useful way to drill essential details. Tools like Passmedicine’s knowledge tutor are also excellent for factual recall of niche yet high-yield topics.

Set Benchmarks and Track Progress

Setting a consistent goal, such as achieving an 80% or higher on practice questions, can be both highly motivating and give assurance that you know a sufficient volume of the content. By the midpoint of my preparation, I aimed to maintain this score in all topics, using it as a benchmark to gauge my understanding. Many question banks offer tracking features, showing your progress within each topic. Use these to identify areas needing further review and concentrate your valuable time where it is required most.

Ensure Familiarity with Question Styles

I think there is a distinct advantage from being familiar with the way in which MRCP questions are constructed, not least from the perspective of time management. The Royal College offers freely available specimen papers, which I strongly recommend reviewing. Some questions from these samples appeared on the actual exam in similar form or (if I recall correctly) almost verbatim, providing free marks for familiarity.

These papers also give insight into the examination’s style and focus, allowing you to refine your approach accordingly. For example, the actual exam questions tend to be much more succinct than those found on Passmedicine, with far fewer large tables of data to have to sift through. When I sat the exam, I was actually pleasantly surprised by how comparatively quickly I was able to get through the questions compared to the Passmedicine alternative.

This leads me on to the advantage of using more than one question bank. Studying from both Passmedicine and Pastest allowed me to experience a range of question styles, as the difficulty and format of questions do vary between them. I found the real exam’s style and difficulty level fell between these two question banks, so practising across both platforms helped me adapt to this variation. This should stem any potentially nasty shocks in terms of differences in difficulty!

Although both parts have more in common than they do differences, it is worth noting that part 2 includes practical data interpretation—ECGs, X-rays, and CT scans—which differ from the more theoretical focus of Part 1. Make sure to dedicate time to reviewing these types of questions, as they require applying your knowledge to real-life clinical scenarios. This is critical, as Part 2’s focus leans more towards applied practice, giving a more realistic context to your decision-making. In my experience - perhaps because of the need for real-life images which limits the number of questions that can be written - there were relatively fewer of these types of question available in the question banks compared to their prevalence in the actual exam. Although I don't recall any of them being particularly nasty, many of them were of the "gotcha" type of diagnosis where you'll probably only know the answer if you've seen it before. Examples of the types of such conditions which spring to mind might be a Brown tumour on an X-ray, idioventricular rhythm on an ECG or pseudomyxoma peritonei on an abdominal CT.

In Summary: Deliberate Practice and Targeted Review

Success in the MRCP exams requires more than just rote learning or doing questions for the sake of questions. Focus on deliberate practice, maximising each question as its own learning opportunity. Use a variety of question styles, leverage knowledge tutors for key factual recall, and focus on trouble areas rather than trying to master every topic. Regularly review your mistakes on mock papers, aiming to achieve and maintain a benchmark score to ensure a satisfactory level of recall.

Finally, approach your revision flexibly, allowing time for focused study and taking advantage of free time wisely. By targeting your weakest areas and maintaining consistent effort, you’ll build a solid foundation for success—and hopefully clear this particular hurdle as painlessly as possible!