Another difficulty in preparing for MRCP(UK) (and particularly for Part 1) is that it is not clear how and what to study. Does every available guideline need to be scrutinised in exquisite detail? Should huge lists of rare complications be memorised for every disease encountered? Clearly there is no single, sure-fire ‘correct way’ of preparing for the exam – all of us have met very knowledgeable doctors who have taken several attempts to pass.

With this book we highlight the key areas of how and what to study, so that candidates can use it to revise and prepare for the exam as effectively as possible. We have attempted to do this in a number of different ways.

Firstly, the questions are in the same style as the exam and, like the exam, include normal values. They reflect the breadth of knowledge and level of difficulty of the exam. This will help candidates to appreciate what to expect on the actual day. It will quickly become obvious that some questions are more difficult than others – this again is a reflection of the exam itself.

Secondly, based on our own experiences of the exam, in the answers we have tried to put an emphasis on and simplify the most difficult topics, sharing key memory aids that we have found useful ourselves – including tables, mnemonics and illustrations.

Thirdly, we have tried to provide thorough but not overly-detailed explanations, with answers that not only explain why one option is correct but also justify why other options are not.

Fourthly, many questions have an accompanying reference, to direct further reading around the topic.

Whilst this book is principally aimed at those preparing for the MRCP(UK) Part 1, we hope it will also be of interest to junior doctors more generally. We have written questions that reflect typical challenging situations that might be encountered on a typical acute ‘medical take’, or dilemmas that might be faced in the clinic.

We hope that you find this book useful – and, hopefully, enjoyable to use. Best of luck for the exam!

The MRCP(UK) Part 1 exam has a two-paper format. Each paper lasts 3 hours and consists of 100 multiple choice questions. All questions take a best of five (BOF) approach, where the single most appropriate answer must be selected from a list of five options. Questions cover the full range of medical specialties and include clinical science. The composition of the papers is shown in .

There is no specific syllabus for the MRCP(UK) Part 1 exam, but the Royal Colleges recommend that candidates refer to the Specialty Training Curriculum for General Internal Medicine, prepared by the Joint Royal Colleges of Physicians Training Board.

The MRCP(UK) Part 1 exam is now marked using a process called equating. Using the equating system means that rather than being given an overall percentage score, candidates will instead be given an ‘overall scaled score’. This score is a number between 0 and 999, which is calculated from the number of questions a candidate has answered correctly (out of the maximum possible) and takes into account the relative difficulty of the exam. Since no two exams contain the same questions, it is inevitable that some papers may be slightly harder (or easier) than others, and equating is a statistical process that addresses this. At present, the equated score required to pass MRCP(UK) Part 1 is 521.

Candidates are strongly advised to visit the MRCP(UK) website for further details of the exam.

Having recently sat the exam ourselves, our advice is to approach revision specialty by specialty. Remember to think laterally when revising, e.g. a question on vasculitis could appear in the renal, rheumatology, respiratory, neurology or dermatology sections. Tackle the questions as you would in the exam, by reading the rubric carefully and thinking about what the correct answer might be before reading the A–E options. Next, select which of the options best fits the answer that you were thinking of. There are no ‘trick’ questions, but there are definitely questions that are not as straightforward as they may initially appear. Use the information in the answer to confirm and expand upon what you already know, or to help understand and remember why a certain answer is more appropriate than others. The references are provided throughout to enable you to clarify any uncertainties or to expand upon your knowledge if the topic particularly interests you. Remember, the key to success is practice, practice, practice!

We would also like to thank a number of people for their helpful comments and providing images for this book:

Dr Steve Ellis, Consultant Radiologist, Barts Health NHS Trust.

Dr Wendy Mills, Consultant Haematologist and James Butler, Section Head of Haematology, Pathology Department, Barts Health NHS Trust.

Dr Sam Khandhadia, Clinical Research Fellow, Eye Unit, University Hospitals Southampton.