MRCP Part 2 Written: The Complete Guide to Format, Scoring and How to Pass

MRCP(UK) Part 2 is the second written examination on the path to full membership of the Royal Colleges of Physicians, sitting between Part 1 and the clinical PACES assessment. For most candidates it is a step up from Part 1: the questions are longer, more clinically integrated, and demand that you not only recall facts but interpret data and make management decisions under time pressure. This guide covers the exam format in detail, how it is scored, and the revision strategy that gives you the best chance of passing on your first attempt.

What is the MRCP Part 2 Written exam?

MRCP Part 2 Written is a computer-based examination that assesses your ability to apply clinical knowledge to the diagnosis and management of patients across the breadth of internal medicine. Where Part 1 leans toward basic science and mechanisms, Part 2 is firmly clinical: expect scenario-based questions that give you a history, examination findings, and investigations, and ask you to choose the best diagnosis, next investigation or management step. You must have passed Part 1 before you can sit it, and passing Part 2 Written is required before you complete the diploma via PACES.

MRCP Part 2 format and structure

The exam consists of two papers, each three hours long and each containing 100 'best of five' multiple choice questions, 200 questions in total. In the best-of-five format, each question presents five options: one correct answer and four plausible distractors. You select the single best response.

• Two papers, three hours each (usually taken on the same day).
• 100 best-of-five questions per paper; 200 questions overall.
• One mark per correct answer, with no negative marking.
• Questions frequently include images, ECGs, chest and other X-rays, CT and MR scans, blood films and pathology slides, that you must interpret.
• Content spans 16 medical specialties, from cardiology and neurology to endocrinology, nephrology and dermatology.

The exam is delivered by computer at test centres in the UK and internationally, so you should be comfortable interpreting clinical images on screen. Because there is no negative marking, you should answer every question, even when you are unsure.

Who can sit MRCP Part 2 Written?

You must have passed MRCP(UK) Part 1 before you are eligible to sit Part 2 Written. There is no requirement to have completed PACES first, many candidates sit the written Part 2 before the clinical exam, but there are time limits within which the whole diploma must be completed after passing Part 1, so plan your sequence with those windows in mind. Candidates come from a wide range of backgrounds, including UK internal medicine trainees and international medical graduates, and the eligibility and any documentary requirements are set by the Federation of the Royal Colleges of Physicians. Confirm the current rules and deadlines before you book.

MRCP Part 2 syllabus: where to focus

The blueprint follows the same 16 specialties as Part 1, but the emphasis shifts toward the specialties with the highest clinical burden. The largest contributors are typically cardiology, neurology, respiratory medicine, endocrinology, gastroenterology and nephrology. Rather than trying to weight your revision perfectly, treat the whole of general internal medicine as fair game, and use your question-bank analytics to find and close the specific gaps that are costing you marks.

A defining feature of Part 2 is data interpretation. A substantial share of questions hinge on reading an investigation correctly, an ECG showing a subtle conduction abnormality, an arterial blood gas, an autoantibody panel, or an imaging finding. Building fluency with these is one of the highest-yield things you can do.

There is no fixed percentage you must hit. The pass mark is set through a process of test equating, which adjusts for how difficult a given paper is and for the ability range of the candidates sitting it. This means a slightly harder paper carries a slightly lower threshold, so your result reflects your ability rather than the luck of an easy or hard sitting. In practice, aiming to consistently score comfortably above the mid-60s percentage in your question-bank practice gives you a healthy safety margin.

A realistic MRCP Part 2 study plan

Most candidates need two to three months of focused preparation, especially if Part 2 follows soon after Part 1 while knowledge is still fresh. A structure that works:

• Phase 1, coverage (weeks 1-4): work systematically through the specialties, doing questions topic by topic in tutor mode and reading every explanation. Prioritise understanding management pathways, because Part 2 rewards knowing the next best step, not just the diagnosis.
• Phase 2, data interpretation drills (weeks 4-7): deliberately practise ECGs, imaging and blood results. Interleave these with mixed question blocks so you keep the whole syllabus warm.
• Phase 3, timed simulation (weeks 7-10): complete full three-hour, 100-question papers under exam conditions to build stamina and pacing. Review your analytics, target weak areas, and taper in the final week.

A few habits consistently separate first-time passes:

• Sit Part 2 while Part 1 knowledge is still fresh, momentum matters.
• Drill data interpretation (ECGs, imaging, blood results) deliberately; these marks are very winnable.
• Focus on the next best step in management, not just the diagnosis.
• Read why every distractor is wrong, not only why the answer is right.
• Build stamina with full three-hour timed papers before the real thing.
• Use your analytics to target the specialties quietly costing you marks.

Common mistakes candidates make

• Under-estimating the jump from Part 1. Part 2 questions are longer and more integrated; passive fact recall is not enough.
• Neglecting image and data interpretation until the end. These marks are very winnable but need dedicated, repeated practice.
• Not sitting timed papers. Two hundred questions across six hours is a test of stamina and pacing as much as knowledge.
• Leaving too long a gap after Part 1. Momentum matters; the closer you sit Part 2 to Part 1, the more foundational knowledge you retain.

What to expect on exam day

Part 2 Written is computer-delivered, and with two three-hour papers of 100 questions each it is a genuine test of stamina as well as knowledge. Treat it like an endurance event: on the day, pace yourself at a little under two minutes per question, use the flag function to mark questions you want to revisit, and be disciplined about moving on when a question is taking too long. Because so many questions involve interpreting an image on screen, an ECG, a scan, a blood film, practise reading these digitally beforehand so the format holds no surprises. With no negative marking, answer every question; a considered guess on a hard item is always better than a blank.

The best way to revise for MRCP Part 2

As an entirely best-of-five exam, MRCP Part 2 is a question bank exam. The most effective preparation combines a large, up-to-date bank of exam-style questions with detailed explanations that teach the clinical reasoning behind each answer, plenty of embedded images to practise interpretation, and performance tracking so you always know where your next marks are. Work in tutor mode early so you can absorb the explanation while the question is fresh, read the reasoning behind every option rather than just the correct one, and in the final weeks move to full timed papers to build the stamina the two-paper structure demands. Working through several thousand well-explained questions, and genuinely learning from each one, is the approach that most reliably converts into a pass.

Passmed's MRCP Part 2 question bank offers thousands of best-of-five questions written by qualified doctors, with detailed explanations, embedded clinical images and a dashboard that pinpoints your weakest specialties. Explore the question bank →

Frequently asked questions

How many questions are in MRCP Part 2?

Two hundred in total, two papers of 100 best-of-five questions each, with every paper lasting three hours.

Is MRCP Part 2 harder than Part 1?

Most candidates find it more clinically demanding. The questions are longer and more integrated and require data interpretation and management decisions, rather than the more mechanism-focused recall of Part 1.

Is there negative marking in MRCP Part 2?

No. You are not penalised for wrong answers, so you should attempt every question.

What is the MRCP Part 2 pass mark?

There is no fixed percentage. The pass mark is set by test equating, which adjusts for the difficulty of the paper and the ability of the cohort, so your result reflects your ability across sittings.

How long should I revise for MRCP Part 2?

Two to three months of focused, question-led preparation suits most candidates, ideally sat before too much time has elapsed after Part 1.

Can I sit MRCP Part 2 before PACES?

Yes. Many candidates sit Part 2 Written before the clinical PACES examination. You do, however, need to complete the whole diploma within the time limits that run from passing Part 1, so plan your order accordingly.

How often is MRCP Part 2 Written held?

It runs several times a year at UK and international test centres. Exact dates and fees are set by the Federation of the Royal Colleges of Physicians and are updated periodically, so check the official schedule when you plan your sitting.

Exam format and scoring details were checked against the official examining bodies (accessed July 2026). Specifications, dates and fees change, always confirm the current details on the official website before you sit.