MRCP Part 1 Guide 2026/27: Format, Fees, Dates, Prep

MRCP(UK) is the membership diploma of the Royal Colleges of Physicians of the UK, and Part 1 is its first exam. It is the standard knowledge test for doctors heading into internal medicine and the medical specialties, both in UK training and for many international doctors planning a UK career.

MRCP Part 1 at a glance

Who should take it

MRCP Part 1 is the entry point to the MRCP(UK) diploma, which continues with Part 2 Written and the clinical PACES exam. In UK training it is typically taken during foundation or internal medicine training. For international doctors, it is also a way to build a UK-recognised credential before or alongside a move. If you are using it as part of a registration plan, compare routes in our guide to working as a doctor in the NHS; for many IMGs the PLAB route remains the main path to registration.

You need at least 12 months' postgraduate experience in medical employment to sit Part 1.

Format in detail

The exam is a single day with two three-hour papers of 100 best-of-five questions each. Each question presents a clinical scenario or a science-based stem with five options, and you select the single best answer. There are no images in the Part 1 papers.

Content covers common and important disorders across the UK curriculum for internal medicine, alongside clinical science (for example physiology, pharmacology, biochemistry, genetics, statistics and evidence-based medicine). A published blueprint sets how questions are distributed across specialties.

At three hours per 100 questions, you have about 1 minute 48 seconds per question. That is more generous than PLAB 1, but stems are longer and more detailed, and the clinical science questions can be time-consuming.

Fees and dates (as of October 2026)

Application windows open and close well before each exam date, and Hong Kong centres have a different application process and fee.

Attempts

MRCP(UK) allows a maximum of six attempts at each part of the diploma. Candidates who reach six may apply for one exceptional additional (seventh) attempt. Withdrawals do not count as attempts.

Six attempts is generous, but every resit costs a fee and months of preparation. Aim to sit when your practice scores are consistently comfortable, not as a trial run.

A 16-week study plan

Adapt the length to your clinical workload; the structure matters more than the exact weeks.

Getting the most from questions

• Review every question, including correct guesses. Write a short rule for each mistake.
• Group mistakes by theme (for example, renal tubular acidosis types, antiepileptic side effects) and revise the theme, not just the question.
• Practise statistics and pharmacology regularly. They are learnable and often neglected.
• Simulate the day: two three-hour papers with a break, at least twice before the exam.

MediFlow's MRCP Part 1 course offers best-of-five questions with explanations and free test questions to start; the same bank runs in our app for short sessions between shifts.

High-yield approach

MRCP(UK) does not reward rare trivia over common medicine. Focus on:

• Mechanisms and pharmacology: drug mechanisms, important side effects and interactions
• Investigations: interpretation of blood results, ECG descriptions, arterial blood gases, lung function and other data in text form
• Management: first-line treatment of common and important conditions following UK guidance
• Clinical science: physiology and basic statistics (sensitivity, specificity, NNT, study design)
• Genetics and inheritance patterns, which appear regularly in best-of-five form

Tips for international candidates

If you trained outside the UK, the medicine is familiar but the framing may not be:

• Use UK guidance. Management questions follow UK practice, so read NICE guidance and the BNF for common conditions rather than relying on your national guidelines.
• Learn UK drug names. Questions use generic names as listed in the BNF.
• Watch the international fee and centre list. The fee for international candidates is higher (£696 for 2026/3 and 2027 sittings), and centre availability differs by country; apply early in the window.
• Plan the whole diploma. Part 2 Written and PACES follow, and PACES is a clinical exam with its own centres and dates. Think about where and when you could realistically sit it before you start.
• Combine with your registration plan. If you also need PLAB, work out which exams come first so that validity windows and fees do not clash.

Common mistakes

1. Starting with your favourite specialty instead of the blueprint's weighting.
2. Skipping clinical science until the last week.
3. Doing questions without review.
4. Never sitting a full three-hour paper before exam day.
5. Applying late. Application windows close well before the exam date.
6. Relying on outdated fee or date tables.

Exam-day checklist

• Booking confirmation and correct ID
• Test centre or online setup checked in advance
• Food and water plan for the break between papers
• Timing plan: about 50 questions per 90 minutes per paper
• Flag-and-move-on rule for any question over three minutes

After Part 1

Once you pass, you can move on to MRCP(UK) Part 2 Written and PACES. In UK training, MRCP progress is closely linked to internal medicine training milestones. For the wider career picture, see working as a doctor in the NHS.