MRCP Part 1 vs Part 2 vs PACES : Key Differences Explained

MRCP Part 1 tests core medical sciences, MRCP Part 2 focuses on advanced clinical problem-solving, while MRCP PACES assesses practical skills, patient interaction, and communication.

Membership in the Royal Colleges of Physicians (MRCP UK) is a prestigious and well-known postgraduate qualification for doctors pursuing a career in internal medicine. It presents an opportunity for physicians seeking to advance their careers in the UK or other countries.

The full MRCP (UK) degree is awarded only after successfully clearing all three parts of the MRCP examination.

This postgraduate qualification comprises three stages:

• MRCP Part 1
  
  

• MRCP Part 2
  
  

• MRCP PACES
  
  

Let us now look at the key differences between these three parts in brief

MRCP PART I

The MRCP Part 1 is the entry-level examination that evaluates the core medical sciences. It is the first step to achieving membership in the Royal College of Physicians.

This is a one-day examination that primarily focuses on testing the knowledge and foundation of the aspirant. MRCP Part 1 emphasizes the fundamental principles of general medicine and clinical sciences.

Exam Format:

• 2 papers (2 hours each)
  
  

• 100 multiple-choice questions in best-of-five format per paper
  
  

• 1 mark for each correct answer
  
  

• No negative marking

Topics Covered in MRCP Part 1:

• Pharmacology
  
  

• Epidemiology
  
  

• Statistics
  
  

• Clinical Specialties such as Cardiology, Neurology, Respiratory Medicine, Gastroenterology, Endocrinology, and others
  
  

Once the aspirant successfully clears MRCP Part 1, they are eligible to proceed with MRCP Part 2.

MRCP Part 2

The MRCP Part 2 is a more advanced clinical written examination that builds upon the knowledge tested in MRCP Part 1. It focuses on advanced clinical knowledge, analytical thinking, and real-world application.

 Exam Format:

• Conducted in one day
  
  

• 2 papers (3 hours each)
  
  

• Best-of-five multiple-choice questions (MCQs)
  
  

Both papers are completed on the same day

Content & Specialties Covered:

• Cardiology
  
  

• Gastroenterology
  
  

• Endocrinology
  
  

• And other major specialties
  
  

 Focus Areas of MRCP Part 2:

• Interpretation of clinical information.
  
  

• Solving complex case scenarios.
  
  

• Diagnostic reasoning and management plans.
  
  

• Interpretation of ECGs, X-rays, CT/MR scans.
  
  

• Application of knowledge in real-life clinical decision-making.
  
  

 Key Assessment Criteria:

• Ability to apply clinical knowledge effectively.
  
  

• Practical judgement in problem-solving.
  
  

• Accountability for clinical decisions and patient outcomes.

MRCP PACES

The MRCP PACES (Practical Assessment of Clinical Examination Skills) is the final step to obtain the GMC registration certificate. It is a practical, clinical exam that tests a physician’s ability to apply medical knowledge in real-life hospital settings.

The exam is designed to assess a candidate’s professionalism, empathy, and ability to clearly and ethically explain complex medical information. PACES consists of five stations that evaluate a wide range of clinical skills.

 MRCP PACES Structure

• 5 stations, each lasting 20 minutes
  
  

• 8 patients in total
  
  

• 2 examiners per station
  
  

 Stations Overview:

• Station 1: Communication & Respiratory Examination (10 + 10 minutes)
  
  

• Station 2: 20-minute Consultation (history, examination, discussion)
  
  

• Station 3: Cardiovascular + Neurological Examination (10 + 10 minutes)
  
  

• Station 4: Abdominal Examination + Communication/Ethics (10 + 10 minutes)
  
  

• Station 5: Brief Focused Consultation + Management Discussion (20 minutes)
  
  

Core Skills Assessed in MRCP PACES

A) Physical Examination
B) Identifying Clinical Signs
C) Clinical Communication
D) Differential Diagnosis
E) Clinical Judgement
F) Managing Patients’ Concerns
G) Maintaining Patient Welfare

MRCP Part 1 vs Part 2 vs PACES – Quick Comparison

Final Thoughts on MRCP Part 1 vs Part 2 vs PACES

The three MRCP parts differ significantly in their format, level, and focus:

• MRCP Part 1 primarily tests theoretical knowledge and the foundations of medical sciences.
  
  

• MRCP Part 2 evaluates a candidate’s applied clinical understanding and ability to solve complex case scenarios.
  
  

• MRCP PACES is the final stage, assessing practical skills, patient interaction, and interpersonal communication in real clinical environments.
  
  Together, these three stages of the MRCP exam ensure that physicians develop a strong foundation of medical knowledge, the ability to apply clinical reasoning in complex scenarios, and the practical skills, communication, and professionalism necessary to provide safe and effective patient care at an international standard.

Frequently Asked Questions

Q1. What is the difference between MRCP Part 1 and Part 2?
MRCP Part 1 tests core medical sciences with basic principles, while MRCP Part 2 focuses on advanced clinical knowledge, complex case scenarios, and interpretation of investigations like ECGs, X-rays, and CT/MRI scans.

Q2. How is MRCP PACES different from Part 1 and Part 2?
Unlike the written exams in Part 1 and Part 2, MRCP PACES is a practical clinical skills assessment. It tests patient examination, communication, professionalism, and real-life diagnostic reasoning.

Q3. Can I attempt MRCP Part 2 without clearing Part 1?
No. You must first pass MRCP Part 1 before becoming eligible to sit for MRCP Part 2.

Q4. How many attempts are allowed in MRCP exams?
There is no strict limit on attempts, but most candidates aim to clear within 6 years. GMC recommends clearing all three parts within 7 years for smooth progression.

Q5. Which part of the MRCP exam is the hardest?
Difficulty varies by candidate. Generally, Part 1 is knowledge-heavy, Part 2 requires strong clinical reasoning, and PACES is often considered the toughest because it tests real-world communication, empathy, and clinical judgment.

Q6. Is MRCP valid outside the UK?
Yes, MRCP (UK) is recognized internationally and is valued in many countries for internal medicine training and specialist registration.