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MRCP(UK) Part 1 written examination

The knowledge gate into UK physicianly training. Heavy on clinical sciences, pharmacology and statistics — the parts most candidates try to skip and then resit.

United KingdomMRCP(UK) Federation written

What is on the MRCP Part 1?

Questions or stations200 verified 2026-08-10 Source says: “a two-paper format... each paper... containing 100 multiple choice questions in 'best of five' format” check it yourself
Time180 minutes verified 2026-08-10 Source says: “each paper being three hours in duration” check it yourself
FormatBest of five, two papers
Adaptive deliveryNo
Pass markA criterion-referenced standard rather than a fixed pass percentage; the pass mark is published with each diet's results. verified 2026-08-10 check it yourself
BlueprintMRCP(UK) examination blueprints and regulations, MRCP(UK) Federation

Timing above is per paper; two papers are sat on the same day, giving 200 questions in total.

Verification status. All 3 published figures on this page have been read in the source document and dated above. Source of truth: MRCP(UK) examination blueprints and regulations, MRCP(UK) Federation. How we verify.

The MRCP Part 1 curriculum, section by section

Every question in this bank is tagged to one of the sections below, and the tag traces to MRCP(UK) examination blueprints and regulations. That is what makes a coverage claim checkable instead of a marketing line. The table shows exactly how many items exist in each section today, including the sections where the answer is none.

Coverage today: 17 of 17 sections. We publish the gap rather than hiding it.

Free sample questions

Full explanations for every option, including the ones you didn't pick. The option you nearly chose is usually the one you needed explained. Read these before paying for anything.

A 68-year-old man has 3 months of worsening exertional breathlessness, orthopnoea and ankle swelling. His jugular venous pressure is raised, he has bibasal crackles and pitting oedema, and echocardiography shows a dilated left ventricle with an ejection fraction of 30%. His NT-proBNP is markedly raised. What is the most likely diagnosis?

  1. Liver cirrhosis with ascites Fluid retention from portal hypertension. A raised NT-proBNP with a reduced ejection fraction of 30% makes it a mimic.
  2. Nephrotic syndrome Oedema from heavy proteinuria and low albumin. A raised NT-proBNP with a reduced ejection fraction of 30% redirects it.
  3. Heart failure correct Correct. Exertional breathlessness, orthopnoea and fluid overload with a reduced ejection fraction and a raised NT-proBNP is heart failure with a reduced ejection fraction.
  4. Chronic obstructive pulmonary disease Breathlessness with a smoking history and airflow obstruction. A raised NT-proBNP with a reduced ejection fraction of 30% raises it.
  5. Anaemia Breathlessness on exertion with a low haemoglobin. A raised NT-proBNP with a reduced ejection fraction of 30% makes it worth checking.

The point: Heart failure is a clinical syndrome of breathlessness, fatigue and fluid retention arising from a structural or functional cardiac abnormality, and it is separated by the left ventricular ejection fraction into reduced (40% or less), mildly reduced and preserved categories, because only the reduced-fraction group has disease-modifying drug therapy. The diagnosis is supported by a raised natriuretic peptide (BNP or NT-proBNP), and confirmed by echocardiography, which measures the ejection fraction and looks for the valvular, ischaemic or infiltrative cause. In heart failure with a reduced ejection fraction the four pillars of therapy each reduce mortality independently: an angiotensin-converting enzyme inhibitor (or an angiotensin receptor-neprilysin inhibitor), a beta blocker, a mineralocorticoid receptor antagonist and a sodium-glucose cotransporter-2 inhibitor. Loop diuretics relieve congestion and symptoms but do not change prognosis. Device therapy with cardiac resynchronisation or an implantable defibrillator is considered in selected patients with a low ejection fraction and broad QRS or a high arrhythmic risk. Acute pulmonary oedema is treated with sitting up, high-flow oxygen, intravenous loop diuretic and nitrates, with non-invasive ventilation for the patient who is not responding.

Source: ESC guidelines for the diagnosis and treatment of acute and chronic heart failure European Society of Cardiology · tier 2, specialty society or college

A 68-year-old man has 3 months of worsening exertional breathlessness, orthopnoea and ankle swelling. His jugular venous pressure is raised, he has bibasal crackles and pitting oedema, and echocardiography shows a dilated left ventricle with an ejection fraction of 30%. His NT-proBNP is markedly raised. What is the most appropriate investigation?

  1. Transthoracic echocardiography correct Correct. Echocardiography measures the ejection fraction and identifies the underlying cause, and it is what confirms the diagnosis after a raised natriuretic peptide.
  2. Chest radiograph Shows cardiomegaly and pulmonary congestion. A raised NT-proBNP with a reduced ejection fraction of 30% supports it.
  3. Bloods for renal function, full blood count and thyroid Finds reversible contributors. A raised NT-proBNP with a reduced ejection fraction of 30% makes it useful.
  4. Coronary angiography For an ischaemic cause where revascularisation is considered. A raised NT-proBNP with a reduced ejection fraction of 30% makes it selective.
  5. 12-lead ECG Looks for ischaemia, arrhythmia and left ventricular hypertrophy. A raised NT-proBNP with a reduced ejection fraction of 30% makes it routine.

The point: Heart failure is a clinical syndrome of breathlessness, fatigue and fluid retention arising from a structural or functional cardiac abnormality, and it is separated by the left ventricular ejection fraction into reduced (40% or less), mildly reduced and preserved categories, because only the reduced-fraction group has disease-modifying drug therapy. The diagnosis is supported by a raised natriuretic peptide (BNP or NT-proBNP), and confirmed by echocardiography, which measures the ejection fraction and looks for the valvular, ischaemic or infiltrative cause. In heart failure with a reduced ejection fraction the four pillars of therapy each reduce mortality independently: an angiotensin-converting enzyme inhibitor (or an angiotensin receptor-neprilysin inhibitor), a beta blocker, a mineralocorticoid receptor antagonist and a sodium-glucose cotransporter-2 inhibitor. Loop diuretics relieve congestion and symptoms but do not change prognosis. Device therapy with cardiac resynchronisation or an implantable defibrillator is considered in selected patients with a low ejection fraction and broad QRS or a high arrhythmic risk. Acute pulmonary oedema is treated with sitting up, high-flow oxygen, intravenous loop diuretic and nitrates, with non-invasive ventilation for the patient who is not responding.

Source: ESC guidelines for the diagnosis and treatment of acute and chronic heart failure European Society of Cardiology · tier 2, specialty society or college

Where MRCP Part 1 sits in the pathway

UK physician training (MRCP) runs MRCP Part 1 → MRCP Part 2 → MRCP PACES. One DocPasser account covers all of them, so moving to the next stage does not mean a new subscription and a progress history you can no longer see.

MRCP Part 2 · MRCP PACES

Questions people actually ask about MRCP Part 1

What is the hardest part of MRCP Part 1?

Statistics and clinical pharmacology, reliably. They carry real weight in the blueprint and are the two areas candidates most often leave until the last fortnight.

How many times can I sit MRCP Part 1?

Attempts are capped by the Federation's regulations, with the cap counted across the whole diploma. Check the current regulations before you book a resit.

What does MRCP Part 1 preparation cost?

MRCP Part 1 is a flat £20 for 12 months of access — one price, one purchase, no tiers. The first 10 questions are free, with the full explanation for every option, so you can judge the quality of the explanations before paying for anything.

DocPasser is exam preparation material, not clinical guidance. Nothing here should be used to make a decision about a real patient. Always work from your own local guidelines and seniors.