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MRCPI Part 2 (General Medicine) written examination

Clinical problem solving with investigations, aimed at the registrar who has to make the decision rather than list the possibilities.

IrelandRoyal College of Physicians of Ireland written

Coming soon. This bank is still in build and not on sale yet. The banks live now are PLAB 1, MRCP Part 1 and AMC MCQ.

What is on the MRCPI Part 2?

Questions or stations150 verified 2026-08-10 Source says: “two papers, each containing 75 Single Best Answer questions” check it yourself
Time150 minutes verified 2026-08-10 Source says: “each paper is 2.5 hours long” check it yourself
FormatTwo best-of-five papers with clinical data and investigations
Adaptive deliveryNo
Pass markSet by RCPI per sitting. verified 2026-08-10 check it yourself
BlueprintRCPI examination regulations and training curricula, Royal College of Physicians of Ireland

Two papers of 75 questions (150 in total), each 2.5 hours, with a break between them. No basic science, unlike Part 1.

Verification status. All 3 published figures on this page have been read in the source document and dated above. Source of truth: RCPI examination regulations and training curricula, Royal College of Physicians of Ireland. How we verify.

The MRCPI Part 2 curriculum, section by section

Every question in this bank is tagged to one of the sections below, and the tag traces to RCPI examination regulations and training curricula. 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.

Curriculum sectionShare of the blueprintItems in this bank
Cardiology 10% 1
Respiratory medicine 9% 1
Gastroenterology and hepatology 9% 1
Neurology 8% 1
Endocrinology and metabolic medicine 8% 1
Nephrology 7% 1
Rheumatology 6% 1
Haematology 6% 1
Infectious diseases and tropical medicine 6% 1
Oncology and palliative care 5% 1
Dermatology 4% none yet
Clinical pharmacology and therapeutics 8% 1
Clinical sciences and statistics 8% none yet
Acute and critical care medicine 6% 1

Coverage today: 12 of 14 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 38-year-old man returns from two weeks in rural Nigeria with a 3-day history of fever, rigors and headache. He took no chemoprophylaxis. Blood film shows ring forms with a parasitaemia of 6%. He is confused and his lactate is 4.2 mmol/L. What is the most appropriate treatment?

  1. Intravenous quinine and doxycycline Effective but second line. Quinine carries hypoglycaemia and cardiotoxicity risk and was shown inferior to artesunate for mortality.
  2. Intravenous artesunate correct Correct. Confusion and a lactate above 4 with parasitaemia over 2% define severe falciparum malaria, and intravenous artesunate is superior to quinine on mortality. Treatment starts immediately, before species confirmation if necessary.
  3. Chloroquine Wrong. Widespread chloroquine resistance in Plasmodium falciparum, particularly across West Africa, makes it unsafe.
  4. Oral artemether–lumefantrine Wrong route for this severity. Oral artemisinin combination therapy is for uncomplicated malaria; a confused patient with lactic acidosis needs intravenous treatment and critical care input.
  5. Primaquine Wrong for the acute illness. Primaquine clears dormant liver stages of vivax and ovale; falciparum has no hypnozoite stage, and G6PD testing is required first.

The point: Severe falciparum malaria: parasitaemia above 2%, impaired consciousness, acidosis, renal impairment, hypoglycaemia, ARDS. Intravenous artesunate, critical care, repeat films. Fever in a returning traveller is malaria until three films say otherwise.

Source: UK malaria treatment guidelines; HPSC Ireland malaria guidance Health Protection Surveillance Centre (Ireland) · tier 1, national regulator or guidance

A 74-year-old woman presents with exertional syncope and breathlessness. Echocardiography shows severe aortic stenosis with a mean gradient of 52 mmHg and a valve area of 0.7 cm². Ejection fraction is 55%. She is frail with a Society of Thoracic Surgeons predicted mortality of 9%, and has severe COPD and previous mediastinal radiotherapy. What is the most appropriate management?

  1. Start an ACE inhibitor and a beta blocker for symptom control Wrong and potentially harmful. Vasodilators must be used cautiously in severe aortic stenosis because a fixed obstruction cannot compensate for a fall in systemic vascular resistance.
  2. Balloon aortic valvuloplasty as definitive treatment Wrong as definitive treatment. Restenosis occurs within months, so it is a bridge to definitive intervention or a palliative measure.
  3. Medical management with a diuretic and review in six months Wrong. Symptomatic severe aortic stenosis has a dismal prognosis without intervention, and there is no medical therapy that alters it.
  4. Conventional surgical aortic valve replacement Reasonable in a low-risk patient, but her surgical risk score, frailty, lung disease and previous mediastinal radiotherapy all push towards a transcatheter approach.
  5. Refer to the heart team for consideration of transcatheter aortic valve implantation correct Correct. Symptomatic severe aortic stenosis is an indication for intervention regardless of ejection fraction, and syncope carries a particularly poor prognosis untreated. High surgical risk from frailty, lung disease and previous mediastinal radiotherapy makes TAVI the appropriate route, and the decision belongs to a multidisciplinary heart team.

The point: Aortic stenosis becomes an intervention decision the moment it becomes symptomatic: angina, syncope, or heart failure. Severe is a mean gradient above 40 mmHg, peak velocity above 4 m/s, or area below 1 cm². Avoid vasodilators. The heart team decides surgery versus TAVI on risk and anatomy.

Source: ESC/EACTS guidelines for the management of valvular heart disease European Society of Cardiology · tier 2, specialty society or college

Where MRCPI Part 2 sits in the pathway

Ireland physician training (MRCPI) runs MRCPI Part 1 → MRCPI Part 2. 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.

MRCPI Part 1

Questions people actually ask about MRCPI Part 2

How long should I prepare for MRCPI Part 2?

Candidates who have recently passed Part 1 typically report a shorter run-in than those returning after a gap, because the basic science recall decays fastest. Plan around your weakest tagged sections rather than around a fixed number of weeks.

What does MRCPI Part 2 preparation cost?

MRCPI Part 2 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.