MRCPsych Paper 3

Examination centres in the UK, Ireland and Hong Kong

The marking scheme for the MRCPsych Written Paper Examinations is available to download

 

The MRCPsych Paper 3 will be 3 hours long, containing a maximum of 200 questions. The paper will include both ‘best answer 1 of 5’ style MCQs and EMIs. The Clinical Topics will be approximately two thirds of the paper. The Critical Review component will make up approximately one third of the paper.

 

 

General Adult

Research methods

Evidence based practice

Statistics

Critical Appraisal

Clinical Topics

Liaison

Forensic

Addiction

Child and adolescent

Psychotherapy

Learning disability

Rehabilitation

Old age psychiatry

 

Breakdown of questions, Paper 3 (Clinical Topics)

%

  • General Adult Psychiatry                                                    
  • Classification of disease, preventative strategies
  • Presentation of illness and treatment
  • Hospital liaison psychiatry
  • Neuropsychiatry
  • Medicine relevant to psychiatry & HIV
  • Research

32

Old age psychiatry

15

Addictions

11

Child & adolescent psychiatry

15

Forensic psychiatry

9

Learning Disability

10

Psychotherapy & Psychopathology

8

 

This breakdown is intended as a general guide to the Clinical Topics content of Paper 3 and is subject to change

 

Clinical topics sample questions

 

Single best answer

 

When assessing a patient with the features of early dementia which of the following would suggest a sub-cortical rather than a cortical cause?

 

a)  Absence of dysarthria

b)  Calculation preserved *

c)  Euthymic mood

d)  Mild aphasia

e)  Normal speed of cognitive processes

 

In an eight year old boy with Attention Deficit Hyperactivity Disorder (ADHD) and no co-morbidity which of the following drugs would be the first line medication to use alongside psychosocial interventions:

 

a)  Amitriptyline

b)  Clonidine

c)  Dexamfetamine

d)  Methylphenidate *

e)  Nortriptyline

 

Sample critical review questions:

 

Extended matching item

 

Theme: Study Design:

 

Options:

 

A. Case Control study

B. Cohort Study

C. Cross Sectional Study

D. Epidemiological study

E. Qualitative study

F. Randomized controlled trial

 

 

From the study described below, select the most appropriate design from the list above

 

1. To investigate the relationship between alcohol consumption and depression, a group of patients attending the psychiatric outpatient clinic with a diagnosis of depression were questioned about their alcohol consumption. A group of non-depressed age and sex matched patients attending the clinic were also questioned about their alcohol consumption using an identical protocol.  A

 

2. To investigate the relationship between certain solvents and dementia, all employees at a factory were questioned about their exposure to an industrial solvent, and the amount and length of exposure measured. These subjects were regularly monitored, and after 20 years a copy of the death certificate for all those who had died was obtained.  B

 

3. A survey was conducted of a random sample of junior doctors employed at a particular hospital. Among other questions, the questionnaire asked about the grade of the doctor and whether he/she was satisfied with the psychiatric training they were receiving.  C

 

4. A group of patients were invited to a focus group to elicit their views on drug treatment and reasons for non-compliance.  E

 

Extended matching item:

 

Theme: Calculations in critical appraisal 

 

Options:

 

A  0

B  1

C  4

D  5

E   6

F  8

G  9

H  20

I    50

J   80

K  100

L   infinity

 

For each of the questions below, select the most appropriate number from the list above.

 

1. The usual upper limit of risk of type II error (expressed as a percentage) in power calculations for randomised trials  H

 

2. The odds of an event if it happens 90% of the time.  G

 

3. The ideal Number Needed to Treat.  B

 

4. The value which, if crossed, the 95% confidence interval of a Number Needed to Treat becomes non-significant. L

 

5. The sensitivity of a test, expressed as a percentage where 80 people were classified “true positive” and 20 people were classified “false negative”.  J

 

 

Single best answer

 

An evaluation of a new screening questionnaire for depression in primary care is conducted. The most important single feature of this questionnaire that would encourage you to use it is:

 

a)  it has Positive Predictive Value of 20%

b)  it has sensitivity of 80% *

c)  it has specificity of 60%

d)  it is brief

e)  it is validated in different languages

 

 

Which of the following clinical questions is better suited to qualitative rather than quantitative research methods?

 

a)  A study detailing the social outcomes of people treated with Cognitive Behavioural Therapy

b)  A study of the costs per unit of ‘patient utility’ in an randomized controlled trial

c)  A study to assess the attitudes of people with borderline personality disorder to their diagnosis *

d)  A study to measure psychiatric symptoms after head injury

e)  A study to measure quality of life in people with Alzheimers disease.

 

Which of the following is the least adequate method of randomisation?

 

a)  Minimisation

b)  Odd/even last digit of date of birth *

c)  Permuted block randomisation

d)  Simple randomisation by computer

e)  Toss of a fair, unbiased coin.

 

The most important component in the development of a clinical guideline is:

 

a)  All stakeholders are consulted.

b)  Economic factors are considered

c)  Meta-analysis of the available data

d)  Systematic development

e)  Systematic literature search  *

 

© 2009 Royal College of Psychiatrists