Dealing with exams

Please visit the RCPsych exams webpages for up-to- date information on the College membership (MRCPsych) examination.

The new curriculum for psychiatric training has been designed to ensure that a high standard of training is achieved using a patient-based and learner-centred approach. The curriculum defines the competencies, professional behaviour, and attitudes which psychiatrists should acquire and demonstrate in their clinical practice.

Workplace-based assessments (WPBAs) 

WPBA’s will take place throughout core and specialist training and competencies will be rated according to the level of training. WPBA’s allow doctors in training to learn and practise clinical skills. Other mental health professionals will be involved in these assessments and trainees will need skills in team working.
Psychiatrists in training must register with the Royal College of Psychiatrists’ Portfolio Online and complete their mandatory WPBAs. The evidence collected in the assessments will form part of the annual review of competence progression (ARCP), at which educational supervisors and College tutors review your training. 

The Examinations Unit within the College is responsible for organising the written and clinical MRCPsych examinations.

The MRCPsych examinations consist of two written papers, A and B, and a practical exam, the Clinical Assessment of Skills and Competencies (CASC). 

  • Each written paper is 3 hours long and contains 150 questions for 150 marks. Questions consist of a mixture of multiple-choice (MCQs) and extended matching items (EMIs). The balance of the two types of questions will vary but will be approximately two-thirds MCQs and one-third EMIs.

  •  MRCPsych Paper A: the scientific and theoretical basis of psychiatry.

  • MRCPsych Paper B: critical review and the clinical topics in psychiatry. The critical review component will comprise one-third of the paper, with the remaining two-thirds covering clinical topics (of which approximately 30% will be general adult psychiatry).

The written papers are followed by CASC. This is a 16-station examination, testing candidates’ competency in clinical skills, appropriate to their stage of training. The examination is split into two sets of eight stations. Five stations are focused on history taking (including risk assessment), five stations focus on examination (both physical and mental state, including capacity assessment) and five stations are focused on patient management.

Circuit 1 consists of:

  •  6 x stations focused on Management
  •  1 x station focused on Examination
  •  1 x station focused on History Taking
  •  4 minutes of reading time before entering each station
  •  7 minutes to perform the task

Circuit 2 consists of:

  • 4 x stations focused on Examination
  • 4 x stations focused on History Taking
  • 90 seconds of reading time before entering each station
  • 7 minutes to perform the task

Membership of the College is the accepted qualification for entry into higher training in psychiatry.

The current syllabuss and the critical review syllabus can be found on the RCPsych exams website.

The CASC examination can be taken after successful completion of Papers A and B and if you have a minimum of 23 months’ (whole-time equivalent) experience in post-foundation training or internship experience in psychiatry. Trainees are advised to start studying early in their training years and to pace their studies throughout training

The Examinations Unit is responsible for processing candidate enquiries, applications, entry and allocation to examination centres and the publication of final results, as well as recruitment, induction, and training of College examiners.

The question papers are prepared by the panels responsible for each paper. All results are monitored and determined by the College’s Examinations Sub-Committee. Regular reports are presented to the Education and Training Committee to ensure that standards are maintained. The Head of Examinations Operations is responsible for the overall management and delivery of the Unit’s activities and manages the examinations team. Further details regarding exams regulations can be found on the College website.

Postgraduate examinations require a significantly greater depth and breadth of knowledge than undergraduate examinations. Passing the MRCPsych examination requires learning and applying large amounts of information.

It is important to reinforce memory by revising and practising recall, as well as linking learning to clinical scenarios that you have encountered.

Belonging to a study group may help you reduce your workload of finding information and enable you to share experience and provide support to each other. Study groups also aid reflection on progress.

Practicing CASC scenarios in pairs or small groups is invaluable. It allows you to get used to the knowledge, approach and timing that are required. It also means that feedback can be regularly provided from study partners, and you can learn from them. 

It is important to discuss learning and your progress with your educational supervisor. If you lack experience or would benefit from more training in a particular area, make sure these educational needs are addressed.

General Tips 

  • Find a place to study that is quiet and comfortable (explore all options, including home, work and public spaces).
  •  Set aside a regular time to study and try to make it part of your weekly routine.
  •  Allow time to plan studying and schedule regular breaks
  •  Keep a balance between work and personal life
  •  Build on your existing knowledge base and experience and identify any gaps in knowledge early on
  •  Think about your personal learning style and use this to plan what resources and approaches suit you best
  •  Try not to focus too much on what others are doing

Preparation

  • The following tips may help you go through the assessments and examinations more easily.
  • Check you are using the most up-to-date syllabus for exams from the college website
  •  Start preparing early in order to plan an effective revision programme
  •  It is recommended that candidates use multiple different sources (attending an MRCPsych course, textbooks, online resources/question banks, NICE guidelines) to prepare

 Ensure that you find the best books/training materials that fit your needs. You can do this by:

  • Checking resources fit with your learning style
  • Reviewing available books (ideally in a bookshop or borrowing from others so you can assess if it is right for you)
  • Speak to trainees who have recently sat, and passed, the exam and also ask supervisors for advice
  • Plan when you are going to take the examinations (take account of your personal circumstances).
  • Try to take annual leave regularly to ensure that you are properly rested.
  • Create your own study programme and map to the curriculum.
  •  Make use of study leave for any revision courses and for the dates of the exams but ensure that applications are submitted in advance.
  • Form a study group with others who are also preparing for the exam.
  • Practise scenarios for the CASC with others who have done the exam before and attend a practice CASC exam if one is being run locally.

Stress management

  •  Identify your support network of family, friends and colleagues. Seek help early if you are struggling
  •  Talk to your clinical and educational supervisor.
  •  Develop healthy coping strategies to deal with anxiety.
  •  Stay healthy by looking after your body and mind.
  •  Ensure that you have time for family, friends, hobbies and interests in amongst work and study.

Administration

Ensure that you apply to take the examinations in plenty of time, as forms must be completed and returned to the College. If you are travelling, ensure that you leave enough time to get to the venue. On the examination day, make sure that you arrive at the examination venue in good time.

If you are not successful

There may be various reasons why you were not successful, and it is important to find out why it happened so you can address the issues. You will receive feedback from the College’s Professional Standards Department. 

It is also advisable to seek advice from your College tutor and your educational supervisor – listen carefully to their suggestions and make notes so that you can look over them later. If you have failed a particular part of the examination, ensure that this area is an identified learning need. 

While you focus on this area, continue to revise the other sections of the curriculum with a range of senior colleagues. This should help you to regain your confidence. Changes may be needed in your knowledge base, skills or attitude and you may need to widen your clinical experience.

This webpage is available as a downloadable PDF help sheet
Read more to receive further information regarding a career in psychiatry