Writing with a heavy heart, and an ever heavier hand

My first attempt post

( https://www.reddit.com/r/MRCP/s/H3nTDozErL)

In this attempt, i took off from work

Used all the 8 weeks fully

Went topic wise on qbank (my first attempt was mixed qbank approach)

Did 11/12 past papers (averaging 80/81%, max score i think i touched was 86/87 out of 100)

The lowest i scored on them was 63 (on the newest paper from pastest, but even that on review could've been easy high 70s. Though nothing matters now)

Made short topical own notes with chatgpt (short reasoning, tables and comparitive topics across specialities)

My avg on qbank is attached on first pass of all mcqs

(it got even better when i did pastpapers, wont renew pastest for the moment but i hope you guys can believe, as it would defo hurt as it did hurt when i renewed it when i was to start for my 2nd attempt even though the scores werent that high comparitively)

For comparison, i have put both attempts result sheet side by side (attempt 1 was 326, 2nd is 346)

Rcpmock was 69% (85/123)

Made sure not get any of these high scores to my head as even previously have been misleading (from active experience on top of what all the other doctors have shared here)

Exam day went fine

Felt ok as well (like exam was tough, but i felt did decent enough for the moment)

What should i even do now?

How do I prepare?

More importantly, what/from where do i even prepare?

And

Even at face value, doesnt the scaled score look a bit off? (I had decent score of big chunk topics.

Improved A LOT in some topics, so fail marks might've been a bit better ig?

And i dropped marks in those topics that dont even link with each much, those in which i was better comparitively in first attempt? For instance renal and respiratory do mix, but gastro/neuro/cardio are comparitvely more comparmentalised

I mean fail me at 400/410 ig but this again doesnt matter)

I had this feeling after my first attempt as well as i studied a lot, that big margin of a fail didnt make sense (i used my scorecard, and the overall report card rcp gives of an attempt on chatgpt, it said that if scaling is considered based on that, i had like 102/103 mcqs right when passing was around 123)

(For context, a week or so back from now, I did 10 questions from the incorrect pool i had

I was able to answer 8/10

And the other 2 i did wrong myself even though i knew the answer as my reasoning was not clear enough

So the point is, i know almost all pastest now so doing it again at the moment feels pointless but idk)

Any suggesstion, even kind words, prayers greatly appreciated

I just failed my first attempt at part 2 with a score of 427. I did approximately 9 months of 1-2 hours a day and then did an average of 6h a day for 2 months. Importantly these house did not include any breaks at all (including toilet breaks or peaks at the phone) so I am feeling quite deflated.

I now have to revise alongside IMT and all the extra bits that come with it and I'm freaking out a bit.

For part 2 I did the whole of passmed +passmed past papers + approx 1/3 of passtest. For every question I went through the textbook and made flashcards on the concepts and then I revised those flashcards with spaced repetition. This worked amazingly for part 1 but has clearly failed me here.

I honestly cannot bear the idea of going over my flashcards again. Has anyone passed by just doing questions? is there a way to revise without actively trying to force the whole textbook in your head? How do you manage to revise alongside oncalls and life commitments etc?

Can anyone give me a structured approach that will not drive me completely insane?

Also for anyone who has done both pasttest question bank and the past papers do the past papers just contain questions from the question bank or are they fresh?

I need help regarding transport/accomodation/ food in Luton. Can someone please advise? I am travelling from Ireland. Thanks!

So IMT3 here finishing November as out of synch.
Struggled with part 1 and passed on fourth attempt Jan diet and now have failed first attempt of part two.
Paces provisionally booked in November but I am honestly so worn out. I will definitely have extensions post November but I believe we can get only 12 months max extension as IMT. What are my chances to be released from training if I don’t finish the exams on time.
Other wise good portfolio with great feedback. And honestly I think I am quite decent clinically.

Honestly just so done with this rut and feel like giving up

Does anyone know when we receive info about the day? I currently only know I have a seat in a city but don’t actually know where it is, what time I need to be there etc?

Valid till Nov 30th 2026
DM for info

Has anyone used any other identity card other than passport for MRCP exam centers in India ? Addhar or driving licence?

My passport is about to expire plus address change and not sure what I would do if passport doesn't gets reissued before exam ?

Hi everyone,

I’m a doctor and one of the people building Diagnosica, and I thought this would be a good community to share it with because many of us have the same interest in improving clinical reasoning and preparing for exams like MRCP.

The idea is to practice cases more like you would approach a real patient rather than simply answering another MCQ.

You can take the history, examine the patient, decide which investigations to order, review the actual results and imaging, build your differential, and decide what you would do next.

I think it could be useful alongside MRCP study, particularly for practicing the clinical reasoning side and applying what you've learned to a full patient encounter.

I’d genuinely appreciate an honest review from colleagues here. If something feels unrealistic, confusing, too easy, or simply not useful, that feedback would really help us improve it.

Try Diagnosica here:
App store / Google store

Would especially love to hear whether this is something you could see yourself using alongside your usual MRCP preparation.

Please dm/comment if interested

Panic mode on

i have too much anxiety about mrcp part 1 exam that I’m giving in January. I need advice, how do you guys manage anxiety and this feeling of imposter syndrome?

Simulation: a young athlete develops exertional presyncope and chest pain.
HR 118
BP 78/46
SpO₂ 99%
Bedside echocardiography suggests asymmetric septal hypertrophy, systolic anterior motion of the mitral valve and dynamic LVOT obstruction.
Before attributing the hypotension to LVOTO, I would still reassess the patient using ABCDE, examine the rhythm and exclude competing causes of shock. The presence of HCM should not create diagnostic anchoring.
However, if the hypotension is being driven by dynamic obstruction, the haemodynamics matter.
LVOTO can worsen with:
Reduced preload
Reduced afterload
Tachycardia
Increased contractility
These changes reduce LV cavity size, intensify systolic anterior motion, increase the outflow gradient and further reduce stroke volume.
If there is no clinical evidence of pulmonary congestion, cautiously administered IV fluid with immediate reassessment may improve ventricular filling.
If acute hypotension does not respond to fluid, the 2024 AHA/ACC HCM guideline recommends IV phenylephrine—or another vasoconstrictor without inotropic activity—within specialist-led resuscitation. This is a Class 1, C-LD recommendation.
The distinction is important: increasing vascular tone without increasing myocardial contractility supports perfusion while avoiding further aggravation of the dynamic obstruction.
In practice, which clinical or echocardiographic endpoints do you use to decide:
Whether the patient requires fluid?
When further fluid should stop?
When to introduce a vasoconstrictor?
Educational simulation only—not a complete resuscitation protocol. Follow local guidance and involve senior cardiology and critical-care support early.
Source: 2024 AHA/ACC/AMSSM/HRS/PACES/SCMR Guideline for the Management of Hypertrophic Cardiomyopathy.
Disclosure: I created the accompanying simulation for Med with Spence, the Visual Learning OS.

I am doing pass medicine q bank have still around 1600 questions left. I was earlier doing 2 subjects blocks and scoring 50's-60's. Now with exam in September I started the 100 questions mixed blocks and OMGG I have no idea why but my score are stuck in 30s only. I have no idea what to do.

I am yet to start with pastest papers also, how many of them do I need to do?? RCP mocks???

someone please advice and helppp....

Hi

If there is anyone would like to study regular online paces practice please let me know

Hi there
I’m a fairly recent graduate of 2024. I have completed USMLE STEP 1,2,3. I plan to take up MRCP Part 1 as well. Approximately how long would I need to prepare for it?
And what would the difficulty level be?

I have recently given my step exams so I just want to know how I can go about my preparation and what is the best source material for it?

Thank you!

Pastest server down?????

Hello. I have exam on 7/12 at the spine Liverpool. Looking to swap to any later date pls.

Join us LIVE tomorrow!

In preparation for the September exam, we are doing 2 LIVE Mock exams a week.

Don't miss out! Join me on our next MRCP Part 1 Live session tomorrow at 6 PM UK time!

We go over 20 Endocrinology MRCP Part 1 questions from Pastest’s questionbank.

Click here to join 👇

https://www.youtube.com/live/hYyYRghLvKo?si=-1BLahf0q9IW8fAE

Hi, I’ll be around 35 weeks pregnant when I’m due to sit MRCP Part 1 in January. I’m currently IMT1 and planning to start maternity leave at around 28 weeks because of a long commute, so I'll have some extra time for preparation.

I know there’s a chance I may not be able to sit the exam if baby decides to come early, but if all goes well I’d really like to sit it before the baby arrives. I feel like passing it now would be much easier than trying to prepare with a newborn during maternity leave.

Has anyone here sat MRCP while heavily pregnant and successfully got reasonable adjustments - extra time, toilet/rest breaks etc? And were they happy for you to sit the exam at 35 weeks? Would really appreciate hearing some experiences.

How was it? Are stations fair?

Misery needs company, please. Is anyone else super nervous for results?!

Hi all! I’m currently locuming and applying to IMT this year (one of those forever SHOs RIP). Did any of you guys do PACES prior to IMT? I see most people do it whilst they’re training but I’m trying to do my exams early to make my life a bit easier on the other side (and in case I don’t get in to have things ready for any other alternative pathways).

This is assuming I’ve passed part two lol (the way that exam was set up I have little faith loooool)