Introduction

This guide provides a detailed overview of MRCPsych Paper B—from its purpose and structure to the syllabus, eligibility criteria, application process, and core study strategies. Whether you are a UK-based trainee or an international medical graduate (IMG) seeking broader opportunities, this blog post will help you navigate each phase of preparing for and taking this important examination.

 What Is MRCPsych Paper B and Why It Matters

Position in the MRCPsych Pathway

• The MRCPsych exams comprise:
  
  • Paper A – focusing on basic sciences such as neuroscience, psychology, and pharmacology fundamentals.
  • Paper B – emphasizing clinical application, psychopharmacology, advanced therapies, and the critical review of research.
  • CASC (Clinical Assessment of Skills and Competencies) – a practical exam using simulated patient scenarios.

Paper B builds on the theoretical groundwork from Paper A. It tests your readiness to apply clinical knowledge in real-world psychiatric settings. Passing Paper B indicates that you are equipped with the clinically relevant competencies and critical appraisal skills needed for higher specialty training and, ultimately, for consultant-level practice.

Global Recognition and Career Mobility

• UK Training Progression: Paper B is required for moving from Core Training (CT) to Specialty Training (ST).
• International Advantage: The MRCPsych credential is acknowledged worldwide, facilitating career prospects and potential consultant roles in various countries.
• Breadth of Clinical Knowledge: Preparing for Paper B consolidates expertise across subspecialties—beneficial for long-term clinical reasoning, teaching, and leadership in psychiatry.

 Exam Structure and Focus

Core Format

• Duration: 3 hours.
• Number of Questions: 150 total.
• Question Types:
  
  • Multiple Choice Questions (MCQs): Approximately two-thirds (~100 questions). Each MCQ uses a single-best-answer format.
  • Extended Matching Items (EMIs): Approximately one-third (~50 questions). Each EMI has a list of possible options to match with different clinical scenarios.

Content Breakdown

Paper B is divided into two major components:

1. Clinical Topics (around 100 marks)
2. Critical Review (around 50 marks)

Clinical Topics

Covers a broad range of psychiatric subspecialties and issues, including:

• General Adult Psychiatry (approx. 20% or ~30 marks)
• Old Age Psychiatry (9% or ~14 marks)
• Child and Adolescent Psychiatry (9% or ~14 marks)
• Psychiatry of Learning Disability (5.5% or ~8 marks)
• Forensic Psychiatry (5.5% or ~8 marks)
• Substance Misuse/Addictions (6.5% or ~10 marks)
• Psychotherapy (5.5% or ~8 marks)
• Organisation and Delivery of Psychiatric Services (5.5% or ~8 marks)

Critical Review

• Marks: ~33.5% of total (50 marks).
• Emphasis: Statistical analysis, research methods, epidemiology, healthcare economics, and applying findings to practice.
• Skills Assessed: Critical appraisal of evidence, recognizing biases in research, understanding study design, and applying evidence-based medicine principles to psychiatric cases.

Time Management and Marking

• No Negative Marking: Candidates do not lose marks for incorrect answers, so it is always best to attempt every question.
• Criterion-Referenced Standard Setting: The pass mark is determined by the Royal College based on the “minimally competent candidate,” rather than by ranking candidates against each other.
• Pacing: With 150 questions in 180 minutes, average ~72 seconds per question. Plan enough time for reading, reasoning, and revisiting flagged items.

 Differences Between Paper A and Paper B

• Paper A: Tests foundational knowledge—neuroscience, pharmacology basics, psychology, and other core sciences that underpin psychiatric practice.
• Paper B: Focuses on applied clinical psychiatry, psychopharmacology, advanced therapies, and critical appraisal of scientific literature.
• Complementary Roles: Mastery of basic sciences (Paper A) supports clinical decision-making (Paper B). Both must be passed before attempting the CASC.

 Eligibility Criteria

Professional Registration

• Must be a fully registered medical practitioner.
• For UK-based candidates, current General Medical Council (GMC) registration is typical.
• International Medical Graduates (IMGs) should have registration with their national medical council or equivalent.

Minimum Psychiatric Experience

• A minimum of 12 months of core psychiatric training (or equivalent clinical exposure) is strongly recommended before attempting Paper B.
• This exposure ensures familiarity with real-world psychiatric cases—knowledge that is vital when answering clinically oriented questions.

IMGs and Qualification Recognition

• IMGs must hold a recognized primary medical qualification, often verified via the World Directory of Medical Schools.

 Key Dates and Exam Logistics

Annual Exam Sittings

Paper B typically has three exam diets per year—often in February (or early Spring), May/June, and October. For the 2025 cycle, the schedule might look like:

Exam Delivery and Centers

• Online Computer-Based Testing: Recently, the College has been delivering the written exams (including Paper B) through an online format with remote proctoring.
• In-Center Testing: Some centers may offer in-person computer-based testing, depending on local regulations and availability.
• CASC vs. Paper B: Keep in mind that the CASC exam is still offered at specific physical test centers (e.g., Sheffield in the UK, Singapore, Doha) but differs from the written Paper B logistics.

Fees and Budgeting

For 2025, Paper B fees typically are:

• £508 for Pre-Membership Psychiatric Trainees (PMPT) and College Affiliates
• £564 for non-PMPT trainees and affiliates

Fees can change yearly. Always refer to the most updated fee schedule from the Royal College. Additional costs may include:

• Revision Courses (optional but can be helpful)
• Travel or Visa Expenses (if choosing an in-person center abroad)
• Study Materials (question banks, textbooks)

 Application and Registration Process

Create/Access Your Online Account

• Visit the Royal College of Psychiatrists (RCPsych) Exams portal.
• New users must register for a web login; returning users should verify details are up-to-date.

Complete the Application Form

• Provide personal information (name exactly as in ID documents).
• Upload primary medical qualification and registration certificates.
• Document psychiatric training history (especially if you need to prove 12 months of experience).
• Identify which written paper (Paper B) you are applying for.

Pay the Examination Fee

• Payment is typically via credit or debit card (Visa/MasterCard).
• You will receive two emails:
  
  1. An application confirmation, and
  2. A payment confirmation.

Book Your Exam Slot

• Once approved, choose your test center or remote proctoring slot via Pearson VUE (or the designated testing platform).
• Book early to get preferred locations or times.

Receive Exam Confirmation

• An admission permit or confirmation document is usually emailed or available in your RCPsych account.
• Print or save it for exam day identification.