For many overseas psychiatrists, as well as UK based trainees, the MRCPsych exams can be overwhelming. Where do you turn for study materials? How do you prepare for the exams? What are the exams dates and fees? Where can I sit the exam? How can I find support online?
To help a little, in this blog we will explore MRCPsych Paper A and everything that you need to know about how to sit the exam, taking a detailed look at the following topics:
An overview of MRCPsych
What is MRCPsych Paper A?
How is the exam structured and marked?
Am I eligible to sit this exam?
As an international psychiatrist, when and where can I sit the exam?
Where and how do I apply?
How much will the exam cost?
What is the best way to prepare for MRCPsych A?
#IMG Tips
Passed? What next?
If you know what you're looking for, skip ahead to the relevant section!
An overview of MRCPsych
The MRCPsych exams are the central components of psychiatry training in the UK. The examination series is designed to test the candidate’s knowledge of basic medical sciences as well as the clinical skills needed for diagnosis and management within psychiatry.
Full MRCPsych satisfies the postgraduate requirements for full GMC registration for international psychiatrists taking this route towards working in the UK.
The exams within the series are as follows:
MRCPsych Paper A
MRCPsych Paper B
MRCPsych CASC
For a more general overview of the MRCPsych examinations via our IMG Resources, please click here.
MRCPsych Paper A
Paper A is a three-hour written exam covering the scientific and theoretical basis of psychiatry.
The exam, comprised of 150 questions, is worth 150 marks:
two-thirds multiple choice questions (MCQ), and
one-third extended matching item questions (EMI)
Exam structure and marking
Paper A covers the following sections of the current syllabus:
The percentage split and marks allocation on the 150-mark exam is broken down as follows:
Section
Percentage
Marks
Behavioural Science and Socio-cultural Psychiatry
16.67%
25 marks
Human Development
16.67%
25 marks
Basic Neurosciences
25%
37 - 38 marks
Clinical Psychopharmacology
25%
37 - 38 marks
Classification and Assessment in Psychiatry
16.67%
25 marks
Eligibility
Trainee psychiatrists from any country in the world can sit the MRCPsych examinations providing that they meet the eligibility requirements.
You are eligible to sit Paper A if you are a fully registered medical practitioner.
Exam locations and dates
We have good news – in response to the COVID-19 pandemic, the Royal College of Psychiatrists has made the decision to move all MRCPsych exams online! This means you can sit the MRCPsych exams from your home country with submission and preparation details available on the Royal College website.
This change makes it immensely easier for international doctors to complete their Royal College exams and work towards GMC registration within a normal timeframe and with reduced disruptions.
Examination dates (at the time of writing) are as follows:
Examination Date
Application Period
Results Publication Date
1 December 2022
26 September - 7 October 2022
15 February 2023
Exams are usually held twice a year – and we will regularly check the Royal College website for updates and changes.
Applications
To apply, you’ll need to complete the Royal College online application form. This form is only available during the published application dates and must be submitted prior to the closing date. If you miss the cut off, your application will not be considered.
For new overseas candidates, you will need to register for a Royal College login first.
You will need to provide the following:
Personal details
Primary Medical Qualifications & Registration
Training
Written paper selection
Fees
At the end of your application, you will be directed to an online payment system where you can pay by credit or debit card, so make sure you have your details ready.
Once your application is complete you will receive two confirmation emails, one to confirm receipt of the application and one to confirm the payment has been received.
See below for MRCPsych Paper A fees for 2021:
PMPT Trainees and Affiliates (UK & Ireland Centres) - £486
Non-PMPT Trainees and Affiliates (UK & Ireland Centres) - £539
Preparation
With lots of resources available online, we have discussed with our IMG Psychiatry Community the best place to start looking for materials relating to the exams. Most IMGs recommended starting with the Royal College, who have created useful resources to help you to prepare for the exams. We’ve collated these below:
Syllabus: We always suggest that this is the best place to start – plan your study around the curriculum topics and make a road map to your success in the exams. You can access this here.
Sample Papers: These will help you prepare and polish your exam techniques and are a good idea to regularly benchmark your knowledge against the syllabus. In addition, sample questions will help you work quickly on the day, you will already know what to expect. The sample papers can be found here.
Marking schemes: Candidates pass or fail the written papers based on their performance, and not how well you perform against other candidates. As such, it is a good idea to understand how the exam is marked, so you can maximise your exam skills and give yourself the best chance of a pass. Marking schemes can be found here.
Sample exam: These can help you understand the exact format of the exam and to familiarise yourself with the online exam environment. This is available here.
Online exam guidance: Detailed guidance written specifically to guide candidates in preparing for an sitting an online exam, including technology checks and timings. The guidance can be accessed here.
The Royal College also suggest taking a look at Passing the MRCPsych - an insider’s guide - a useful resource to help you to get over the first steps. This is available here.
#IMG Tips
Start early – preparation is key and the best way to avoid last-minutes stress and cramming.
Use the Royal College website – this should be your best friend...or at least one of them. There are so many useful resources on these – what better place to start your revision?
Join our online support community - for all things psychiatry, including access to a community of likeminded psychiatrists and MRCPsych aspirants, follow IMG Connect on social media and join the conversation.
Passed? What next?
If you are completing the papers in order, the next step will be to apply for Paper B. For more information take a look at our blog where we explore MRCPsych Paper B and everything you need to know about how to sit the exam, including syllabus, dates, results, fees and preparation.
For more useful blogs & articles on the MRCPsych exams, registrations & qualifications to help you find your dream job in the NHS - take a look at our IMG library.
Good luck in your MRCPsych Paper A exam!
In response to the high number of inquiries we've had from overseas pathologists about the arrangements for the Autumn sitting of the FRCPath Histopathology Part 2 exam, we've been in contact with the Royal College of Pathologists and have summarised these updates under the headings below.
When will the FRCPath Histopathology Part 2 exam be held?
The publicised dates for the exam are Tuesday 11 and Wednesday 12 October 2022, although these are subject to change due to the ongoing COVID-19 pandemic.
The withdrawal deadline for the exams is Friday 15 July 2022.
Can I sit the FRCPath Histopathology Part 2 exam in Autumn 2022?
The RCPath guidance which asks candidates to wait to sit the Part 2 exam the year after passing the Part 1 exam was in place to avoid overwhelming the limited capacity of the exam centres. Those who were successful in the Spring 2021 Part 1 exam are able to sit the Part 2 exam in Spring 2022. If the College needs to prioritise bookings, it will be done in the same way as previously. Therefore, if there is a requirement for candidates who have passed in Spring 2022 to wait until Spring 2023 to apply, a notice will be put on the News section of the examinations page around the end of May/ beginning of June.
It is therefore important to check regularly for updates to the examinations page, which you can do here.
Where can I sit the FRCPath Histopathology Part 2 exam in Autumn 2022?
Details on the Autumn 2022 sitting of FRCPath Part 2 have yet to be finalised, however, unlike Spring 2022, it may be possible to arrange to sit the exam in Irbid (Jordan), Dubai (UAE) or Cairo (Egypt) if there are sufficient applicants. The availability of FRCPath Part 2 examination centres outside the UK will be indicated on the Royal College website (when the application window opens for Autumn 2022 at the end of May) and candidates should contact the Examinations Department to express their interest in taking the exam in the available centre when they make their application.
We therefore advise that you keep an eye on the RCPath application page here.
Will the College have any microscopes available for me to use for the exam?
The College's overall policy is that the College and centres have no obligation to provide microscopes. Candidates can bring their own as this is equipment they are familiar with, or can hire a microscope. Some overseas centres may be more able to provide microscopes and if that is the case it would be stated on the letter sent to candidates with their centre confirmation.
If you would like to borrow a microscope for your FRCPath Histopathology Part 2 exam, we advise that you check well in advance what the options are for your chosen centre, or are available to you online.
If you have any further questions about the FRCPath exams, your route to the UK as an overseas histopathologist, or any other aspect of GMC Registration, the NHS or relocating to the UK, please get in touch with us here.
We'd also like to invite you to join the IMG Histopathologists online community - as well as support on Royal College exams, our Facebook group of international pathologists and dedicated pathology recruiters offers guidance on other aspects of working in the UK, including finding NHS posts and CESR.
Follow us on social media through the links below for regular news and updates on the Royal Colleges, relocating to the UK and working in the NHS:
IMGs often have questions about the best ways to prepare for the MRCPsych Paper B exam, particularly with a new exam format and so many online materials geared towards UK trainees and applicants.
So, what study materials, courses and support are available for international psychiatrists? Here we have compiled some of the best guidance and resources to help in your preparation for the Paper B exam. We will also address some of the changes in the availability of test centres and exam delivery as a result of the COVID-19 pandemic.
The topics we’ll cover are as follows:
What is MRCPsych Paper B?
How do I get started with my preparation?
What other resources are available?
How has the exam been affected by COVID-19?
#IMG Tips
Passed? What’s next?
If you know what you’re looking for, skip ahead to the relevant section.
If you’d like an overview of the entire examination series, take a look at the article published in our IMG Resources library here.
MRCPsych Paper B
Let’s begin with a quick recap of the second exam in the MRCPsych examination suite.
MRCPsych Paper B is a three-hour written exam which asses critical review and the clinical topics in psychiatry.
The 150-mark paper comprises It is made up of around two-thirds multiple-choice questions (MCQ) and one-third extended matching item questions (EMI). One third of the paper covers critical review, with the other two thirds covering clinical topics.
The breakdown of the sections is as follows:
For full guidance on the structure of the exam, visit the examination page of the Royal College website or see our detailed blog on the MRCPsych Paper B exam here.
Preparation
It can be tough to know the best place to start, and after talking with some psychiatry consultants (both IMGs and UK trainees), the consensus was that the Royal College website is the best place to begin. There are some great resources on their website to help applicants to prepare for the exam. See below:
Syllabus: We always suggest that this is the best place to start – plan your study around the curriculum topics and make a road map to your success in the exams. You can find this here.
Current critical review syllabus: For Paper B, candidates will need to ensure that they make optimal use of the MRCPsych Paper B critical review - evidence-based practice syllabic content, available here.
Sample Papers: These will help you polish your exam techniques and are a good way to regularly benchmark your knowledge against the syllabus. Additionally, they will help you work quickly on the day as you will already know what to expect. The samples can be found here.
Marking schemes: Candidates pass or fail the written papers based on their performance. As such, it is a good idea to understand how the exam is marked so you can maximise your exam skills, giving you the best chance of a pass. These can be accessed here.
Sample exam: These can help you understand the exact format of the exam and to familiarise yourself with the online exam environment. This is available here.
Online exam guidance: Detailed guidance written specifically to guide candidates in preparing for an sitting an online exam, including technology checks and timings. The guidance can be accessed here.
The Royal College also suggest taking a look at Passing the MRCPsych - an insider’s guide - a useful resource to help you to get over the first steps. This is available here.
Other resources
IMG Connect has a library of written resources geared towards preparation for the Paper B exam. If you’re interested in any of these, please get in touch here and we would be delighted to share these with you.
Other online resources available for the exam include a mixture of paid and free resources. These include:
SPMM Starter Study Materials: A range of comprehensive study materials and subject-based question banks with evidence-based answers and explanations (SPMM HiYield and SmartRevise). These are available for 6 months from the date of purchase for the price of £299 and can be found here.
SPMM Video Lectures: A course covering the most important questions pertaining to clinical and critical appraisal topics. This is delivered through 19 hours of viewing - 10.5 hours of clinical topics and 8.5 hours of critical appraisal. Also provided is a PDF of Q-Bank to print and practice. These are available for 3 months from the date of purchase for the price of £199 and can be found here.
Brainscape Flashcards: Sets of web and mobile flashcards with hundreds of questions across all of the syllabus covered in the MRCPsych Paper B exam. This free resource can be used as either revision or practice material and is available here.
Superego Café Question Bank: This question bank provides over 500 multiple choice questions to help you prepare for your examination. The question bank includes constantly updated revision questions and is available as a mixed variety to reflect the MRCPsych Paper B examination. This can be accessed here.
BMJ Revision Questions: The BMJ has created an app-based revision resource with over 270 core questions, including the SBA and EMQ formats that will be seen in the exam. They are available at several price points dependent on the duration of access, from £29.99 for one month to £129.99 for 12 months. These are available here.
Get Through MRCPsych Paper B: Written by authors with recent exam success, the book provides candidates with realistic and up to date MCQ and EMIs, closely matched to themes appearing most often in the Paper B exam. This can be found here.
TrickCyclists Exam Notes: A series of psychiatry notes specifically tailored to the MRCPsych Paper B exam, including the nine topics covered by the exam and more. They are available in word and PDF format and are free to be used, distributed and modified. They are available here.
Courses
The SPMM and MRCPsychMentor resources are the most highly recommended by IMG psychiatrists we have spoken to and are available in different formats depending on your revision needs.
MRCPsych Mentor Mock Exam
A three-hour long exam which simulates exam conditions with a mock exam paper comprising new questions not available in the question bank. It includes a revision mode, timed tests, extensive performance analysis and powerful question review functions.
Duration
6 weeks
Cost
£15
Next start date
On demand
Website
www.mrcpsychmentor.com/mocka/index.php
SPMM Booster Mock Exams
These practice tests are simulations of the real exam prepared to the exam blueprint, allowing you to identify your weakest areas before the actual exam. This package includes access to 6 individual practice papers, comprising reconstructed questions from the most recent exams. Subscriptions can be purchased only 10 weeks before the College exam date.
Duration
N/A
Cost
£249
Next start date
On demand
Website
spmmcourse.com/local/coursepackages.php
IMG Psychiatrists MRCPsych Paper B Crash Course
This is a tailored MRCPsych Paper A course for overseas psychiatrists. This course offers weekly sessions covering the exam and its various domains. This is accompanied by practice MCQs and EMQs for exam-style practice, delivered by an experienced NHS psychiatrist and specialist psychiatry recruiters. These sessions are completely free to all doctors.
The course is supplemented by additional advice and guidance on MRCPsych as a whole, GMC registration support, as well as guidance and webinars on other topics such as finding work in the NHS, relocation support and specialist registration.
You can access our IMG Psychiatrists Paper B Study Course by joining the Facebook group here.
How the exam has been affected by COVID-19
As a result of the pandemic, all MRCPsych exams have moved online. Applicants from Singapore and Hong Kong who intended to sit exams in local centres are also invited to apply for the online sitting of the exam. You can learn more about the online exams for MRCPsych in the blog we've written here.
The application process for the exam takes 15 – 20 minutes where candidates will need a valid debit/ credit card, as well as the email address and full details of your sponsor. Further details on the application process can be found here.
#IMG Tips
Start your revision early – starting in advance allows you to pace yourself and get ahead of the stresses of last-minute revision and anxiety.
Build on your existing knowledge and experience – you’re being tested on things which you’ll likely be familiar; take your experiences and use that to bolster any new information you learn through your revision.
Think about your personal learning style and use this to plan effective revision - consider the ways you study best and use them to your advantage; take what’s available online and maximise their impact on your preparation.
Maintain a work-life balance – whilst you should dedicate time to study for the exam, it’s important to avoid burnout by setting aside time away from work and revision to reset and clear your mind.
Join the online psychiatry community - for news and updates about all things psychiatry for IMGs, follow IMG Connect on social media and join the conversation here.
For regular news and updates on the Royal College and all things histopathology, follow IMG Connect on social media using the links below:
Passed? What next?
Great stuff, this is a massive achievement and you deserve to put your feet up for a while! After a well-earned break, you can apply to sit the CASC exam, which you are eligible for once you’ve passed the MRCPsych Paper A and Paper B exams. For more information, take a look at our blog we will explore MRCPsych CASC and everything that you need to know about how to sit the exam, including syllabus, dates, results, fees and preparation.
For more useful blogs & articles on exams, registrations & qualifications to help you find your dream job in the NHS - take a look at our IMG Resources library.
Overseas medical oncologists looking to register with the GMC through the postgraduate qualification route will need to attain Membership of the Royal College of Physicians (MRCP UK).
Here we take a closer look at the MRCP (UK) examinations for doctors who have chosen their specialism in medical oncology, including a breakdown of each exam, fees and eligibility.
International Medical Graduates (IMGs) from any country in the world can sit the MRCP examinations, provided certain eligibility criteria are met. These are summarised below along with a broad look at the following topics:
What is MRCP (UK)?
Where does MRCP fit into my oncology training?
How are the MRCP exams structured?
Eligibility for overseas doctors
How do I apply for the exams and what do they cost?
Where can I sit the exams as an overseas medical oncologist?
How should I prepare for the exams as an IMG?
I’ve passed, what’s next?
Skip ahead to the relevant section if you know what you're looking for.
What is MRCP(UK)?
The Royal College of Physicians is the professional body responsible for the specialty of medicine throughout the UK. Among many other duties, its role is to set and monitor the educational curriculum for those training to enter the profession.
As medical oncology comes under the umbrella of medicine, the postgraduate exams for medical oncologists are set and delivered by the Royal College of Physicians. For clinical oncologists, the Royal College of Radiologists are the overseeing body for training and exams. You can learn more about the clinical oncology postgraduate route here.
The MRCP examinations assess a candidate’s knowledge of basic medical sciences, as well as clinical skills required for the diagnosis and management of disease. The exams are designed to test both applied basic science and principles of medicine to the level of a UK trainee with two to three years postgraduate experience.
Therefore, completion of MRCP will allow you to work in the UK from ST3 level upward, with seniority beyond ST3 level dependent on experience.
MRCP (as a postgraduate qualification) is one of the two main routes an overseas doctor can take to gain full GMC registration, the other being the PLAB route. For in-depth information on each of the MRCP exams, see our IMG Resources library here.
MRCP as Part of Training in Oncology
Full MRCP (UK) is a requirement for all oncologists wishing to go on to a specialty training post in the UK.
For doctors who wish to find more senior roles in the NHS which are reflective of their current practice and experience, IMG Connect advise that MRCP (UK) would be the best route to take to GMC registration.
MRCP (UK) Exams Structure
The MRCP exam has three parts as outlined below:
MRCP (UK) Part 1
The first exam in the MRCP exam suite tests a sample of medical knowledge skills and behavior are specified in the UK specialty training curriculum for core medical training / internal medicine training.
The first examine that MRCP suite is designed to assess the candidate's knowledge and understanding of the clinical silences relevant to medical practice and of common or important disorders to a level appropriate for entry to specialist training.
The examination has a two-paper format - each paper is 3 hours long and contains 100 multiple choice questions in a ‘best of five’ format. The paper both tests core knowledge and comprehension as well as a candidate's ability to interpret information and solve clinical problems.
Each question has five options: one correct answer and four alternatives to the correct answer.
The exam is also designed to help prepare candidates for the more challenging Part 2 written and PACES exam.
Specialty
Number of questions
Cardiology
14
Clinical Pharmacology and Therapeutics
15
Clinical sciences
25
Dermatology
8
Endocrinology, diabetes and metabolic medicine
14
Gastroenterology and Hepatology
14
Geriatric medicine
8
Haematology
14
Infectious diseases
14
Neurology
14
Oncology
5
Medical ophthalmology
4
Palliative medicine and end of life care
4
Psychiatry
9
Renal medicine
14
Respiratory medicine
14
Rheumatology
14
Total
200
For more detailed information on the content of the exam, see the Royal College website here.
MRCP (UK) Part 2
The second exam in the exam suite builds on the knowledge assessed in Part 1 and again tests the acquisition of a representative sample of medical knowledge skills and behavior.
The questions will usually have a clinical scenario, may include the results of investigations and may be illustrated with images such as clinical photographs, pathology slides, inheritance trees ECGs, X-rays, CT and MR scans and echocardiograms.
Questions are asked about the diagnosis investigation management and prognosis of patients using multiple choice questions in a ‘best of five’ format.
Specialty
Number of questions
Cardiology
19
Clinical Pharmacology and Therapeutics
18
Dermatology
9
Endocrinology, diabetes and metabolic medicine
19
Gastroenterology and Hepatology
19
Geriatric medicine
9
Haematology
9
Infectious diseases
19
Medical ophthalmology
3
Neurology
17
Oncology, Palliative medicine & end-of-life care
9
Psychiatry
3
Renal medicine
19
Respiratory medicine
19
Rheumatology
9
Total
200
For more detailed information on the content of the exam, see the Royal College website here.
MRCP (UK) PACES
The MRCP (UK) Practical Assessment of Clinical Examination Skills (PACES) assesses a candidate’s ability to carry out essential clinical skills.
There are five clinical stations where there are either patients with a given condition, or trained stand-ins (surrogates). At each station, there are two independent examiners who will observe and evaluate the candidates' performance.
PACES Carousel
For more detailed information on the content of the exam, see the Royal College website here.
Eligibility for Overseas Medical Oncologists
Part 1
To be eligible for MRCP (UK) Part 1, you must have a GMC recognised Primary Medical Qualification and a minimum of 12 months postgraduate experience in medical employment.
Part 2 & PACES
To be eligible for MRCP (UK) Part 2 & PACES, you must have passed Part 1 within the last seven years.
Please note, whilst it is not essential to successfully complete Part 2 to sit PACES, the Royal College strongly advises you to do so, as pass-rates are much lower for those who sit PACES before passing Part 2.
Applications
Applications for all MRCP exams are made online through My MRCP(UK) account, via the Royal College website. You will need to create an account and submit evidence of your primary medical qualification, then make a payment online to confirm your application.
The cost of the MRCP exams are as follows:
Candidate
Part 1
Part 2
PACES
UK
£460
£460
£657
International
£616
£616
£1,202
Exam Centres
The MRCP exams are held 4 times a year and can be sat in several locations around the world, including the UK, Manama, Dhaka, Cairo, Accra, Hong Kong, Reykjavik, Chennai, Hyderabad, Kerala, Kolkata, Mumbai, New Delhi, Erbil, Amman, Nairobi, Kuwait City, Kuala Lumpur, Malta, Kathmandu, Muscat, Karachi, Lahore, Doha, Jeddah, Riyadh, Singapore, Sri Lanka, Khartoum, Abu Dhabi, Dubai, New Jersey, Barbados, Jamaica, Trinidad and Harare.
Please note that the number of sittings for each exam varies between countries – you can find the full list of cities and dates here.
The Part 1 and Part 2 exams are held online in the UK for candidates within the UK and Republic of Ireland.
During the COVID-19 pandemic, there is limited availability of spaces for the PACES exam, and whilst every effort will be made to provide as many places as possible, if the number of applications for the exam exceeds the places available, candidates in UK training will be prioritised.
Preparation and Resources
With lots of resources available online, we have discussed with IMGs the best place to start looking for materials relating to the exams. Most IMGs recommended starting with the Royal College, who have created useful resources to help you to prepare for the exams. These include:
Curriculum: Applicants are tested on a range of common and important disorders in General Medicine as set out in the Joint Royal Colleges’ Specialty Training Curriculum for Core Medical Training. We recommend getting to know the curriculum as early as possible and using it as a roadmap for your study.
Sample questions for Part 1 & Part 2: It is a good idea to regularly benchmark your knowledge by testing yourself using example questions from the current exam syllabus provided by the Royal College see below:
Part 1
Part 2
PACES scenarios: To familiarise yourself with the format of the PACES exam, take a look at sample scenarios from the stations. You can find these here.
IMG Oncologists
Join the IMG Oncologists Facebook group for access to a community of like-minded MRCP aspirants and dedicated oncology recruiters.
In this group you will find tailored resources for oncology IMGs, including access to our MRCP crash courses, completely free to all doctors.
You can access our IMG Oncologists community here.
For an overview of how to prepare for exams, including advice on study groups, online community support, the best use of online resources & Royal College materials and courses, take a look at our blog: IMG Connects Top Tips for exam preparation.
For more information on the MRCP exams including structure, preparation, dates and a content drill down, see the blogs we’ve written on each part of the examination suite:
MRCP (UK) Part 1
MRCP (UK) Part 2
MRCP (UK) PACES
I’ve passed, what’s next?
First of all, congratulations! This is a massive achievement and you deserve to put your feet up after all that hard work. With full MRCP, you can now apply for a full GMC registration with a license to practice (once you’ve passed an English language exam). Once the GMC has approved your application, you can work as a doctor in the UK. Nice one!
Get in touch
Don’t hesitate to contact an IMG oncology recruitment specialist to discuss GMC registration, oncology positions in the NHS, including typical NHS salaries, the most suitable UK locations and hospitals for you, and relocation.
For regular news and updates on the Royal College and all things oncology, follow IMG Connect on social media using the links below:
GMC Registration can be a long and complex process. With a few options available for demonstration evidence of skills and knowledge, it can be difficult for IMGs to decide the best route to take to register with the GMC.
For international doctors planning their route to the UK, there are essentially two main pathways to consider – postgraduate qualifications (for psychiatrists, this is MRCPsych) or PLAB.
Whilst these are the most common routes to GMC registration, this is not an exhaustive list. There are other options such as Royal College sponsorship and GMC-approved qualifications or licensing exams, and you can read more about these here.
Here we provide a summary of both of the main pathways and briefly consider their benefits.
PLAB for GMC Registration
MRCPsych for GMC Registration
Which is better for me as an overseas psychiatrist, PLAB or MRCPsych?
#IMG Tips
How do I get started?
Professional & Linguistics Assessment Board (PLAB)
The first and most common route we’ll be discussing, which tends to be popular among junior doctors, is PLAB.
PLAB is a two-part exam (one written and one practical element), which assesses whether a candidate is at least as capable as a doctor starting the second year of their Foundation Programme Training and can therefore work safely as an SHO in the NHS.
The GMC has a useful video summary of the PLAB exams which you can watch here, or for a more detailed overview, see our IMG Resources library.
MRCPsych - UK Postgraduate Qualification for Psychiatrists
The UK’s postgraduate qualifications are a more popular route for senior overseas doctors, and those looking to gain posts in the NHS which are reflective of their experience.
Within psychiatry, this can be done by attaining Membership of the Royal College of Psychiatrists. The Royal College of Psychiatrists is the professional body that regulates the specialism of psychiatry in the UK, and Membership of the College of the Royal College of Psychiatrists (MRCPsych) is the full qualification attained through these examinations. Take a look at our IMG Resources library for complete guides on MRCPsych to learn more.
PLAB vs MRCPsych
Both MRCPsych and PLAB are legitimate routes that demonstrate skills and knowledge and will allow you to register with the GMC and work in the UK. To decide which route is best for you, you’ll need to consider the benefits of each and how they align with your needs and priorities in moving to the UK.
Seniority of Positions in the NHS
It would be difficult for an overseas psychiatrist to obtain a more senior post in the NHS without either MRCPsych, a GMC-approved training programme, or extensive experience from a similar, English speaking healthcare system. PLAB alone will not give overseas doctors access to senior posts in the NHS.
Specialty Training
To practice as a consultant in the UK, you must have gone through specialty training and will need a GMC-recognised postgraduate qualification to do so, whether a qualification from the country in which you completed your specialty training, or MRCPsych.
Only one type of evidence is required to demonstrate skills and knowledge, so once you pass MRCPsych, you would not need to additionally sit the PLAB exams. However, due to the more specialised nature of MRCPsych, psychiatrists may want to sit the MRCPsych exams at a later date, to allow them access to more senior roles and competitive salaries.
Time
PLAB has two stages and can take anywhere between 3-9 months to prepare from start to finish.
MRCPsych has three stages, the last of which must be taken after at least 36 months of postgraduate experience in psychiatry and can take anywhere between 24-36 months to prepare from start to finish.
Cost
MRCPsych costs just under £2,000 for the three exams. All MRCPsych exams can now be sat online, so there is no longer the added expense of international travel. You can read about the changes to the exam format here.
PLAB costs £1,189, and both exams are sat in person. PLAB 1 can be taken in the UK or several overseas centres, which you can find here. PLAB 2 must be taken in the UK.
So, for PLAB 2, candidates will have to travel to the UK, meaning that the additional cost of visas, accommodation and flights must be factored in.
It’s important to note that these costs can rise if re-sits of the exams are necessary.
Summary
PLAB, as an exam which examines a doctor’s ability to work safely as a Senior House Officer (SHO), does not assess ability in psychiatry specifically. For this reason, PLAB tends to be a route for junior doctors who have not already chosen their field of specialisation in medicine, I.e., psychiatry.
PLAB allows doctors to enter the UK system much faster than other routes and for this reason alone, it is favoured by international doctors when considering their path to the UK.
MRCPsych involves three more difficult examinations and takes more time to prepare for. However, for overseas doctors, attaining MRCPsych will allow you to jumpstart your career in the UK, as you don't need PLAB or Core Training.
Additionally, MRCPsych will facilitate the application for more senior roles in UK psychiatry than PLAB.
#IMG Tips
Determine your priorities – your goals and timeline for relocating to the UK are important in deciding which route is best for, and this is different for everyone.
Plan well ahead – depending on the route you choose, you may be embarking on a long journey through these exams, so plan how you will fit them into your life and how best to prepare to maintain a good work-life balance at the same time.
Find a support network – once you know which exams you will sit, find a support network of others who are also preparing for the exam. A great way to do this is to join the IMG Psychiatrists Facebook group, an online psychiatry community of UK and NHS psychiatry aspirants and dedicated psychiatry recruiters. You’ll find advice, guidance and news and updates about all things psychiatry for IMGs. Join the conversation here.
Getting started
Once you’ve decided which exams are best for you, it’s time to delve deeper into the exams and what they entail. For more useful blogs and articles on PLAB or MRCPsych exams, registrations and qualifications to help you find your dream job in the NHS - take a look at our IMG Resources library.
Or if you have any questions on PLAB or postgraduate qualifications, please get in touch with our psychiatry recruiters here. They will be more than happy to help you.
To receive the latest news and updates on all things psychiatry, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation.
Are you an overseas psychiatrist preparing to take the MRCPsych CASC exam?
International doctors often have questions about how to prepare for the CASC exam, particularly when there are so many materials and information online which can be overwhelming or mostly geared towards UK applicants and trainees.
What study materials, courses and support are available for IMGs? Here we have compiled some of the best advice and resources available to help in your preparation for the exam.
The topics we’ll cover are as follows - skip to one of these sections if you know what you're looking for:
What is MRCPsych CASC?
How do I get started with my preparation?
What other resources are available?
#IMG Tips
How have the exams been affected by COVID-19?
What’s next for me?
If you’d like an overview of the entire examination series, take a look at the article published in our IMG Library here.
What is MRCPsych CASC?
Let’s begin with a quick recap of the CASC exam. The Clinical Assessment of Skills and Competencies or CASC is a practical exam which takes the format of an OSCE and tests your clinical skills in a range of competencies.
It is made up of two circuits of individual stations made up of:
Five stations on history taking, including risk assessment
Five stations on examination, including physical and mental state
Six stations on patient management
For full guidance on the structure of the exam, visit the examination page of the Royal College website or see our detailed blog on the MRCPsych CASC exam here.
Getting started with preparation
It can be tough to know the best place to start, and after talking with some psychiatry consultants (both IMGs and UK trainees), the general consensus was that the Royal College website is the best place to begin. There are some great resources on their website to help applicants to prepare for the exam.
Royal College Materials
Syllabus: this is the best place to start - you should always plan your study and preparation around the topics within the curriculum to start you off on the best path to success. You can find this here.
CASC candidate guide: this handy guide contains information on domain-based marking, candidate instructions, pass mark, exam criteria and grade descriptors, which you can access here.
Blueprint: the CASC blueprint is a more detailed breakdown of the skills being assessed within the exam and the categories and stations candidates should expect to find. This is available here.
Marksheets: copies of the marksheets which are used in the exam are available online for history, management and examination and allow candidates to familiarise themselves with the marksheets in advance, found here.
Sample stations videos: you can watch videos of sample stations from a face-to-face examination – this will be similar to what you can expect on the day as the principles will remain the same for online exams. You can access these here.
What other resources are available?
IMG Connect have a library of written resources geared towards preparation for the CASC exam. If you’re interested in any of these, please get in touch here and we would be delighted to share these with you.
Other online resources available for the exam include a mixture of paid and free resources. These include:
Books
These are the most highly rated books for MRCPsych CASC on Amazon:
Pass the CASC for MRCPsych – Seshni Moodliar (£34.70)
Get Through MRCPsych CASC – Melvyn W. B. Zhang (£45)*
How to Pass the MRCPsych CASC – Andrew Iles (£33.99)
* Get Through MRCPsych CASC is particularly highly regarded by recent CASC candidates who have passed the exam.
Other resources
Passing the MRCPsych Exams – an insider’s guide: a useful guide to the MRCPsych CASC exam written by former trainees and members of the Psychiatric Trainees’ Committee (PTC). This can be found here.
MRCPsych CASC flashcards: flashcards created by a former candidate who has passed the exam. 136 flashcards which cover different aspects of the exam. These are available for free here on Brainscape.
CASC Cluster Cards – Oxfordpsych revision cards written by a consultant psychiatrist in the UK. This is a set of 100 CASC scenarios with instructions and guidance to remember. These can be found here at a cost of £169.
CASC Videos – SPMM: 86 exam stations performed by consultants and role players under exam conditions, featuring advice and tips from examiners for each task. 6 months access is priced at £180 and is available on demand. These are available here.
Oxfordpsych – access to the Oxfordpsych online video bank featuring short and long instruction CASC stations, covering the range of stations and tasks listed in the CASC blueprint. 6 months access costs £169 and £99 for 3 months and can be found here.
Online courses
CASC Prepare mock exam
This exam consists of 16 stations which have all featured in previous RCPsych CASC exams. The mock will be conducted in the format of the actual exam and detailed written feedback on RCPsych marking sheets will be provided after the exam. Other aspects of the exam such ass time management, and communication strategies will also be discussed.
Duration
4 hours
Cost
£310
Next start date
Ongoing
Website
https://www.cascprepare.com/mock-exam
Oxfordpsych CASC mock exam
These online exams are based on the RCPsych CASC blueprint. Candidates take the 16 stations under exam conditions and interview with professional actors with CASC experience. Candidates will receive written feedback for each station.
Duration
4 hours
Cost
£475
Next start date
Autumn 2022
Website
http://www.oxfordpsychcourse.co.uk/index.php/online-registration
CASC Master mock exam
This mock exam is carried out over skype or zoom and has 8 continuous stations with one 20-minute break, followed by the final 8 stations. It is set according to the CASC blueprint and is available with or without an actor.
Duration
4 hours
Cost
£325
Next start date
TBC
Website
https://www.cascmaster.com/skypemockcasc
IMG Psychiatrists MRCPsych CASC Crash Course
This is a tailored MRCPsych CASC course for overseas psychiatrists sitting the CASC exam. This course offers weekly sessions covering the entire exam and its various domains, including marking and station requirements. This is accompanied by small group role play sessions to allow IMGs to practice stations across various scenarios with feedback on each station, delivered by an experienced NHS psychiatrist and specialist psychiatry recruiters. These sessions are completely free to all doctors.
The course is supplemented by additional advice and guidance on MRCPsych as a whole, GMC registration support, as well as guidance and webinars on other topics such as finding work in the NHS, relocation support and specialist registration.
You can access our IMG Psychiatrists CASC Study Course by joining the Facebook group here.
#IMG Tips
Start your revision early – starting in advance allows you to pace yourself and get ahead of the stresses of last-minute revision and anxiety.
Find the right materials for you – whether its online courses, books or flashcards, try to figure out what the best materials are to jumpstart your preparation
Speak to your peers and colleagues – your senior colleagues may have been through this process themselves and may have helpful tips and guidance to share. Or maybe you’ll find a like-minded peer with whom you can be study buddies! Take advantage of those around you to support you on this journey.
Practise, practise, practise - Our IMGs have shared that it’s crucial that you practice your clinical examinations as often as possible, preferably under the supervision of a senior colleague which will allow you to receive feedback.
Join our online psychiatry community - for news and updates about all things psychiatry for IMGs, follow IMG Connect on social media and join the conversation.
I've passed, what’s next?
Once you’ve passed MRCPsych CASC, you’ve completed the Royal College of Psychiatrists examination suite. Great stuff, this is a massive achievement! Armed with this and your English language test, you are ready to apply for full GMC registration with license to practice.
You may want to start looking for NHS jobs and with the click of a button, you can receive them directly to your inbox. To receive jobs postings which you can tailor to your desired grade, specialty and sub-specialism, sign up here.
If you have any questions about any element of CASC, the Royal College exams as a whole or any other queries related to the processes involved in IMGs coming to the UK to work in the NHS, please get in touch and our psychiatry specialist will be more than happy to assist you.
For access to a community of like-minded MRCPsych aspirants and dedicated psychiatry recruiters, join the IMG Psychiatrists Facebook group.
To receive the latest news and updates on all things psychiatry, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation.
Geriatric medicine SCE is the higher postgraduate qualification delivered by the Royal College of Physicians as a specialist qualification for geriatric medicine doctors.
It is one of 11 SCEs offered by the Royal College and offers physicians a postgraduate qualification which demonstrates to prospective employers the achievement of a standard equivalent to UK specialist doctors.
Here we take a closer look at the MRCP (UK) Geriatric Medicine Specialty Certificate Examination for doctors who have chosen to specialise in geriatric medicine. We cover the content of the exam, as well as fees and the eligibility criteria, all summarised below along with a broad look at the following topics:
What is the geriatric medicine SCE?
Where does the SCE fit into my training?
What is the structure of the geriatric medicine SCE?
How do I apply for the exams and what do they cost?
Where can I sit the exams as an overseas geriatric medicine doctor?
How should I prepare for the exams as an IMG?
I’ve passed! What’s next?
Skip ahead to the relevant section if you know what you're looking for.
MRCP (UK) Geriatric Medicine SCE
The geriatric medicine specialty certificate exams are administered as a compulsory component of assessment for Certificate of Completion of Training (CCT) in geriatric medicine for all UK trainees.
The purpose of an SCE is to:
ensure that certified specialists have sufficient knowledge of their specialty to practice safely and competently as consultants
complement workplace-based assessments
provide a rigorous national assessment to establish public confidence
offer a challenge similar to sub-specialty certification examination in North America
For in-depth guide to the MRCP exams, see our IMG Resources library here.
Geriatric Medicine SCE as part of UK training
Since the MRCP(UK) exams are taken during the Internal Medicine Training years (ST1-ST3), the geriatric medicine SCE allows physicians to demonstrate that they are able to practice independently at a consultant level.
The SCE has no official entry requirements (both for UK and overseas candidates); however, UK trainees would normally take the SCE in their penultimate year of higher specialty training (ST6). UK trainees should have made at least one attempt by the time of their penultimate year assessment.
Exam Structure
The SCE assesses candidates on a wide range of common and important disorders, as set out in the syllabus of the curriculum. This should be taken as an indication of the likely number of questions – the actual number may vary:
Acute Illness (Diagnosis & Management)
Number of questions
Anaemia/ Haematology
1
Cardiovascular Medicine
4
Dermatology
1
Endrocrine medicine
2
Gastroenterology
3
Infection
4
Musculoskeletal medicine
2
Neurology
4
Renal medicine inc. fluid/ electric imbalance
2
Respiratory medicine
4
Sensory impairment
2
Chronic Disease & Disability(Diagnosis & Management)
Number of questions
Anaemia/ Haematology
1
Cardiovascular Medicine
4
Dermatology
1
Endrocrine medicine
3
Gastroenterology
3
Infection
4
Musculoskeletal medicine
4
Neurology
4
Renal medicine inc. Fluid/ electric imbalance
3
Respiratory medicine
4
Sensory impairment
2
Cognitive Impairment
Number of questions
Delirium
8
Dementia
12
Geriatric Assessment
Number of questions
Factors affecting health status
5
Measurement of health status
3
Subspecialty Topics
Number of questions
Palliative care
10
Old age psychiatry
7
Orthogeriatrics and osteoporosis
10
Stroke care
15
Tissue viability
6
Other
Number of questions
Basic science and gerontology
6
Continence
10
Falls and poor mobility
16
Surgical liaison
3
Intermediate care & long-term care
9
Nutrition
4
Rehabilitation, transfers of care
14
TOTAL
200
The questions in each category are distributed across both papers.
All SCEs are computer-based and are administered by Pearson VUE at a test centre in the UK or internationally.
Geriatric Medicine SCE Applications
SCEs are held once a year and applications are made online through My MRCP(UK) account, within the Upcoming Exams section of the Royal College website.
The application process is as follows:
Register online through My MRCP(UK) (candidates have the opportunity at this point to register any special arrangements)
Request a preferred test country and city
Pay applicable examination fee
Application is confirmed via an automatically generated email
Receive test centre confirmation email from Pearson VUE within four weeks of the examination date.
The Royal College of Physicians has created a helpful video guide on SCE applications which you can watch here.
Cost
The cost of the SCE exams are as follows:
UK centres: £665
International centres: £833
Exam Centres
UK Centres
Candidates who choose to sit the geriatric medicine SCE in the UK must contact Pearson VUE to book their test. There are up to 137 test centres throughout the UK for each SCE, and the Royal College of Physicians advise that candidates should book their exam as early as possible to secure their preferred test centre, as bookings operate on a first come, first served basis.
International Centres
Candidates are given a choice of regions and are then asked to nominate a particular city in that region as their desired test location. The Royal College of Physicians will pass this request to Pearson VUE once the application period has closed, and Pearson VUE will confirm final test centre details to candidates via email at least three weeks before the date of the examination. If the exam is not available in a requested location, candidates will be offered a choice of the nearest available test centres.
Please note, international candidates should not book their own test centre with Pearson VUE - attempting to do so may delay a candidate's application.
The full list of international SCE test centres can be found here.
Preparation and Resources for the Geriatric Medicine SCE
It can be difficult for IMGs to know where to start with their preparation and revision.
Preparation for the SCE requires a wide breadth of knowledge around the curriculum and should involve reading of textbooks, journals and guidelines. Experience of the MRCP (UK) examinations provides an excellent background to the format of the examination.
Curriculum: Applicants are tested on a range of common and important disorders in Geriatric Medicine as set out in the Joint Royal Colleges’ Curriculum for Geriatric Medicine Specialist Training. We recommend getting to know the curriculum as early as possible and using it as a blueprint for your study.
Sample questions: It is a good idea to regularly assess your knowledge and progress using example questions from the current exam syllabus. You can find these here.
For an overview of how to prepare for exams, including advice on study groups, online community support, the best use of online resources & Royal College materials and courses, check out at our blog here.
I’ve passed! What’s next?
First of all, congratulations - this is a massive achievement! With your MRCP (UK) and geriatric medicine SCE in hand, you can apply for a full GMC registration with a license to practice. Once the GMC has approved your application, you can work as a doctor in the UK. Great stuff!
Don’t hesitate to get in touch with an IMG medicine recruitment specialist to discuss GMC registration, geriatric medicine positions in the NHS, including typical NHS salaries, the most suitable UK locations and hospitals for you, and relocation.
To receive the latest news and updates, including the Royal Colleges, GMC registration and the NHS, follow us on social media and join the conversation.
The NHS offers an extensive training scheme and career development for histopathologists, and the quality and depth of this programme is recognised as a gold standard across the medical community.
The training provided to UK histopathology trainees is regularly reviewed and updated, in keeping with advances and progression in the landscape of pathology around the world and across the profession. This makes the training programme attractive to UK graduates, as well as overseas histopathologists seeking the best training programmes for their field.
In this article, we will explore the training pathway for histopathologists in the UK, covering the following topics:
What is the NHS Training Pathway?
How do you enter the training pathway?
What does the specialty training programme look like for histopathology?
What happens after completing the histopathology training programme?
Can I enter specialty training in the UK as an IMG?
The NHS Training Pathway
The NHS training pathway is the name given to the complete programme undertaken by UK trainees, from medical school to the completion of specialist training within I.e. within histopathology.
It is important for IMGs to understand this as it helps to provide an understanding of at what stage they can most likely enter the system if they are interested in training in the UK.
Entering the NHS Training Pathway
After graduating from medical school, doctors with receive provisional registration from the GMC which allows them to enter the Foundation programme (a two-year work-based training programme).
Upon completion of the first year (FY1), doctors will gain full registration with the GMC and will be able to apply for further study and training in a specialised area I.e. histopathology – this is known as Specialty Training (ST).
Specialty Training in Histopathology
The Specialty Training programme in Histopathology is 5 years long, and whilst doctors may pass through training quicker depending on how quickly they achieve their competencies, this is rarely the case and histopathologist will usually take the indicated time, or slightly longer to complete the Specialty Training programme.
Successful applicants entering into year one of specialty training (ST1), will follow the Royal College of Pathologist’s 2021 Histopathology Curriculum, which sets the expected syllabus as well as required assessments and workload case numbers.
Histopathology training as a run-through programme
Unlike some specialisms where you complete a period of core training before entering into specialty training (requiring two applications), histopathology specialty training works as a run-through programme. You only have to apply once, at the beginning of the programme, as you are recruited for the full duration of Specialty Training.
Foundation Training (FY1 – FY2)
The foundation programme usually involves six different rotations or placements in medical or surgical specialties. These rotations enable trainees to practise and gain competence in basic clinical skills.
Specialty Training (ST1 – ST5+)
ST1)
Year one trainees enter the training programme. In this first stage, trainees will initially develop knowledge of laboratory work, with basic training in all areas of cellular pathology.
Training starts with a 1-2 week induction from the training school. This includes some time in the lab seeing how specimens are prepared and processed. Trainees are taught how to use a microscope, how to approach simple cases under the microscope and the principles of macroscopic assessment and sampling (AKA ‘cut up’). Many training schools do a separate autopsy induction.
When not at block teaching weeks, trainees are rotating through the various specialities in histopathology.
ST2 – ST3
This part of training takes place from year 2 to year 3, with the focus on achieving the FRCPath Part 1 Exam. This will normally be taken after 18 – 24 months of training.
Trainees will consolidate and develop their knowledge base from ST1. Year two trainees are given more independence and are expected to be able to cut up most specimens by the end of this stage.
In many deaneries, this is the time when trainees complete rotations in sub specialities including paediatric pathology, neuropathology and oral pathology. Trainees may rotate to placements in local district general hospitals to gain valuable experience in managing a general histopathology workload.
Autopsy and cervical cytology training continue as mandatory elements of ST2-ST3. Some trainees choose not to continue these specialities when they have completed this stage.
The FRCPath Part 1 exam aims to determine whether you have successfully acquired a core body of knowledge that will underpin your ability to practise in Histopathology.
For more information of the first exam in the Royal College of Pathologists examination suite, take a look at our IMG Resources library here.
Please note, trainees must pass the FRCPath Part 1 examination at the end of ST3 in order to progress to ST4.
Selection
Here, trainees will either choose to continue with general histopathology or peruse subspecialisation in neuropathology, paediatric/perinatal pathology, cytopathology or forensic pathology.
ST3 – ST4
This training takes place from years 3 – 4, where trainees will either continue with general histopathology or peruse subspecialisation in neuropathology, paediatric/perinatal pathology, cytopathology or forensic pathology. Trainees are expected to be competent in the macroscopic and microscopic assessment of all specimens, and will also receive training in leadership, management and teaching in preparation for their future roles as consultants.
The focus during this stage is also on achieving the FRCPath Part 2 Exam, thereby obtaining the status of Fellow of the Royal College of Pathologists.
This final exam is designed to test your practical skills and understanding, and show that you can apply your expertise appropriately and safely.
Trainees who wish to continue in general histopathology may opt to sit further exams in cervical cytopathology and autopsy practice if they wish to continue these as a consultant.
To learn more about the final exam in the in FRCPath examination suite, read our detailed blog here.
Please note, trainees must pass the FRCPath Part 2 examination at the end of ST4 in order to progress to ST5.
ST5+
This is the final stage of training before CCT during which histopathology trainees may wish to peruse special interests in particular subspecialties, such as gastrointestinal, skin or gynaecological pathology. Having passed the FRCPath Part 2 exam, trainees will continue to take on responsibility to enable the transition to independent practice required of those with CCT, i.e. signing out reports without consultant review.
Completion of the Histopathology Specialty Training Programme
Upon completion of the training programme, the choice is made as to whether the trainee will be awarded a Certificate of Completion of Training (CCT) in Histopathology. This will be based on criteria set out in the curriculum by the Royal College. You can find the 2021 curriculum here.
At this point, the histopathologists are entered onto the specialist register and can now take permanent consultant posts in the NHS.
Specialist Registration for overseas doctors
Doctors who completed part or all of their histopathology training outside of the UK are eligible for specialist registration through the CESR or CESR-CP pathways. To learn more about specialist registration for overseas doctors, read our blog here.
Joining the Histopathology Specialty Training Programme as an IMG
It is possible for overseas doctors to join the Specialty Training programme in Histopathology in the UK, however it is very competitive.
IMGs interested in UK specialty training must have:
Full GMC registration
Completion of a minimum 12-month (FY1 equivalent) internship
English language test
PLAB
AND
12 months post-internship experience by the time you begin ST1
Although UK trainees are not given priority for specialty training places, it can be very difficult to join the Specialty Training programme without NHS experience.
So here you have it, the NHS Specialty Training pathway for trainees in a nutshell. This training scheme is the core of training for histopathologists in the UK, and for IMGs looking to join the training programme, understanding of the pathway allows you to better align your overseas training with the relevant stage you would enter into Specialty Training in the UK.
If you have any further questions about your route to the UK as an overseas histopathologist, FRCPath, or any other aspect of GMC Registration, the NHS or the UK, please get in touch with us here.
We'd also like to invite you to join the IMG Histopathologists online community - as well as support on Royal College exams, our Facebook group of international pathologists and dedicated pathology recruiters offers guidance on other aspects of working in the UK, including finding NHS posts and CESR.
Follow us on social media through the links below for regular news and updates on the Royal Colleges, relocating to the UK and working in the NHS:
Respiratory medicine SCE is the higher postgraduate qualification delivered by the Royal College of Physicians as a specialist qualification for respiratory medicine doctors.
It is one of 11 SCEs offered by the Royal College and offers physicians a postgraduate qualification which demonstrates to prospective employers the achievement of a standard equivalent to UK specialist doctors.
Here we take a closer look at the MRCP (UK) Respiratory Medicine Specialty Certificate Examination for doctors who have chosen to specialise in respiratory medicine. We cover the content of the exam, as well as fees and the eligibility criteria, all summarised below along with a broad look at the following topics:
What is the respiratory medicine SCE?
Where does the SCE fit into my training?
What is the structure of the respiratory medicine SCE?
How do I apply for the exams and what do they cost?
Where can I sit the exams as an overseas respiratory medicine doctor?
How should I prepare for the exams as an IMG?
I’ve passed? What’s next?
Skip ahead to the relevant section if you know what you're looking for.
MRCP (UK) Respiratory Medicine SCE
The respiratory medicine specialty certificate exams are administered as a compulsory component of assessment for Certificate of Completion of Training (CCT) in respiratory medicine for all UK trainees.
The purpose of an SCE is to:
ensure that certified specialists have sufficient knowledge of their specialty to practice safely and competently as consultants
complement workplace-based assessments
provide a rigorous national assessment to establish public confidence
offer a challenge similar to sub-specialty certification examination in North America
SCE as part of Training in Respiratory Medicine
Since the MRCP(UK) exams are taken during the Internal Medicine Training years (ST1-ST3), the respiratory medicine SCE allows physicians to demonstrate that they are able to practice independently at a consultant level.
The SCE has no official entry requirements (both for UK and overseas candidates); however, UK trainees would normally take the SCE in their penultimate year of higher specialty training (ST6). UK trainees should have made at least one attempt by the time of their penultimate year assessment.
For in-depth guide to the MRCP exams, see our IMG Resources library here.
Exam Structure
The SCE assesses candidates on a wide range of common and important disorders, as set out in the syllabus of the curriculum. This should be taken as an indication of the likely number of questions – the actual number may vary:
Topic
Number of questions
Airways disease
35
Interstitial lung disease (ILD)
25
Disorders of the pleura and mediastinum, including pneumothorax
25
Pulmonary infections
35
Pulmonary vascular disease
20
Sleep-related breathing disorders and hypoventilation
5
Thoracic oncology
35
Other*
20
Total
200
*Other: Critical and high-dependency care of respiratory disease; Genetic and developmental lung disease; Lung transplantation; Pharmacology; Practical procedures; Statistics
The questions in each category are distributed across both papers.
All SCEs are computer-based and are administered by Pearson VUE at a test centre in the UK or internationally.
Respiratory Medicine SCE Applications
SCEs are held once a year and applications are made online through My MRCP(UK) account, within the Upcoming Exams section of the Royal College website.
The application process is as follows:
Register online through My MRCP(UK) (candidates have the opportunity at this point to register any special arrangements)
Request a preferred test country and city
Pay applicable examination fee
Application is confirmed via an automatically generated email
Receive test centre confirmation email from Pearson VUE within four weeks of the examination date.
The Royal College of Physicians has created a helpful video guide on SCE applications which you can watch here.
Cost
The cost of the SCE exams are as follows:
UK centres: £665
International centres: £833
Exam Centres
UK Centres
Candidates who choose to sit the respiratory medicine SCE in the UK must contact Pearson VUE to book their test. There are up to 137 test centres throughout the UK for each SCE, and the Royal College of Physicians advise that candidates should book their exam as early as possible to secure their preferred test centre, as bookings operate on a first come first served basis.
International Centres
Candidates are given a choice of regions and are then asked to nominate a particular city in that region as their desired test location. The Royal College of Physicians will pass this request to Pearson VUE once the application period has closed, and Pearson VUE will confirm final test centre details to candidates via email at least three weeks before the date of the examination. If the exam is not available in a requested location, candidates will be offered a choice of the nearest available test centres.
Please note, international candidates should not book their own test centre with Pearson VUE - attempting to do so may delay a candidate's application.
The full list of international SCE test centres can be found here.
Preparation and Resources for the Respiratory Medicine SCE
It can be difficult for IMGs to know where to start with their preparation and revision. This list should provide a good starting point for any international respiratory medicine doctors preparing to sit the SCE:
Curriculum - Applicants are tested on a range of common and important disorders in Respiratory Medicine as set out in the Joint Royal Colleges’ Curriculum for Respiratory Medicine Specialist Training. We recommend getting to know the curriculum as early as possible and using it as a blueprint for your study.
Guidelines - These tools are helpful for supplementing your knowledge:
American Thoracic Society
British Thoracic Society
European Respiratory Society
National Institute for Health and Care Excellence (NICE)
Scottish Intercollegiate Guidelines Network (SIGN)
Journals
American Journal of Respiratory and Critical Care Medicine
CHEST
European Respiratory Journal
Thorax
Sample questions: It is a good idea to regularly assess your knowledge and progress using example questions from the current exam syllabus. You can find these here.
For an overview of how to prepare for exams, including advice on study groups, online community support, best use of online resources & Royal College materials and courses, check out at our blog: IMG Connects Top Tips for exam preparation.
I’ve passed? What’s next?
First of all, congratulations - this is a massive achievement! With your MRCP(UK) and Respiratory Medicine SCE in hand, you can apply for a full GMC registration with a license to practice. Once the GMC has approved your application, you can work as a doctor in the UK. Great stuff!
Don’t hesitate to get in touch with an IMG medicine recruitment specialist to discuss GMC registration, respiratory medicine positions in the NHS, including typical NHS salaries, the most suitable UK locations and hospitals for you, and relocation.
To receive the latest news and updates, including the Royal Colleges, GMC registration and the NHS, follow us on social media and join the conversation.
GMC Registration can be a long and complex process. With a few options available for clinical oncologists to provide evidence of their skills and knowledge, it can be difficult for IMGs to decide the best route to take to register with the GMC.
For international doctors considering their route to the UK, there are essentially two main pathways to consider: PLAB and the postgraduate route - FRCR (Oncology).
Whilst these are the most common routes to GMC registration, this is not an exhaustive list. There are other options such as Royal College sponsorship and GMC-approved qualifications or licensing exams, and you can read more about these here.
Here we provide a summary of both pathways and briefly consider their benefits.
PLAB for GMC Registration
FRCR (Oncology) for GMC Registration
Which is better for me as an overseas pathologist, PLAB or FRCR (Oncology)?
#IMG Tips
How do I get started?
Professional & Linguistics Assessment Board (PLAB)
The first and most common route which is often a popular choice among junior doctors is PLAB.
PLAB is a two-part exam with one written and one practical element, that assesses whether candidates are at least as capable as doctors starting the second year of their Foundation Programme Training, and can therefore work safely as an SHO in the NHS.
The GMC has a useful video summary of the PLAB exams which you can watch here or for a more detailed overview, see our IMG Resources library.
FRCR (Oncology) - UK Postgraduate Qualification for Clinical or Radiation Oncologists
The UK’s postgraduate qualifications are a more popular route for senior overseas doctors, and those looking to gain posts in the NHS which are reflective of their experience. Within clinical or radiation oncology, this can be done by attaining Fellowship of the Royal College of Radiologists. The Royal College of Radiologists is the professional body that regulates the specialism of clinical oncology in the UK.
Fellowship of the Royal College of Radiologists (FRCR Oncology) is the full qualification attained through these postgraduate exams for clinical or radiation oncology. The exams assess a candidate’s knowledge and clinical understanding against the Specialty Training Curriculum for Clinical Oncology. FRCR (Oncology) has three components, with two written and one clinical and oral element.
For complete guides on FRCR (Oncology), take a look at our IMG Resources library.
It is important to note that the FRCR (Oncology) exams are for clinical or radiation oncologists only. Overseas clinical oncologists are not required to also sit the MRCP (UK) exams.
PLAB vs FRCR (Oncology)
FRCR (Oncology) is a legitimate route that demonstrates skills and knowledge and will allow oncologists to register with the GMC and work in the UK. To decide which route is best for you, you’ll need to consider the benefits of each exam, as well as how they align with your needs and priorities in moving to the UK.
Seniority of Positions in the NHS
It may be difficult for an overseas clinical oncologist to obtain a more senior post within the NHS without FRCR (Oncology), GMC-approved training, or extensive experience from a similar, English-speaking healthcare system. PLAB alone will not give overseas doctors access to senior posts in the NHS.
Time
PLAB has two stages and can take anywhere between 3-9 months to prepare from start to finish.
FRCR (Oncology) has three stages, the last of which must be taken after at least 36 months of postgraduate experience in clinical or radiation oncology.
These exams can take anywhere from between 24-36 months to prepare from start to finish.
Cost
The FRCR (Oncology) exams cost just over £1,600, but all the exams are sat in person and there are only a few overseas exam centres.
PLAB costs £1,189, and both exams are sat in person. PLAB 1 can be taken in the UK or several overseas centres, which you can find here. PLAB 2 must be taken within the UK.
SO, for PLAB 2, candidates will have to travel to the UK, meaning that the additional cost of visas, accommodation and flights must be factored in.
It’s important to note that the total cost of each exam can rise if re-sits are necessary.
Summary
PLAB, as an exam which examines a doctor’s ability to work safely as a Senior House Officer (SHO), does not assess ability in oncology specifically. For this reason, PLAB tends to be a route for junior doctors who have not already chosen their field of specialisation in medicine, I.e., oncology. PLAB allows doctors to enter the UK system much faster than other routes and for this reason alone, it is favoured by international doctors when considering their path to the UK.
FRCR (Oncology) involves three more difficult examinations and takes more time to prepare for. However, for overseas oncologists, attaining FRCR (Oncology) will allow you to jumpstart your career in the UK, as you will not need PLAB or Core Training.
The Royal College of Radiologists’ exams will facilitate the application for more senior roles in UK oncology than PLAB.
#IMG Tips
Determine your priorities – your goals and timeline for relocating to the UK are important in deciding which route is best for, and this is different for everyone.
Plan well ahead – depending on the route you choose, you may be embarking on a long journey through these exams, so plan how you will fit them into your life and how best to prepare to maintain a good work-life balance at the same time.
Find a support network – once you know which exams you will sit, find a support network of others who are also preparing for the exam.
Join the community - join the IMG Oncologists Facebook group for access to a community of like-minded FRCR (Oncology) aspirants and dedicated oncology recruiters.
In this group you will find tailored resources for oncology IMGs, including access to our FRCR (Oncology) crash courses, completely free to all doctors.
You can access our IMG Oncologists community here.
Getting started
Once you’ve decided which exams are best for you, it’s time for a deep dive into the exams and what they entail. For more useful blogs and articles on PLAB, FRCR (Oncology), GMC registration and finding your dream job in the NHS - take a look at our IMG Resources library.
If you have any further questions on PLAB or postgraduate qualifications, please get in touch with our oncology specialists here. We’d be more than happy to help you.
For advice, guidance and news and updates about all things oncology for IMGs, join the conversation through the links below
In this blog we will explore MRCPsych Clinical Assessment of Skills and Competencies (CASC) including dates, exam locations, fees and eligibility.
In our exploration of CASC, we will take a broad look at the following topics:
What is the format of the CASC exam?
How is the CASC marked?
Am I eligible?
Assessment Portfolio for Overseas Candidates
Sponsorship requirements
How do I apply?
How much will it cost me?
Where can I sit the CASC exam?
How do I prepare for the CASC exam?
Passed? What next?
For a more general overview of the MRCPsych examinations, click here.
MRCPsych CASC is a practical exam taking the format of an OSCE and tests your clinical skills in a range of competencies.
What is the format of the CASC exam?
The CASC format is like an OSCE (Objective Structured Clinical Examination).
The exam is made up of two circuits of individual stations which will test your clinical skills:
The morning circuit will have 4 minutes to read the instructions and 7 minutes to complete the task
The afternoon circuit will have 90 seconds to read the instructions and 7 minutes to complete the task.
The sixteen CASC station exam is made up of:
five stations focused on History Taking, including risk assessment
five stations focused on Examination - both physical and mental state, including capacity assessment.
six stations focused on patient Management
Each circuit follows the topics below:
Circuit 1:
6 stations focused on Management
1 x station focused on Examination
1 x station focused on History Taking
4 minutes reading
7 minute task
Circuit 2:
4 x stations focused on Examination
4 x stations focused on History Taking
90 seconds reading
7 minute task
How is the CASC marked?
You can find details on how the test is marked here. See also marksheets for your information.
History Marksheet
Management Marksheet
Examination Marksheet
The Royal College also suggest taking a look at Passing the MRCPsych - an insider’s guide - a useful guide to help you to get over the first steps.
As ever at IMG Connect we believe in preparation. In order to succeed in the clinical exam, IMGs have told us that it is vital that you practice your clinical examinations as frequently as possible, preferably under the supervision of a senior colleague. This will give you confidence in approaching and examining patients with examiners present.
Am I eligible for the CASC exam?
You are eligible to take CASC if you have 24 months post internship experience in Psychiatry, by the time of sitting the CASC.
AND
You have a pass in both Paper A and B
AND
You can demonstrate the following:
AND
You have sponsorship in place – sponsorship forms must be submitted by an appropriate medical education lead confirming that the eligibility requirements to sit the MRCPsych examinations have been met.
Overseas candidates must show their sponsor evidence of having achieved equivalent competencies at appropriate competency levels (year 1, 2, 3) for each component of the examination.
Assessment Portfolio for Overseas Candidates:
As above, one aspect of eligibility for CASC as to complete an Assessment Portfolio. This must demonstrate achievement of equivalent competencies to those defined in the ARCP documented on the application form, this must include competencies in Psychotherapy AND Child and Adolescent Psychiatry, or Learning Disability have been achieved by the time of applying for the MRCPsych CASC.
In addition, overseas candidates must demonstrate that they undertake the following activities as part of their structured job plans:
observation in interviewing patients in ward rounds for specified reasons
observation in interviewing patients in out-patient or community settings or other contexts for specified reasons
assessment via formal presentation of cases with their medical notes; discuss management of cases with their Clinical or Educational Supervisor
formal assessment in having achieved competencies in Child and Adolescent Psychiatry or Learning Disability AND Psychotherapy.
Assessments and achievement of competencies should take place in a range of settings and psychiatric specialties with structured, documented feedback on performance having been provided.
Whilst there is not an assessment criteria form available as this is incorporated into the online submission, take a look at the ARCP assessment portfolio form for CT1-3 in the UK, which should help give you a starting point for your own portfolio.
Sponsorship requirements:
International candidates must have a sponsor in place in order to support evidence that their three years of training satisfy Royal College criteria of having achieved equivalent competencies at appropriate competency levels (year 1, 2, 3) for each component of the examination.
Sponsorship is required by all applicants for entry to the CASC examination.
Your sponsor should be an appropriate medical education lead confirming you have met the requirements to sit the MRCPsych examinations.
You will be required to provide the sponsor’s title, full name and email.
Acceptable sponsors are:
College Tutor
Training Programme Director
Educational Supervisor
Head of School
Director of Medical Education (or equivalent)
Head of Department of Psychiatry
Consultant responsible for employee/trainee appraisal
Once your sponsor has authorised your application, you will receive a confirmation email from the Royal College, and you will be asked to complete your application and proceed to payment.
How do I apply?
To apply you’ll need to complete the Royal College online application form. This form is only available during the published application dates and must be submitted prior to the closing date, if you miss the cut-off, your application will not be considered.
You will need to provide the following:
Personal details
Primary Medical Qualifications & Registration
Training
Written paper selection
Sponsor evidence for Assessment Portfolio for Overseas Candidates
How much will it cost me?
At the end of your application you will be directed to an online payment system where you can pay be credit or debit card, so make sure you have your details ready.
Once your application is complete you will receive two confirmation emails, one to confirm receipt of the application and one to confirm the payment has been received.
The fees for MRCPsych CASC for 2023 are as follows:
PMPT Trainees and Affiliates - £1,054
Non-PMPT Trainees and Affiliates - £1,171
Where can I sit the CASC exam?
The final diet of the CASC exam which will involve online delivery will be in May 2023. From September 2023, the exam will be back in-person, being delivered in the UK with international test centres to be confirmed from 2024.
Examination dates can be found here and results from the CASC examinations will be released around 1 month later.
How do I prepare for the CASC examination?
With lots of materials online we have discussed with IMGs the best place to start looking for resources and materials relating to the exams. Most IMGs recommended starting with the Royal College, who have created useful resources to help you to prepare for the exams. See below:
Syllabus: We always suggest that this is the best place to start – plan your study around the curriculum topics and make a road map to your success in the exams.
Syllabus: summary of areas of core medical knowledge underpinning specialist training in psychiatry
Marking scheme (CASC): A good start with CASC preparation is to get to know how you will be assessed, take a look at the criteria for scoring a pass mark in CASC, as well as the History Marksheet, Management Marksheet and Examination Marksheet.
CASC examination guide: The Royal College have produced a helpful guide for candidates which provides information on stations, role plays and assessment.
CASC preparation videos: Here you will have the opportunity to see CASC stations in action. This will give you a good idea of what to expect and help you prepare.
CASC Blueprint: This helpful summary details stations in some detail and gives a useful overview of the exam format.
The Royal College also suggests taking a look at Passing the MRCPsych - an insider’s guide - a useful guide to help you to get over the first steps.
IMG Psychiatrists MRCPsych CASC Study Course
This is a tailored MRCPscyh CASC course for overseas psychiatrists sitting the CASC exam. This course offers weekly sessions beginning with an overview and in-depth breakdown of the exam and its various domains, including marking and station requirements. This is followed by small group role play sessions to allow IMGs preparing for the exam to practice stations across various scenarios with feedback on each station, delivered by an experienced NHS psychiatrist and specialist psychiatry recruiters. These sessions are completely free to all doctors.
The course is supplemented by additional advice and guidance on MRCPsych as a whole, GMC registration support, as well as guidance and webinars on other topics such as finding work in the NHS, relocation support and specialist registration.
You can access our IMG Psychiatrists CASC Study Course by joining the Facebook group here.
#IMG Tips
Start your revision early – starting in advance allows you to pace yourself and get ahead of the stresses of last-minute revision and anxiety.
Find the right materials for you – whether its online courses, books or flashcards, try to figure out what the best materials are to jumpstart your preparation
Speak to your peers and colleagues – your senior colleagues may have been through this process themselves and may have helpful tips and guidance to share. Or maybe you’ll find a like-minded peer with whom you can be study buddies! Take advantage of those around you to support you on this journey.
Practise, practise, practise - Our IMGs have shared that it’s crucial that you practice your clinical examinations as often as possible, preferably under the supervision of a senior colleague which will allow you to receive feedback.
Join the online psychiatry community - for news and updates about all things psychiatry for IMGs, follow IMG Connect on social media and join the conversation.
I've passed, what’s next?
Once you’ve passed MRCPsych CASC, you’ve completed the Royal College of Psychiatrists examination suite. Great stuff, this is a massive achievement! Armed with this and your English language test, you are ready to apply for full GMC registration with license to practice.
You may want to start looking for NHS jobs and with the click of a button, you can receive them directly to your inbox. To receive jobs postings which you can tailor to your desired grade, specialty and sub-specialism, sign up here.
As ever at IMG Connect, we believe in preparation. In order to succeed in the clinical exam, IMGs have told us that it is vital that you practise your clinical examinations as frequently as possible, preferably under the supervision of a senior colleague. This will give you confidence in approaching and examining children with examiners present.
Getting started
If you have any questions about any element of CASC, the Royal College exams as a whole or any other queries related to the processes involved in IMGs coming to the UK to work in the NHS, please get in touch and one of our psychiatry specialists will be more than happy to assist you.
For access to a community of like-minded MRCPsych aspirants and dedicated psychiatry recruiters, join the IMG Psychiatrists Facebook group.
To receive the latest news and updates on all things psychiatry, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation.
Are you an overseas psychiatrist taking the postgraduate route to GMC registration? Are you just beginning your journey through the MRCPsych exams?
Today, we’re back with Dr Kevin Li, who will be sharing some top tips on the MRCPsych Paper A and Paper B for overseas MRCPsych A & B aspirants. Kevin is a brilliant psychiatry specialty doctor who relocated to the UK from Hong Kong, having passed the MRCPsych and received full GMC registration with license to practice.
1. Start with the Royal College website
This is the best place to begin as it has key information including the syllabus - on which the exam is based, helping to guide the course of your preparation and revision.
2. Don’t use resources that are more than 3 years old – 5 years maximum
The curriculum and syllabus for Specialty Training in Psychiatry are updated regularly, so it’s best to find and use resources that are as up-to-date as possible.
3. Don’t combine study for Paper A and Paper B
Focus on each paper as an individual element – they each have different requirements, including what sections of the syllabus they are targeting and how much experience you must have before sitting the exam.
4. Divide your time according to the marks weighting of the sections
For example, general adult and critical review have the most marks in the exam, with 20% and 33.5% respectively, so you should prioritise these in your revision, then try to spend a proportionate amount of time on each section based on the marks it holds.
5. Perfect what you know
If there are any areas you are experienced or confident in, try to perfect these in order to gain the most marks possible in what you find to be the least challenging areas. These areas may also be easier to revise if they are better aligned with your training and practice to date.
6. Which exam should you sit first? It depends
If you want to pass the exams as quickly as possible, it makes sense to apply for the nearest upcoming diet of whichever exam comes first.
Knowledge wise Paper B has more sections and requires a lot more time and practice, particularly for critical review calculations. This combined with the Royal College’s advice of having 12 months’ experience in psychiatry before sitting the exam means that for most people, sitting Paper A first is the best choice.
7. Use diagrams for more challenging topics
Find or better still, create diagrams to better illustrate and explain the mor difficult to understand topics. Especially where you have little experience of a topic, it can be helpful to represent it visually.
8. Keep difficult topics fresh in your mind
If you need longer than 3 months to prepare for either exam, either leave the more difficult topics to the end of your revision or begin with them and be sure to revisit them at the end. You may not retain this information long-term, so it’s important to have it as fresh in your mind as possible when coming up to the exam.
9. Take time off before the exam for intense study
If you can, try to put some time aside in the week(s) coming up to the exam to for a final push of intense study before the exam.
10. Practice is key
Books are great resources for increasing your overall psychiatry knowledge, however they are not necessarily the best resources for the Paper A and Paper B exams. Question banks and past papers such as SPMM are very useful in preparing for the MRCPsych Paper A & B.
Getting started
For access to a community of like-minded MRCPsych aspirants and dedicated psychiatry recruiters, join the IMG Psychiatrists Facebook group.
For news and updates on all things psychiatry, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation.
The postgraduate route to GMC registration, whilst not the fastest, can be the most rewarding in the long run. The MRCPsych exams are the central components of psychiatry training in the UK, and as an international psychiatrist, this is the route that allows you to most closely align your qualifications with the requirements of more senior jobs in the NHS.