MRCP (UK) PACES - a guide for overseas medicine doctors
- October 16, 2022
PACES is the final exam in the MRCP UK examination series.
Attaining full MRCP UK will facilitate registration with the GMC for overseas doctors, allowing you to secure a job in one of the many medical specialties in the NHS, depending on your experience and specialisation. In this article we will consider the following:
- What is PACES?
- Am I eligible to sit MRCP PACES?
- What is the content and format?
- How is PACES marked?
- As an overseas candidate where can I take the exam?
- When should I take PACES?
- How can I prepare for the exam?
- Passed? What next?
What is PACES?
The Practical Assessment of Clinical Examination Skills (PACES) is designed to test the clinical knowledge and skills of trainee doctors who hope to enter higher specialist training (ST3). The exam sets rigorous standards to ensures trainees are competent across a wide range of skills and are ready to provide high-quality care to patients.
Am I eligible to sit MRCP PACES?
You must have passed the Part 1 written examination within the last seven years before taking PACES. The Royal College strongly advises trainees to apply after competing two years practical experience and Part 2 of the examination.
What is the content and format?
PACES is based on a format that is similar to OSCEs, a practical assessment in a clinical setting. There are five clinical stations with either patients with a given condition, or trained stand-ins (surrogates).
The exam is sat over a half-day and assesses seven core skills over five stations. IMGs can expect eight patient encounters assessed independently by a total of ten examiners (two at each station).
The seven core skills:
- Physical examination – demonstrate correct, thorough, systematic, appropriate and professional technique of physical examination.
- Identify physical signs – identifying physical signs correctly.
- Clinical communication – elicit a clinical history relevant to the patient’s complaints, in a systematic, thorough and professional manner.
- Differential Diagnosis – create a sensible, clinically assessed differential diagnosis for a patient.
- Clinical Judgment – select an appropriate management plan for a patient or clinical situation. Select appropriate investigations or treatments for a patient that the candidate has clinically assessed.
- Managing patients concerns – seeks, detect, acknowledge and address patients or relatives concerns, confirming their understanding and demonstrate empathy.
- Maintain patient welfare – treat a patient or relative respectfully and sensitively in a manner that ensures their comfort, safety and dignity.
The PACES Carousel:
The Carousel consists of five stations, each assessed by two independent examiners. Candidates start at any of the five stations, moving round the carousel at 20-minute intervals, until completed. A five-minute period between each station is given.
Candidates are marked on clinical skills at each encounter in the examination. An encounter is when a candidate has an interaction with a patient or a surrogate. Stations 2 and 4 involve one encounter, whereas stations 1, 3 and 5 have two encounters.
How is PACES marked?
PACES is marked on seven skills, A-G, these are:
Skill A: Physical examination (stations 1, 3 and 5)
Skill B: Identifying physical signs (stations 1, 3 and 5)
Skill C: Clinical communication (stations 2, 4 and 5)
Skill D: Differential diagnosis (stations 1, 2, 3 and 5)
Skill E: Clinical judgement (all stations)
Skill F: Managing patients’ concerns (all stations)
Skill G: Maintaining patient welfare (all stations)
Skill B, identifying physical signs, is often considered the most challenging skill to pass.
As an overseas candidate, where and when can I take the exam?
It is a little more complicated than Part 1 or 2 exams and exam slots are often in short supply. Whilst the Royal College is working hard to increase the number of spaces, it is not always possible to offer a place to all applicants.
Priority is given to those candidates who are near the end of their stage 2 eligibility period. A full list of examination dates can be found here, please note these are subject to change.
Examination centres are subject to change, so for up-to-date information, please see the Royal College website here.
The examination is run at clinical centres across the UK (England, Scotland, Wales and Northern Ireland); these vary from diet to diet.
When should I take PACES?
Royal College performance data provides some food for thought when considering when to apply for PACES. The data suggests:
- Wait at least 36 months after graduation before applying.
- Those taking the exam before this period were less likely to pass.
- 24-36 months post-graduation – 50% pass rate
- 36-48 months after graduation – 77%
- Candidates that had already passed part 1 & 2 written examinations were significantly more likely to pass PACES at first attempt.
How can I prepare for the exam?
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. See below:
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, using it as a road map for your study plan.
It is recommended that to give yourself the best chance, you gain clinical experience involving care of emergency patients, adults and children.We advise you to regularly invite senior colleagues to observe and provide feedback on your clinical assessments, so you will be comfortable with the PACES format and give you confidence in approaching and examining patients with examiners present.
PACES station 4 examiner guidance examples: This useful guide contains examples of the types of statements found in the examiner guidance section of station 4 scenarios.
This will help you to understand what the examiner is looking for.
PACES sample scenarios: These will provide you with the most accurate and relevant scenarios to prepare you for the real thing. Sample scenarios cover Station 2, 4 & 5 (‘history taking’, ‘communication skills and ethics’ and ‘clinical consultations’ respectively.
Most of these have been previously used in a recent exam, but please note that during the exam you will only receive the section marked ‘information for the candidate’.
Videos on what to expect on the day: These helpful videos will give you a true reflection of what to expect on the day of the exam, easing some of the pressure and ensuring you can focus on the task at hand.
PACES candidate video: Whilst there are lots of useful videos online that are easy to find, the PACES candidate video contains important information about the exam, and practical examples of how the exam will run.
Candidate guide notes: these guidenotes created by the Royal College help IMGs to understand what to expect on the day, from your arrival to the completion of the test.
It can also be useful to understand how IMGs have failed the exam in the past, as this will give you the best chance to pass first time. The ‘how I failed PACES’ guide provides tips to help you to identify where you might be going wrong, along with practical advice to help you to improve.
For a useful 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 - take a look at our blogs on exam tips and preparation.
Passed? What next?
First of all, congratulations! After you have passed all parts of MRCP (UK) you can apply for a full registration with a license to practice. Once the GMC have approved your application, you can work as a doctor in the UK.
IMG Jobs
Specialise in gastroenterology, respiratory, neurology, dermatology, geriatrics or any other areas within specialist medicine? Search and find live specialist medicine NHS doctor jobs in the UK.
General & Acute medicine? Search for live vacancies here.
IMG Resources
Read more useful articles on finding an NHS trust doctor job, pay scales & doctor’s salary in the UK, relocation and much more!
Get in Touch
Get in touch using the buttons above (and below) to discuss specialist medicine job opportunities in the NHS, including discussions regarding a typical doctor salary in the UK and the most suitable hospital locations for you.
Follow us on social media for news and updates on GMC registration, the Royal College and NHS through the links below:
Relevant Jobs
An NHS acute hospital in the South East is looking for a Specialist Acute Physician with an interest in Same Day Emergency Care and Ambulatory Medicine. The Acute Internal Medicine department comprises a team of 13 consultants and is supported by a large team of middle grade doctors. This Acute Medicine job is open to both international applications and UK-based doctors, though those with European Specialist or MRCP (UK) qualifications are most encouraged to apply.
Anyone requiring portfolio support (formally known as CESR) can have their required support discussed on a case by case basis.
JOB REQUIREMENTS AND DETAILS
MBBS or equivalent, full GMC registration, MRCP, and a minimum of 4 years’ post-graduate NHS experience (with at least 2 years in Acute Medicine) are required for this role, and anyone with an interest in expanding SDEC and short stay services should apply. The salary will be between £96,990 - £107,155 dependent on experience or grade.
CORE DUTIES OF THIS ROLE
-
Provision of the Acute Internal Medicine service, including same day emergency care, inpatients on the AMU, and the Short Stay Unit
-
Receiving referrals from primary care to provide clinical advice and triage for potential admissions
-
Supervision of junior doctors and alternative workforce, including advice on treatment plans
-
Participation in clinical education and governance activities, and supporting development of the department
LIFE IN THE SOUTH EAST
This role is based in a major coastal city in the South East, with nearby living options ranging from lively urban centres to scenic rural towns. The region offers strong transport connections, reputable schools, and a wide range of leisure pursuits including historic attractions, beaches, and outdoor activities. Known for its maritime heritage, this area has longstanding ties to British naval and defence history.
HOW WILL IMG CONNECT SUPPORT YOU?*
When applying with IMG Connect you’ll have the full support of an expert recruitment team who will be your recruitment and relocation partners throughout the process. We\'ll support you with:
CV Preparation with a bespoke session with one of our specialists
Application support with expert knowledge of NHS specialisms & recruitment practice
At least two video calling interview preparation sessions
Contract and offer negotiations for salary, relocation packages, tenure and more
Once you have accepted your new role, you’ll then be supported and led throughout by one of our dedicated relocation executives who will guide you through all the way to starting to your new role including:
Document gathering and checking COS and Visa Application support if applicable
Support sourcing short- and long-term accommodation
Travel Arrangements Family support for finding schools and any other aspects of pastoral care
A Yorkshire based general hospital is looking for a Locum Consultant in Gastroenterology with an interest in inflammatory bowel disease, hepatology or advanced therapeutic endoscopy. The gastroenterology department is staffed by a team of consultants and supported by middle grade doctors. This opportunity welcomes applications from both UK-based and international doctors, especially those holding European Specialist or MRCP(UK) qualifications.
Anyone requiring portfolio support (formally known as CESR) can have their required support discussed on a case by case basis.
JOB REQUIREMENTS AND DETAILS
MRCP (or equivalent), extensive experience in gastroenterology, and ideally some NHS experience will be required for this role, and anyone with an interest in inflammatory bowel disease, hepatology or therapeutic endoscopy should apply. The salary will be between £105,504 and £139,882 dependent on experience or grade.
CORE DUTIES OF THIS ROLE
-
Deliver consultant-level care for inpatients and outpatients in gastroenterology.
-
Participate in a shared on-call rota and cover gastroenterology services on a rotational basis.
-
Conduct at least two endoscopy sessions and two outpatient clinics each week.
-
Support departmental audit, teaching, research, and development initiatives.
LIFE IN YORKSHIRE
Located in South Yorkshire, the hospital is near vibrant city living in Sheffield or quieter countryside communities such as Wickersley. The area offers good schools, strong public transport links, and leisure activities suitable for families and professionals alike. Yorkshire has a rich industrial past and plays a notable role in British history, contributing to its unique character and charm.
HOW WILL IMG CONNECT SUPPORT YOU?
When applying with IMG Connect you’ll have the full support of an expert recruitment team who will be your recruitment and relocation partners throughout the process. We\'ll support you with:
- CV Preparation with a bespoke session with one of our specialists
- Application support with expert knowledge of NHS specialisms & recruitment practice
- At least two video calling interview preparation sessions
- Contract and offer negotiations for salary, relocation packages, tenure and more
Once you have accepted your new role, you’ll then be supported and led throughout by one of our dedicated relocation executives who will guide you through all the way to starting to your new role including:
- Document gathering and checking
- COS and Visa Application support if applicable
- Support sourcing short- and long-term accommodation
- Travel Arrangements
- Family support for finding schools and any other aspects of pastoral care
An NHS acute hospital in the South of England is looking for a Specialist Grade Doctor in Stroke Medicine with an interest in hyper-acute stroke care.
The Stroke Medicine department comprises a team of 2 stroke consultants and is supported by a large team of middle grade doctors. This Stroke Medicine job is open to both international applications and UK-based doctors, though those with European Specialist or MRCP (UK) qualifications are most encouraged to apply.
Anyone requiring portfolio support (formally known as CESR) can have their required support discussed on a case by case basis.
JOB REQUIREMENTS AND DETAILS
Full GMC registration with a license to practice and at least 12 years of medical work (with a minimum of 6 years in Stroke Medicine) are required for this role, and anyone with an interest in hyper-acute stroke intervention should apply. The salary will be between £96,990 - £107,155 dependent on experience or grade.
CORE DUTIES OF THIS ROLE
-
Deliver high-quality hyper-acute, acute, and stroke rehabilitation care as part of a comprehensive stroke service.
-
Diagnose and manage patients presenting with stroke and stroke-mimic symptoms, including administering thrombolysis.
-
Participate in TIA clinics, ward rounds, multidisciplinary meetings, and contribute to clinical governance.
-
Supervise junior doctors and participate in research and clinical audits.
LIFE IN THE SOUTH OF ENGLAND
This post is located in a beautiful coastal region of the South of England, with great access to both scenic countryside and vibrant seaside towns. Options include family-friendly rural villages or more bustling urban centres nearby.
The area boasts good schools, fast transport links to mainland cities, and plenty of leisure and cultural opportunities, including outdoor sports, local festivals, and historical landmarks.
Famous for its heritage in British history and offering a high quality of life, the region is ideal for professionals and families alike.
HOW WILL IMG CONNECT SUPPORT YOU?
When applying with IMG Connect you’ll have the full support of an expert recruitment team who will be your recruitment and relocation partners throughout the process. We\'ll support you with:
CV Preparation with a bespoke session with one of our specialists
Application support with expert knowledge of NHS specialisms & recruitment practice
At least two video calling interview preparation sessions
Contract and offer negotiations for salary, relocation packages, tenure and more
Once you have accepted your new role, you’ll then be supported and led throughout by one of our dedicated relocation executives who will guide you through all the way to starting to your new role including:
Document gathering and checking
COS and Visa Application support if applicable
Support sourcing short- and long-term accommodation
Travel Arrangements
Family support for finding schools and any other aspects of pastoral care
An NHS acute hospital in the South East is looking for a Consultant or Specialist grade Geriatrician with an interest in Frailty Services.
The Geriatrics department comprises a team of 3 consultants and is supported by a large team of middle grade doctors. This Geriatrics job is open to both international applications and UK-based doctors, though those with European Specialist or MRCP(UK) qualifications are most encouraged to apply.
Anyone requiring portfolio support (formally known as CESR) can have their required support discussed on a case by case basis.
JOB REQUIREMENTS AND DETAILS
Full GMC registration and at least 6 years of post-graduate clinical experience are required for this role, and anyone with an interest in Frailty Services should apply. The salary will be between £96,990 to £107,155 for Specialist grade and £105504 to £139,882 for Consultant grade
CORE DUTIES OF THIS ROLE
-
Provision of a comprehensive inpatient medical service and specialist outpatient clinics.
-
Responsibility for the diagnosis and treatment of elderly patients.
-
Participation in the 1:11 consultant general medical on-call rota including weekend rounds.
-
Professional supervision and management of junior medical staff.
LIFE IN THE SOUTH EAST
This role is based in a coastal area in the South East of England, with urban living options in busy towns and rural choices in scenic villages.
The region offers excellent transport connections to the mainland, good schools, and plenty of outdoor activities including water sports and countryside trails.
Known for its historical and cultural significance, the area features beautiful coastlines, historic estates, and hosts several festivals throughout the year.
HOW WILL IMG CONNECT SUPPORT YOU?
When applying with IMG Connect you’ll have the full support of an expert recruitment team who will be your recruitment and relocation partners throughout the process. We\'ll support you with:
CV Preparation with a bespoke session with one of our specialists
Application support with expert knowledge of NHS specialisms & recruitment practice
At least two video calling interview preparation sessions
Contract and offer negotiations for salary, relocation packages, tenure and more
Once you have accepted your new role, you’ll then be supported and led throughout by one of our dedicated relocation executives who will guide you through all the way to starting to your new role including:
Document gathering and checking COS and Visa Application support if applicable
Support sourcing short- and long-term accommodation
Travel Arrangements Family support for finding schools and any other aspects of pastoral care
A hospital in the Channel Islands is looking for a Staff Grade Doctor in General Medicine with interests in Respiratory, Renal, or Care of the Elderly. The department comprises a team of consultants and is supported by a large team of middle-grade doctors. This role is open to both international applications and UK-based doctors, though those with European Specialist or MRCP qualifications are most encouraged to apply.
Anyone requiring portfolio support (formally known as CESR) can have their required support discussed on a case-by-case basis.
JOB REQUIREMENTS AND DETAILS
Full registration with the General Medical Council and a minimum of 2 years of post-qualifying experience are required for this role, and anyone with an interest in Respiratory, Renal, or Care of the Elderly should apply. The salary will be between £58,742 and £97,050 dependent on experience or grade.
CORE DUTIES OF THIS ROLE
- Provide high-quality care across both inpatient and outpatient services within the chosen specialty.
- Participate in the middle-grade tier rota, including on-call duties.
- Support the clinical management of patients in various units, including emergency and intensive care.
- Collaborate with consultants and multidisciplinary teams to ensure continuous service improvement.
LIFE IN THE CHANNEL ISLANDS
The hospital is located in a vibrant town, with popular residential areas offering both urban and rural living options. The region offers excellent schools, efficient transport links, and a wide range of leisure activities for both adults and families, including beautiful beaches, sports facilities, and cultural events. The area has a rich history, having been a strategic location during World War II and now boasting a unique blend of cultural influences.
HOW WILL IMG CONNECT SUPPORT YOU?
When applying with IMG Connect you’ll have the full support of an expert recruitment team who will be your recruitment and relocation partners throughout the process. We\'ll support you with:
- CV Preparation with a bespoke session with one of our specialists
- Application support with expert knowledge of NHS specialisms & recruitment practice
- At least two video calling interview preparation sessions Contract and offer negotiations for salary, relocation packages, tenure and more
Once you have accepted your new role, you’ll then be supported and led throughout by one of our dedicated relocation executives who will guide you through all the way to starting to your new role including:
- Document gathering and checking COS and Visa Application support if applicable
- Support sourcing short- and long-term accommodation
- Travel Arrangements Family support for finding schools and any other aspects of pastoral care