MRCPsych - a guide for overseas psychiatrists
For overseas psychiatrists looking to register with the GMC and find a psychiatry job in the NHS, one option is to complete the Membership of the Royal College of Psychiatrists examinations - MRCPsych. Here we will take a detailed look at the MRCPsych exams, fees and centres.
International Medical Graduates (IMGs) from any country in the world can sit the MRCPsych examinations, provided certain eligibility criteria are met. These are summarised below along with a broad look at the following topics:
The Royal College of Psychiatrists is the professional body responsible for the specialty of Psychiatry throughout the UK. Among many other duties, its role is to set and monitor the educational curriculum for those training to enter the profession.
What is MRCPsych?
The MRCPsych examinations are the central component of training for psychiatrists in the UK and the examinations are designed to test your knowledge of basic medical sciences as well as the clinical skills required for diagnosis and management within psychiatry.
For international doctors, MRCPsych is one of the two main routes IMGs can take to full GMC registration - you can find a range of articles covering these routes in our resource library here: Royal College or PLAB route.
For doctors who wish to take more senior roles reflective of their current practice, IMG Connect advise that MRCPsych would be the best route to take.
Overseas doctors must be registered with a recognised medical board in their country of residence and should have undertaken 3 years of training and MRCPsych (UK) is a prerequisite to anyone wishing to go on to a specialist training post as a physician in the UK
What is the exam content and format?
The MRCPsych examinations consist of two written papers (Paper A + Paper B) and one clinical examination (CASC).
Typically, a UK Psychiatrist would sit Paper A from FY2. Candidates will then progress through MRCPsych examinations from CT1 – CT3, before going on to specially training for CCT.
Paper A – The scientific and theoretical basis of psychiatry – 3 hours
This is a written paper, worth 150 marks and comprising 150 questions made up of approximately two thirds multiple choice questions (MCQ) and one third extended matching item questions (EMI).
It covers the following sections of the syllabus:
Paper A is now taken online.
Paper B - Critical review and the clinical topics in psychiatry – 3 hours
This is a written paper, worth 150 marks and comprising 150 questions made up of approximately one third covering critical review and two thirds covering clinical topics.
It covers the following sections of the syllabus:
Paper B is now taken online.
CASC - Clinical Assessment of Skills and Competencies
The CASC is based on a format that is similar to OSCEs. Specifically, the examination consists of two circuits which must be completed on the same day.
In total, the circuit includes 16 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
Stations consist of several elements with instructions provided to all candidates, marked against the examiners construct.
These have a standardised format with elements in common between stations of a similar type. Find out more here.
The CASC exam is taken in person.
Eligibility for overseas doctors
The MRCPsych examinations can be taken by both:
- Doctors from the EU, who are working overseas
- Non-Eu doctors who are working overseas
Each examination has different criteria, to complete the full MRCPsych, an overseas doctor must be registered with a recognised medical board in their country of residence and complete the Assessment Portfolio for Overseas Candidates demonstrating that they have complete 3 years of equivalent training.
Furthermore, prior to taking CASC, overseas candidates must demonstrate competencies in Psychotherapy AND Child & Adolescent Psychiatry or Learning Disability.
For each part of the exam the Royal College suggest the following eligibility criteria:
MRCPsych Paper A
You are eligible for Paper A if you are a fully registered medical practitioner.
MRCPsych Paper B
It is a recommended to have at least 12 months experience in psychiatry before taking this examination.
Clinical Assessment of Skills and Competencies (CASC):
You are eligible to take CASC if you have 24 months post internship experience in Psychiatry, by the time of sitting the CASC
You have a pass in both Paper A and B
You can demonstrate 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.
In addition, 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:
- be observed interviewing patients in ward rounds for specified reasons
- be observed interviewing patients in out-patient or community settings or other contexts for specified reasons
- be assessed via formal presentation of cases with their medical notes; discuss management of cases with their Clinical or Educational Supervisor
- be assessed formally 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.
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 and your sponsor should be an appropriate medical education lead confirming you have met the requirements to sit the MRCPsych examinations.
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 will need to complete an online application form. It takes about 15 – 20 minutes. You can sit Paper A and B in any order. You will be required to enter contact details and training history, including your medical registration.
Payment is made by credit/debit card.
If applying for the CASC, you will also need to provide the contact details of your sponsor.
It is important to note that the online form for Paper A, B and CASC will only be available during the published application dates and must be submitted before the closing date and time. Applications submitted after, will not be accepted.
How much will it cost me?
PMPT Trainees and Affiliates (UK & Ireland Centres)
Non-PMPT Trainees and Affiliates (UK & Ireland Centres)
Where and when can I sit the examinations?
The good news is that changes have been made in response to the COVID-19 pandemic, and Paper A and B can be taken online, making it much easier for IMGs to complete the MRCPsych examinations and work towards their GMC registration in a normal time frame. To maintain the integrity fo the CASC exam, delivery will be in-person only from September 2023.
You can sit the examination from your home country with details on submissions and preparation for an online exam available on the Royal College website.
For up-to-date information on application and exam dates, please see the Royal College website here.
How do I prepare for the MRCPsych examinations?
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:
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
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.
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. Please note: you may be required to be a member to access these.
Paper A sample questions
Paper B sample questions
Marking schemes (Paper A and B):
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 worked, so you can maximise your exam skills, giving you the best chance of a pass.
Marking schemes can be found here.
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.
Written papers marksheet example:
Again, this is a useful tool to help you familiarise yourself with the exam format and improve your test skills. An example marksheet can be found here.
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.
This helpful summary details stations in some detail and gives a useful overview of the exam format.
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 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.
Passed? What's next?
First of all, congratulations! After you have passed all parts of MRCPsych 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.
Don’t hesitate to get in touch using the buttons above (and below) and chat with an IMG Consultant to discuss your options for NHS roles with CESR support and start your journey towards Specialist Registration with IMG Connect.
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