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.
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Relevant Jobs
A UK-based NHS hospital is looking for a Specialty Doctor in Acute Medicine with an interest in general medicine. The department comprises a team of consultants and middle-grade doctors, all working together to provide high-quality care to patients. This Acute Medicine role is open to both international applications and UK-based doctors, though those with MRCP or equivalent qualifications and those within 6 months of CCT 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
Candidates must be fully registered with the GMC and possess MRCP or equivalent qualifications. Entry on the Specialist Register or within six months of CCT at the time of interview is essential. Expertise in a broad range of medical conditions and the ability to lead a multi-professional team is required. Sub-specialty interests will be supported. The salary will be competitive and dependent on experience or grade.
CORE DUTIES OF THIS ROLE
- Lead and manage patients in the Acute Medical Unit and related wards.
- Supervise and mentor junior medical staff.
- Provide consultant support as part of the general medicine on-call rota.
- Contribute to clinical governance, audit, and quality improvement initiatives.
LIFE IN THE REGION
This hospital is located in a well-connected town offering both city and rural living. With excellent schools, public transport options, and numerous leisure activities, it\'s ideal for both individuals and families. The area is known for its rich history and easy access to outdoor activities, making it a wonderful place to live and work.
A leading NHS Trust in the East Midlands is offering an exciting opportunity for a Consultant in Acute and General Internal Medicine. This role is ideal for doctors passionate about delivering high-quality care within a supportive and dynamic environment. The position is based at a CQC-rated \"Outstanding\" hospital, part of a trust recognized for its exceptional staff engagement and commitment to innovation. The role combines acute and sub-acute care responsibilities with opportunities to develop sub-specialist interests.
The Trust also provides CESR Portfolio Pathway support for international medical graduates (IMGs), facilitating the journey to consultant accreditation in the UK.
What is the NHS Trust like?
This NHS Trust serves a diverse population of over 500,000, providing acute and community care through a network of hospitals and clinics. Known for its collaborative approach, the Trust works closely with local health and social care providers to deliver integrated, patient-centered services.
The Trust is committed to fostering a culture of excellence, with a focus on diversity, inclusion, and staff wellbeing.
What is the department like?
The GIM department combines acute care expertise with specialty clinics, ensuring comprehensive and patient-focused services. Consultants lead a multidisciplinary team, supported by advanced diagnostic tools and robust training programs.
The team includes specialists in nephrology, geriatrics, and rheumatology, providing a collaborative environment where consultants can develop their expertise while delivering exceptional care. Supported by registrars, SHOs, and F1 doctors, consultants oversee a high volume of admissions—approximately 14,000 unselected medical emergencies annually—ensuring efficient and effective patient management.
Continued Professional Development
The role offers extensive CPD opportunities, including CESR support, specialty training, and leadership development programs. Consultants are encouraged to engage in research, audits, and teaching.
Location
Located in a vibrant region of the East Midlands, this area offers affordable living, excellent schools, and diverse cultural and recreational activities. With strong transport links, it is an ideal base for professionals and families.
Am I eligible for this role?
UK based candidates:
- Experience in Acute & General Internal Medicine
EEA candidates:
- Experience in Acute & General Internal Medicine
- European Specialist Qualification
Non-EEA candidates:
- MRCP
- Experience in Acute & General Internal Medicine
A leading NHS hospital in Northern England is looking for a Consultant in Neurology and Stroke Medicine with an interest in hyperacute stroke care and research. The department consists of a highly skilled team of consultants and middle-grade doctors, providing advanced stroke services. This opportunity is open to both international and UK-based doctors, especially those with appropriate specialist qualifications or equivalent experience.
Anyone requiring portfolio support (formally known as CESR) can have their required support discussed on a case-by-case basis.
JOB REQUIREMENTS AND DETAILS
Essential qualifications and experience include GMC registration with expected inclusion in the specialist register within six months and expertise in stroke medicine, including thrombolysis. Candidates with an interest in hyperacute stroke care, thrombectomy, and TIAs are encouraged to apply. The salary will be competitive and based on experience or grade.
CORE DUTIES OF THIS ROLE
- Deliver expert care for stroke patients, focusing on treatments like thrombolysis and thrombectomy.
- Participate in an on-call rota for stroke services, with support for telemedicine consultations.
- Contribute to stroke-related clinical trials and research initiatives.
- Play a pivotal role in enhancing stroke care services across the organization.
This hospital is situated in a vibrant city in Northern England, surrounded by beautiful countryside and close to the coast. The region offers diverse living options, including affordable urban housing and charming rural areas.
Families will benefit from access to excellent schools, both public and independent, alongside strong transport connections via major roadways, rail links to London, and nearby international airports.
Rich in history and culture, the area has been a hub of innovation and boasts a proud heritage, making it an appealing place to live and work.
A UK-based hospital is looking for a Consultant in Stroke Medicine with an interest in TIA clinics and stroke rehabilitation. The department comprises a collaborative multidisciplinary team supporting patient care and research. This role is open to both international applications and UK-based doctors, though those with relevant specialist 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
Candidates must possess full GMC registration and be on the Specialist Register (or within six months of eligibility). A relevant specialist qualification is required. Experience or an interest in TIA clinics and acute stroke services is highly desirable. The salary will be competitive and dependent on experience or grade.
CORE DUTIES OF THIS ROLE
- Deliver consultant-led stroke care, including acute services and TIA clinics.
- Participate in the on-call rota and support weekend services for acute stroke care.
- Contribute to clinical governance, service enhancement, and ongoing research initiatives.
- Collaborate with the multidisciplinary team to train junior medical and allied health staff.
LIFE IN THE REGION
This hospital is located in a vibrant metropolitan district offering both urban living and tranquil suburban options. The region provides excellent schools, efficient transport networks, and diverse cultural and leisure opportunities. Its rich heritage and commitment to innovation make it a dynamic and rewarding place to work.
A general hospital in the Channel Isles is looking for a Consultant Dermatologist with an interest in medical dermatology, paediatric dermatology, and skin surgery. The dermatology department includes a lead consultant and is supported by a team of dedicated nurses and administrative staff. This dermatology role is open to both international and UK-based doctors, with preference given to those holding a GMC Specialist Registration or an equivalent Royal College qualification.
Anyone requiring portfolio support (CESR) can discuss their needs on a case-by-case basis.
JOB REQUIREMENTS AND DETAILS
- A Primary Medical Degree and GMC Specialist Registration are required for this role, and those interested in skin cancer prevention and general dermatology are encouraged to apply.
- The salary will be between £102,090 - £152,196 per annum, depending on experience or grade.
CORE DUTIES OF THIS ROLE
- Conduct outpatient clinics focused on medical and general dermatology, including minor procedures.
- Collaborate with Primary Care and other specialists for patient referrals and skin cancer prevention.
- Participate in weekly multidisciplinary team meetings focused on skin cancer.
- Provide mentorship and support for nursing staff within the dermatology department.
LIFE IN THE CHANNEL ISLES
The Channel Isles offer an idyllic coastal lifestyle with easy access to both the UK and France. Residents can enjoy the vibrant town life of St. Helier or the serene countryside across the island’s parishes.This area has excellent schools, convenient transport links to major UK cities, and diverse leisure activities including beach sports, hiking, and water sports. With its blend of British and French cultural influences and scenic coastlines, the area is ideal for work and family life. Historically, the Channel Isles are known for their rich heritage and distinctive cultural blend, offering unique historical landmarks and fortifications.
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 all the way to starting 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