MRCP(UK) Part 1 study guide
MRCP(UK) Part 1 · Work through your exam, one topic at a time.
MRCP(UK) Part 1 is the entry examination of the Royal College of Physicians' three-part membership assessment, and it sits alongside Part 2 and PACES within the Federation's examinations portfolio. It is a written examination, taken by doctors who are building a career in hospital medicine - most often those in core medical training, internal medicine training or equivalent posts - as the first formal hurdle on the route to full MRCP(UK) and entry into higher specialty training. The MRCP(UK) Part 1 study guide has 12 sections and about 3,488 words.
01Cardiology
Ischaemic heart disease dominates. Know STEMI criteria (ST elevation ≥1 mm in two contiguous limb leads, ≥2 mm in V2–V3 in men, or new LBBB with ischaemic symptoms), the role of high-sensitivity troponin in NSTE-ACS, and the time-critical nature of primary PCI.
311 words, about 2 min02Respiratory Medicine
Start with spirometry: obstruction is a reduced FEV1/FVC ratio (<0.7), restriction a reduced FVC with preserved or raised ratio. Asthma shows variable, reversible airflow obstruction with diurnal variation; COPD shows persistent obstruction with a smoking or occupational history, graded by FEV1 percentage predicted (GOLD) and assessed for exacerbation frequency.
309 words, about 2 min03Gastroenterology (including Hepatology)
Read liver biochemistry by pattern: hepatocellular (ALT/AST rise out of proportion to ALP) versus cholestatic (ALP and GGT rise). Cirrhosis complications: variceal bleeding (band ligation, terlipressin, prophylactic antibiotics), ascites (diagnostic tap; serum-ascites albumin gradient ≥11 g/L means portal hypertension), spontaneous bacterial peritonitis (ascitic neutrophils 250 cells/mm³; cephalosporin plus albumin), hepatic encephalopathy (lactulose plus find the precipitant), hepatorenal syndrome.
276 words, about 1 min04Endocrinology and Diabetes Mellitus
Diabetes is diagnosed by HbA1c ≥48 mmol/mol, fasting glucose ≥7.0 mmol/L, or 2-hour glucose ≥11.1 mmol/L; HbA1c is unreliable in haemoglobinopathy, pregnancy, advanced CKD and recent transfusion. DKA (ketosis, acidosis, glucose usually 11 mmol/L) versus HHS (very high glucose, hyperosmolality, minimal ketosis) both need fluids, insulin and potassium replacement guided by the potassium level.
283 words, about 1 min05Renal Medicine
KDIGO defines AKI as a creatinine rise ≥26 µmol/L in 48 hours, ≥1.5× baseline within 7 days, or urine output <0.5 mL/kg/h for 6 hours. Divide into prerenal (responds to fluid; bland urine; fractional excretion of sodium <1%), intrinsic (acute tubular necrosis, glomerulonephritis, interstitial nephritis, myoglobin, contrast) and postrenal (obstruction - image the tract).
308 words, about 2 min06Neurology
Stroke: sudden focal deficit; thrombolysis within 4.5 hours and thrombectomy up to 24 hours in selected large-vessel occlusion; exclude hypoglycaemia and haemorrhage first. Localise: anterior circulation (hemiparesis, aphasia, hemianopia), posterior circulation (vertigo, diplopia, ataxia, crossed signs), lacunar syndromes (pure motor, pure sensory, sensorimotor, ataxic hemiparesis).
278 words, about 1 min07Rheumatology
Rheumatoid arthritis: symmetrical small-joint synovitis, morning stiffness over an hour, anti-CCP (more specific than rheumatoid factor), erosions; treat early with methotrexate and escalate to biologics; know extra-articular disease (nodules, interstitial lung disease, vasculitis, Felty's syndrome, cervical subluxation). Spondyloarthritis: inflammatory back pain, sacroiliitis, HLA-B27, associated psoriasis, uveitis and inflammatory bowel disease, with asymmetric large-joint and entheseal involvement.
274 words, about 1 min08Haematology
Classify anaemia by mean corpuscular volume. Microcytic: iron deficiency (low ferritin, low transferrin saturation), thalassaemia (normal or high ferritin, target cells, family history), anaemia of chronic disease (low iron, low TIBC, high ferritin).
289 words, about 1 min09Infectious Diseases and Tropical Medicine
Sepsis is infection with organ dysfunction: cultures, lactate, antibiotics within an hour and fluid resuscitation. HIV: serology has a window period; CD4 count drives prophylaxis (co-trimoxazole under 200, azithromycin for Mycobacterium avium under 50); know the opportunistic infections (Pneumocystis pneumonia, toxoplasmosis, cryptococcal meningitis, CMV retinitis, Kaposi's sarcoma) and post-exposure prophylaxis within 72 hours.
291 words, about 1 min10Clinical Pharmacology and Therapeutics
Pharmacokinetics: absorption, distribution (volume of distribution), metabolism (phase I cytochrome P450, phase II conjugation) and excretion. First-order kinetics eliminates a constant fraction per unit time and reaches steady state after 4–5 half-lives; zero-order kinetics (phenytoin, ethanol, high-dose salicylate, theophylline) eliminates a constant amount, so small dose increments cause disproportionate rises.
293 words, about 1 min11Dermatology
Describe before diagnosing: site, distribution, symmetry, colour, border, surface and mucosal involvement. Eczema is itchy, ill-defined and flexural in atopic disease; treat with emollients and topical steroids chosen by potency and site (mild for the face, potent for limbs).
304 words, about 2 min12General Internal Medicine and Geriatric Medicine
The geriatric giants are falls, immobility, incontinence and intellectual impairment. Falls: assess gait, vision, medications (sedatives, antihypertensives, anticholinergics), postural blood pressure, syncope, vitamin D and bone health.
272 words, about 1 min