100+ Free MRCPI GM Part II Written Practice Questions
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Key Facts: MRCPI GM Part II Written Exam
150 SBA questions
Two papers of 75 single-best-answer questions each on the Part II Written exam
RCPI MRCPI General Medicine Part II Written
5 hours
Total exam time, 2.5 hours per paper with a 90-minute break under remote invigilation
RCPI MRCPI General Medicine Part II Written
€750
Exam fee for the 2026 MRCPI Part II Written diets for all candidates
RCPI Examinations Schedule 2026
No negative marking
Each correct answer scores one mark and unanswered questions are not penalised
RCPI MRCPI General Medicine Regulations
No basic science
Part II contains no basic science questions, unlike Part I
RCPI MRCPI General Medicine Part II Written
5 options
Each official question presents a stem with five options and one single best answer
RCPI MRCPI General Medicine Regulations
6 years
Part I must have been passed within the previous six years to apply for Part II
RCPI MRCPI General Medicine Part II Written
100
Free original SBA practice questions provided here
OpenExamPrep
The MRCPI General Medicine Part II Written exam is RCPI's second-stage written test of internal medicine, sat after Part I and before the Part II Clinical. It is two papers of 75 Single Best Answer questions each (150 total), delivered online via remote invigilation, with 2.5 hours per paper and a 90-minute break, for five hours in total. The 2026 fee is €750 and there is no negative marking. Questions are blueprinted by specialty (cardiology, respiratory, gastroenterology and hepatology, nephrology, endocrinology each carry 10%; neurology and related disciplines, rheumatology, and immunology and haematology each 10%; infectious diseases, oncology and palliative care, dermatology, and therapeutics each 5%) and emphasise data interpretation and management. This 100-question bank provides original SBA practice mapped to that blueprint.
Sample MRCPI GM Part II Written Practice Questions
Try these sample questions to test your MRCPI GM Part II Written exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.
1A 68-year-old man presents with 40 minutes of central crushing chest pain. ECG shows 2 mm ST elevation in leads II, III and aVF. Which coronary artery is most likely occluded?
2A 72-year-old woman with an inferior STEMI becomes hypotensive after sublingual nitrate. Her chest is clear and JVP is elevated. Which additional ECG lead is most useful to confirm the likely cause?
3A 60-year-old man has progressive exertional dyspnoea. Echocardiography shows left ventricular ejection fraction of 30%. Which class of drug has the clearest mortality benefit and should be started first alongside a beta-blocker?
4A 75-year-old man with heart failure and an ejection fraction of 28% remains symptomatic on maximal ACE inhibitor and beta-blocker. He is in sinus rhythm at 82 bpm with potassium 4.4 mmol/L. What is the most appropriate next addition?
5A 70-year-old woman has palpitations. ECG shows an irregularly irregular rhythm with no P waves at 130 bpm. She is haemodynamically stable with onset more than 48 hours ago. What is the most appropriate immediate priority?
6A 55-year-old man with non-valvular atrial fibrillation has hypertension and diabetes but no prior stroke. Using the CHA2DS2-VASc score, what is the most appropriate management of his thromboembolic risk?
7A 38-year-old man presents with pleuritic chest pain that is relieved by sitting forward. ECG shows widespread saddle-shaped ST elevation and PR depression. What is the most likely diagnosis?
8A 64-year-old man has exertional syncope and an ejection systolic murmur radiating to the carotids with a slow-rising pulse. Echocardiography shows a valve area of 0.8 cm2 and a mean gradient of 50 mmHg. What is the definitive treatment?
9A 28-year-old intravenous drug user has fever, a new pansystolic murmur and multiple cavitating lung lesions on chest imaging. Which valve is most likely affected?
10A 45-year-old man is found to have a blood pressure of 170/105 mmHg on repeated readings. Investigations show potassium 3.0 mmol/L, an elevated aldosterone-to-renin ratio and a left adrenal adenoma. What is the most likely diagnosis?
About the MRCPI GM Part II Written Exam
The MRCPI General Medicine Part II Written examination is the second of three components of the MRCPI in General Medicine, the postgraduate membership qualification of the Royal College of Physicians of Ireland for internal medicine. It is taken after MRCPI General Medicine Part I and assesses the diagnosis and management of patients across the breadth of hospital general (internal) medicine. The exam consists of two papers, each with 75 Single Best Answer questions, delivered online via remote invigilation worldwide. Unlike Part I, there are no basic science questions; vignettes are longer and more clinical, and many questions require interpretation of investigations, imaging and data. Questions are blueprinted across cardiology, respiratory medicine, gastroenterology and hepatology, nephrology, endocrinology, neurology and related disciplines, rheumatology, immunology and haematology, infectious diseases, oncology and palliative care, dermatology, and therapeutics and toxicology.
Assessment
Two papers, each with 75 Single Best Answer (SBA) questions, for 150 questions in total. Each question is a clinical vignette with five options and one best answer; all questions are equally weighted with one mark each and no negative marking.
Time Limit
Five hours in total: each paper is 2.5 hours, with a 90-minute break between the two papers under remote invigilation.
Passing Score
Criterion-referenced. A pass standard is set for each diet by standard-setting so the standard stays consistent between examinations; there is no fixed percentage published and no negative marking.
Exam Fee
€750 for the 2026 diets, for both Irish and overseas candidates, paid by credit or debit card at application. (Royal College of Physicians of Ireland (RCPI))
MRCPI GM Part II Written Exam Content Outline
Cardiology
Acute coronary syndromes, heart failure, arrhythmias, valvular and pericardial disease, hypertension, endocarditis and ECG, echocardiography and haemodynamic interpretation.
Respiratory Medicine
Asthma, COPD, pneumonia, interstitial lung disease, pulmonary embolism, pleural effusion and interpretation of spirometry, arterial blood gases and chest imaging.
Gastroenterology & Hepatology
Inflammatory bowel disease, upper and lower GI bleeding, chronic liver disease and decompensation, pancreatitis, coeliac disease and liver-function and endoscopic interpretation.
Nephrology
Acute kidney injury, chronic kidney disease, glomerulonephritis, electrolyte and acid-base disorders, hypertension and interpretation of renal and urinary investigations.
Endocrinology & Metabolic Medicine
Type 1 and 2 diabetes and emergencies, thyroid, adrenal, pituitary, parathyroid and calcium disorders, and interpretation of dynamic endocrine testing.
Neurology, Ophthalmology & Psychiatry
Stroke and TIA, seizures and status epilepticus, headache, neuromuscular and movement disorders, plus common ophthalmic and psychiatric presentations seen by physicians.
Rheumatology
Rheumatoid and seronegative arthritis, SLE and connective tissue disease, vasculitis, crystal arthropathies and interpretation of autoantibody and inflammatory marker patterns.
Immunology & Haematology
Anaemias, haematological malignancies, coagulation and thrombosis, transfusion medicine and immunodeficiency, with blood film, coagulation and electrophoresis interpretation.
Infectious Diseases & Genitourinary Medicine
Sepsis and antimicrobial selection, HIV, tuberculosis, hospital and travel-related infection and sexually transmitted infections in the medical patient.
Oncology & Palliative Care
Oncological emergencies, principles of systemic anti-cancer therapy and immunotherapy toxicity, paraneoplastic syndromes and symptom control in palliative care.
Dermatology
Eczema, psoriasis and skin infections, cutaneous signs of systemic disease, drug eruptions and recognition of dermatological emergencies such as toxic epidermal necrolysis.
Therapeutics & Toxicology
Clinical pharmacology, prescribing in renal and hepatic impairment and pregnancy, drug interactions and adverse effects, and the assessment and management of poisoning.
How to Pass the MRCPI GM Part II Written Exam
What You Need to Know
- Passing score: Criterion-referenced. A pass standard is set for each diet by standard-setting so the standard stays consistent between examinations; there is no fixed percentage published and no negative marking.
- Assessment: Two papers, each with 75 Single Best Answer (SBA) questions, for 150 questions in total. Each question is a clinical vignette with five options and one best answer; all questions are equally weighted with one mark each and no negative marking.
- Time limit: Five hours in total: each paper is 2.5 hours, with a 90-minute break between the two papers under remote invigilation.
- Exam fee: €750 for the 2026 diets, for both Irish and overseas candidates, paid by credit or debit card at application.
Keys to Passing
- Complete 500+ practice questions
- Score 80%+ consistently before scheduling
- Focus on highest-weighted sections
- Use our AI tutor for tough concepts
MRCPI GM Part II Written Study Tips from Top Performers
Frequently Asked Questions
How many questions are on the MRCPI General Medicine Part II Written exam?
There are 150 Single Best Answer questions, split across two papers of 75 questions each. Each question is equally weighted with one mark and there is no negative marking, so candidates should attempt every question.
How long is the MRCPI Part II Written exam?
Each paper lasts 2.5 hours, giving five hours of exam time in total. Under remote invigilation there is currently a 90-minute break between the two papers.
Is there a fixed pass mark for MRCPI Part II Written?
No. The pass standard is set for each diet using standard-setting so the required standard is consistent between examinations. There is no published fixed percentage and no negative marking.
Does Part II include basic science questions?
No. Unlike Part I, the Part II Written exam contains no basic science questions. It focuses on the diagnosis and management of patients, with longer clinical vignettes and frequent interpretation of investigations and data.
What are the entry requirements for the Part II Written exam?
You must have passed MRCPI General Medicine Part I or MRCPI Paediatrics Part I within the last six years, or hold an exempting qualification. If that six-year period has expired you must re-sit Part I. FRACP holders may apply for exemption.
Where and how is the exam delivered?
The Part II Written exam is computer-based and delivered worldwide via remote invigilation, so candidates can sit it anywhere with a reliable internet connection. The 2026 fee is €750.