Free Practice Questions for MRCP PACES

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MRCP(UK) Part 1

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Sample MRCP PACES Practice Questions

Try these sample questions to review concepts for the MRCP PACES exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1How many clinical stations and how many separate patient encounters make up the PACES (PACES23) carousel?

A.Four stations and six encounters

B.Five stations and eight encounters

C.Six stations and ten encounters

D.Five stations and five encounters

Explanation: PACES is a five-station carousel comprising eight patient encounters. Stations 2 and 5 each contain a single 20-minute consultation, while Stations 1, 3 and 4 each contain two 10-minute encounters, giving eight encounters in total.

2Which scoring values are awarded for each clinical skill on a PACES marksheet?

A.Satisfactory 3, Borderline 2, Unsatisfactory 1

B.Pass 1, Fail 0

C.Satisfactory 2, Borderline 1, Unsatisfactory 0

D.Excellent 4, Good 3, Adequate 2, Poor 1

Explanation: Each skill on each encounter is graded on a 0-1-2 scale: Satisfactory scores 2 marks, Borderline scores 1 mark and Unsatisfactory scores 0 marks. Examiners calibrate against the standard of a trainee ready to enter higher specialty training.

3PACES assesses seven core clinical skills labelled A to G. Which option correctly pairs a skill letter with its descriptor?

A.Skill A = Differential Diagnosis

B.Skill B = Identifying Physical Signs

C.Skill C = Clinical Judgement

D.Skill G = Managing Patients' Concerns

Explanation: The seven skills are A Physical Examination, B Identifying Physical Signs, C Clinical Communication, D Differential Diagnosis, E Clinical Judgement, F Managing Patients' Concerns and G Maintaining Patient Welfare. Skill B is correctly 'Identifying Physical Signs'.

4Which two stations are the 20-minute consultation stations in which all seven clinical skills are assessed?

A.Stations 1 and 4

B.Stations 3 and 4

C.Stations 1 and 3

D.Stations 2 and 5

Explanation: Stations 2 and 5 are the integrated consultation ('clinical consultation') encounters lasting 20 minutes each, and all seven skills A-G are assessed in them. Together they account for over one-third of the total marks, so weak performance there strongly threatens an overall pass.

5To pass PACES overall, a candidate must meet two requirements. What are they?

A.Achieve at least the overall minimum total mark only

B.Pass each of the seven clinical skills AND achieve the overall minimum total mark

C.Pass at least five of the seven skills and any total mark

D.Be graded Satisfactory on every single encounter

Explanation: Passing PACES is a conjunctive standard: the candidate must reach the pass mark for each of the seven individual skills AND reach the overall minimum total score (168 marks available, with 113 needed across the skill totals and at least 127 overall in PACES23). Failing either condition is a fail.

6In a Station 1 communication encounter, which set of skills do the two examiners assess?

A.A, B, D, E, G (physical examination skills)

B.All seven skills A to G

C.C, E, F, G (communication, judgement, concerns, welfare)

D.C and F only

Explanation: The communication encounters in Stations 1 and 4 assess skills C (Clinical Communication), E (Clinical Judgement), F (Managing Patients' Concerns) and G (Maintaining Patient Welfare). There is no physical examination, so skills A, B and D are not assessed in these encounters.

7How long is allowed for the physical examination itself in a 10-minute examination encounter (e.g. respiratory, cardiovascular or abdominal)?

A.A maximum of 6 minutes, followed by about 4 minutes of discussion

B.The full 10 minutes for examination with no discussion

C.8 minutes for examination and 2 minutes of discussion

D.4 minutes for examination and 6 minutes of discussion

Explanation: In a 10-minute physical examination encounter a maximum of about 6 minutes is allowed for examining the patient, followed by roughly 4 minutes of discussion with the examiner covering findings, diagnosis, investigations and management.

8How many examiners assess a candidate over the whole PACES carousel, and how are they distributed?

A.Five examiners, one per station

B.Eight examiners, one per encounter

C.Sixteen examiners, two per encounter

D.Ten examiners, two per station

Explanation: Each station has two independent examiners, giving ten examiners across the five stations. Each examiner completes a marksheet for the relevant encounter(s), and examiners calibrate against the patients/scenarios beforehand to agree the satisfactory standard.

9In the PACES23 communication encounters in Stations 1 and 4, what is the format regarding examiner interaction?

A.A 5-minute viva with the examiners follows the patient interaction

B.There is no examiner-candidate viva; marks are based on observation only

C.Examiners interrupt to ask questions during the encounter

D.The candidate presents a written summary to the examiners afterwards

Explanation: A key PACES23 change is that the 10-minute communication encounters have no candidate-examiner question-and-answer component. Examiners award marks based solely on their observation of the candidate's interaction with the patient or surrogate.

10Within a 20-minute Station 2 or Station 5 consultation, how is the time conventionally divided?

A.20 minutes with the patient and no examiner discussion

B.10 minutes history and 10 minutes examiner viva

C.15 minutes with the patient (history, examination, discussion) then a 5-minute discussion with a lead examiner

D.5 minutes with the patient and 15 minutes of viva

Explanation: In the consultation stations the candidate has 15 minutes with the patient to take a focused history, perform a relevant examination, explain the likely diagnosis/management and address concerns, with a 2-minute warning at 13 minutes. This is followed by a 5-minute discussion with the lead examiner.

About the MRCP PACES Exam

MRCP(UK) PACES is the final clinical component of the MRCP(UK) diploma. It assesses seven core skills across eight patient encounters in a five-station carousel, marked Satisfactory (2), Borderline (1) or Unsatisfactory (0) by two examiners per station. Candidates must have passed MRCP Part 1 before sitting PACES.

Exam sponsor: Federation of the Royal Colleges of Physicians of the UK. The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

Five-station carousel with eight encounters: Station 1 (communication + respiratory), Station 2 (consultation), Station 3 (cardiovascular + neurological), Station 4 (communication + abdominal) and Station 5 (consultation).

Time Limit

Half-day; each of the five stations lasts 20 minutes with 5-minute breaks (approximately 125 minutes of assessed time).

Passing Score

Criterion-referenced. 168 marks are available; candidates must pass each of the seven clinical skills and reach the overall minimum (about 126-127 marks in PACES23).

Exam / Certification Fees

PACES23: £716 (UK applicants) and £1,311 (international applicants) for 2026 diets; confirm on the Federation website before applying.

Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Official sources

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

20%

Consultation and clinical judgement (Stations 2 and 5)

Two 20-minute integrated consultations assessing all seven skills: focused history, examination, diagnosis, investigation and management with attention to the patient's concerns.

21%

Neurological examination (Station 3)

Cranial nerve, limb and gait neurology, including localising upper vs lower motor neurone, cerebellar, peripheral nerve and neuromuscular junction signs.

13%

Communication and ethics (Stations 1 and 4)

Two 10-minute communication encounters assessed by observation only, covering breaking bad news, capacity, consent, confidentiality, candour and managing concerns.

12%

Cardiovascular examination (Station 3)

Valvular heart disease, prosthetic valves, pulse character, JVP waveform, murmurs and dynamic auscultation manoeuvres.

12%

Abdominal examination (Station 4)

Organomegaly, chronic liver disease stigmata, transplanted kidney, polycystic kidneys, stomas and demonstrating ascites.

12%

Exam format and marking

The carousel structure, the seven skills A-G, 0-1-2 grading, examiner calibration and the conjunctive pass criteria.

10%

Respiratory examination (Station 1)

Pulmonary fibrosis, consolidation, pleural effusion, COPD, bronchiectasis and surgical or transplant signs, with correct sign identification.

Preparing for the MRCP PACES Exam

What You Need to Know

Passing score: Criterion-referenced. 168 marks are available; candidates must pass each of the seven clinical skills and reach the overall minimum (about 126-127 marks in PACES23).
Assessment: Five-station carousel with eight encounters: Station 1 (communication + respiratory), Station 2 (consultation), Station 3 (cardiovascular + neurological), Station 4 (communication + abdominal) and Station 5 (consultation).
Time limit: Half-day; each of the five stations lasts 20 minutes with 5-minute breaks (approximately 125 minutes of assessed time).
Exam / certification fees: PACES23: £716 (UK applicants) and £1,311 (international applicants) for 2026 diets; confirm on the Federation website before applying. Official sources

Using Our Practice Resources

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MRCP PACES: Suggested Study Strategy

1Practise slick, time-boxed physical examinations (about 6 minutes each) on real patients during ward rounds and clinics until the routine becomes muscle memory, then rehearse presenting findings with a clear diagnosis and management plan.

2Stations 2 and 5 plus the communication encounters carry over one-third of the marks and test all seven skills, so drill integrated consultations and structured communication frameworks (e.g. SPIKES, ICE, teach-back) rather than only spotting signs.

3Never fabricate a clinical sign: reporting findings that are not present earns an Unsatisfactory for Skill B; describe what you genuinely find and offer a sensible differential and completion.

Frequently Asked Questions

How is MRCP PACES structured?

PACES is a five-station carousel with eight patient encounters. Stations 2 and 5 are single 20-minute consultations, while Stations 1, 3 and 4 each contain two 10-minute encounters (communication or physical examination). Two examiners assess each station, ten in total.

What are the seven skills assessed in PACES?

Skill A Physical Examination, B Identifying Physical Signs, C Clinical Communication, D Differential Diagnosis, E Clinical Judgement, F Managing Patients' Concerns and G Maintaining Patient Welfare. Each is graded Satisfactory (2), Borderline (1) or Unsatisfactory (0).

What is the pass mark for PACES?

PACES uses criterion-referenced marking with 168 marks available. Candidates must pass each of the seven skills (113 across skill totals) and reach the overall minimum of about 126-127 marks. Failing either condition is a fail.

How much does MRCP PACES cost in 2026?

For 2026 diets the PACES23 fee is £716 for UK applicants and £1,311 for international applicants. Candidates must have passed MRCP(UK) Part 1 before sitting PACES.