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MRCPsych Paper A

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Sample MRCPsych Paper B Practice Questions

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

1A randomised controlled trial reports that an antidepressant reduces the absolute risk of relapse from 40% to 25% over 12 months. What is the number needed to treat (NNT) to prevent one relapse?

A.About 7

B.About 4

C.About 15

D.About 2

Explanation: NNT is the reciprocal of the absolute risk reduction (ARR). ARR = 40% - 25% = 15% = 0.15, so NNT = 1/0.15 = 6.67, which rounds to about 7. This means roughly 7 patients must be treated to prevent one additional relapse.

2A case-control study examines the association between a rare adverse drug reaction and a new antipsychotic. Which measure of association is most appropriately derived from this design?

A.Relative risk

B.Absolute risk reduction

C.Odds ratio

D.Hazard ratio

Explanation: Because participants in a case-control study are selected on the basis of outcome (case or control), incidence cannot be measured directly, so relative risk cannot be calculated. The odds ratio is the appropriate measure and approximates relative risk well when the outcome is rare.

3In a study comparing mean Hamilton Depression scores between two independent groups of patients, the data are normally distributed with equal variances. Which statistical test is most appropriate?

A.Mann-Whitney U test

B.Paired t-test

C.Unpaired (independent) t-test

D.Wilcoxon signed-rank test

Explanation: Comparing the means of two independent groups with normally distributed continuous data and equal variances calls for the unpaired (independent samples) t-test. The data being parametric rules out the rank-based non-parametric alternatives.

4A trial reports a relative risk of 0.70 with a 95% confidence interval of 0.45 to 1.10 for the effect of an intervention on hospital readmission. How should this result be interpreted?

A.A statistically significant 30% reduction in readmission

B.A non-significant result because the confidence interval crosses 1

C.A statistically significant increase in readmission

D.Insufficient data to comment on significance

Explanation: For a ratio measure such as relative risk, the value 1.0 represents no effect. Because the 95% confidence interval (0.45 to 1.10) includes 1.0, the result is not statistically significant at the 5% level, even though the point estimate suggests benefit.

5Which type of bias is most directly minimised by ensuring that outcome assessors in a trial are unaware of treatment allocation?

A.Selection bias

B.Detection (ascertainment) bias

C.Recall bias

D.Lead-time bias

Explanation: Blinding outcome assessors prevents detection (ascertainment) bias, in which knowledge of allocation systematically influences how outcomes are measured or recorded. Blinding assessors keeps outcome measurement objective across groups.

6A diagnostic test for a depressive disorder has a sensitivity of 90% and a specificity of 60%. In a population with low prevalence of the disorder, what happens to the positive predictive value (PPV)?

A.It rises towards 100%

B.It falls because most positives are false positives

C.It is unaffected by prevalence

D.It equals the specificity

Explanation: Positive predictive value depends heavily on prevalence. When prevalence is low, even a test with good sensitivity yields many false positives relative to true positives, so the PPV falls. Sensitivity and specificity remain constant but predictive values shift with prevalence.

7An investigator wishes to combine the results of several randomised trials into a single quantitative summary estimate of treatment effect. What is this technique called?

A.Narrative review

B.Meta-analysis

C.Sensitivity analysis

D.Subgroup analysis

Explanation: Meta-analysis is the statistical technique that pools quantitative results from multiple studies to produce a single combined effect estimate, usually displayed in a forest plot. A systematic review may or may not include a meta-analysis.

8In a forest plot from a meta-analysis, the I-squared statistic is reported as 85%. What does this indicate?

A.Low statistical heterogeneity between studies

B.Substantial heterogeneity between studies

C.A statistically significant pooled effect

D.High publication bias

Explanation: The I-squared statistic quantifies the proportion of total variation across studies due to heterogeneity rather than chance. A value of 85% indicates substantial (considerable) heterogeneity, suggesting the studies differ meaningfully and pooling should be interpreted cautiously, often favouring a random-effects model.

9A researcher sets the significance level (alpha) at 0.05. What does committing a Type I error mean in this context?

A.Failing to reject a false null hypothesis

B.Rejecting a true null hypothesis

C.Accepting the alternative hypothesis when it is true

D.Reducing the power of the study

Explanation: A Type I error (alpha error) is rejecting the null hypothesis when it is in fact true, i.e. a false positive. Setting alpha at 0.05 means accepting a 5% probability of making this error.

10A study is underpowered. Increasing which of the following would most directly increase the statistical power to detect a true effect?

A.Decreasing the sample size

B.Increasing the sample size

C.Reducing the effect size of interest

D.Lowering alpha to 0.01

Explanation: Statistical power increases with larger sample size, larger effect size, larger alpha, and smaller variance. Increasing the sample size reduces the standard error and improves the ability to detect a true effect.

About the MRCPsych Paper B Exam

MRCPsych Paper B is the second written paper of the Royal College of Psychiatrists membership examination, assessing critical review and clinical topics in psychiatry. It is a 3-hour, 150-mark paper of MCQs and extended matching items, of which roughly one-third (33.5%, 50 marks) is critical review, statistics and evidence-based practice and two-thirds is clinical psychiatry. The exam is delivered through Pearson VUE at test centres or via OnVUE remote online proctoring.

Exam sponsor: Royal College of Psychiatrists (RCPsych). The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

150 questions in 3 hours, worth 150 marks: about two-thirds single-best-answer MCQs and one-third extended matching items, covering critical review and clinical psychiatry.

Time Limit

3 hours (180 minutes)

Passing Score

Criterion-referenced pass mark set per diet using the modified Angoff method; there is no fixed percentage pass mark.

Exam / Certification Fees

2026: GBP 511 for PMPT trainees/affiliates, GBP 567 for non-PMPT trainees/affiliates (set by RCPsych).

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.

34%

Critical Review

Evidence-based practice, study design, bias, confounding, diagnostic statistics, hypothesis testing, regression and meta-analysis (officially 33.5% / 50 marks).

20%

General Adult

Mood, psychotic, anxiety and personality disorders, psychopharmacology, risk assessment and ECT (30 marks).

Old Age

Dementia, delirium, late-life depression and safe prescribing in older adults (14 marks).

Child & Adolescent

ADHD, autism, eating disorders, self-harm, development and attachment (14 marks).

Substance Misuse

Alcohol and opioid dependence, detoxification, relapse prevention and dual diagnosis (10 marks; officially 6.5%).

Organisation and Delivery

Service models, Mental Health Act, Mental Capacity Act, clinical governance and audit (8 marks; officially 5.5%).

Psychotherapy

CBT, IPT, psychodynamic concepts, defence mechanisms and trauma-focused therapy (8 marks; officially 5.5%).

Forensic

Risk assessment, fitness to plead, the insanity defence and Mental Health Act court disposals (8 marks; officially 5.5%).

Learning Disability

Classification, genetic and behavioural phenotypes, capacity and challenging behaviour (8 marks; officially 5.5%).

Preparing for the MRCPsych Paper B Exam

What You Need to Know

Passing score: Criterion-referenced pass mark set per diet using the modified Angoff method; there is no fixed percentage pass mark.
Assessment: 150 questions in 3 hours, worth 150 marks: about two-thirds single-best-answer MCQs and one-third extended matching items, covering critical review and clinical psychiatry.
Time limit: 3 hours (180 minutes)
Exam / certification fees: 2026: GBP 511 for PMPT trainees/affiliates, GBP 567 for non-PMPT trainees/affiliates (set by RCPsych). Official sources

Using Our Practice Resources

Work through all 100 available questions
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MRCPsych Paper B: Suggested Study Strategy

1Prioritise critical review and statistics: it is the single largest section (33.5%, 50 marks) and strong performance can offset weaker clinical areas. Drill NNT/NNH, odds ratio versus relative risk, confidence intervals, bias and study design.

2Map your revision to the official RCPsych weightings so you give General Adult (20%) the most clinical time while still covering subspecialties you may not have rotated through.

3Practise applying NICE guidance to clinical vignettes (e.g. clozapine for treatment-resistant schizophrenia, lithium monitoring, first-line ADHD and anorexia treatment) rather than memorising isolated facts.

Frequently Asked Questions

How many questions are on MRCPsych Paper B and how long is it?

Paper B has 150 questions worth 150 marks and lasts 3 hours. About two-thirds are single-best-answer multiple-choice questions and one-third are extended matching items.

How much of Paper B is critical review and statistics?

Critical review (research methods, statistics and evidence-based practice) makes up 33.5% of the paper, worth 50 of the 150 marks. The remaining two-thirds cover clinical psychiatry.

What is the pass mark for MRCPsych Paper B?

There is no fixed percentage pass mark. RCPsych sets a criterion-referenced pass mark for each diet using the modified Angoff standard-setting method, so it varies slightly between sittings.

How much does Paper B cost in 2026 and who delivers it?

In 2026 the fee is GBP 511 for PMPT trainees and affiliates and GBP 567 for non-PMPT candidates. The exam is delivered through Pearson VUE at a test centre or online via OnVUE remote proctoring.