1.2 The Official Blueprint and Mark Allocation

The Blueprint Is a Marks Map

The Federation publishes an explicit blueprint for Part 1: a table of the likely number of questions under each broad clinical heading, updated to match the terminology of the UK Internal Medicine curriculum and in use since the 2020/1 diet. The Federation notes the figures are "an indication of the likely number of questions — the actual number may vary slightly", but they are stable enough to plan around. Revising without reference to this table is the single most common structural error in Part 1 preparation, because subjective interest rarely tracks mark weighting.

The Official Specialty Distribution

Inside Clinical Sciences

Clinical sciences is the largest single heading at 25 questions, and the Federation breaks it down further:

Two features of this sub-table repay attention. Statistics, epidemiology and evidence-based medicine is worth 5 marks — more than oncology, more than medical ophthalmology, more than palliative medicine. It is also the most learnable block in the whole exam: sensitivity, specificity, predictive values, likelihood ratios, relative and absolute risk, number needed to treat, and the choice between parametric and non-parametric tests are a finite, formula-driven syllabus that does not change between diets. Candidates who skip it are volunteering to drop marks they could have banked.

Second, the Federation states that clinical science questions "will include a clinical stem" wherever appropriate. You are not being asked to recite the Krebs cycle; you are being asked which enzyme deficiency explains a specific patient's hypoglycaemia and hepatomegaly.

Turning the Blueprint Into a Revision Plan

Work out the marks-per-hour of each block rather than revising alphabetically.

1. The 40-mark foundation. Clinical sciences (25) plus clinical pharmacology and therapeutics (15) is 40 marks — 20% of the exam, and larger than any single clinical specialty. This material is also highly portable: cytochrome P450 interactions, therapeutic drug monitoring and hypersensitivity mechanisms reappear inside specialty questions.
2. The eight 14-mark specialties. Cardiology, endocrinology, gastroenterology and hepatology, infectious diseases, neurology, renal medicine, respiratory medicine and rheumatology carry 112 marks between them — 56% of the exam. No one of these can be sacrificed; a candidate who neglects rheumatology because it feels niche is discarding the same weight as cardiology.
3. The mid-weight block. Haematology (10), psychiatry (9), dermatology (8) and geriatric medicine (8) total 35 marks — 17.5%. Psychiatry and geriatrics are commonly under-revised by candidates who assume Part 1 is a "pure medicine" paper; between them they are worth more than haematology.
4. The small-but-cheap block. Oncology (5), medical ophthalmology (4) and palliative medicine (4) total 13 marks. Each has a small, high-yield core — oncological emergencies, the acute red eye, the WHO analgesic ladder and opioid conversion — and a few focused hours can convert most of these marks.

A Worked Prioritisation

Suppose you have 200 hours of revision. Allocating hours in proportion to marks gives roughly 25 hours to clinical sciences, 15 to pharmacology, 14 to each of the eight major specialties (112 hours), 35 across haematology, psychiatry, dermatology and geriatrics, and 13 to oncology, ophthalmology and palliative medicine. That distribution feels uncomfortable to most candidates because it forces time into psychiatry and geriatrics and caps time in a favourite specialty — which is precisely the corrective the blueprint exists to provide.

• Audit your question-bank performance by blueprint heading, not by overall percentage.
• A 60% score in a 14-mark specialty costs you 5.6 marks; the same 60% in medical ophthalmology costs 1.6. Fix the expensive gaps first.
• Re-check the published blueprint before each diet, since the Federation updates it when the Internal Medicine curriculum changes.

Three Common Misreadings of the Blueprint

1. "Clinical sciences is basic science I can skip." It is 25 marks, the largest heading, and the Federation states that questions carry a clinical stem wherever appropriate. A genetics question is a pedigree with a recurrence risk; an immunology question is a patient with recurrent encapsulated organism infection.
2. "Rheumatology and infectious diseases are minor specialties." Both sit at 14 questions, identical to cardiology. Candidates from cardiology-heavy jobs consistently under-invest here.
3. "Small headings are not worth revising." Oncology, ophthalmology and palliative medicine total 13 marks against a pass standard that turns on a handful of items. The content is narrow enough that near-complete coverage is realistic in a few hours.