MRCP Part 1 for IMGs: The Ultimate Guide

If you qualified outside the UK and you are thinking about a career in UK internal medicine, MRCP Part 1 is usually the first exam that makes the plan feel real. It is sat in many countries, it asks for relatively little by way of paperwork, and it tests the medical knowledge you already use every day. What it does not do is forgive unfamiliarity with how medicine is practised and written about in the UK.

This guide from Revision Pro’s consultant-led team is written for international medical graduates (IMGs). It covers eligibility, booking and overseas centres, the format, revising for a UK exam when you trained elsewhere, and how Part 1 leads on to Part 2, PACES, GMC registration and Internal Medicine Training. Every exam rule below was checked against The Federation of Royal Colleges of Physicians and the GMC. Where those sites are silent, so are we.

Why MRCP(UK) matters to international doctors

MRCP(UK) is a three-part diploma: the Part 1 written exam, the Part 2 written exam and the Part 2 clinical exam, PACES. It is run by the Royal Colleges of Physicians through The Federation, and it is the postgraduate qualification UK physicians are expected to hold before higher specialty training.

For IMGs it does two jobs. It is a respected qualification in its own right, and the full MRCP(UK) is on the GMC’s list of acceptable UK postgraduate qualifications for full registration. That is why many doctors weigh it against PLAB, as we explain in MRCP vs PLAB. If you are deciding whether to start straight after graduating, read MRCP after MBBS first.

Are you eligible? What the regulations actually say

The rules are simpler than many IMGs expect. According to the current MRCP(UK) regulations (April 2025 version) and the Part 1 FAQs:

• You need a primary medical qualification from an institution recognised by the GMC or listed in the World Directory of Medical Schools.
• You cannot sit Part 1 until 12 months after the graduation date on your primary medical qualification. The Federation recommends 12 months’ experience in medical employment (Foundation Year 1 or equivalent), and that experience can come from a hospital anywhere in the world.
• If you are not GMC registered, you submit a scan of your primary medical qualification, with a certified translation if it is not in English. Checks can take up to 20 working days after applications close.
• You have a maximum of six attempts at each part of the diploma. After six, you can apply for one exceptional additional attempt, backed by evidence of further education or training. Withdrawals, as MRCP(UK) defines them, do not count as attempts.

Two points catch people out. First, the name on your ID must exactly match your admission document, so resolve any differences in name order well before exam day. Second, all parts of the diploma are conducted in English. The Colleges advise that your English should be equivalent to IELTS 7.5, although you do not need to have taken IELTS to sit the exam.

Booking, fees and choosing an overseas centre

You apply through your My MRCP(UK) account, declare whether you are UK or non-UK trained, choose a centre and pay by card. Applications open and close at 8:00am UK time, so convert that to your local time zone well in advance.

There are three Part 1 diets a year. On the Federation’s dates and fees page, the fee from the September 2026 sitting onwards is £520 (UK) and £696 (international). The next sitting listed is 20 January 2027, with applications open from 27 October to 3 November 2026. Check the official Part 1 dates and fees page before you budget.

The Federation’s centre list includes locations across South Asia, the Middle East, Africa, South East Asia, the Caribbean, Australia, New Zealand, the Republic of Ireland and the United States, among others. Hong Kong has its own application process and fee, and candidates in Myanmar and Sudan sit a remote online proctored exam. From the September 2026 diet the exam is otherwise delivered in test centres. The Federation says it will try to assign your preferred centre or the nearest available one, and venue details arrive roughly three to four weeks before the exam. Always confirm your city on the UK and international centres page, as the list is updated.

What the exam looks like on the day

Part 1 is a one-day, computer-based exam with two papers. Each paper lasts three hours and contains 100 best-of-five questions, 200 in total. There are no images in Part 1, so clinical findings reach you as text. Each correct answer earns one mark and there is no negative marking, so never leave a question blank.

Results are reported as a scaled score. The Federation states that the pass mark from the first 2026 diet is a scaled score of 450, and that equating keeps results comparable between sittings. We explain what that means for your preparation in our guide to the MRCP Part 1 pass mark.

The blueprint is worth knowing by heart. Clinical sciences carries 25 questions and clinical pharmacology and therapeutics 15. Cardiology, endocrinology, gastroenterology, infectious diseases, neurology, renal medicine, respiratory medicine and rheumatology carry 14 each, with smaller allocations for haematology, psychiatry, dermatology, geriatric medicine, oncology, palliative medicine and ophthalmology. See our syllabus weightage breakdown for how to turn those numbers into study time.

Personal calculators and stationery are not permitted; pen and paper are provided. You need photo ID before each paper. Pack water in a clear bottle, a snack that is not strong-smelling and a warm layer, because temperature control in the room may be limited.

Revising for a UK exam when you trained elsewhere

For many international candidates the hard part is not knowledge but framing. The “best” answer is chosen with UK practice in mind, and your instincts were trained in a different system. Treat this as a skill to learn, not a gap to be embarrassed about.

Learn UK drug names. The UK uses British Approved Names, so you will see adrenaline rather than epinephrine, paracetamol rather than acetaminophen, salbutamol rather than albuterol, and glyceryl trinitrate rather than nitroglycerin. If your home formulary uses brand names, switch to generic names now.

Think in SI units. Glucose is in mmol/L, creatinine in micromol/L and HbA1c in mmol/mol. Build a personal sheet of the normal values you use most and learn to spot abnormality fast, because in the exam there is no time to convert.

Absorb the UK management mindset. Questions tend to reward the stepwise approach found in national guidance such as NICE: first-line before second-line, conservative before invasive, and the safest next step in an unstable patient. When two answers both seem reasonable, ask which one a UK medical registrar would do first. You need the logic of the guidance, not the documents.

A 16-week plan for international candidates

Sixteen weeks is a sensible span if you are working full time and also handling paperwork, travel and perhaps an English test. Adjust it to your starting point.

1. Weeks 1 to 2: set up. Book the diet, confirm your centre, check your ID and name match, and sit the official Federation sample test to see the interface. Do a timed block of 50 mixed questions to find your baseline.
2. Weeks 3 to 10: systematic coverage. Work through the specialties in blueprint order, starting with the heavy hitters. For each topic, read concise notes, then do questions in tutor mode and read every explanation, including those for questions you got right.
3. Weeks 11 to 13: clinical sciences and pharmacology. Together these carry 40 questions, and they reward focused, repeated memory work on the basic science and drug knowledge behind clinical medicine. Spaced-repetition flashcards are very efficient here.
4. Weeks 14 to 15: timed practice. Move to full three-hour timed papers under exam conditions, with no pauses. Review weak topics between papers.
5. Week 16: consolidate. Revisit your error log, light question practice, sleep, and plan the travel to your centre.

A question bank written for the UK exam matters even more for IMGs, because each explanation teaches the UK framing as well as the fact. A bank with past papers and timed mocks, such as Revision Pro’s MRCP Part 1 platform, lets you practise both. Use the Federation’s free sample questions alongside it.

Reading the question: language and style

Best-of-five stems are long and written in formal British English. These habits help, especially if English is not your first language.

• Read the final line first. “Most likely diagnosis”, “most appropriate next investigation” and “most appropriate initial management” are different questions, and the stem is written to trap the wrong one.
• Watch the qualifiers. Words such as “initial”, “definitive”, “most useful” and “least likely” change the answer entirely.
• Expect four plausible distractors. Often two options are correct in principle and only one is best at this moment for this patient.
• Practise the arithmetic by hand. Without a calculator, anion gap, corrected calcium and simple statistics need to be quick with pen and paper.
• Keep pace. Three hours for 100 questions gives you under two minutes each, so flag and move on rather than rereading a stem five times.

Where Part 1 fits: Part 2, PACES, GMC registration and IMT

You must pass Part 1 before applying for the other two parts. After that, the Part 2 written exam and PACES can be taken in either order. Part 2 has the same two-paper, 200-question structure but adds images such as ECGs, X-rays and pathology slides. PACES is a half-day clinical exam with five stations and eight patient encounters, assessing seven core clinical skills, and the Colleges recommend about two years of post-graduation experience first. The old rule that you had to finish Part 2 and PACES within seven years of Part 1 has been removed; the six-attempt limit now applies instead.

For GMC registration, the qualification that counts is the full MRCP(UK), awarded only once all three parts are passed. Part 1 alone does not give you registration. The GMC expects the postgraduate qualification to have been awarded within three years of approving your application, otherwise you need extra evidence of recent practice, and the qualification must be independently verified. MRCP(UK) cannot be used to prove your English, so you still need separate evidence of English, most simply an IELTS or OET certificate from the last two years that meets the GMC’s minimum scores, unless the GMC’s exemption for nationals and graduates of countries where English is the first language applies to you. Our GMC registration with MRCP guide walks through the whole application.

Part 1 also helps with Internal Medicine Training. The 2026 IMT CT1 person specification lists MRCP(UK) Part 1 as a desirable criterion, while full GMC registration is an eligibility requirement. IMT is a three-year programme, and the Federation states that trainees need the full diploma to progress to specialty training at ST4. Revision Pro’s IMG success series covers the IMT application itself.

Frequently asked questions

Can I sit MRCP Part 1 without GMC registration?

Yes. You do not need GMC registration to sit Part 1. You need a primary medical qualification from an institution recognised by the GMC or listed in the World Directory of Medical Schools, and you must be at least 12 months past your graduation date. If you are not GMC registered, you submit a copy of your qualification, translated if it is not in English.

Do I need an IELTS or OET score to take Part 1?

No. The Colleges advise that your English should be at roughly IELTS 7.5 level, but you do not need to have taken any language test to sit the exam. Remember the separate GMC position: MRCP(UK) cannot be used to demonstrate English, so you will still need acceptable evidence of English when you apply for registration.

How much does Part 1 cost at an international centre?

The Federation lists an international fee of £696, against a UK fee of £520, for sittings from September 2026 onwards. Hong Kong has its own fee and process. Fees are reviewed, so always confirm the current figure on the official dates and fees page before you apply, and budget separately for travel to your centre.

Is MRCP Part 1 enough for GMC registration?

No. The GMC’s list of acceptable postgraduate qualifications includes MRCP(UK) membership, which is awarded only after you pass Part 1, Part 2 written and PACES. Part 1 is a strong first step and is listed as desirable for IMT applications, but on its own it does not give you registration.

How many times can I attempt Part 1?

You can have up to six attempts at each part of the diploma. After six, you may apply for one exceptional additional attempt, supported by evidence of further education or training. A formal withdrawal does not count as an attempt, but failing to attend without notifying MRCP(UK) is recorded as absence, and absence does count.