This workflow is for core psychiatry trainees using BMJ OnExamination for MRCPsych Paper B — the written paper combining critical review and clinical topics. It addresses that written MCQ and extended-matching paper only. Two limitations to state first: BMJ OnExamination has no proprietary adaptive engine, so you drive the "adaptive" part by hand; and its Paper B bank is comparatively small, so the critical-appraisal and statistics component — the part candidates most fear — needs deliberate protection rather than incidental coverage.
What BMJ OnExamination offers for MRCPsych Paper B right now
As of 19 July 2026, BMJ OnExamination lists an MRCPsych Paper B bank of 270+ questions — described as over 220 best-answer MCQs and over 50 extended matching questions (vendor-reported), mapped to the current curriculum. Subscriptions run from about £29.99 for one month to £139.99 for twelve months (vendor-reported), with ten free questions a day on trial. Features include mock tests around recent exam themes, a "Select Questions" tool to choose difficulty and recap hard items, detailed explanations with a Key Learning Point, a group-learning leaderboard and an offline app. Verify the current count, price and features on onexamination.com before subscribing.
Two honest audit points. First, "adaptive": the page describes user-directed personalisation, not an automated adaptive-difficulty algorithm — you stay in charge of coverage. Second, the page does not specifically foreground the critical-appraisal and statistics content that carries real weight in Paper B, and at 270+ questions the bank is far smaller than the Paper A product; both facts mean you should confirm how much genuine critical-review material is included and plan to supplement it.
MRCPsych Paper B: the official shape of the exam
Paper B is a written paper of multiple-choice questions and extended matching items — roughly two-thirds MCQ and one-third EMI — of about 150 questions over three hours, delivered by computer at Pearson VUE. It has two strands: a substantial critical review component (research methods, epidemiology, statistics and critical appraisal of the evidence) and clinical topics across the psychiatric specialties (general adult, old age, child and adolescent, forensic, learning disability, psychotherapy, substance misuse and organic psychiatry). Confirm the current count and duration on rcpsych.ac.uk. The CASC (an OSCE-style clinical examination) sits separately; this workflow does not address it, and iatroX is not a CASC simulator — it is a written-knowledge and unseen-MCQ layer.
For any psychopharmacology fact, the UK medicines reference is the SmPC via the electronic medicines compendium (eMC), read with NICE and SIGN — not a formulary shorthand.
Baseline week: measure before you personalise
Before any personalisation, complete a small blueprint-stratified unseen sample — around 60–90 questions split deliberately between the two strands, and inside the critical-review strand cover study design, measures of effect and risk, diagnostic-test statistics, bias and confounding, and basic inferential tests. Record first-attempt accuracy per domain, and treat critical review as its own tracked block from day one. That baseline is what a rising overall percentage would otherwise hide.
First pass: set domain floors — and a critical-review floor
The specific Paper B trap is that clinical topics feel more comfortable than statistics, so candidates over-practise the clinical strand and let critical review drift. Prevent it with domain floors, and set an explicit, non-negotiable floor for the critical-review strand — a minimum number of attempted appraisal and statistics items before the headline number counts. Because BMJ's Paper B bank is small, expect to hit its critical-review ceiling and to need a second source for that strand specifically.
Error taxonomy: label every miss
Sort each wrong answer into one of six causes:
- Knowledge gap — a clinical fact or a statistical concept not known.
- Misread stem — misreading the vignette or a long EMI option list.
- Premature closure — answering before reading the whole item.
- Guideline/classification error — an outdated criterion or a NICE/ICD mismatch.
- Calculation error — a statistics slip: risk, odds, likelihood ratios, confidence intervals, numbers needed to treat.
- Time-pressure error — a mistake that only appears under the clock.
For Paper B, watch the calculation and knowledge-gap tallies inside critical review especially; they respond to a drilled method and a small set of formulae, not to more clinical reading.
Review interval: match the fix to the error
Do not simply repeat a missed statistics item — repetition trains recognition of that item, not the method. A statistics knowledge gap earns a worked-method drill plus a new transfer question using the same calculation on different numbers; a clinical knowledge gap earns a short source read and a fresh transfer question; a classification error earns a primary-source check and spaced review; misreads earn timed practice. Reserve immediate repeats for genuine slips.
Mixed-block switch: when to stop filtering
Filtered practice builds; mixed blocks test. Switch once all domain floors — including the critical-review floor — are met and per-domain first-attempt accuracy is within a narrow band of target. The objective trigger: when critical review is no longer dragging and errors are increasingly misreads and pacing, cut filtered practice and increase full-length, timed, random blocks that mirror the ~150-question paper, deliberately keeping the one-third EMI share in the mix.
Exit criteria: what "ready" actually means
Exit when five things hold: every domain, critical review included, clears its coverage floor; first-attempt accuracy on unseen items is stable across two or more sittings; you are pacing at roughly a question a minute; retention holds on spaced re-tests; and you have calibrated against the College's own sample questions rather than the commercial bank alone. Given the bank's size, "clears its floor" for critical review will usually mean you supplemented BMJ with a dedicated statistics source.
Worked example: a seven-day plan
A core trainee, six weeks out, revising around clinical work. BMJ OnExamination does one job — MCQ/EMI volume and topic drill — and iatroX supplies unseen transfer measurement. No proprietary-algorithm claims.
- Day 1: Blueprint-stratified baseline (about 75 items), critical review tracked separately; log first-attempt accuracy.
- Day 2: Service the critical-review strand to its floor; drill one statistics method to a worked template.
- Day 3: Source reads for day-2 gaps; verify any drug fact against the SmPC/eMC.
- Day 4: A timed mixed block spanning both strands; separate calculation slips from knowledge gaps.
- Day 5: A fresh, unseen, timed MRCPsych Paper B block in iatroX — no filtering, no assistance — to measure transfer.
- Day 6: Spaced review of statistics methods and classification errors; a short EMI technique drill.
- Day 7: Recompute floors (critical review first) and the error tally; set next week's minimums.
Decision checklist: continue, supplement, switch or stop
- Continue if floors are filling and unseen first-attempt accuracy is trending up.
- Supplement — almost certainly — with a dedicated critical-appraisal and statistics source, given the bank's small Paper B size.
- Switch emphasis to mixed timed practice once floors, critical review included, are met.
- Stop filtered practice in the final fortnight; move to timed, mixed, unseen blocks plus official-material calibration.
Decide on measurable gaps — above all in critical review — not on how many questions remain unticked.
Bottom line
BMJ OnExamination is a curriculum-mapped bank that can anchor Paper B's clinical strand, but its Paper B product is small and does not foreground the critical-appraisal and statistics load that decides many candidates' results. Drive it by the blueprint, set an explicit critical-review floor, plan to supplement statistics from a dedicated source, and preserve a clean unseen set to measure transfer. Learn on the bank; measure elsewhere; prepare the CASC separately.
FAQ
Is BMJ OnExamination enough for MRCPsych Paper B on its own? No. Its Paper B bank is comparatively small at 270+ questions and does not foreground the critical-appraisal and statistics component that carries real weight, so it should anchor the clinical strand while you supplement critical review from a dedicated source. Add the College's own sample questions and a clean unseen set for calibration, and remember it does not touch the CASC.
Which MRCPsych Paper B component does BMJ OnExamination not reproduce well? The critical-review strand — research methods, epidemiology, statistics and critical appraisal — is under-served relative to its exam weight, and the bank's overall size limits how much unseen statistics practice it can give. It also cannot prepare you for the CASC, which is a separate clinical examination and should never be treated as MCQ practice.
How many BMJ OnExamination questions should I complete per day for MRCPsych Paper B? There is no official figure, and because the Paper B bank is small you will exhaust it quickly if you rush; pace it. Roughly 30–50 reviewed questions a day, with statistics items drilled by method rather than memorised, is more useful than a larger unreviewed block. Prioritise the critical-review floor and error-tagging over a daily count.
When should I stop using BMJ OnExamination and move to mixed mocks? Once every domain — critical review included — clears its floor and unseen first-attempt accuracy is stable, filtered practice yields little. In the final two to three weeks the binding constraints are pacing across roughly 150 questions in three hours and retention of statistics methods, so shift to timed, mixed, unseen blocks and the College's own material for calibration.
How should I combine BMJ OnExamination with iatroX without duplicating practice? Give each bank one job: learn and drill on BMJ OnExamination, and reserve iatroX for fresh, unseen, timed blocks that measure transfer — never re-enter a BMJ item into iatroX or the reverse. That separation, set out in the iatroX two-Q-bank rule, keeps calibration honest: one bank to build on, one unseen bank to measure on — which matters most in the small-bank critical-review strand.
Editorial notes and references
Written by Dr Kolawole Tytler, NHS GP and founder of iatroX. Last checked 19 July 2026; product figures are vendor-reported and change without notice, so verify the question count, price and features on onexamination.com before purchase, and confirm the exam format on rcpsych.ac.uk. Disclosure: iatroX operates a competing MRCPsych question bank; this article confines iatroX to the unseen-measurement role BMJ OnExamination does not claim to fill, is explicit that iatroX is not a CASC simulator, and makes no proprietary-algorithm claims. Corrections are welcome via the feedback route on iatrox.com. References: Royal College of Psychiatrists MRCPsych Paper B syllabus and sample questions (rcpsych.ac.uk); NICE, SIGN and the electronic medicines compendium (medicines.org.uk) for the SmPC; the iatroX pillar on building a blueprint-coverage matrix and "Your Q-Bank Percentage Is Not Your Exam Score"; iatroX MRCPsych Paper B bank and comparison hub.