Pass rates are an imperfect measure of difficulty — they reflect candidate preparation, demographics, and exam design as much as inherent difficulty. But they are the best available proxy, and understanding where your exam sits relative to others helps calibrate your preparation effort.
This ranking uses the most recent available pass rate data for each exam. Where pass rates vary significantly between sittings, the range is shown.
The ranking
PSA (Prescribing Safety Assessment) has a pass rate of approximately 95 per cent. The high pass rate reflects the exam's design as a minimum competence assessment for final-year medical students, combined with the availability of three free official practice papers. The PSA is the least selective UK postgraduate medical assessment.
MRCGP AKT sits at approximately 72 to 80 per cent. The exam is well-served by preparation resources (Pastest, PassMedicine, iatroX) and most candidates are GP trainees with strong clinical exposure.
PLAB 1 sits at approximately 65 to 75 per cent. The candidate pool is entirely international medical graduates, and the range reflects variation in cohort preparation levels.
MRCP Part 1 sits at approximately 55 to 65 per cent. This is the first significant selectivity hurdle in UK postgraduate medicine and the exam where many trainees experience their first postgraduate failure.
MRCEM SBA sits at approximately 60 to 70 per cent. The broad emergency medicine curriculum makes this a demanding exam, though the pass rate is stable.
MSRA sits at approximately 70 to 80 per cent for the CPS component. The Professional Dilemmas component is not scored as pass/fail in the same way — it contributes to an overall ranking score.
SCE pass rates range from 50 to 80 per cent depending on specialty and sitting. Specialties with high international candidate proportions sit at the lower end.
MRCPCH FOP and TAS sit at approximately 50 to 65 per cent. AKP is similar but with more variation due to the N-of-many format.
MRCPsych Paper A sits at approximately 45 to 67 per cent. The sciences focus and heavy pharmacology weighting catch underprepared candidates.
MRCPsych Paper B sits at approximately 55 to 70 per cent. The clinical focus makes it marginally more accessible than Paper A for candidates with strong clinical exposure.
FRCA Primary MCQ sits at approximately 55 to 60 per cent. The basic sciences focus and 40 per cent pharmacology weighting are consistent failure drivers.
FRCA Final Written sits at approximately 60 to 65 per cent. The ICU weighting catches candidates with limited intensive care exposure.
GPhC CRA sits at approximately 58 per cent. The November 2024 sitting saw a 42 per cent failure rate, reflecting the exam's genuine difficulty.
ORE Part 1 sits at approximately 51 to 78 per cent. The wide range reflects cohort composition — the expanding GDC capacity is bringing a broader candidate pool.
NDEB AFK sits at approximately 32 to 63 per cent. The most volatile pass rate of any exam in this ranking.
FRCOphth Part 1 sits at approximately 32 to 39 per cent — the lowest pass rate of any UK postgraduate medical exam. The optics and refraction physics content is uniquely challenging.
What the ranking means for your preparation
If your exam has a pass rate below 65 per cent, you need at least three months of structured, dedicated preparation with a comprehensive question bank. Clinical experience alone is insufficient for exams in this range.
If your exam has a pass rate below 50 per cent, you are sitting one of the most selective UK postgraduate assessments. Four months of preparation is the minimum, and an adaptive question bank that identifies and targets your weakest areas is not a luxury — it is a necessity.
iatroX covers every exam in this ranking except PSA and FRCOphth. All question banks — SCE (all 13 specialties), MRCPCH, MRCPsych, FRCA, MRCP, MRCGP, PLAB, MRCEM, GPhC, ORE, MFDS, and the specialist diplomas — are included in a single subscription at £29 per month or £99 per year.