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The scientific and theoretical written paper of MRCPsych — 150 questions covering psychopathology, psychopharmacology, neuroscience, genetics and human development. Delivered via Pearson VUE with an AI-adaptive question bank grounded in the Maudsley Prescribing Guidelines and ICD-11.
Full MRCPsych Paper A bank, AI Tutor and timed mocks — $29/month or $99/year. All paid exam banks included.
150 questions · 3 hours · mix of single-best-answer (MCQ) and extended-matching items (EMI)
Delivered through Pearson VUE — either at a test centre or online with remote proctoring. The CASC (clinical) exam remains in-person.
Once you pass your first written paper (Paper A or Paper B), you have 1,643 days (approximately 4.5 years) from the publication of your result to pass the remaining parts of MRCPsych.
Open to any fully registered medical practitioner. Most UK candidates sit during CT1–CT3 of core psychiatry training. International candidates can sit at any time once registered.
Three diets per year — typically January/February, May/June, September/October. Exact 2026 dates and application windows are published on the RCPsych examinations page. Application windows close approximately 8 weeks before each sitting.
Approximate question distribution across the MRCPsych Paper A syllabus. Used to drive iatroX adaptive sequencing.
Source: official Royal College of Psychiatrists (RCPsych) blueprint
Drawn from the RCPsych Paper A syllabus, Maudsley Prescribing Guidelines (14th edition) and item density in iatroX.
Phenomenology — Schneider's first-rank symptoms (audible thoughts, voices arguing/commenting, somatic passivity, thought withdrawal/insertion/broadcasting, delusional perception, made-actions/affect), formal thought disorder subtypes (knight's move, derailment, neologisms)
Antipsychotic receptor profiles — D2 affinity (haloperidol, risperidone), 5-HT2A blockade (atypicals), M1 muscarinic (olanzapine, clozapine), H1 (olanzapine, quetiapine), α1 (clozapine, risperidone). Side-effect profiles follow receptor binding.
Antidepressant mechanisms — SSRIs (citalopram QT, sertraline GI), SNRIs (venlafaxine BP, duloxetine), mirtazapine (5-HT2A/3 + H1 + α2), agomelatine (MT1/2 + 5-HT2C), vortioxetine (multimodal). Tetracyclic vs tricyclic.
Mood stabiliser principles — lithium (TDM 0.6–1.0 mmol/L, narrow therapeutic index, nephrogenic DI, thyroid effects), sodium valproate (avoid in childbearing potential), lamotrigine (rash, Stevens-Johnson risk), carbamazepine (autoinduction, HLA-B*1502).
Neuroanatomy — limbic system (hippocampus, amygdala, cingulate, fornix), basal ganglia direct/indirect/hyperdirect pathways, frontal lobe syndromes (orbitofrontal disinhibition, dorsolateral executive dysfunction, mesial akinetic mutism)
Genetics — twin/adoption study heritability for schizophrenia (~80%), bipolar (~85%), MDD (~40%), autism (~80%). Copy number variants (22q11.2 deletion → 20-fold psychosis risk). Gene-environment interaction (5-HTTLPR x life events).
Statistics — reliability (test-retest, inter-rater kappa interpretation), validity types (content, criterion, construct), effect sizes (Cohen's d), RCT methodology, ITT vs per-protocol, NNT for psychiatric interventions.
Classification — ICD-11 changes from ICD-10 (gaming disorder added, gender incongruence moved out of mental disorders chapter, complex PTSD as separate disorder). Differential criteria for major disorders.
Observations from UK psychiatry trainees and recent Paper A candidates. Verify against current RCPsych syllabus.
Candidate-reported observations — not official guidance.
A pragmatic phased approach used by recent UK core trainees who passed Paper A.
A live item from the iatroX bank. Try it before launching a full session.
A 63-year-old woman with schizophrenia has received continuous antipsychotic treatment for 12 years. Over several months, she develops repetitive lip-smacking and chewing movements, intermittent tongue protrusion and choreiform “piano-playing” movements of her fingers. She has no bradykinesia, rigidity, fever or altered consciousness. Which antipsychotic adverse effect is the most likely diagnosis?
Why iatroX is built differently for MRCPsych Paper A.
Every iatroX item is tagged to a blueprint topic, so your performance dashboard mirrors the structure of the exam itself.
The engine surfaces your weakest topics first, in real time, instead of marching you through a static syllabus.
Incorrect items return at increasing intervals to interrupt the forgetting curve and lock knowledge into long-term memory.
Timed full-length simulations that mirror the official exam structure under realistic conditions.
One iatroX subscription includes the MRCPsych Paper A bank, the Socratic Tutor inside supported sessions, and every other premium iatroX exam bank.
Cancel anytime · 7-day money-back guarantee on annual
Paper A is the scientific and theoretical paper — psychopathology, psychopharmacology, neuroscience, genetics, history and philosophy. Paper B is the applied-clinical and critical-review paper — clinical psychiatry across subspecialties, psychotherapy, critical appraisal of psychiatric research. Both are written exams; CASC is the separate clinical OSCE.
RCPsych typically runs three diets per year — typically spring (April), summer (May/June) and autumn (October). Exact 2026 dates and application windows are published on the RCPsych examinations page. Confirm directly before planning.
A single paper of 150 questions over 3 hours. Question types are a mix of single-best-answer MCQs and extended-matching items (EMIs). Delivered via Pearson VUE either at a test centre or online with remote proctoring.
No — they are sat in separate diet windows. Many candidates spread them across consecutive diets or sit them on adjacent days within a diet where the schedule permits. Once you pass your first written paper, you have approximately 4.5 years (1,643 days) to pass the remaining parts of MRCPsych.
Paper A: £565 for PMPT (Pre-Membership Psychiatric Trainees) and Affiliates; £627 for non-PMPT trainees and affiliates (2026 rates). Paper B is slightly cheaper. CASC is significantly more expensive. RCPsych reviews fees annually.
The pass mark for each Paper A diet is set by criterion-referenced standard setting (similar approaches to other Royal College exams). Recent pass rates have varied — check the most recent diet performance reports published by RCPsych.
Yes. A single iatroX subscription (£29/month or £99/year for UK users; $29/$99 elsewhere) includes the MRCPsych Paper A bank alongside MRCPsych Paper B and every other premium iatroX exam bank. No add-ons or per-exam fees.
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Reviewed by Dr Kola Tytler MBBS CertHE MBA MSt MRCGP · Last reviewed 12 May 2026
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