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The applied clinical and critical review paper of MRCPsych — 150 questions covering adult, old age, child, forensic, learning disability and addiction psychiatry, plus critical appraisal of psychiatric research. Delivered via Pearson VUE with an AI-adaptive question bank mapped to the published RCPsych Paper B syllabus and assessment framework.
Full MRCPsych Paper B 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 MCQs and extended-matching items (EMIs)
Delivered through Pearson VUE — either at a test centre or online with remote proctoring. The CASC (clinical) exam remains in-person.
Applied clinical psychiatry across the lifespan and subspecialties plus critical appraisal of psychiatric research and the Mental Health Act / capacity framework
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.
Three diets per year — typically February, May/June and October. Application windows close approximately 8 weeks before each sitting. Confirm 2026 dates and application windows on the RCPsych examinations page.
Approximate question distribution across the MRCPsych Paper B syllabus. Used to drive iatroX adaptive sequencing.
Source: official Royal College of Psychiatrists (RCPsych) blueprint
Mapped to the published RCPsych Paper B syllabus and prioritised using item-density signals across the iatroX bank.
Mental Health Act sections — Section 2 (assessment, up to 28 days), Section 3 (treatment, up to 6 months renewable), Section 5(2) (doctor's holding power, 72 hours), Section 5(4) (nurse's holding power, 6 hours), Section 136 (police, 24 hours)
Antidepressant sequencing — SSRI first-line, switching strategies (washout for fluoxetine, cross-taper for others), augmentation (mirtazapine + SSRI, lithium, atypical antipsychotic), serotonin syndrome recognition
Antipsychotic management — clozapine eligibility (treatment-resistant after 2 antipsychotic failures), monitoring (FBC weekly × 18 weeks then less frequent, metabolic screen), recognising agranulocytosis vs myocarditis, LAI antipsychotics
Suicide risk assessment — frameworks (DSH-2 etc.), dynamic vs static risk factors, recognising imminent risk patterns, no contracts for safety, IMPACT on outcomes
Critical appraisal of psychiatric trials — STAR*D depression sequencing, CATIE schizophrenia, BALANCE bipolar, RAID liaison, GENDEP for SSRI choice. Interpret HRs, NNTs, CIs, funnel plots
Capacity — MCA in psychiatric practice, functional test (understand, retain, weigh, communicate), IMCA referrals, advance decisions to refuse treatment (ADRTs), LPA-health-and-welfare
Substance misuse — alcohol detox regimens (chlordiazepoxide tapered), Wernicke's prevention (parenteral thiamine before glucose), opioid substitution (methadone vs buprenorphine), benzodiazepine tapers
Psychotherapy evidence base — CBT for moderate depression, IPT for postnatal depression, family therapy for adolescent eating disorders, EMDR for PTSD per NICE NG116, DBT for emotionally unstable PD
Observations from UK psychiatry trainees and recent Paper B candidates. Verify against current RCPsych syllabus and Mental Health Act Code of Practice.
Candidate-reported observations — not official guidance.
A pragmatic phased approach used by recent UK core trainees who passed Paper B.
A live item from the iatroX bank. Try it before launching a full session.
A 60-year-old man on a coronary care unit develops fluctuating inattention, confusion, visual hallucinations and agitation 48 hours after cardiac surgery. CAM-ICU assessment supports a diagnosis of delirium. He has no focal neurological signs and no history of head trauma. His medications include morphine by patient-controlled analgesia, furosemide and amiodarone. According to NICE CG103, what is the most appropriate initial management priority?
Why iatroX is built differently for MRCPsych Paper B.
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 B 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, Mental Health Act framework and critical appraisal of psychiatric research. Both are written exams; CASC is the separate clinical OSCE.
RCPsych typically runs three diets per year — typically February, May/June and October. Exact 2026 dates and application windows are published on the RCPsych examinations page. Confirm directly before planning. Once you pass your first written paper, you have approximately 4.5 years (1,643 days) to pass the remaining parts of MRCPsych.
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. Approximately 60-65% of items are MCQ-style and 35-40% are EMI-style.
About 13% (19 questions). This is one of the highest-yield blocks in Paper B and is consistently under-prepared. Items test interpretation of RCT abstracts, forest plots in meta-analyses, hazard ratios, NNTs and study design strengths/weaknesses. Practise with real psychiatric trial papers.
Paper B: £508 for PMPT (Pre-Membership Psychiatric Trainees) and Affiliates; £564 for non-PMPT trainees and affiliates (2026 rates). Slightly cheaper than Paper A and significantly cheaper than CASC. RCPsych reviews fees annually.
Yes — there is no required order. The papers can be taken in either order or even on adjacent days within a diet where the schedule permits. Many candidates sit Paper A first for the scientific foundation, but some prefer Paper B first to capitalise on clinical exposure.
Yes. A single iatroX subscription (£29/month or £99/year for UK users; $29/$99 elsewhere) includes the MRCPsych Paper B bank alongside MRCPsych Paper A 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
See our methodology and editorial policy.