MRCP Part 2 Written: Exam Format and the 200-Question Blueprint
Published Oct 5, 2026
The MRCP(UK) Part 2 Written exam has a fixed, published structure, and knowing it changes how you plan your revision. Here's what the Federation of the Royal Colleges of Physicians' own format page (https://www.thefederation.uk/examinations/part-2/format) says.
The exam is two papers taken on one day. Each paper lasts 3 hours and has 100 multiple-choice questions, so 200 questions in total. It is computer-based, delivered by Surpass at test centres in the UK and internationally. From the 2026/2 diet, Part 2 moved to in-centre delivery, except for candidates in Myanmar and Sudan, who continue to sit it by remote online proctoring.
Every question is "best of five": one correct answer and four distractors that the Federation describes as closely related to the preferred option but less correct. Each correct answer earns one mark, and there is no negative marking, so an unanswered question is always a lost mark.
Questions often include investigation results, and many are illustrated with images: clinical photographs, pathology slides, inheritance trees, ECGs, X-rays, CT and MR scans, and echocardiograms.
The published blueprint sets how many of the 200 questions come from each specialty: cardiology 20; endocrinology, diabetes and metabolic medicine 20; gastroenterology and hepatology 20; renal medicine 20; respiratory medicine 20; infectious diseases 16; neurology 16; clinical pharmacology and therapeutics 12; dermatology 10; geriatric medicine 10; haematology 10; rheumatology 10; oncology 6; medical ophthalmology 4; palliative medicine and end-of-life care 4; and psychiatry 2. The Federation notes that actual numbers may vary by up to 2%, and that a proportion of questions covers adolescent medicine.
Study takeaway: five specialties (cardiology, endocrinology, gastroenterology, renal and respiratory) make up half of the exam at 20 questions each, so weight your revision by the blueprint rather than spreading it evenly, and practise with image-based questions, because ECGs, scans and clinical photographs appear throughout both papers.