MRCP PACES (Practical Assessment of Clinical Examination Skills) is the last—and for many, the most intimidating—component of the Membership of the Royal College of Physicians (MRCP UK) examination. As a trainee in the UK or an International Medical Graduate (IMG), passing PACES takes more than clinical expertise; it takes accuracy, confidence, communication, and an astute preparation strategy.
What is the MRCP PACES Exam?
The PACES exam is the third component of the MRCP(UK) qualification. It’s a face-to-face, practical assessment that is intended to check whether you can apply clinical knowledge to real-life situations, with an emphasis on:
- Clinical Examination
- Communication Skills
- Diagnostic Reasoning
- Professionalism
Structure:
PACES exam consists of 5 stations and consists of 8 varied patient encounters that address:
- Respiratory and Abdominal Examination
- History Taking
- Cardiovascular and Neurological Examination
- Communication Skills and Ethics
Integrated Clinical Assessment Why PACES is Difficult—and How to Approach It
The actual challenge of PACES is performing under stress—in live time, with live patients and examiners observing. Many great doctors fail not for lack of knowledge but for poor technique, poor time management, or communication issues.
Here’s the way to turn the tables and ace every station.Expert Preparation Strategies for MRCP PACES.
1. Begin Early – Plan at Least 3–6 Months in Advance
PACES is a performance examination. You require steady practice over time—not cramming at the last minute. Develop a realistic study plan depending on your existing clinical exposure and timetable.
2. Familiarize Yourself with the Marking System
There are 7 skills examined across different stations. They include:
- Physical Examination
- Identifying Physical Signs
- Clinical Communication
- Differential Diagnosis
- Clinical Judgement
- Managing Patient Concerns
- Maintaining Patient Welfare
Knowing how you’re assessed enables you to make your practice more suitable.
3. Participate in a PACES Study Group
Solo practice is not sufficient. Join a local PACES group or online forum to practice stations, share feedback, and build confidence with various cases and accents.
4. Master Clinical Examinations Systematically
Employ standardized examination protocols for neuro, cardio, respiratory, etc.
Always vocalize what you are doing and why. Acclimatize yourself to succinctly summarizing findings under pressure.
5. Polish Your Communication and Ethics
Employ role-play for communication stations.Practice delivering bad news, explaining treatment plans, and dealing with angry or anxious patients.Be empathetic, clear, and calm.
6. Record Yourself
Record your performance during practice MRCP exams to watch your body language, tone, and timing. This feedback loop on yourself is incredibly effective at streamlining your style.
Know how to engage with patients in a respectful manner, with consent, and in line with safeguarding procedures.Get used to British clinical vocabulary and accent for better communication.Time Management is Paramount.Every contact is timed—about 10 minutes. Learn to:
- Prioritize major findings
- Avoid unnecessary detail
- Keep to exam templates
- Rehearse brief but comprehensive presentations final Checklist Prior to the Exam
- Revisit typical cases (stroke, COPD, heart failure, etc.)
- Practice every day with colleagues
- Read MRCP examiners’ feedback
- Sleep well and hydrate
- Come early with proper ID and documents Bonus: Day-of-Exam Tips
- Be respectful and professional to all, including the staff and simulated patients.
- Don’t panic if a station doesn’t go well—just move on.
- Keep your presentation concise: don’t ramble.
- Always do a general inspection first and wash/sanitize hands before handling patients.
You Can Ace PACES!
With strategic preparation, regular practice, and a good understanding of the marking system, you can pass MRCP PACES with confidence. Thousands of UK trainees and IMGs have overcome the jitters and pressure to pass—and so can you.
