What is MRCP PACES?

TL;DR

The MRCP PACES (Practical Assessment of Clinical Examination Skills) is the final part of the MRCP(UK) exams, testing bedside skills through five clinical stations. If you’re wondering what is MRCP PACES, it is a structured practical exam assessing communication, physical examination, and clinical reasoning. Candidates face real and simulated patients under exam conditions. Success requires systematic preparation, awareness of pitfalls, and repeated practice.

Why this matters

MRCP PACES is a milestone for aspiring physicians. Unlike MRCP Part 1 and Part 2 Written, which test factual knowledge, PACES examines whether you can apply that knowledge with patients. Passing it demonstrates readiness for higher specialist training and reassures employers you can practise safely.

What is MRCP PACES?

MRCP PACES stands for Practical Assessment of Clinical Examination Skills. It is part of the Membership of the Royal Colleges of Physicians of the United Kingdom (MRCP[UK]) exams.

• Format: Five stations with real and simulated patients.

• Duration: Around 3 hours, with 20 minutes per station.

• Core domains: History-taking, communication, physical examination, and clinical judgement.

• Eligibility: Passing MRCP Part 1 is required before attempting PACES.

👉 See our MRCP Part 1 overview for details on the written stage.

Structure of the PACES Exam

According to MRCP(UK), the exam consists of five stations, each supervised by examiners who grade candidates across seven clinical skills.

Station	Focus Area	Skills Tested
1	Respiratory & Abdominal exam	Systematic bedside examination
2	History taking	Focused history, management discussion
3	Cardiovascular & Neurology exam	Clinical signs, interpretation
4	Communication & Ethics	Explaining, consent, breaking bad news
5	Integrated clinical assessment	Mixed tasks, overall competence

Practical examples / mini-cases

• Station 1 (Respiratory): Patient with basal crackles and clubbing. Candidates should recognise features of pulmonary fibrosis, discuss differentials, and outline investigations.

• Station 4 (Communication): Explaining the need for anticoagulation to a patient worried about bleeding risks.

• Station 5 (Integrated): A patient with ankle oedema and breathlessness. You must combine cardiovascular and respiratory findings, then suggest next management steps.

These cases highlight the applied, real-world focus of PACES.

Common pitfalls (and fixes)

1. Rushing examinations → Fix: Stick to a structured routine, even under time pressure.

2. Ignoring patient cues → Fix: Maintain empathy, summarise, and clarify patient concerns.

3. Overcomplicating answers → Fix: Focus on practical bedside management, not subspecialty details.

4. Poor time management → Fix: Practise full 20-minute stations under exam timing.

5. Uncertainty with signs → Fix: Describe what you see or hear, even if unsure of diagnosis.

   
   

FAQs

Q1: Is MRCP PACES harder than MRCP Part 1?

They test different skills. Part 1 is knowledge-based, while PACES tests bedside and communication skills. Many find PACES challenging without structured practice.

Q2: How many attempts are allowed?

There is no strict limit, but repeated failures can delay training. Passing early is best.

Q3: Where is PACES held?

Centres are worldwide, including the UK, India, and the Middle East. Candidates choose based on availability.

Q4: Do I need clinical experience before PACES?

Yes. Unlike Part 1, PACES assumes hands-on patient experience.

Q5: What is the pass rate?

According to MRCP(UK), pass rates vary (~50–60%) depending on centre and cohort.

Ready to start?

Mastering PACES requires knowledge, practice, and feedback. Start early with systematic study, observe seniors, and practise in small groups.

At Crack Medicine, we support your journey:

• Try our Free MRCP MCQs to consolidate knowledge.

• Start a mock test to simulate exam pressure.

• Explore our main blog hub for more strategies.

Next step: Read our sibling article: Study plan for MRCP Part 1.

Sources

• MRCP(UK) – PACES Overview

• Royal College of Physicians

• MRCP(UK) Regulations and Syllabus