MRCP PACES exam format explained (2026): stations, timings and skills

PACES at a glance

The current format has been used since the third PACES diet of 2023. Here is every encounter in the order of the stations:

The skills are: A Physical examination, B Identifying physical signs, C Clinical communication, D Differential diagnosis, E Clinical judgement, F Managing patients' concerns and G Maintaining patient welfare. How they add up to a pass is explained in how PACES is marked.

How the carousel works

• Five candidates rotate together. Each starts at a different station and moves to the next every 20 minutes, with a 5-minute interval between stations. The whole cycle takes 125 minutes.
• The intervals are reading time. Before Stations 1, 2, 4 and 5 you read the written scenario during the 5-minute interval. A second copy is kept in the room, and you can take blank paper notes in with you. They are destroyed afterwards and are not marked.
• The order inside a station is fixed. At Stations 1 and 4 the communication encounter always comes before the examination. At Station 3 cardiovascular normally comes first; you will be told during the interval if the order is reversed.
• The examiners stay put. Each pair of examiners marks the same station for the whole cycle, independently of each other.

The examination encounters

The respiratory, cardiovascular, neurological and abdominal encounters each last 10 minutes: up to 6 minutes examining, then at least 4 minutes of questions.

• You get a warning at 5 minutes. You can finish early, but questioning only starts once you say you have finished, and it stops at the bell.
• The introduction poses a clinical problem rather than just naming a system. In neurology the examiner will point you to the part of the body to examine (for example, "examine this patient's lower limbs").
• You will only be asked to elicit signs that both examiners have independently agreed are present. The Federation's own advice is not to report signs you cannot find just to fit a diagnosis; confidence in a normal finding is valued too.
• A patient with no abnormal findings can appear, so be ready to say "I found no abnormality" when that is true.
• Never examine through clothing. Ask permission and expose appropriately while protecting the patient's dignity.

The communication encounters

Stations 1 and 4 each open with a 10-minute conversation with a patient, relative or surrogate. There is no examiner–candidate interaction: you are marked purely on what the examiners observe. You get a warning at 8 minutes, and if you finish early the surrogate stays in the room until time is up. The approach that works is covered in our communication station guide.

The consultation encounters

Stations 2 and 5 are 20-minute consultations. You read a short note or referral letter in the interval, then have 15 minutes to take a focused history, examine, explain your findings, agree a plan and address the patient's concerns, followed by 5 minutes of examiner questions.

• You get a warning at 13 minutes, and the full 15 minutes must pass before questioning starts, even if you finish early.
• Each cycle has one acute and one less acute scenario. The history may come from the patient or from a surrogate.
• Consultations are the only encounters that mark all seven skills, so they carry the most marks. See our consultation station guide for a minute-by-minute structure.

Fees, dates and eligibility (2026)

• Applications open for one week per diet and are not first come, first served. For the 2026/03 diet the window was 16 to 23 June 2026. Late applications are not accepted.
• Eligibility: you need to have passed MRCP(UK) Part 1 and to have been clinically active since. The old seven-year rule has been removed. The Federation advises at least two years' hospital experience after qualifying, though this is advice rather than a rule.
• Attempts: there is a maximum of six attempts at any part of MRCP(UK).

What the format means for your preparation

1. Practise to the clock. Six minutes is short. Rehearse a complete routine for each system that fits comfortably inside it, leaving time to step back and gather your thoughts.
2. Rehearse presenting out loud. Four minutes of questions starts with your presentation. A crisp one-minute summary sets up the rest of the discussion (see how to present a case).
3. Treat consultations as the biggest prize. They are worth more than any other encounter because they test all seven skills.
4. Plan your communication encounters in the interval. Five minutes of reading time is enough to decide your aims, the key facts you need to convey and the concerns you expect.
5. Expect back-to-back systems at Station 3. Cardiovascular and neurology run consecutively, and neurology is where candidates fall furthest short of the maximum score (see PACES pass rates).

Sources

• Federation of the Royal Colleges of Physicians: PACES format
• Examiners’ Guide to PACES (version 3, February 2025)
• Preparatory advice and information to candidates, PACES (May 2026)
• Changes to MRCP(UK) exam fees from the 2026/03 diet
• Applications for PACES 2026/03
• PACES: how to apply and eligibility
• Removal of the seven-year eligibility period