How PACES is marked: skills A–G and the 126/168 pass mark

The three judgements

For every skill tested in an encounter, each of the two examiners independently records one of three judgements:

A skill that should be tested but isn't (for example, because you ran out of time before reaching it) is marked as Unsatisfactory.

The seven skills and their pass marks

Each skill's maximum depends on how many encounters test it. These are the pass marks the Federation has applied since the 2023/03 diet, and it has said they apply to all subsequent assessment periods:

To pass PACES you must reach both the overall pass mark and the pass mark for every individual skill. Failing a single skill means failing the exam, whatever your total.

Why the overall mark is the real hurdle

Add up the seven skill pass marks and you get 114, which is 12 marks short of the 126 you need overall. Scraping past every skill is therefore not enough on its own.

A useful way to think about it: 84 judgements at 2 marks each gives 168. If half of your judgements were Satisfactory and half Borderline, you would score exactly 126. Every Unsatisfactory costs you twice as much as a Borderline. In practice, the candidates who pass reliably are the ones who avoid Unsatisfactory judgements altogether and turn Borderlines into Satisfactory ones in the skills that come up most often: E and G are tested in all eight encounters.

Skill G leaves almost no room for error

Patient welfare is judged 16 times (8 encounters, 2 examiners) for a maximum of 32, and the pass mark is 28. That means you can lose at most four marks across the whole exam, the equivalent of two Unsatisfactory judgements. The examiners' guide also says that any candidate scoring 28 or less on Skill G is discussed by the examiner group.

Welfare marks are lost through things like causing pain, failing to ask permission, poor exposure or dignity, ignoring distress and not thanking or covering the patient. These are habits, so they have to be built into every practice run.

What examiners are looking for in each skill

• A Physical examination: a fluent, correct technique that you can perform without looking hesitant, with appropriate exposure and never through clothing.
• B Identifying physical signs: reporting the signs that are there, and only those. Don't invent signs to fit a diagnosis; be confident about normal findings.
• C Clinical communication: a clear structure, plain language, checking understanding and giving information in manageable chunks.
• D Differential diagnosis: the most likely diagnosis first, then sensible alternatives that fit your findings.
• E Clinical judgement: safe, appropriate investigations and management, including what you would do next and when to escalate.
• F Managing patients' concerns: finding out what worries the patient and addressing it as soon as it comes up, not saving it for the end.
• G Maintaining patient welfare: consent, comfort, dignity and respect throughout every encounter.

Sources

• Federation of the Royal Colleges of Physicians: PACES pass standard
• Examiners’ Guide to PACES (version 3, February 2025)
• PACES format and marking
• PACES 2025 Annual Performance Report