Understanding how the MRCPsych is scored is a strategic advantage. If you know how the pass mark is set, you can make better decisions about time management, question prioritisation, and when to guess.
The MCQ Format: Single Best Answer
Both Paper A and Paper B use single best answer (SBA) format. Each question has five options, and exactly one is the best answer. There is no negative marking — you are not penalised for incorrect answers.
Critical implication: You should never leave a question unanswered. Even a blind guess has a 20% chance of being correct. An educated guess (where you eliminate 2–3 distractors) has a 33–50% chance. Guessing costs you nothing and gains you marks.
How the Pass Mark is Determined
The MRCPsych does not use a fixed pass mark. Instead, it uses a modified Angoff method (standard setting). A panel of expert psychiatrists reviews each question before the exam and estimates what proportion of “borderline” candidates would answer it correctly. These estimates are summed to produce the pass mark.
This means:
- The pass mark varies slightly between sittings (typically 60–65% for Paper A, 60–65% for Paper B)
- The pass mark is set before you sit the exam (not a curve — you are not competing against other candidates)
- A difficult paper has a lower pass mark; an easy paper has a higher pass mark
Key takeaway: You are racing against the standard, not against other trainees. Focus on accuracy, not speed — but do not run out of time.
Mark Allocation
Each question in both papers carries exactly 1 mark. There are 150 questions per paper, total 150 marks. You need approximately 90–98 marks (60–65%) to pass.
Time: 3 hours = 180 minutes. That is 1.2 minutes per question. This sounds tight, but most candidates finish with 15–30 minutes to spare. The real time pressure comes from:
- Questions with long clinical vignettes (common in Paper B)
- Critical review calculations (NNT, sensitivity, specificity — take 2–3 minutes each)
- MHA questions where you need to recall sections precisely
Strategy: Which Questions to Prioritise
Not all marks are equal in terms of time cost. Some questions can be answered in 30 seconds; others take 2 minutes. The strategic approach:
- First pass (90 minutes): Answer all the questions you are confident about. If a question takes longer than 60 seconds, flag it and move on. Your goal is to secure the marks you know.
- Second pass (60 minutes): Return to the flagged questions. Spend 1–2 minutes on each, using clinical reasoning and elimination.
- Third pass (30 minutes): Select an answer for every remaining question. Even if you have to guess, pick one. Never leave a blank.
The 10-Question Review Rule
At the end of the exam, review your answers to the last 10 questions. These are the ones most affected by time pressure and fatigue. If you have time, read their stems again. Candidates often make more errors in the final minutes of the exam than at any other point.
How Your Score is Reported
Results are reported as a scaled score (mean 250, SD 40). The pass mark is typically around 240 (the exact value depends on the sitting). You receive:
- Overall scaled score (pass/fail threshold)
- Domain-level breakdown (your performance in each section)
- Comparison cohort (how you performed relative to other candidates — informational only, not used for pass/fail)
The domain-level breakdown is particularly useful if you need to retake. It tells you exactly which sections cost you marks. For example, if you scored 70% in neurosciences but 40% in psychopharmacology, your revision plan is clear.
Resit Implications
You can attempt each paper up to 3 times in a 12-month period. After 3 failed attempts, you must discuss your performance with the Training Programme Director and may need a period of additional training before reattempting.
The statistics show:
- First-attempt pass rate for Paper A: ~65–75%
- First-attempt pass rate for Paper B: ~70–80%
- Repeat attempt pass rate: ~50–60% (lower, partly because of demoralisation and burnout)
This is why investing in high-quality preparation before your first attempt is so important. The data consistently shows that candidates who use structured adaptive preparation outperform those who rely on volume alone.
Practical Implications for Your Study Strategy
- Target 75% in mocks: If you consistently score 70%+ in timed simulation, you are at the pass boundary. Aim for 75%+ to give yourself a safety margin for exam-day variability.
- Focus on the bottom third: Most candidates have a “tail” of weak domains. Exam simulation tells you which ones. Spend 80% of your revision time on these, even though it feels less productive than reviewing what you already know.
- Practise under timed conditions: Knowledge without time pressure is not exam-relevant. At least 30% of your practising should be timed.
- Use adaptive testing: An adaptive question bank gives you a more accurate estimate of your true ability than a static bank, because it calibrates question difficulty to your performance level.
PsychStar’s exam simulation mode mirrors the real exam structure, timing, and difficulty weighting. You get a scaled score estimate, domain breakdown, and percentile ranking after every mock. Try 5 free questions at psychstar.io/try.