Over the years, I have collected honest feedback from trainees after they sat Paper A. The consistent theme is: “I wish I had known X before I started.” This article is a compilation of the most common pieces of advice — the things that no textbook tells you but every trainee discovers through hard experience.
1. “I Wish I Had Started Neurosciences First”
Neurosciences is the largest section and the one that takes the longest to learn. It is not intuitive. You cannot infer neuroanatomy from clinical experience the way you can infer management of depression from your clinical work. It requires deliberate, structured memorisation.
Trainees who started with pharmacology, then moved to clinical topics, and left neurosciences until last — consistently reported that they ran out of time. They ended up cramming the highest-weighting section in the final weeks.
Advice: Study neurosciences first, while your energy and motivation are highest. Leave the clinical topics (which feel natural because you see them at work) for later.
2. “I Wish I Hadn’t Bought Four Different Question Banks”
There is a common belief that more question banks = more coverage. In practice, trainees who used 3–4 different banks ended up spending more time learning each platform’s interface than actually answering questions. They also reported contradictory explanations (different banks gave different answers to similar questions).
The most efficient strategy is one comprehensive bank with high-quality explanations — used thoroughly — supplemented by targeted reading of weak domains. Depth beats breadth for question banks.
Advice: Pick one primary question bank and exhaust it. Use other resources for notes and guidelines, not for questions.
3. “I Wish I Had Done More Timed Mocks”
This is the most frequently reported regret. Trainees who studied content for weeks without simulating exam conditions were surprised by the time pressure. Not because they ran out of time broadly — but because they spent too long on early questions and had to rush the final 30.
Paper A has 150 questions in 180 minutes. That is 72 seconds per question. If you spend 2 minutes on a difficult neuroscience question, you have lost that time from the easier questions ahead.
Advice: From week 4 of your revision, do at least one timed 50-question block per week. From week 8, do full 150-question mocks. Condition yourself to the rhythm of the exam.
4. “I Wish I Hadn’t Ignored Classification”
Classification (17% of marks) sounds like the easy section. Trainees assume they know ICD-11 criteria from clinical work. But exam classification questions test boundaries: what distinguishes moderate from severe depression? When does generalised anxiety disorder become panic disorder? What is the exact duration criterion for schizophrenia?
Trainees who did not deliberately memorise classification criteria lost 5–10 marks in this section to “close but not precise” answers.
Advice: Spend one full day memorising the diagnostic criteria for the 10–12 most commonly tested conditions. Write them out from memory. Check your accuracy. Repeat.
5. “I Wish I Had Known About the Pharmacology Receptor Profiles”
Pharmacology questions in Paper A are not asking “which drug is best for depression” (that’s Paper B territory). They are asking: “Which receptor does drug X block?” “Which drug causes QT prolongation?” “What is the mechanism of action of mirtazapine?”
Trainees who studied pharmacology by indication (what it is used for) rather than by mechanism (how it works) found the questions unrecognisable. They knew the drug but could not answer the question.
Advice: Organise pharmacology by mechanism. For each drug class, learn: receptor targets → downstream effects → therapeutic effects → side effects. This makes the side effects predictable rather than memorisable.
6. “I Wish I Had Stopped Cramming Two Weeks Earlier”
Burnout is real. Trainees who studied intensively up to the night before the exam reported that their memory was worse on exam day, not better. They were exhausted, anxious, and making careless errors.
The brain consolidates memories during sleep. The final week should be about consolidation and confidence, not new content. If you do not know it by the final week, you are unlikely to learn it well enough to recall under exam pressure.
Advice: Taper your study in the final 10 days. No new content after day T-7. Light review only in the final 3 days. Sleep, hydration, and activity are more valuable than one more hour of cramming.
7. “I Wish I Had Used an Adaptive Question Bank”
This is a relatively new insight because adaptive banks for MRCPsych are a recent development. Trainees who used fixed question banks reported a common phenomenon: they were good at answering questions from the domains they studied most, and poor at everything else. But they did not know that until they sat the exam.
An adaptive platform reveals your blind spots early, so you can address them while there is still time. It also prevents you from over-studying domains you are already strong in. The efficiency gain is not marginal — it is structural.
Advice: If you can access an adaptive MRCPsych platform, use it from the beginning, not just in the final weeks. The data it collects on your performance becomes more valuable the longer you use it.
8. “I Wish I Had Believed I Could Pass First Time”
This is the most emotional piece of feedback. Many trainees approach Paper A with the mindset that it is normal to fail first time. They tell themselves: “Most people need two attempts anyway.” This becomes a self-fulfilling prophecy.
First-attempt pass rates for Paper A are 65–75% — the majority pass. The difference between those who pass and those who fail is not IQ. It is preparation structure. Candidates who use a systematic, adaptive approach with regular simulated testing pass at significantly higher rates than those who study by reading and hoping.
Advice: Approach Paper A as a pass-first attempt, not a reconnaissance mission. Structure your preparation, test yourself early and often, and trust the process.
Final Thought
Every trainee who passed Paper A will tell you: the exam is hard, but it is fair. It tests what the curriculum says it tests. The candidates who pass are not the ones who know everything — they are the ones who know their weaknesses and addressed them.
PsychStar’s adaptive engine is designed to identify and close those gaps. You can try it for free at psychstar.io/try and see your own blind-spot map form in real time.