MRCPsych (Member of the Royal College of Psychiatrists) is a postnominal qualification awarded to physicians who have completed the prescribed training requirements and membership examinations mandated by the Royal College of Psychiatrists. Candidates must be registered with the GMC or a recognized medical board in their own country and should have undergone three years of training. Although initially a two-part exam, the examination has undergone a radical change in the past few years, notably in terms of focus and structure. Although originally a two-part exam, the current examination is 3 parts, consisting of 2 written papers (Paper A and Paper B) and a clinical exam (CASC). Paper A focuses on Neuroscience, Pharmacology, Psychology and theory, while Paper B focuses on Current Clinical Practice & Evidence within General Adult and the various subspecialties of Psychiatry, Epidemiology, Statistics, Critical Appraisal and Psychotherapy The Royal college of psychiatrists has announced the change of format of the CASC exam changes for the exam in January 2018. The 4 linked stations in the morning session will now become 8 single stations with 4 minute to read and 7 minutes to complete the task. 6 of these will be patient management focus and the other 2 history taking. The other 8 single stations remain the same format 90 s to read and 7 minutes for the exam.
From March 2008, the MRCPsych exam was changed from a two-part exam to a four-part exam, driven by changes in postgraduate education. This meant that there were now three written exams and a Clinical Assessment of Skills & Competencies (CASC). In order to obtain membership candidates currently need to complete 30 months post foundation/internship experience in Psychiatry and a pass in all components of the MRCPsych Examinations.
The MRCPsych examination consisted of a Part 1 and a Part 2 exam, both of which had written and clinical parts.
Part I: Written examination: The written paper comprised 133 Individual Statement Questions and 30 Extended Matching Questions based on themes stated in the syllabus. The examination was of 90 minutes duration. The examination carried a total of 223 marks - 133 marks for the Individual Statements (IS) and 90 for the Extended matching items (EMI). Combined IS and EMI marks were converted into a closed score between 0 and 10.
Clinical examination: The clinical examination consisted of Objective Structured Clinical examination stations (OSCE). The OSCE comprised 12 stations which are chosen with a view to sample across the range of psychiatric knowledge and skill areas appropriate to expected level of competency. Each station was 7 minutes duration. Candidates were required to complete all stations. The duration of the OSCE circuit was 1 hour and 36 minutes.
Part 2: Written examination: The MCQ component of the examination consists of 165 Individual Statements and 15 Extended Matching Items based upon 5 themes. The examination was of 90 minutes duration. The examination carried a total of 210 marks - 165 marks for the Individual Statements and 45 for the Extended Matching Items. For each of the MCQ papers (Basic Sciences and Clinical Topics) the combined IS and EMI marks will be converted into a closed score between 0 and 10. These closed scores are then combined to give a total closed score for the MCQ component overall. The remainder of the written examination comprised a Critical Review Paper (90 minutes) and an Essay Paper (90 minutes).
Clinical examination: It consisted of, Individual Patient Assessment (IPA) and Patient Management Problems (PMP). The IPA, for all practical purposes a ‘long case’, was a total of 1hour and 30 minutes duration, with candidates expected to take a history and physical examination unobserved for 1 hour and then present the case to the examiners over the next 30 minutes, leaving time for formulation, discussing differentials, discussing risk and management and interviewing the patient in front of the examiners. For the PMP Candidates were presented with 3 vignettes, to be marked by two examiners. For each vignette candidates were assessed on an 11 point scale. The PMP examination was of 30 minutes duration.
The written exam was changed to three papers and the terminology was changed accordingly to reflect this. 'Paper 1', 'Paper 2' and 'Paper 3' were to comprise the written component of the exam. The role of clinical skills testing was transferred to a real-time structured non-exam setting at the workplace by consultant supervisors and other professionals. Clinical skills were also tested in a formal exam setting as the fourth and final part of the exam titled - Clinical Assessment of Skills & Competencies(CASC).
MRCPsych Paper 1: 3 hours long, containing 200 questions. The paper includes both single best answer and extended matching questions. Approximately one third of the Examination consists of extended matching questions. Knowledge domains to be tested include basic sciences, general adult psychiatry, ethics, cross cultural psychiatry and the history of psychiatry.
MRCPsych Paper 2: 3 hours long, containing 200 questions. The paper includes single best answer and extended matching questions. Approximately one third of the Examination consists of extended matching questions. Knowledge tested includes advanced psychiatric theory, pharmacology, psychiatric epidemiology and research.
MRCPsych Paper 3: 3 hours long, containing a maximum of 200 questions. The paper includes both single best answer and extended matching questions. The Clinical Topics is approximately two thirds of the paper. The Critical Review component is approximately one third of the paper. Knowledge domains to be tested include psychiatric specialities, critical appraisal skills and medical statistics.
CASC:. One circuit will consist of 8 individual stations of 7 minutes with a preceding 1 minute ‘preparation’ time. The other circuit will consist of 4 pairs of linked stations. Here the stations each last 10 minutes with an additional 2 minutes of 'preparation' time.
Since 2015 the Royal College of Psychiatrists have changed the exams. Candidates are now required to sit in for Paper A (AI and AII), Paper B and the CASC. For an interim period, Paper A will be held in two halves of 90 minutes and 100 marks each. Each half will maintain the two-thirds/one-third MCQ/EMI split.
Paper A(i) will cover the following sections of the syllabus:
1) Behavioural Science and Sociocultural Psychiatry
2) Human Development
5) Classification and Assessment in Psychiatry
Paper A(ii) will cover the following sections of the syllabus:
3) Basic Neurosciences
4) Clinical Psychopharmacology