MRCPsych Paper B

The MRCPsych Paper B: A Comprehensive Guide 2023

As an international medical graduate or even as UK trainee, navigating the structure and requirements of the MRCPsych Paper B exam can seem overwhelming. This blog post aims to shed light on the MRCPsych Paper B, outlining its structure, content, and how to approach MRCPsych revision effectively.

Understanding the Exam Structure

MRCPsych Paper B is a 3-hour exam with 150 questions. The questions are a mix of multiple-choice questions (MCQs) making up two-thirds of the paper and extended matching item questions (EMIs) forming one-third. Scoring is straightforward, with each question worth one mark, totalling 150 marks for the whole paper.

The critical review forms a significant part of the exam, constituting about 33.5% (50 marks). The remaining 66.5% (100 marks) cover clinical topics.

Syllabus Breakdown

The clinical topics in the MRCPsych Paper B syllabus encompass a broad range of areas:

Organisation and Delivery of Psychiatric Services (5.5%/8 marks): This involves understanding how psychiatric services are structured and delivered, both in general terms and within the context of the NHS.

General Adult Psychiatry (20%/30 marks): The largest clinical section, it covers a wide range of psychiatric disorders affecting adults, including schizophrenia, mood disorders, anxiety disorders, and personality disorders.

Old Age Psychiatry (9%/14 marks): Focusing on mental health issues in older adults, including dementia and depression.

Psychotherapy (5.5%/8 marks): Understanding the principles of various forms of psychotherapy, like cognitive behavioural therapy (CBT), dialectical behaviour therapy (DBT), and psychodynamic therapy.

Child and Adolescent Psychiatry (9%/14 marks): This encompasses psychiatric disorders common in children and adolescents, including ADHD, autism spectrum disorder, and eating disorders.

Substance Misuse/Addictions (6.5%/10 marks): The focus here is on the psychiatric aspects of substance misuse and addictive behaviours.

Forensic Psychiatry (5.5%/8 marks): Involves understanding psychiatric disorders in the context of criminal behaviour and the criminal justice system.

Psychiatry of Learning Disability (5.5%/8 marks): Covers psychiatric disorders in people with learning disabilities.

Critical review (33.5% / 50 marks): Forms an integral part of Paper B. It assesses your ability to critically appraise scientific literature, understand research methods, and apply the findings to clinical practice.

Each section of the syllabus has a corresponding set of resources on the PassMRCPsych course, designed to maximise your MRCPsych preparation.

MRCPsych Paper B

A More Detailed Look at the MRCPsych Paper B Syllabus

Organisation and Delivery of Psychiatric Services

Understanding the structure and delivery of psychiatric services is crucial for a well-rounded psychiatrist. This section encompasses various aspects, such as the roles and responsibilities of different mental health professionals, the structure of mental health services, and the legislation and policies impacting psychiatric practice. Effective revision in this area will involve understanding not just the national standards, but also the local nuances that may affect the delivery of services.

General Adult Psychiatry

General Adult Psychiatry covers the diagnosis, management, and treatment of a broad spectrum of mental health conditions. These include common conditions such as depression and anxiety, to more complex disorders like schizophrenia and bipolar disorder. Understanding the pathophysiology, epidemiology, clinical features, and the latest evidence-based treatments is crucial. This area forms the core of psychiatric practice, so a solid foundation in this topic is crucial for success in both the MRCPsych exams and your clinical practice.

Old Age Psychiatry

Old Age Psychiatry focuses on the unique mental health challenges faced by older adults. This section covers conditions such as dementia, depression in the elderly, late-onset schizophrenia, and delirium. Understanding the specific psychosocial issues that can impact this population, as well as the biological changes associated with ageing that can affect psychiatric symptoms and treatments, is vital.


While medication management forms a significant part of psychiatric treatment, psychotherapy is equally crucial. This section covers the basic principles and techniques of various forms of psychotherapy, including cognitive-behavioural therapy, interpersonal therapy, psychodynamic psychotherapy, and others. Even if you do not plan on specialising in psychotherapy, understanding these principles is vital as they are often integrated into comprehensive treatment plans.

Child and Adolescent Psychiatry

Child and Adolescent Psychiatry covers the mental health conditions that affect children and teenagers. These include conditions like ADHD, autism spectrum disorder, and childhood-onset depression and anxiety disorders. Knowledge in this area involves not only understanding these conditions but also the unique ethical and legal issues involved in treating this population.

Substance Misuse/Addictions

The Substance Misuse/Addictions section deals with the psychiatric aspects of substance use disorders. This includes alcohol and drug addictions, and the co-occurring mental health conditions that often accompany them. Here, the focus is not only on understanding the effects of these substances on the brain but also on developing competence in managing withdrawal syndromes, implementing harm-reduction strategies, and treating comorbid conditions.

Forensic Psychiatry

Forensic Psychiatry involves the intersection of mental health and the law. This section covers various topics, including risk assessment, legal issues around mental health, treatment of offenders, and working with victims of crime. Revision in this area can involve understanding landmark legal cases that have shaped psychiatric practice, as well as the various risk assessment tools used in the field.

Psychiatry of Learning Disability

The Psychiatry of Learning Disability section covers psychiatric disorders in individuals with learning disabilities. These individuals often have unique presentations of common psychiatric disorders and may require modified approaches to treatment. Knowledge in this area should cover the wide range of mental health conditions seen in this population, as well as the impact of learning disabilities on these individuals’ lives and experiences.

Critical Review

Critical review forms an integral part of Paper B. It assesses your ability to critically appraise scientific literature, understand research methods, and apply the findings to clinical practice. Mastery in this area involves understanding different research designs, statistical analysis methods, and being able to identify the strengths and weaknesses of individual studies. This is a crucial skill not only for the exam but also for evidence-based practice.

Remember, success in MRCPsych Paper B and indeed the overall MRCPsych exam is not just about rote memorisation, but understanding and application. Make use of the resources available at to supplement your preparation. Best of luck in your journey to becoming a psychiatrist!

Approach to Revision – PassMRCPsych

Given the breadth of topics covered, it’s crucial to have a structured approach to your MRCPsych revision. Start by understanding the syllabus and then build your revision around it.

The PassMRCPsych course offers an excellent platform for your MRCPsych exam preparation. We have meticulously syllabus-matched revision notes available in a succinct textbook style. Over 5000+ MCQs and realistic mock exams further help you practise and understand the exam format.

Our unique offering includes an innovative mobile app, giving you access to all our notes and MRCPsych questions on-the-go. This accessibility ensures you can make the most of your revision time, no matter where you are.

While the clinical sections are self-explanatory, many find the critical review part challenging. The key here is understanding how to critically appraise scientific papers and studies. Our critical review blog posts can provide you with valuable insight into tackling this part of the exam.

Remember, success in MRCPsych Paper B relies on understanding the syllabus, strategic planning, consistent revision, and plenty of practice.

Our blog has other valuable posts about specific topics in the MRCPsych course, MRCPsych exam dates, and many more that could support your MRCPsych exam preparation journey.

Finally, remember that taking the MRCPsych exam is a step towards becoming a competent and knowledgeable psychiatrist, capable of delivering high-quality patient care. As such, every moment spent in MRCPsych revision is a step towards this important goal. Good luck with your preparation!

Applying to RCPsych for the MRCPsych Paper B Exam

If you’re preparing for the MRCPsych exam and feel ready to make that commitment, it’s crucial to know the application process. The Royal College of Psychiatrists (RCPsych) has a designated page where you can find all the necessary details and proceed with your application. Visit the MRCPsych Exam Application page, and you’ll find all the information about deadlines, eligibility, and how to apply. Remember, applying for the exam is a significant step towards achieving your goal of becoming a psychiatrist. So, take this step with confidence and determination.