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4. Membership of the Royal College of Physicians of Ireland (MRCPI General Medicine Part II Written): Practical Study Tips

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 Membership of the Royal College of Physicians of Ireland (MRCPI General Medicine Part II Written): Practical Study Tips
=========================================================================================================================

  A focused plan for management-heavy SBAs, two-paper stamina, and remote-invigilation readiness.

  [     MDster Editorial Team ](https://mdster.com/about) ·      Mar 11, 2026  ·      7 min read  ·       125

  [     Reviewed by Dr. Ali Ragab, MBBCH, MSc, MCAI ](https://mdster.com/medical-reviewers/dr-ali-ragab) [Editorial Policy](https://mdster.com/editorial-policy) | [Corrections Policy](https://mdster.com/corrections)

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 The most common mistake with **Membership of the Royal College of Physicians of Ireland (MRCPI General Medicine Part II Written)** is treating it like Part I plus extra reading. It is not. In the current RCPI regulations available in March 2026, Part II Written remains **two 2.5-hour papers of 75 single best answer questions**, focused on **diagnosis and management**, and delivered by **remote invigilation**. So your revision has to become more clinical, more selective, and much more timed. If you are still spending hours on isolated basic science detail, you are revising for the wrong exam. [\[1\]](#cite-1 "Reference [1]")

Study the blueprint before you study the textbook
-------------------------------------------------

RCPI’s blueprint is your best starting point because it tells you where the marks live. The Part II Written blueprint allocates **80% of questions across eight 10% domains** and **20% across four 5% domains**. That should shape your timetable from day one. [\[1\]](#cite-1 "Reference [1]")

PriorityWeightingWhat to doCardiology, Endocrinology, Gastro/Hepatology, Haematology/Immunology, Neurology, Nephrology, Respiratory, Rheumatology80% totalBuild first-pass notes and most of your question practice hereDermatology, ID/GUM, Oncology/Palliative Care, Therapeutics/Toxicology20% totalCover after your big eight are functioning

Use that weighting practically:

- Spend your first 4-6 weeks getting the **big eight** exam-ready.
- For each specialty, make a one-page sheet on **acute presentations, key investigations, first-line treatment, escalation triggers, and common traps**.
- Build revision around **hospital medicine problems**: ACS, arrhythmia, COPD/asthma exacerbation, AKI, GI bleed, DKA/HHS, stroke/TIA, meningitis, vasculitis, neutropenic sepsis, anticoagulation reversal.

RCPI also states the exam is aligned with the **BST curriculum**, but the curriculum is **not exhaustive**. Use it as a checklist, then stress-test it against real admissions, discharge summaries, and guideline-driven management decisions. [\[1\]](#cite-1 "Reference [1]")

Train for the actual SBA decision, not just fact recall
-------------------------------------------------------

Part II Written asks you to pick the **single best** answer in management-heavy clinical scenarios. Questions may include **photographs, imaging, graphical data, and pathology material**, so passive reading is too blunt a tool. Your core method should be a disciplined SBA review process. [\[1\]](#cite-1 "Reference [1]")

For every missed question, write down five things:

1. **What is the diagnosis or syndrome?**
2. **What clue in the stem should have triggered it?**
3. **What is the immediate next step?**
4. **Why is the best option better than the second-best option?**
5. **Was the error knowledge, interpretation, or prioritisation?**

Use resources like this:

- **Question banks:** do them in **timed blocks**, not tutor mode only.
- **Concise textbooks/guideline summaries:** open them **after** the block to repair gaps.
- **Image libraries:** schedule ECG, CXR, CT, fundoscopy, and dermatology review twice weekly.
- **Study groups:** one hour a week is enough if the rule is simple: each person brings **five management SBAs** and defends why four options are wrong.

> **Pro Tip:** If two answers both look reasonable, ask yourself, *Which option changes management safely right now?* That is often where the best answer sits.

Study Schedule Template
-----------------------

A short, structured cycle usually beats a long vague one. Here is a workable **8-week template** for busy trainees.

PeriodMain goalWeekly non-negotiablesWeeks 8-5Coverage of big eight specialties5 days x 25-30 timed SBAs; 1 x 75-question paper; 2 one-page specialty summariesWeeks 4-2Exam-mode practice2 x 75-question papers; 1 image/data session; wrong-answer log reviewFinal 7 daysRepair and rehearsal2 full two-paper simulations; algorithm review only; tech check on exam device

Keep one notebook or spreadsheet called **errors I must not repeat**. Sort mistakes into three columns: **knowledge gap**, **misread data**, **wrong management priority**. Candidates improve fastest when they target the error type, not just the topic.

> **Pro Tip:** Do not aim to finish all resources. Aim to finish **your review of the same mistakes**.

Use a paper strategy that respects the clock
--------------------------------------------

Each paper gives you **150 minutes for 75 questions**, so your average is about **2 minutes per question**. That is enough if you do not get trapped in early uncertainty. Also remember that **marks from both papers are combined** and there is **no negative marking**, so every question should receive an answer. [\[1\]](#cite-1 "Reference [1]")

Try a 3-pass method:

- **Pass 1:** answer straightforward items quickly.
- **Pass 2:** return to data-heavy or calculation-style stems.
- **Pass 3:** make your best call on the remaining marked items; do **not** leave blanks.

Because this is a two-paper day, practise stamina properly. At least twice before the exam, sit **Paper 1 in the morning, take a real break, then sit Paper 2**. That rehearsal matters more than squeezing in another chapter you will barely remember.

Prepare for remote invigilation like it is part of the exam
-----------------------------------------------------------

Remote delivery changes how you should prepare. RCPI requires a **quiet single-occupancy room**, **one computer screen only**, reliable internet, webcam and microphone, and advance setup with the exam platform. Candidates are instructed to **book their start time at least 72 hours before the exam** and to **log in at least 15 minutes early** on the day; late log-in can prevent you from sitting the paper. [\[1\]](#cite-1 "Reference [1]")

So this week, do one full mock exactly as you will sit the real exam:

- Same laptop
- Same desk and chair
- Same internet connection
- Notifications off
- ID ready
- Water, breaks, and room setup planned

This is not admin trivia. It is risk reduction.

Common Pitfalls
---------------

- Over-revising Part I-style basic science instead of management decisions. [\[1\]](#cite-1 "Reference [1]")
- Doing untimed questions and then being shocked by the clock.
- Reviewing only why the right answer is right, instead of why the distractors are wrong.
- Ignoring images and data interpretation until the final week. [\[1\]](#cite-1 "Reference [1]")
- Leaving questions blank despite **no negative marking**. [\[1\]](#cite-1 "Reference [1]")
- Treating remote invigilation as an afterthought. [\[1\]](#cite-1 "Reference [1]")

Key Takeaways
-------------

- Map your next two weeks to the **official blueprint**, not your favourite specialty.
- Sit one **75-question timed paper** every 3-4 days.
- Build a wrong-answer log by **error type**.
- Add two weekly sessions for **images and graphs**.
- Complete one full **remote-invigilation rehearsal** on your real exam setup.

This exam becomes much more manageable when your preparation looks like the paper itself: **broad, management-focused, timed, and clinically realistic**. Start there, and your revision will feel sharper within a week.

        References  (3)
------------------

 1. 1.  [ www.rcpi.ie/Portals/0/Document%20Repository/Exams/Regulations/MRCPI%20General%20Medicine%20Regulations%20October%202025.pdf?ver=tWmaGzQLpUxQi9ibmNHFZQ%3D%3D     ](https://www.rcpi.ie/Portals/0/Document%20Repository/Exams/Regulations/MRCPI%20General%20Medicine%20Regulations%20October%202025.pdf?ver=tWmaGzQLpUxQi9ibmNHFZQ%3D%3D)   [↩](#cite-ref-1-1 "Back to text")
2. 2.  Royal College of Physicians of Ireland. Regulations and Information for Candidates: MRCPI General Medicine Regulations. October 2025.
3. 3.  Royal College of Physicians of Ireland. Basic Specialist Training in General Internal Medicine Curriculum 2025.

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