Regulations and

Information for
Candidates

MRCPI Part I
General Medicine

2013 Edition

Royal College of Physicians of Ireland

Frederick House
19 South Frederick Street
Dublin 2
Tel: 00353 1 8639700
© 2013 Royal College of Physicians of Ireland
Contents
Page

1. Introduction ...................................................................................... 3

2. MRCPI Qualification......................................................................... 3
2.1 MRCPI Qualification Map ............................................................................ 4

3. MRCPI Part I General Medicine Examination

3.1 Entry requirements .......................................................................... 5
3.2 Exemptions ................................................................................... 5
3.3 Examination locations ...................................................................... 5
3.4 Preparation for MRCPI Part I General Medicine Written Examination ........ 5
3.5 Part I General Medicine Blueprint ................................................................ 5
3.5 Syllabus........................................................................................................ 6

4. How to enter the MRCPI Part I General Medicine Written

Examination
4.1 Method of application................................................................................... 7
4.2 Visas ............................................................................................................ 7
4.3 Examination fees ......................................................................................... 7
4.4 Withdrawal from the examination ................................................................ 8
4.5 Examination Registration ............................................................................. 8

5. MRCPI Part I General Medicine Examination Format

5.1 Single Best Answer (SBA) ................................................................ 8
5.2 The question paper ...................................................................................... 9
5.3 How to complete a SBA answer sheet....................................................... 10
5.4 Examination rules and guidelines .............................................................. 10
5.5 Sample SBA answer sheet ........................................................................ 13

6. Fire Evacuation .............................................................................. 14

7. Code of Conduct ......................................................................................... 14

7.1.1 Report procedure ..................................................................................... 15
7.1.2 Investigation procedure ........................................................................... 15

8. Adapted Examination Arrangements ........................................... 16

9. Examination Results .................................................................................. 16

9.1 Recheck procedure and appeals policy ..................................................... 16

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1. Introduction
Membership of the Royal college of Physicians of Ireland (College) is governed by the By-Laws
of the College. The following Regulations apply to all candidates entering for the MRCPI
examinations. Any decision on the interpretation of these Regulations made by the College is
binding. The acceptance of any application is at the sole discretion of the College. Every
candidate for the Membership of the College must pass all parts of the Membership Examination
unless exemption has been granted as indicated in section 3.2 below.

The MRCPI Part I examination is designed to assess a candidate's knowledge and

understanding both of the basic sciences relevant to medical practice and of the common or
important disorders, to a level appropriate for entry to specialist training. The College conducts
the MRCPI Part I examination in General Medicine and Paediatrics. Candidates who wish to
become Members of the College must pass this examination in order to progress to the MRCPI
Part II Examinations.

2. MRCPI Qualification
The MRCPI Part I examination is held in Dublin as well as a number of overseas centres.
Details of these centres can be accessed via the website at www.rcpi.ie. Candidates who wish
to apply to sit the MRCPI Part I General Medicine will not be accepted for the examination
before the expiry of 12 months from the date given on their diploma of medical qualification.

Candidates are not required to have undergone training in specific posts before entry to the
examination, but the College recommends that candidates prepare by spending time gaining
clinical experience in suitable hospital posts, studying up-to-date clinical textbooks and by
reading current medical journals. In addition, it is recommended that candidates study section 5
in this booklet dealing with best of many question papers.

There is no restriction to the number of times a candidate can apply to sit the MRCPI Part I
examination in order to pass. Candidates must pass the Part I examination before applying to
enter the MRCPI Part II General Medicine Written examination, unless they have been granted
an exemption. Candidates have 7 years from the date of successfully passing MRCPI Part I
General Medicine in which to obtain MRCPI Part II General Medicine Written. Successful
candidates then have an additional two years from the date of passing MRCPI Part II General
Medicine Written in which to pass MRCPI Part II General Medicine Clinical. There will be no
extension to this 7 year period. MRCPI Part I General Medicine examination will need to be
retaken if more than 7 years has elapsed since passing Part I.

Every candidate for MRCPI Part II Written membership exams must have submitted testimonials
of his/her professional qualification and character references from two Medical Practitioners of at
least 5 years standing and statements on the approved form regarding:

● Professional experience acceptable to the Education and Examination Committee

● Not keeping an open shop for the sale of medicine

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2.1 Qualification map

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3. MRCPI Part I General Medicine
3.1 Entry requirements

Candidates must have received their primary medical degree and a minimum of 12 months must
have passed between the date of their primary medical degree and the date of the exam.

3.2 Exemptions

Applications claiming exemption must be accompanied by adequate documentary evidence.

The following qualifications can be considered eligible for exemption from MRCPI:

MRCPI (Part I only) MRCPI (Part I and Part II Written only)

 MRCP(UK)  FRACP
 MRCPath
 MRCPCH In addition to the above, the following
 MRACP qualifications are also recognised for exemption
 FRCP(C) from MRCPI Part I for Obstetrics and
Gynaecology ONLY:
 FCP(SA)
 MRCPsych  MRCOG Part I
 M. Med Malaysia (O&G)*
 Arab Boards in Medicine and Paediatrics
 Saudi Boards in Medicine and Paediatrics
 FCP&S in Medicine and Paediatrics (Pakistan)  MRACOG (Australia)
 The American Boards in General (Internal  MRNZCOG (New Zealand)
Medicine and Paediatrics M. Med.(Malaysia)  FCOG (SA)
 FCPS (O&G) (Pakistan)
 MRANZCOG
*Applicable only to holders of this qualification from 2008
onwards

Candidates claiming exemption must accompany their application with attested/certified proof of
this qualification. Documents can be attested by any one the following:

 Commissioner for Oaths

 Solicitor
 An Garda Siochana (Police)
 Issuing Authority

3.3 Examination locations

The MRCPI Part I General Medicine is held in Dublin together with a number of overseas
centres. Details of these centres can be accessed via the website at www.rcpi.ie.

3.4 Preparation for MRCPI Part I General Medicine Examination

All MRCPI examinations are conducted in the English language.

There is a guideline syllabus to assist with the preparation for the MRCPI Part I General
Medicine on the website www.rcpi.ie. The guidelines present a framework of topics which
should be covered, but it is not intended to be inclusive and candidates should not limit their
studies solely to these topics.

3.5 Part I General Medicine Blueprint

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Each examination will consist of 100 questions in the single best answer style. The questions
are selected to achieve a balanced spread of questions across the specialties, the sciences
underlying evidence based medical practice, and basic skills required in general medicine. The
questions will be on common or important diseases, including medical emergencies. At least
75% of the questions will concern direct clinical care of in-patients and out-patients in hospital
medical practice. Correct answers will be within up-to-date guidelines for diagnosis and
management. The usual number of questions on each paper, N, by specialties and skills are
shown on the following tables.

Specialties and Sciences N

Anatomy, Bacteriology, Biochemistry, Ethics, Genetics, Immunology,

Metabolic, Physiology, Principles of evidence based practice and 5-15
Statistics
Cardiovascular 5-15
Dermatology 2-8
Endocrinology 5-15
Gastroenterology 5-15
Haematology 5-15
Infectious diseases 2-8
Nephrology 5-15
Neurology 5-15
Ophthalmology in the context of General Medicine 0-3
Psychiatry 0-3
Respiratory medicine 5-15
Rheumatology 5-15
Therapeutics and Pharmacology 5-15

Skills N

Manage emergencies in medicine 5-20

Apply knowledge of disease 5-25
Understand mechanisms of disease 5-20
Interpret clinical information 5-30
Interpret data 5-20
Interpret images 0-10
Plan investigations 5-20
Plan non-drug therapy 5-20
Plan drug therapy 5-20

3.6 Syllabus

The BST curriculum is fully aligned with the syllabus of the Membership examinations.

January 2013 6
4. How to enter the MRCPI Part I General Medicine Examination
4.1 Method of application

All exam application forms together with supplemental documentation and payment must be
completed online. The method of payment is by credit card and debit/Laser cards.

Applications will not be accepted by the College before the published opening date or after the
published closing date.

Dublin and Overseas

The application form together, with the examination calendar, can be downloaded from the
College’s website at www.rcpi.ie.

Saudi Arabia Centre only

Candidates sitting examinations in Saudi Arabia are required to pay a separate administration
fee of SAR200 on the day of examination. Please refer to the website www.rcpi.ie which is
updated regularly with local centre information.

Candidates must upload certified copies of their original diplomas (first time entrants only) of
Medical Qualification, which must be adjudged to be satisfactory to the College. Copy diplomas
must be attested by a member of an Garda Siochana (police), Solicitor, Commissioner for Oaths
or the Issuing Authority. The receipt of the retention fee issued by the Medical Council is not
acceptable as evidence of registration. Official translations will only be accepted if they have
been prepared and/or authenticated by:

(i) the issuing University or Medical School

(ii) an Irish or British Consulate
(iii) the candidate’s own Embassy or High Commissioner

Application checklist:
 Application form
 Proof of Qualification (if seeking exemption)

The candidate’s full name must be given at the time of entry to the examination and must agree
with the name(s) given on Medical Council documentation. The name you provide will be used
on all official correspondence (such as diplomas, qualifications and certificates) issued by RCPI.
Candidates who change their name(s) by marriage or deed poll must upload documentary proof
of this, if they wish to be admitted to the examination in their new name.

Candidates who take Part I General Medicine may take Part II in any available specialty,
regardless of the paper in which they were successful in Part I subject to the eligibility criteria
required for each speciality.

4.2 Visas

If a candidate requires a visa to sit an examination, it is the responsibility of the individual to

ensure the visa application is made in sufficient time before the examination date for which it has
been sought. The College has no influence in granting or refusing visas. A refund will not be
given if a candidate is unable to attend the examination as a result of a visa related problem.

4.3 Examination fees

The fees payable on entry to the MRCPI Part II General Medicine Examinations are published
annually.

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No candidate will be permitted to take any part of the examination unless all outstanding fees
are paid in full.

4.4 Withdrawal from the examination

Notice of withdrawal from an examination must be given in writing to the College. A refund less
10% will be made if written notice of withdrawal is received by the College on or before the
closing date of entry to the examination. No fee will be held over to a future examination.
Refunds will not be made where candidates submit their withdrawal request after the closing
date unless there are exceptional extenuating circumstances. Each request will be dealt with on
a case by case basis at the discretion of the Dean of Examinations, whose decision is final.
Documentary evidence is required in all cases. Any request (accompanied by supporting
evidence) must be submitted within 2 weeks of the examination date if it is to be considered.

4.5 Examination Registration

Registration will take place 30 minutes prior to the commencement of the examination.
Candidates will be admitted to the examination under the names (surname and first name(s)) as
given in the current edition of the Medical Register of Ireland or of the United Kingdom or on
their original medical registration certificates or diplomas of medical qualification or official
translations of the diplomas. The last name will be taken as the surname. Passport, equivalent
national identity card or drivers licence must be produced at all parts of each examination.

5. MRCPI General Medicine Part I Examination Format

The examination is 3 hours in duration and consists of one Single Best Answer (SBA) style
paper containing 100 questions to answer.

5.1 Single Best Answer

Each question is equally weighted. There is no negative marking, so you are strongly advised to
give a considered response to every question.

The questions will appear in the format of the following example:

A 55-year-old man presents to the Emergency Department with a one hour history of severe
central chest pain which increased over about 15 minutes, spread down his left arm and was
since then persistent. He also has nausea and vomiting. He has a long history of chest pain on
exertion, which had worsened during the previous week. He is a cigarette smoker.

On examination, he is sweating. His pulse is regular at 100 beats per minute and his blood
pressure is 132/84 mmHg. There is a short mid-systolic murmur audible at the apex. There are
crackles in both lung fields, left worse than right.

Investigations:
troponin T not elevated
creatine kinase 60 U/L (24‒195)
C reactive protein 2 mg/L (<10)
ECG see IMAGE below

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What is the most likely diagnosis?

A. aortic dissection
B. myocardial infarction
C. oesophageal rupture
D. pericarditis
E. pneumothorax

Correct answer B

1. [A] [B] [C] [D] [E]

An example of the SBA answer sheet is shown on page 13 below. Candidates are expected to
complete lines 1 to 100.

The standard necessary to achieve a pass is set to achieve excellence in physician training.
Every question is carefully reviewed and assessed for difficulty. Criterion referencing and test
equating procedures are applied to every examination, so that the standard is fair and consistent
between examinations. The score you receive is not a raw score but has been normalised to
achieve a consistent scale and thereby allow easier comparison of your performance between
examinations should it be necessary for you to repeat.

5.2 The question paper

The General Medicine paper contains questions designed to test the knowledge of the basis of
medical practice over a wide area, including elementary statistics and clinical sciences, e.g.
anatomy, physiology, biochemistry, pathology, microbiology and pharmacology.

The examination paper will cover elementary and clinical sciences. Increased emphasis will in
future be given to basic science topics. Questions in both options may be set on relevant
principles of cell molecular and membrane biology, immunology, genetics and on biochemistry,
as well as anatomical, physiological, microbiological and pharmacological topics.

It is important that a candidate fully understands how to complete the answer sheet before they
sit the examination. Please see detailed instructions at point 5.3 below.

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5.3 How to complete SBA answer sheet

An example of the SBA answer sheets is on page 13. The completed answer sheet is computer
scored which means the following instructions must be complied with fully, otherwise they may
be rejected by the scoring machine.

5.3.1 Use only the PENCIL (Grade 2B) supplied. Answers in ink or a different grade of pencil
cannot be read by the computer.

5.3.2 The answer sheet contains a row of boxes for each question. Each box refers to a single
item and is numbered accordingly (i.e. 1A, 1B, 1C, 1D, 1E). Candidates should indicate
which of the five possible answers is correct by pencilling in the appropriate box.

5.3.3 Candidates may rub out an answer by using the eraser provided. To avoid too many
erasures on the answer sheets, candidates are advised to indicate their answers in the
question book in the first instance, before transferring them to the answer sheets.
Remember to allow sufficient time to do so.

5.3.4 Do not fold or crease the answer sheets.

5.3.5 At the end of the examination, the question books and answer sheets must be left on the
desk. On no account should they be removed from the examination centre.

5.4 Examination rules and guidelines

5.4.1 These Regulations apply to all candidates for examinations of the College. Candidates
should note that by applying to enter to sit an examination, they are deemed to have
understood and agreed to comply by these Regulations.

5.4.2 Candidates are advised to allow for any transport delays when planning time of arrival at
the examination centre. The College cannot guarantee candidates will be permitted to
enter the examination centre after the start of the examination.

5.4.3 Candidates should assemble outside the examination centre for registration at least 30
minutes before the start of the examination and will not enter until instructed by an
invigilator(s).

5.4.4 Candidates will not be permitted entry into the examination centre if they arrive 30
minutes after the start of the examination.

5.4.5 Candidates must have their personal identity card and notification email with them at all
MRCPI Examinations as proof of identity. A passport or drivers licence may be accepted
if the candidate’s name is stated in the same manner as on their primary medical degree.
Candidates will not be admitted to the examination unless they produce photographic
identification.

5.4.6 Candidates should note that drugs will almost always be referred to by their UK
approved names (National Formulary) rather than their trade names. Biochemical and
other measurements will be expressed in SI units.

5.4.7 Candidates are not permitted to bring into the examination centre, mobile phones,
pagers, laptop computers, palm pilots, calculators, text books, documents or items of any
kind other than those specifically allowed for that particular examination and previously
notified to them.

January 2013 10
 Any candidate found to be in possession of such a device during the examination will
receive a verbal warning from the exam invigilator. A written report will be drafted and
signed by the invigilator and countersigned by a witness to the event. This report will be
forwarded to the Dean of Examinations. If the Dean considers the event to be a serious
infringement of the exam regulations, the candidate will be advised that he/she is
suspended from the exam. This will result in exam failure, the loss of the exam fee and
possible exclusion from re-entry to future exams.

5.4.8 Candidates are not permitted to have their bags and/or other personal items at their
desks during the examination. Invigilators will direct candidates to a secure area for
personal items to be deposited for the duration of the examination.

5.4.9 Question papers are individually numbered with Examination Numbers at the top right
hand corner.

5.4.10 Candidates must ensure they are sitting at the correct desk and their Examination
Number corresponds to the desk number.

5.4.11 Candidates must place their Identity Card at the top right hand corner of the desk to
enable the invigilators to carry out a check during the exam.

5.4.12 Candidates must use the pencil provided when filling out the answer sheet.

5.4.13 It is recommended that candidates initially indicate their answer against the questions in
the questions box in the question paper. Candidates should leave sufficient time to
transfer their answers to the answer sheet.

5.4.14 Rough work paper is not provided and candidates must confine notes to the question
paper.

5.4.15 Candidates are not permitted to remove the question paper or image booklet from the
examination hall nor are they allowed to copy out questions from the paper.

5.4.16 It is strictly forbidden for candidates to talk or attempt in any way to communicate with
other candidates while the exam is in progress.

5.4.17 Pencil in the boxes on the answer sheet neatly and boldly. Completely fill in the area
within the box. The scoring machine has been programmed to ignore erasures, which
can leave smudges. Faint responses and those boxes that are only partially filled may be
ignored by the scoring machine. It is the candidate’s responsibility to ensure only a single
clear response is recorded for each question.

5.4.18 Smudges may be caused by dirty erasers. Cleaning can be accomplished by rubbing the
eraser against any clean part of the question book. Candidates should inform an
invigilator if they are concerned about the appearance of their erasures.

5.4.19 If a candidate wishes to leave the examination early, they must raise their hand and wait
for an invigilator to collect the paper. Candidates cannot leave the examination hall 30
minutes before the end of the examination. The College cannot take responsibility for
lost or mislaid papers.

5.4.20 At the end of the examination, candidates must stop writing when instructed to do so by
the invigilator and remain in their seat until the exam paper and answer sheet have been
collected. Any candidate continuing to write after being instructed to stop will have their
examination number noted. Their behaviour will be reported to the Dean of Examinations
who will make a decision on further action.

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5.4.21 Smoking is not permitted in any part of the examination centre. Candidates will not be
permitted to leave the building for a smoke break during the examination.
5.4.22 Toilet breaks are permitted during the examination, but in an effort to minimise disruption
candidates are requested to visit the toilet before the exam commences. Candidates
visiting the toilet during the exam will be escorted by an invigilator.

5.4.23 Candidates are advised to provide their own refreshments during the examination,
bearing in mind that hot food is not permitted.

5.4.24 Any candidate acting in breach of any of the above Regulations, or misbehaving in any
way, may be suspended from the examination or be deemed to have failed the
examination. If an infringement of the College Regulations is deemed to be particularly
severe, the candidate concerned may be permanently disbarred from entering any
future College examinations.

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5.5 Sample SBA Answer Sheet

January 2013 13
6. Fire Evacuation
6.1 The emergency exits will be pointed out to candidates during the announcements prior to
the commencement of the examination.

6.2 Unless otherwise advised, all alarms should be treated as an emergency. If the alarm is
sounded, a College staff member will be responsible for the evacuation of the
examination venue.

6.3 Candidates should note that they remain subject to examination rules during the
evacuation and should not communicate or have contact with other candidates.
Candidates must not attempt to collect personal belongings.

6.4 On instruction from the College staff member, all students will cease writing and leave
their answer booklets on the desk.

6.5 The College staff member will instruct the invigilators to act as ‘Fire Marshalls’ and these
marshals will be responsible for leading their designated sections of candidates.

6.6 The Fire Marshall should collect the exam register and evacuate the candidates to the
assembly point using the emergency exists.

6.7 Do not use the lift.

6.8 When assembled the Fire Marshall will check the candidates against the examinations
register.

6.9 If it is possible to resume the examination, candidates will be instructed to endorse their
scripts with the words ‘examination interrupted’ indicating the time of the interruption and
the time of resumption. Candidates will be allowed compensatory time equivalent to the
period from the time the alarm sounded to the resumption of the examination, plus 10
minutes for re-reading the examination paper and settling back into the examination.
The invigilator will inform candidates of the revised finishing time for the examination.

6.10 A written report of the evacuation will be filed by the College staff member and forwarded
to the Dean of Examinations.

6.11 A delay of more than thirty minutes will automatically require a re-scheduling of the
examination concerned. In this case, invigilators will announce to the students that they
should contact the Examinations Department regarding alternative examination
arrangements. Students may then leave.

7. Code of Conduct
This code shall apply to all candidates for examinations of the College. Candidates should note
by applying to enter to sit an examination they are deemed to have understood and agreed to
comply by this code. Misconduct includes, but is not restricted to:

7.1 Introduction into any examination of materials other than those specifically permitted for
the examination.

7.2 Any attempt to communicate with another candidate or any person other than an
invigilator on duty.

7.3 Any attempt to gain access to or plagiarise the work of another candidate.

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7.4 Any attempt to gain or pass on information with regard to the content of the examination
in advance of the date of the examination.

7.5 Impersonation of a candidate.

7.6 Bribery of another candidate or examination official.

7.7 Unacceptable or disruptive behaviour during an examination.

7.8 Failure to abide by the instructions of an invigilator or other examination official.

7.9 Falsification or alteration of any results document or qualification.

7.1.1 Report procedure

Suspected misconduct may be reported to the College by examiners, invigilators, candidates,

patients and any other person who becomes aware of suspected misconduct.

Where an invigilator suspects a candidate of violation of examination rules and guidelines, they
will:

(a) Confiscate any unauthorised material in the possession of the candidate.

(b) Make a note of the time when the alleged infringement was discovered. An invigilator will
ask another invigilator to act as a witness to the alleged infringement and countersign the
note to confirm this.

(c) Allow the candidate(s) to continue the examination. Ejection from the examination centre
will only take place in the event of a candidate(s) causing disruption to other candidates.

(d) Inform the candidate(s) at the end of the examination that a written report of the incident will
be submitted to the Dean of Examinations.

(e) Within three working days of the examination, the invigilator will submit a written report on
the alleged incident together with any confiscated materials to the Dean of Examinations.

7.1.2 Investigation procedure

The Dean of Examinations will review the report of the alleged case of misconduct and will
determine whether there is sufficient evidence of a case to be answered after consulting with
other members of College staff where necessary. In cases deemed to be of a very minor or
technical nature, a letter of reprimand will be issued, and no further action is taken.

In all other cases the Dean of Examinations will inform the candidate in writing of the allegations
that have been made about them within 10 working days of receiving a report of alleged
misconduct. The candidate will be invited to reply to the allegation of misconduct.

The candidate will provide their response in writing to the allegation within 10 working days from
the date of the Dean of Examinations letter. If no response is received within 10 working days, a
warning letter will be sent. If no response to this warning letter is received within another 10
working days, the file will be sent to the College Executive for a final decision along with a
recommendation of an appropriate penalty.

Where a candidate admits in writing to the allegations, full details of the case shall be passed to
the College Executive to formally consider the case. The candidate will have the opportunity to
include with their response a written statement which may be considered by the Executive. On

January 2013 15
full review of the case, the Executive will make a final decision, together with a recommendation
of an appropriate penalty. The candidate will be notified of the Executive’s decision in writing.

8. Adapted Examination Arrangements

Any candidate who has a physical disability, learning disability or any other special need that
they believe could affect their performance in an examination, may be entitled to adapted
examination arrangements. The purpose of any specific arrangement is to compensate for any
restrictions imposed by a disability without impairing the validity of the examination. All such
candidates should inform the Examinations Department at the time of application of their
circumstances in writing, together with a consultant’s report to support their application. Failure
to include this information at the time of application may affect the arrangements that can be put
in place in time for the examination. The information provided is treated strictly confidentially.

9. Examination Results
The College processes the marking of the MRCPI Part I General Medicine examination as
quickly as possible, consistent with ensuring accuracy, fairness and a stable pass standard.
Every effort is made to inform candidates of their result before the closing date for receipt of
applications for the next available MRCPI Part II Written examination, although admittance to
that examination cannot be guaranteed. Secure transport of candidate’s optical mark sheets to
the College from overseas centres, human inspection of the adequacy of the candidate’s pencil
shadings and optical scanning are required to obtain accurate data. Mathematical performance
indicators are then calculated and scrutinised by the Board, to confirm the fairness of every
question. The pass mark is approved by the Board of Examiners.

 Examination results for successful candidates only will be posted on the College website,
approximately four working weeks after the date of the examination. Under no
circumstances will examination results be given over the telephone, by fax, email or by
visiting the College in person.

 All result letters will be posted to candidates shortly thereafter.

 Please refrain from telephoning the College regarding your result during this period, as this
will delay the process.

9.1 Recheck procedure and appeals policy

Candidates can request a recheck of their examination results in any section of the MRCPI
examinations. There is a fee of €150 for this procedure. This charge will be refunded if a recheck
changes the overall examination result to a pass mark.

Please complete the recheck application form which is available on our website www.rcpi.ie and
return to the Examinations Department within four weeks of the results release date.

For details of our appeals policy, please go to the website www.rcpi.ie.

January 2013 16