MRCPsych Paper A — Information & Free Practice

About MRCPsych Paper A

MRCPsych Paper A · GB

Key exam facts

Provider

Royal College of Psychiatrists (RCPsych), examination owner; Pearson VUE, digital delivery partner.

Format

Digitally delivered at Pearson VUE test centres or, on request, remotely with OnVUE. The formal examination has 100 five-option single best answer MCQs and 50 extended matching items.

Exam questions

Total questions: 150.

Time limit

Three hours for the standard examination; individually approved reasonable adjustments may apply.

Passing score

A criterion-referenced pass mark is set for each paper using Modified Angoff. The final pass mark is the Angoff-derived mark plus 2 × standard error of measurement, approved by the Examinations Sub-Committee; this is not a fixed permanent percentage.

Exam fee

For 2027 examinations: GBP 571 for Pre-Membership Psychiatric Trainees (PMPT) and College affiliates; GBP 633 for other candidates.

Topics covered

The authority publishes percentage ranges for each content area. The practice percentages below use the midpoint of each range, normalized to 100%; they are not exact percentages published by the authority. Practice question counts may differ slightly because of rounding.

• Psychology and Human Development — Official range: 30–36% (Practice allocation: 33%)

  • Sensation and perception
  • Sensory threshold, detections, modalities, adaptation and coding
  • Active and passive perception
  • Auditory, the vestibular sense, the skin senses, pain, smell, taste and visual sensations (including colour, contract and shape), interoception and proprioception
  • Visual pathway, dorsal and ventral systems, the binding problem, perceptual constancy, unconscious inference and illusions, the development of visual perception as an interaction between the intrinsic and extrinsic factors
  • Network models of perception, feature nets, features to geons to meaning, depth and motion, the role of redundancy of perception, figure ground differentiation, Gestalt theories
  • Information processing and attention, salience theory and the relevance of perceptual theory to hallucinations and other psychopathology
  • Awareness, sleep and consciousness
  • Neural correlates of consciousness, the global workspace hypothesis
  • Mind-body dichotomy, its fallacies and dual aspect monism
  • Sleep, sleep structure and dreaming, parasomnias, biorhythms, effects of sleep deprivation
  • Altered state of consciousness, spiritual, religious, drug induced, trance state, 'psychedelic' induced states and dissociative states
  • Consciousness, the cognitive unconscious, translating thoughts into words and critiques of the conscious unconscious divide
  • Mistaken introspections and identities, unconscious attributions
  • Brain damage and unconscious functioning, arousal, delirium
  • Learning and learning theories
  • Neural basis for learning, how different species learn
  • Psychology of punishment and reward, emotional regulation and learning including threat, soothing and drive
  • Classical conditioning and the relationship between the conditioned and unconditioned reflexes
  • Thorndike and the law of effect, Skinner and operant behaviour
  • Generalisation of learning and habituation, chaining, shaping, cueing and the impact of various reinforcement schedules
  • Observational learning theory including Piaget, Vygotsky and Bruner
  • Changing behaviours or acquiring knowledge
  • Relation of learning processes to development of clinical problems
  • Memory
  • Acquisition, storage, consolidation, retrieval, constructive and reconstructive
  • Neural basis for memory including models of long-term potentiation
  • Sensory memories, working memory model, Baddeley's phonological loop and visuo-spatial scratch pad model
  • Short-term memory, long-term memory, establishing long-term memories
  • Hierarchy of memory types, episodic and semantic memory, subtypes of episodic memory, explicit and implicit (emotional and procedural) memory
  • Gaps in memory, distortion, inference, forgetting and memory intrusions, false memory, flashbulb memory, accuracy of eyewitness testimony, trauma and memory
  • Memory disorders and their assessment, and the relevance of memory and cognitive function in psychiatric disorders and their assessment
  • Intelligence
  • Intelligence as a construct, factor analysis and the idea of general intelligence
  • Intelligence testing, the psychometric approach, measuring intelligence and assessment tools, reliability and validity, cultural context and limitations
  • A hierarchical model of intelligence, fluid intelligence (gf) and crystallised intelligence (gc)
  • Mental speed, working memory and attention, executive control, other influences on intellectual functioning
  • Practical intelligence, emotional intelligence, the theory of multiple intelligences
  • The cultural context of intelligence
  • Problems with 'nature vs. nurture', genetics, epigenetics and individual IQ, environment and individual IQ, heritability ratios, group differences in IQ
  • Thought and higher cortical functions
  • Concepts, prototypes and cores, heuristics and dual process theory
  • Executive functions, high level such as initiation, planning and multi-tasking versus low level inhibition, cognitive flexibility and working memory judgment (Miyake model), deductive and inductive reasoning
  • Reasoning, cognitive bias such as recency and confirmation bias, logical fallacies, cognitive consistency and dissonance
  • Factors affecting decision making, including groupthink, cultural factors, human factors
  • Problem solving, hierarchical organisation, automaticity, obstacles to problem solving and overcoming obstacles to solutions
  • Theories of creativity including associative theory, interactionist theory and play
  • Language and communication
  • Sound units, morphemes and words, phrases and sentences
  • Language in nonhumans, the social origins of language learning
  • Language differences and development and impact on thought, experience and understanding
  • Development of language in infancy, language deprivation, language without sound, children deprived of access to some of the meanings, children exposed to more than one language, the case of bilingualism, the sensitive period hypothesis
  • How language connects to thought
  • Communicative competence, verbal, paraverbal and non-verbal communication
  • Motivation
  • Motivational states, extrinsic and intrinsic stimuli
  • Physiological systems, link to dopaminergic reward systems, the hypothalamus, thermoregulation
  • Satiety, hunger, eating, and obesity, physiological, cultural and cognitive aspects of hunger and eating
  • Emotional states and link to motivation
  • Threat and aggression, physiological aspects of threat and aggression
  • Cultural and cognitive aspect of threat and aggression, sexual behaviour, motivation, belonging and achievement
  • Maslow and the hierarchy of needs
  • Need for achievement (nAch)
  • Emotion
  • Facets of emotion, cognitive appraisal, differentiation and the status of primary emotions
  • Functions of emotion, social communication, survival and motivation
  • Critical appraisal of James-Lange and Cannon-Bard theories
  • Stress, physiological and psychological aspects of stress response, the role of adrenaline and the parasympathetic nervous system, rating scales and physiological measurements
  • Situational factors, life events, daily hassles and uplifts, conflict and trauma, vulnerability and invulnerability, type A or B responses
  • Emotion regulation, adaptive, harmful coping mechanisms, locus of control, learned helpfulness, learned resourcefulness, resilience and burn out
  • Social psychology
  • Social cognition
  • Attitudes, components and measurement by Thurstone, Likert and semantic differential scales, attitude change, persuasive communication and attitude behaviour relationships
  • Attribution, interpersonal issues, person perception, affiliation and friendship, attribution theory, 'naive psychology' and the primary (fundamental) attribution error and social behaviour in social interactions
  • 'Theory of mind' and its relation to autism spectrum conditions (ASC)
  • Psychology and psychopathology of the self, including self-psychology, self-concept, self-image, self-recognition, experiential self and personal identity
  • Social influence
  • Leadership, power and obedience, types of social power, influence operating in small and large groups or crowds, influence of culture, religion and media including social media
  • Conformity, obedience, compliance, polarisation, 'groupthink', deindividuation
  • Communication in relationships
  • Group processes, intergroup behaviour, prejudice, stereotypes and intergroup hostility
  • Theories of social identity and group formation, structure and membership, Bion and Foulkes
  • Aggression, explanations according to social learning theory, operant conditioning, ethnology, frustration and arousal concepts, the influence of broadcast and other media including social media, family and social backgrounds of aggressive individuals
  • Altruism, social exchange theory and helping relationships
  • Interpersonal co-operation, attraction and love
  • Social science and socio-cultural psychiatry
  • Descriptive terms, social class, socio-economic status and their relevance to psychiatric disorder and health care delivery
  • Social roles of doctors, sick role and illness behaviour
  • Family life in relation to major mental illness, knowledge and critical appraisal of theories including high expressed emotion
  • Social and geopolitical factors in relation to in relation to specific mental health conditions, social structures, poverty and wealth distribution, climate change, environmental factors and global events
  • Life events and their subjective, contextual evaluation
  • Sociology of residential institutions including psychiatric institutions and impact of institutionalisation
  • Basic principles of criminology and penology
  • Stigma and prejudice, racism including institutional racism, cultural bias, androcentrism, ethnocentrism and cultural relativism
  • Ethnicity and mental health
  • Cultural formulation, influence of identity, idioms of distress, explanatory models, help seeking behaviour
  • Host and migrant interactions, acculturation, multicultural society, assimilation and 'melting pot', marginalisation and segregation
  • Pathoplasticity and the influence of culture in shaping presentation of illness
  • Ethics and philosophy in psychiatry, framework for assessing ethical issues including legal, moral and societal aspects, epistemology, principles of medical ethics, rights and values
  • Underlying concepts related to human development
  • Basic frameworks for conceptualising development, nature and nurture, stage theories, maturational tasks (Erikson) and possible definitions of maturity
  • Examination of gene-environment interactions with specific reference to intelligence, relative influence of early versus later adversities, the relevance of developmental framework for understanding the impact of specific adversities such as trauma
  • Methodology for studying development, cross sectional, cohort and individual studies, identification and evaluation of influences
  • Genetic and epigenetic influences on development including gene environment interactions
  • Neuroimaging and its role in understanding development and up to date findings in this field
  • Theories and concepts related to stages of human development
  • Psychoanalytic theories of development
  • Attachment theories and relevance to emotional development, affect regulation and human relationships in childhood and later on, conditions for secure attachment, types and clinical relevance of insecure and disorganised attachment, early separation and its consequences, consequences of failure to develop selective attachments, maternal 'bonding', parental sensitivity, impact of deprivation and neglect with reference to relevant literature
  • Adverse childhood experiences (ACE), bereavement, parental divorce on subsequent development and mental health of the child and adult
  • Family relationships and parenting practices, the influence of parental attitudes compared with parenting practices, systemic theory including supportive systems in development, and aspects of distorted family function, discord, overprotection, rejection, and enmeshment, different family structures and cultural influences on family and stages of family
  • Factors affecting parent-child relationships, origins, typologies and stability of temperament and the evolution of character and personality, childhood vulnerability and resilience with respect to mental health
  • Development of social competence and relationships with peers, acceptance, group formation, co-operation, friendships, isolation and rejection and the components of popularity
  • Moral development with critical reference to Kohlberg's stage theory and relationship to development of social perspective taking
  • Development of emotion literacy and emotional regulation in childhood and adolescence including development of fears in childhood and adolescence with reference to age and possible aetiological and maintenance mechanisms
  • Sexual development, including the development of sexual identity and preferences, psychological, physiological, cultural and cognitive aspects of sexuality and sexual orientation
  • Adolescence as a developmental phase with special reference to pubertal changes, task mastery, conflict with parents and authority, affective stability and 'turmoil', normal and abnormal adolescent development, hormonal change and impact on mental state
  • Adaptations in adult life, such as pairing, parenting, illness, bereavement and loss
  • Pregnancy and childbirth and their stresses both physiological and psychological and embryological development
  • Development of personal (ego) identity in adolescence and adult life, work, ethnic, gender and other identities, mid-life 'crises'
  • Normal ageing and its impact on physical, social, cognitive and emotional aspects of individual functioning, impact of menopause, social changes accompanying old age, importance of loss, personality changes with ageing, social and economic factors in old age, attitude, status of the elderly, retirement, income, accommodation and socio-cultural differences

• Neuroscience — Official range: 22–28% (Practice allocation: 25%)

  • Concepts related to neuropsychology
  • Neuropsychological and cognitive assessments related to diagnosis and assessment of neurodevelopmental disorders and neurodiversity, acquired brain injury, dementias and neurodegeneration and other psychiatric conditions
  • Basic techniques in neuroscience
  • Neurophysiology of neurological investigations
  • Single unit recordings
  • Electro-neurophysiology and electroencephalogram (EEG) or frequency bands, normal findings, evoked response techniques, applications to investigation of cerebral pathology, seizure disorders, sleep and psychiatric disorders and effects of drugs on the EEG
  • Neuroimaging and its role in understanding brain function, including CT, structural MRI, DTI, FMRI, PET, MR spectroscopy
  • Microdialysis
  • Cerebro-spinal fluid (CSF) analysis or lumbar puncture in pathogenic states, in diagnosis of dementia, neuro-degenerative conditions, auto immune and infective encephalitis with neuropsychiatric symptoms and CSF correlates in common psychiatric conditions
  • Neurophysiology of physical interventions in clinical and research psychiatry
  • Perturbing brain function
  • Lesion studies
  • Electrical stimulation
  • Optogenetics
  • TMS
  • TDCS
  • Deep brain stimulation
  • Vagus nerve stimulation
  • Animal models of psychiatric disease
  • In vitro models including iPSCs and organoids
  • Data analysis and computational modelling
  • Cells
  • Cells found within the nervous system and their anatomical and functional localisation in layers in different parts of the cortex
  • Fundamental concepts in the physiology of neurones, synapses and receptors, including an understanding of resting potential, action potential, ion fluxes and channels, G-protein coupled receptors, allosteric modulation of receptors, long-term potentiation, synaptic plasticity and pruning
  • Modelling single neurons and their combination in circuits
  • Glia
  • Neurochemistry and neurophysiology
  • Basic neurochemical mechanisms with particular focus on central nervous system (CNS) function
  • Brain metabolism, oxygen utilisation, glucose metabolism, the tricarboxylic acid (TCA, citric acid, krebs) cycle, the GABA shunt and the role of co-factors in physiological functioning, such as acetyl co-enzyme A, folate
  • Synthesis and metabolism, relevant initiating compounds, enzymes and metabolites of the major neurotransmitters of relevance to psychiatric well-being and disorder, catechol or indole amine, acetylcholine, excitatory and inhibitory amino acids
  • Physiology of neurotransmission
  • Chemical synapse
  • Mechanisms of transmitter ('first messenger') storage, release ('exocytosis') and disposal, intrasynaptic breakdown, receptor interactions, reuptake and recycling
  • Receptor subtypes, structure and function, metabotropic, G protein-coupling and its effects, ionotropic, surface, intracellular
  • Intracellular effects of receptor activation, including 'second messengers'
  • Neuromodulation and the role of neuropeptides
  • Large molecule transportation system ('endocytosis')
  • Neurochemistry of opioids and common recreational drugs
  • Neuroanatomy
  • Anatomy of the brain and the functions of the lobes and some of the major gyri including the prefrontal cortex, cingulate gyrus, limbic system and knowledge of cranial nerve and spinal cord structure
  • Anatomy of the basal ganglia, caudate, putamen, globus pallidus, ventral striatum, substantia nigra and subthalamic nucleus
  • Internal anatomy of the temporal lobes, hippocampal formation and amygdala, neurogenesis and its possible role in mental health, temporal lobe epilepsy
  • Internal anatomy of the frontal lobes and cingulate gyrus
  • Major white matter pathways, corpus callosum, fornix and other pathways relevant to integrated behaviour
  • Ascending neurotransmitter systems including the nigrostriatal, mesolimbic and mesocortical dopamine pathways, the ascending noradrenergic pathway from the locus coeruleus, the basal forebrain cholinergic pathway, the brain stem cholinergic pathway, the corticofugal glutamate system and serotonin pathways
  • Neural circuits
  • Neural circuits and how these functions are disturbed in psychiatric disorders
  • Appetite, hunger and thirst, disturbance in eating disorders and mood disorders, medication side-effects
  • Sleep, arousal, effects of sleep deprivation, primary sleep disorders, role of sleep in other psychiatric disorders
  • Sex, including effects of hormonal treatments, gender identity, disturbances related to psychiatric disorder and psychotropic-induced disturbance
  • Violence and aggression
  • Nociception and pain
  • Motor system and movement disorders, including neurobiology of extra-pyramidal side-effects
  • Learning, including computational models both in normal learning and in pathology, associative learning by Hebbian adaptation, unsupervised vs. supervised, reinforcement
  • Habit formation, neurobiology of obsessions and compulsions
  • Motivation, reward and pleasure, relevance to mood disorders and psychosis
  • Emotion and its regulation, relevance to mood disorders, psychosis and emotional instability, emotional instability apathy, anhedonia and fatigue
  • Perception
  • Attention, impairment in attention deficit hyperactivity disorder (ADHD)
  • Memory, including in dementia and Post Traumatic Stress Disorders (PTSD)
  • Fronto-executive functions including hypofrontality and impulsivity in different psychiatric conditions
  • Empathy, theory of mind, autism and dissocial behaviour
  • Language comprehension, expression and processing
  • Brain networks and dysconnectivity including default mode, task focus and salience networks
  • Modulators, hormones and inflammatory responses
  • Hypothalamic-pituitary (neuroendocrine) axis
  • Stress response and glucocorticoids
  • Hormonal changes and neuroendocrine changes in psychiatric disorders
  • Inflammation and immune responses
  • Auto-immune contributions to psychiatric illness
  • Obesity and metabolism, role in psychiatric disorders and effects of treatments
  • Neuro-endocrine hypothalamic-pituitary-gonadal (HPG) reproductive axis
  • Genetics
  • Basic genetic principles, methodologies for identifying genes, basic concepts, chromosomes, cell division, gene structure, transcription and translation, structure of the human genome, patterns of inheritance, traditional techniques, family, twin and adoption studies, distinction between direct gene analysis and gene tracking, genetic markers, linkage studies, linkage disequilibrium and logarithm of the odds (LOD) scores, genome wide association studies, genetic variants, genetic influences on development including gene-environment interactions, the functions of microRNA and other mechanisms for RNA inhibition
  • Common genetic variation
  • Rare variation and structural variation, conditions associated with chromosome abnormalities, principal inherited conditions encountered in psychiatric practice and the genetic contribution to specific psychiatric disorders
  • Methods to identify genetic disorders and molecular phenotyping, techniques in molecular genetics, restriction enzymes, molecular cloning and gene probes, whole genome sequencing, gene expression, microarray and RNA sequencing, proteomics, metabolomics and molecular quantitative trait loci
  • Molecular and genetic heterogeneity, phenotype and genotype correspondence and endophenotypes and biotypes
  • Epigenetics, the types, causes and effects of epigenetic modification and the transmission of these changes through generations, epigenetic techniques, methylation, chromatin accessibility, histone modifications, transgenerational epigenetic inheritance and how drugs, psychotherapy and good and adverse experiences can modify epigenetics
  • Gene modification, gene editing and functional validation, clustered regularly interspaced short palindromic repeats (CRISPR) and massively parallel reporter assays (MPRA)
  • Genetic techniques for causal inference including mendelian randomisation
  • Clinical application of genetics in psychiatry, prenatal identification, genetic counselling, the organisation of clinical genetic services, DNA banks and polygenic risk scores
  • Neurodevelopment and neuroplasticity
  • Brain structure development and function throughout the lifespan from the foetal stages onwards
  • Neurodevelopmental models of psychiatric disorders
  • Neurobiology of attachment and the effect of trauma
  • Neuroplasticity
  • Neurobiological effects of stress, pre-natal, peri-natal, post-natal, developmentally and in adults
  • Neurobiological effects of learning
  • Intellectual and learning disability
  • Effects of injury at different ages on the brain and mental function, traumatic brain injury, inflammatory lesions, multiple sclerosis, and neoplastic lesions
  • Integrated neurobiology of syndromes and states
  • Autism
  • ADHD
  • Drug use, addiction, tolerance, withdrawal, relapse
  • Anxiety disorders
  • PTSD
  • Obsessive compulsive and related disorders
  • Major depressive disorders
  • Bipolar affective disorders
  • Psychosis
  • Neurocognitive deficits in psychotic disorders
  • Self-harm and suicidality
  • Medically unexplained symptoms, including 'functional neurological disorder' (FND), somatic symptom disorder (SSD) and bodily distress disorder (BDD)
  • Delirium
  • Sleep disorders
  • Intellectual and learning disability including specific genetic syndromes
  • Eating disorders
  • Epilepsy and seizures
  • Personality disorders
  • Comorbidity and multimorbidity
  • Menstrual related disorders
  • Neurobiology of specific treatment approaches
  • Emerging pharmacotherapies including ketamine, psychedelics and neuroplastogens
  • Pharmacogenetics
  • Electroconvulsive therapy
  • Psychological therapies
  • Brain and vagal stimulation
  • Autonomic nervous system (ANS) and peripheral nervous system (PNS) relevant to mental health
  • Neurodegeneration
  • Concepts in the pathophysiology of neurodegeneration, prodromal disease and mild cognitive impairment, preclinical stages, spectra, domains and dimensions of disease, reserve and resilience, environmental causes, comorbidity and dual pathology
  • Alzheimer's disease
  • Vascular dementia
  • Fronto-temporal dementias, primary progressive aphasia and posterior cortical atrophy
  • Lewy body diseases including Parkinson's disease, multiple system atrophy (MSA) and associated syndromes
  • Prion diseases
  • HIV and related brain disease
  • Chronic traumatic encephalopathy
  • Metabolic conditions causing dementia syndromes, Wilson's disease
  • Fronto-striatal conditions such as motor neuron disease (MND) and amyotrophic lateral sclerosis (ALS)

• Clinical Psychopharmacology — Official range: 22–28% (Practice allocation: 25%)

  • General Pharmacology
  • Classification, major classes and intra-class groups
  • Placebo effect in general and in research
  • Compliance, adherence, concordance, relevance and methods of maximisation including medicine optimisation
  • Assessment methods for efficacy and tolerability and monitoring including investigations such as laboratory testing and clinical rating scales
  • Basic principles of drug development and evaluation
  • Phases I - II
  • Phase III, randomised control trial (RCT) in psychiatry, importance of randomisation, endpoints (primary and secondary), superiority vs non-inferiority trials and accounting for missing data
  • Drug regulation, the purposes and processes of licensing, 'approved' versus 'offlabel' use, branded versus generic drugs
  • Principles of evidence-based prescribing, the 'risk-benefit' appraisal and personalisation
  • Pharmacokinetics
  • Factors affecting bioavailability
  • General principles of absorption, interaction, distribution, metabolism and elimination
  • Effect of different modes of administration of drugs on kinetics
  • Protein binding of drugs and its consequences in health and disease
  • Half-life (t1/2), Tmax, Cmax, volume of distribution (Vd), area under the curve (AUC), relevance to prescribing and clinical effects
  • Principle of kinetic modelling, linear versus zero-order kinetics, practical implications including accumulation and discontinuation of drugs
  • Drug metabolism, hepatic enzyme induction, the cytochrome P450 system, major isoforms, substrates, inducers and inhibitors
  • Kinetic changes across the life span in health and disease
  • Drug-drug interactions and medication through pharmacokinetics
  • Psychotropics
  • Lipophilicity versus hydrophilicity
  • Blood-brain barrier, structure and function
  • Principles of pharmacogenomics and pharmacogenetics
  • Principles of therapeutic drug monitoring, limitations with psychotropics including lithium and clozapine
  • Pharmacodynamics
  • Targets of psychotropic agents including receptors, channels, transporters and enzymes
  • Main receptor subtypes in relation to drug actions
  • Outline knowledge of receptor structure, function and subclasses
  • Metabotropic and G protein-coupled receptors
  • Ionotropic
  • Receptor binding mechanisms, concept of affinity, including Ki and occupancy basic assessment using clinical, laboratory and imaging methods
  • Receptor binding profiles of psychotropic agents
  • Major pharmacological actions at receptor sites
  • Concept of intrinsic activity
  • Agonism, antagonism, partial agonism and inverse agonism
  • Intracellular effects of receptor activation signalling cascades, second messengers and gene networks
  • Pharmacodynamically mediated drug-drug interaction
  • Outline knowledge of specific transporter structure or function
  • Neurotransmitter sodium symporters
  • Antiporters
  • Putative mechanisms of action of major psychotropic and psychoactive classes, 'target' actions at molecular and systems levels
  • Antipsychotics
  • Antidepressants
  • Drugs for mood disorder prophylaxis and for treatment of mania
  • Drugs used in the treatment of anxiety disorder
  • Agents used in the treatment of dementia and neurodegenerative conditions including anti-dementia medications and immune therapies
  • Sleep enhancing medications including hypnotics, melatonin and related formulations and dual orexin receptor antagonists (DORA)
  • Cognitive enhancers
  • Opioids including substitution regimes
  • Psychostimulants
  • Cannabinoids
  • Psychedelics including psilocybin
  • Empathogens including 3,4-Methylenedioxymethamphetamine (MDMA)
  • Novel and new psychoactive substances
  • Major aetiological theories underpinned by pharmacological mechanisms
  • Dopamine hypothesis
  • Biogenic amine hypothesis
  • Cholinergic hypothesis, cognition
  • Cholinergic-adrenergic (balance) hypothesis (mood)
  • Glutamatergic hypothesis
  • Amyloid cascade hypothesis
  • Adverse effects of major psychotropic and psychoactive agents and their management
  • General pharmacology, postural hypotension, sedation, sexual dysfunction, weight gain and metabolic dysfunction QTc prolongation
  • Specific pharmacology, extrapyramidal symptomatology, neuroleptic malignant syndrome (NMS) and serotonin syndrome (SS)
  • Idiosyncratic, toxic, allergic reactions, blood dyscrasias hepatotoxicity, allergic hepatitis skin reactions, Stevens-Johnson syndrome, toxic epidermal necrolysis myocarditis and cardiomyopathy
  • Teratogenicity, developmental abnormalities and complications associated with psychotropic drug use in pregnancy and breastfeeding
  • Other medications and their use in psychiatric practice
  • Muscarinic and antimuscarinics
  • Antiepileptics
  • Analgesics, opioid and non-opioid
  • Beta-blockers
  • Dopamine agonists
  • Adrenergic agonists
  • Putative neurochemical changes associated with physical treatments such as ECT, rTMS, vagal nerve stimulation
  • Commonly used herbal remedies of relevance to psychiatry
  • Therapeutics
  • Medicine optimisation
  • Establishing goals of treatment
  • Rational prescribing
  • Specific psychiatric diagnoses, disorders and severities of disorder
  • Phases of illness, acute, subacute and maintenance
  • General health status and co-prescribed medications
  • Age
  • Tailored prescribing and the individual risk-benefit appraisal
  • Clinical prescribing
  • Dose ranges, minimum effective doses and time scales for evaluating efficacy
  • Strategies for managing poor response or non-response
  • Standardised definitions of 'treatment resistance' including for schizophrenia and major depression
  • Recommendations for switching within major classes and across compounds
  • Monitoring of efficacy and tolerability
  • Drug dependence, tolerance, discontinuation symptoms and withdrawal, putative mechanisms of actions and management
  • With substances use and addiction
  • With prescribed psychotropics
  • Prescribing in special circumstances
  • Childhood and adolescence
  • Older people
  • In eating disorders
  • In medical co-morbidities, hepatic failure, renal failure, cardiovascular disease
  • During pregnancy, postpartum period, breast feeding
  • During premenstrual dysphoric disorder and around menopause
  • Controlled substances in the United Kingdom (UK), drugs used in management of addictions and modes of action and safety, tolerability
  • Pharmacotherapy for management of psychiatric emergencies, minimising and mitigating medication side effects
  • Management of psychiatric emergencies including use of drugs in rapid tranquilisation, as required use of drugs
  • Drug management of psychiatric emergencies related to adverse effect of prescribing, NMS, SS, akathisia
  • Adverse event reporting
  • Social and legal implications in prescribing

• Classification and Assessment in Psychiatry — Official range: 14–20% (Practice allocation: 17%)

  • Descriptive psychopathology
  • Fundamental concepts
  • Consciousness and its disorders
  • Disorders of memory and cognition
  • Disorders of perception and reality distortion
  • Disorders of thinking
  • Process
  • Content
  • Disorders of self and body, including depersonalisation and derealisation
  • Disorders of language and speech
  • Disorders of affect and emotion
  • Disorders of movement, volition and execution
  • Classificatory systems
  • International Classification of Diseases (ICD) and Diagnostic and Statistical Manual of Mental Disorders (DSM) as related to psychiatric diagnostics
  • International Classification of Functioning, Disability and Health (ICF)
  • Special needs education
  • Clinical assessment
  • History taking
  • Examination of the mental state
  • Physical examination, including ability to identify and prioritise relevant clinical findings in routine psychiatric practice, including basic knowledge of primarily medical disorders which comprise prominent psychiatric symptomatologies, endocrine disorders, neurological disorders
  • Ordering and interpretation of routine laboratory investigations
  • Research-based special investigations and findings, neuroendocrinology, imaging methods and correlates of psychopathology
  • Ability to assess biological, psychological and social factors in predisposition to and onset and maintenance of psychiatric disorders
  • Interpretation of psychopathology and other findings within specific frameworks
  • Psychodynamic, such as defence mechanisms, including transference and countertransference
  • Cognitive and behavioural
  • Theories relevant to systemic therapy and other therapeutic frameworks
  • Rating scales in research and routine psychiatric practice
  • Diagnostic scales linked to structured assessment
  • Symptom-level scales for establishing 'caseness'
  • Symptom-change scales for monitoring course
  • Self- versus clinician-administered scales and semi-structured interviews
  • Likert and visual analogue scales
  • Risk assessment and safety planning, understanding of the evidence base, principles including predictive values and principles of co-producing or mutually agreed safety plans

How to prepare

Work through the topics, read the explanation after each answer, and revisit the areas where you miss questions. Use the official outline and reference materials below to guide your study.

These independent practice questions are not actual exam items and do not guarantee a passing result.

Frequently asked questions

Official sources and references

• MRCPsych Paper A Syllabus

  Paper A, p. 7

• MRCPsych Examination Syllabus

  Opening applicability statement

• MRCPsych Paper A Syllabus

  Syllabus Coverage, domain allocation table, p. 6

• MRCPsych Paper A Syllabus

  Introduction, p. 5

• MRCPsych Paper A Syllabus

  Syllabus Coverage, p. 6

• MRCPsych Eligibility Criteria and Regulations

  Section 2.2(a)(i), p. 10

• RCPsych Papers A and B marking scheme

  MCQ format

• RCPsych Papers A and B marking scheme

  Standardisation

• RCPsych Applying for your exam

  Fees — What fee do I pay for 2027 Examinations?

• RCPsych Exams news and updates

  15 October 2026 — MRCPsych Theory Syllabus updated for 2027

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