MRCPsych Paper A vs Paper B: what each paper tests

Paper A is around 100 multiple choice questions plus around 50 extended matching items (EMIs), sat in 180 minutes with five options throughout. RCPsych confirms Paper A covers five domains, and its emphasis is basic science and psychopharmacology.

That means the neurosciences underpinning psychiatric illness, the classification and assessment of mental disorder, clinical psychopharmacology, human development, and the behavioural and socio-cultural dimensions of psychiatry — tested for scientific understanding rather than clinical management.

Paper B is the same shape — around 100 multiple choice questions plus around 50 EMIs in 180 minutes — but the content shifts to clinical psychiatry and critical review. RCPsych confirms Paper B's format; its content leans general adult psychiatry, the psychiatry of other patient groups such as older adults, forensic and child and adolescent psychiatry, and critical review of the evidence base and research methods.

Critical review is the domain most distinct from Paper A: it tests reading and appraising a piece of published research, not recalling a fact about it.

Both papers carry an EMI section alongside the multiple choice questions. An extended matching item presents a themed list of options serving several stems, and asks you to pick the best match for each — a different skill from a straight multiple choice question, because the distractors are close relatives of the right answer rather than obviously wrong.

RCPsych confirms Paper A's five domains and Paper B's format, but it does not publish exact percentages for most of them. Two figures are an exception: Paper B's Critical Review (around a third of the paper) and General Adult Psychiatry (around a fifth) come from RCPsych-hosted trainee guidance, not the official syllabus. Every other weight quoted for either paper, including on this site, is an estimate drawn from the syllabus's relative depth rather than a college-published number.

Treat every percentage beyond those two as indicative. It is useful for planning where to spend time; it is not a figure RCPsych has stated.

• Split practice by paper: basic science and psychopharmacology reasoning for Paper A, clinical management and critical appraisal for Paper B.
• Practise EMIs in their real layout on both papers, working from the stem and lead-in before hunting the option list.
• Weight time toward Critical Review and General Adult Psychiatry on Paper B, since those are the two figures RCPsych's own trainee guidance actually confirms, while still covering every domain on both papers.
• Track accuracy per domain and let misses come back on a spacing schedule rather than re-reading what you already know.

The SpecialityMCQs MRCPsych revision keeps Paper A and Paper B as the separate exams they are, tilts sessions toward whichever domain is currently weakest, and presents EMIs with the themed option list beside the stem the way the paper does. Every answer names the reference or guideline it rests on.