PACES practice

How to prepare for the PACES

PACES is eight patient encounters across five stations (four physical examinations, two communication encounters and two consultations), with two examiners at each station and seven clinical skills marked across the exam. Prepare by examining as many patients as you can, including people with no abnormal signs, against a six-minute timer with seniors watching; rehearse communication and consultation scenarios out loud; and study the examiners' published reasons why candidates fail each skill.

What happens in the PACES exam: parts, timings and marking A complete PACES practice station, with its scorecard PACES dates and countdown

Step by step

  1. 1

    Check eligibility, attempts and dates

    You must have passed Part 1. You have up to six attempts at PACES, and the old rule of passing within seven years of Part 1 has gone. Centres and dates are allocated at random, so be ready to sit on any date in the assessment period.

  2. 2

    Learn what 'satisfactory' means

    Before each exam, examiners calibrate every case and agree what you must cover for a satisfactory mark, judged against an internal medicine trainee entrusted to act with indirect supervision. Practise against the published marksheets for all eight encounters; the Federation reminds candidates that examiners are not looking for perfection.

  3. 3

    Examine many patients against the clock

    Each examination encounter allows at most six minutes to examine, and a patient with no abnormal findings may appear. The Federation advises examining as many patients as possible, including those without abnormalities, having seniors watch your technique and practising with a timer. Examiners value confidence that a sign is absent as much as finding one that is present.

  4. 4

    Present your findings and answer precisely

    At least four minutes of each examination encounter are questions. Practise presenting the signs you found, then the most likely diagnosis first, a differential that fits this patient, investigations and management. Answer exactly what is asked; if an examiner cuts across you, it is to cover every skill in the time.

  5. 5

    Use the five minutes' reading time

    Before each communication and consultation encounter you have five minutes with the scenario. MRCP(UK) advises using it to be clear about the task and to plan the interview, and you can take your notes in. Practise with the Federation's sample scenarios, which it describes as very similar to the real ones.

  6. 6

    Rehearse whole consultations in 15 minutes

    At Stations 2 and 5 you have 15 minutes to take a history, examine and respond to the patient's concerns, then five minutes of questions; one case is likely to be acute and the other less so. Rehearse with a timer, leaving time to examine and to ask the patient what questions they have.

  7. 7

    Practise communication with a senior watching

    The two 10-minute communication encounters test how you guide the interview, explain clinical information, apply knowledge including ethics and give emotional support, and the examiners ask no questions. Ask a senior colleague to watch, avoid specialist language, and finish by summing up what you have agreed and the way forward.

  8. 8

    Get your kit and dress right

    Bring your own stethoscope, and declare an amplifying stethoscope or magnifying ophthalmoscope on arrival if you want to use one. UK centres usually require short sleeves (or sleeves rolled up) and no tie, watch or wrist jewellery; if you do not comply you cannot sit and will not get a refund.

Official resources

Common mistakes examiners report

  • Reporting signs you did not find to fit a diagnosis. MRCP(UK) calls this unprofessional and says it usually earns unsatisfactory marks for identifying physical signs, which the Federation lists among the most common reasons for failing PACES. source
  • Examining through clothing. Candidates who do so usually receive unsatisfactory marks for physical examination in that encounter. source
  • Reciting a 'textbook' list of differentials instead of the likely diagnoses for the patient you have just seen; a good differential for the wrong signs is not satisfactory. source
  • Parking the patient's concerns until later. MRCP(UK) advises addressing them as soon as they are raised; delay can leave too little time and cost marks for managing patients' concerns. source
  • Visiting your allocated hospital, even on a course, after you are told where you will sit. MRCP(UK) treats it as suspected misconduct. source

Practise with MedMock

MedMock covers the four spoken PACES encounters, the Communication encounters at Stations 1 and 4 and the Consultations at Stations 2 and 5, with the real reading time and timings, against an AI patient and examiner. The physical examination encounters, and the examination inside each consultation, are not simulated, so you still need real patients and seniors for those skills. You can have each encounter you finish marked; the worked example shows a Station 2 consultation marked this way.

Practise PACES stations Free trial, no card needed.

Questions candidates ask

How many attempts do I get at PACES?

Up to six. If you reach six without passing, you can apply once for an exceptional seventh attempt, backed by your educational supervisor and training programme director, based on additional educational attainment. Withdrawals do not count as attempts.

Do I still have to pass PACES within seven years of Part 1?

No. MRCP(UK) removed that rule and replaced it with the limit on attempts, so you can still apply if you passed Part 1 more than seven years ago.

What do I need to pass?

You must reach the pass mark in each of the seven skills and an overall score of at least 126 out of 168. The format page lists the pass mark for each skill.

What feedback will I get?

Your results letter gives your total score for each skill and each encounter, and you can ask your college for copies of your marksheets. MRCP(UK) advises discussing the breakdown with your educational supervisor.

Do I need a PACES course?

No course is required, and MRCP(UK) Central Office does not endorse any. It advises against booking a clinical course that falls within the main assessment period. The Federation's preparation pages, marksheets and sample scenarios are free.

Sources

Checked on 27 September 2026.

Exams and their regulations change. MedMock is not affiliated with any examining body; always check the current guidance on the official site before you book.