Use this MRCP(UK) PACES exam week checklist to tighten performance, not to relearn a textbook. In the final seven days, your biggest gains come from rehearsing the real station timings, protecting your sleep, and making your answers sound safe, structured, and relevant. The current exam is a half-day carousel with five stations, eight encounters, and a total running time of 125 minutes, so the last week should feel organised rather than heroic.
That matters because PACES is not just a knowledge test. Examiners assess seven core skills; consultation stations give you up to 15 minutes with the patient or surrogate followed by 5 minutes of examiner questions, while the examination encounters expect you to complete the physical examination within 6 minutes so there is time for discussion. Exam week should therefore be about execution under pressure.
Official examiner guidance is also reassuring: if one encounter feels poor, it does not poison the next one, and examiners are not trying to catch you out. They want precise, relevant answers that let them see what kind of physician you are in real time.
Your MRCP(UK) PACES exam week checklist
Days 7 to 5: lock down the controllables
Do the boring admin first. Anxiety rises when basics are vague.
- Check the venue, route, parking, and backup travel plan now. The candidate guidance says to arrive in good time because start times can be delayed by calibration or overrunning cycles.
- Lay out exam-day clothing now. Official guidance stresses professional dress, local infection-control rules, and compliance with the host centre's requirements.
- Make sure your photo ID is ready. Without acceptable ID you will not be admitted.
- Do not arrange a 'look around' at the allocated hospital or centre after you have been placed there. Seeking prior knowledge of cases or visiting the centre for that purpose is treated as suspected misconduct.
Then run one full timed mock. If you cannot organise a whole carousel, do one 20-minute consultation, one communication station, and two 10-minute examination encounters back-to-back, with real 5-minute gaps. Keep the timings strict. PACES rewards fluency under the clock, not beautiful answers that take too long.
Your aim this week is not to cover every rare syndrome. It is to make common tasks look polished:
- a 6-minute cardiovascular, respiratory, abdominal, or neurological examination
- a clean findings summary
- a sensible top differential plus two or three realistic alternatives
- a management plan that starts with safety, then investigations, then next steps
- one closing question that actively checks the patient's concern
Days 4 to 2: rehearse the stations you can still improve
Use official PACES sample scenarios for your last heavy reps. MRCP(UK) says these are very similar to what you will meet in the exam, which makes them ideal for late practice rather than collecting fresh third-party notes.
A good final-week practice block looks like this:
- 2 consultation stations per day
- 2 communication scenarios per day
- 4 timed physical examination drills per day
- 1 short debrief after every rep: What lost me marks? What sounded vague? Where did I ignore the patient's concern?
For consultation stations, use a repeatable answer frame after you have seen the patient:
- one-line summary
- most likely diagnosis
- key alternatives you have actively considered
- immediate risks or red flags
- focused investigations
- initial management
- what you think matters most to the patient
Example: a 67-year-old with chest pain and weight loss. A better discussion answer is not a long list of causes of chest pain. It is something like: This sounds most likely malignant disease until proved otherwise; I would also consider pulmonary embolism and infection; my first priorities are stability, analgesia, oxygen only if needed, urgent imaging, and explaining clearly to the patient what we are worried about and what happens next.
For communication encounters, keep a simple structure:
- clarify the task
- set an agenda
- explain in short chunks
- check understanding
- surface concerns
- close with next steps and safety-netting
If you ramble, you sound uncertain. Short, clear sentences score better.
The last 48 hours: reduce noise
Two days out, stop collecting resources. Re-read your own short notes, not everyone else's.
If you use your five-minute pre-reading time well, you usually start better. In stations with written scenarios, jot down only three prompts on the rough paper you are given: the task, the main safety issue, and the patient's likely concern. The candidate guidance says rough notes are allowed for these encounters, but they stay in the station afterwards.
This is also the point to decide what not to do:
- no new question banks
- no late-night group panic calls
- no marathon ward shifts followed by midnight revision
- no trying to fix every weak area at once
If you use an amplifying stethoscope, declare it as soon as you arrive. If you are genuinely unwell, do not try to bluff your way through a patient-facing exam. Current regulations allow withdrawal up to the start time; a withdrawal does not count as an attempt, and refund arrangements depend on timing and whether exceptional circumstances are evidenced.
Night before and exam morning
Aim to feel steady, not inspired.
Eat normally. Pack early. Sleep as much as you reasonably can. On the morning, leave early enough that one travel problem does not become your whole day.
On arrival you should expect ID checks, completion of 16 marksheets, and some waiting before the circuit starts. Official candidate material says you may be asked to attend at least an hour before the exam, and the 2B pencil for the marksheets is provided at the centre.
Leave anything avoidable out of your pockets and bag. Candidate guidance and regulations are clear that you must not carry phones, smart watches, notes, or recording devices into the examination.
Use the final few minutes before each scenario to decide your opening line. Do not start reading passively. Ask yourself:
- What is the task?
- What is the likely concern?
- What will I do first when I walk in?
- What would make me look unsafe in the first 30 seconds?
Final station checks
Consultation stations: look integrated, not fragmented
Stations 2 and 5 are 20-minute consultations, with up to 15 minutes for the interaction and examination, followed by 5 minutes of examiner discussion. Official format guidance says one consultation is likely to be more acute and the other less acute.
That means your last-week target is integration. You are not doing a written long case out loud. You are showing that you can think and communicate while the patient is in front of you.
Use this checklist:
- open with a clear agenda
- take a focused history rather than a complete clerking
- examine only what changes the case
- summarise before the examiner has to rescue you
- lead with the most likely diagnosis
- give a prioritised plan
- answer the patient's concern before the bell beats you
A strong closing sentence sounds like this: The leading concern is decompensated heart failure, though I would still consider ischaemia and valvular disease; I would assess severity, examine for fluid overload, obtain urgent ECG and imaging, start treatment according to stability, and explain to the patient what we think is happening and what will happen next.
Communication encounters: structure beats eloquence
In the communication encounters you get written instructions in the five-minute interval before the station, then a 10-minute interaction with the patient or surrogate. During that interaction the marks come from examiner observation rather than examiner questioning.
So your job is to lead gently. Do not drift into a vague chat.
Use a simple pattern:
- introduce yourself and confirm the task
- find out what the patient or relative already knows
- explain the issue in plain English
- pause and check understanding
- invite questions explicitly
- close with next steps
A reliable line near the end is: Before we finish, what is the main thing worrying you right now? That single question often rescues marks for managing patient concerns.
Physical examination encounters: be clean, efficient, and believable
In the examination encounters, the official guidance is blunt: complete the examination within 6 minutes, do not examine through clothing, and do not invent signs that are not there. You are expected to identify the agreed physical signs, present them clearly, and then discuss differential diagnosis and management.
Your checklist is simple:
- wash or gel hands
- introduce, consent, position, and expose properly
- perform a structured exam without unnecessary flourishes
- give a concise findings summary
- commit to a most likely diagnosis
- offer a focused next-step plan
Example findings summary: This is a regular tachycardia with elevated JVP, bibasal crackles, peripheral oedema, and a displaced apex, consistent with fluid overload and likely heart failure.
If you recognise a patient from training or a course, say so immediately. Declaring prior knowledge is expected; hiding it is the problem.
Common mistakes in the final week
- Cramming obscure medicine instead of rehearsing the actual station timings.
- Giving textbook differentials that do not fit the patient in front of you.
- Spending all of consultation time on history and leaving no space for concerns or examiner questions.
- Examining through clothes or with poor exposure.
- Talking over the patient rather than checking what matters to them.
- Carrying a phone or smart watch into the exam area.
- Ruminating over one bad station and donating the next one as well.
Most of these errors map directly to the official preparation guidance and candidate rules. They are avoidable if you practise with a timer and reset after every encounter.
Practice workflow for the final week
If you still want a plan, keep it tight.
A realistic 7-day run-in
- Day minus 7: full mock circuit or the closest version you can organise
- Day minus 6: debrief and targeted repair on the weakest station
- Day minus 5: six-minute examination drills plus findings presentation
- Day minus 4: consultation-heavy day
- Day minus 3: communication-heavy day
- Day minus 2: short mixed mock, then stop expanding notes
- Day minus 1: light rehearsal only
After every mock viva or PACES circuit, ask three questions:
- Which skill was I really being marked on?
- What did I say or do that sounded safe and specific?
- Where did I become vague, rushed, or impersonal?
If you use AI for rehearsal, use it as a prompt generator or mock surrogate, not as your source of truth. Ask it to interrupt you, challenge vague plans, or play an anxious relative. Then sense-check the medicine with a senior colleague, trusted PACES materials, or your own guideline-based knowledge.
The official website also gives you candidate videos, sample scenarios, and station-specific preparation advice. Use those in the final week before you reach for random forum tips.
Summary
- In MRCP(UK) PACES week, execution beats expansion.
- Rehearse real timings: 10-minute encounters, 20-minute consultations, 6-minute physical exams, 5-minute reading gaps.
- Protect logistics early: ID, travel, clothing, and devices.
- In every station, sound safe, structured, and patient-centred.
- If one encounter goes badly, reset fast and win the next one.
References
- https://www.thefederation.uk/examinations/paces
- https://www.thefederation.uk/examinations/paces/preparation
- https://www.thefederation.uk/sites/default/files/documents/Candidate%20guide%20notes.pdf
- https://www.thefederation.uk/sites/default/files/uploads/Preparatory%20advice%20and%20information%20to%20candidates%20PACES%20Examination%20Website%20May%202026.pdf
- https://www.thefederation.uk/examinations/paces/format