MRCP PACES 2026: Fee Rise, Part 1 In-Centre, and a 12-Week Study Plan

Two MRCP(UK) changes matter in 2026. Exam fees rise by 3.6% — in line with UK CPI — from 1 July 2026, applying to the 2026/03 diet onwards, across Part 1, Part 2 written, and PACES. And Part 1 moves to in-centre, computer-based delivery from the September 2026 (2026/03) sitting, ending remote proctoring internationally. If you are sitting this year, both affect your planning. Below is what changed, then a realistic 12-week PACES study plan for trainees working full clinical weeks.

What changed for 2026

Fees up 3.6% from 1 July 2026. The Federation confirmed an inflation-linked rise (the December 2025 CPI rate) from the 2026/03 diet. PACES sits at around £1,358 and the written parts at around £696 — but the Federation's fees pages hold the exact, current figure, so confirm there before you budget.

Part 1 moves in-centre from September 2026. From the 2026/03 diet, Part 1 is delivered in-centre as a computer-based exam, ending the remote-proctoring option in international locations. The September application window opens on 14 July 2026 and is the first to carry the new fees.

Neither change alters the PACES exam itself. But the fee rise sharpens the cost of a re-sit, and the Part 1 delivery change matters for anyone planning their international sitting logistics. The case for passing first time is a little stronger than it was last year.

The five stations (and what each actually tests)

PACES in 2026 is still a five-station carousel. Stations 1, 3, and 4 have two ten-minute encounters each; stations 2 and 5 have a single twenty-minute consultation.

• Station 1: Respiratory and abdominal examination. Signs elicitation and a focused differential.
• Station 2: History-taking. One patient, twenty minutes, realistic consultation.
• Station 3: Cardiovascular and neurological examination. Same pattern as station 1.
• Station 4: Communication skills and ethics. Breaking news, consent, capacity, complaints.
• Station 5: Brief consultation. Two ten-minute integrated encounters testing history, examination, and management together.

Every station is marked against two themes: clinical skill (examination, history, diagnosis, management) and the softer judgement skills (communication, managing patient concerns, professional behaviour). Fail the softer skills and strong clinicals will not save you.

The 12-week plan

This plan is built for the real version of a registrar's life. Twelve weeks. One weekday hour when you can get it. Two half-days at the weekend. Bedside exposure opportunistic, not scheduled.

Weeks 1–2: Baseline and weaknesses

Sit one full timed practice exam with an ST5+ colleague or at a PACES course. The goal is not to pass — it is to identify your three worst stations. Write them down. Everything that follows is weighted toward those three. Order the MRCP PACES Manual, the Oxford Handbook of Clinical Medicine, and a PACES question-bank subscription.

Weeks 3–6: Station blocks

Work in two-week blocks, each covering one station group.

• Block A (stations 1 and 3 — examinations): Two sessions per week. One bedside examination with a registrar, one at home. Say the signs out loud — examiners mark what they hear, not what you think.
• Block B (station 2 — history): One recorded mock history per week. Play it back. The skill is closing a consultation to time, not the history itself.

If you can get to a formal PACES course in this window, do. The bedside reps compound fast.

Weeks 7–9: Station 4 and station 5

Station 4 kills good candidates because the content feels soft and therefore unprepared-for. It is not. The themes are predictable: breaking serious news, capacity assessment, discussing DNACPR, managing a complaint, consent for a procedure. Work through each verbally with a colleague, structured: setting, listen, explain, check understanding, summarise, offer written information.

Station 5 is where everything comes together under pressure. Practise with a two-minute timer. Arrive at a working diagnosis within that time, then manage.

Weeks 10–11: Full mocks

Two full mock carousels, at least a week apart. Ideally one at home-hospital with PACES-qualified colleagues, one at a paid course. Record feedback. Apply it.

Week 12: Taper

Read through your PACES notes. Sleep. Do not sit a new mock in the last five days — it only erodes confidence. Review the station 4 frameworks and the six most common examination signs you are likely to miss.

What working trainees get wrong

• Over-indexing on question banks. PACES is not tested by MCQ. A question bank is useful for facts; it does not prepare you for a live examiner.
• Under-practising station 2. Most candidates do three station 2 mocks before the exam. That is not enough. A good history consultation is a learned rhythm.
• Skipping station 4. If you have to choose, choose station 4 over a fourth cardiovascular bedside. The scenarios are predictable and the marks are scoreable.
• Ignoring the patient. Examiners notice who looks at the examiner and who looks at the patient. Look at the patient.

Staying clinically current while you prepare

PACES rewards candidates who are clinically current — who recognise the conditions and know the up-to-date management. The reading habit that keeps you current for the exam is the same one that keeps you safe on the ward. Our guide on CPD reading for doctors covers how to build it without adding hours to the week.

The authoritative source for dates, fees, and exam structure is the Federation / MRCP(UK). This post is preparation guidance, not official exam regulation — always confirm the current rules with the Federation.

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