The MRCPath examination is the appropriate professional qualification for medical trainees progressing to the Certificate of Completion of Specialist Training (CCST) in clinical biochemistry (with or without metabolic medicine sub-specialisation) and clinical scientists in training in clinical biochemistry.
The examination is designed to assess the clinical biochemistry aspects of training, whereas clinical assessment of medical candidates is undertaken through the Record of In-Training Assessment (RITA). In addition, candidates undertaking training in metabolic medicine have to demonstrate clinical competence by passing the MRCP examination prior to acceptance for training in the subspecialty.
The MRCPath examination is a key assessment tool (but not the only one) used at three stages of training, as detailed in the table below.
Stage Examination Factor assessed Tool
At around two years of HST (medical and scientist) Part 1 Core knowledge baseBasic laboratory skillsIntegration of laboratory data with clinical situations Part 1 written essaysPart 1 practical, OSPE (see below) and calculation paperData interpretation paper
Between second and fourth years of HST Part 2(written option) Ability to formulate question that can be answered by laboratory meansAbility to undertake self-directed laboratory workAbility to write up work in standard scientific format Dissertation, portfolio of papers or evidence of higher degree
At four to five years of HST Part 2 (oral) Clinical patient management (medical), laboratory problem solving (scientist), laboratory management (both), readiness for independent practice Prepared and extended oral examination
The general section of these regulations contains advice on the qualifications required for entry to the examination. Candidates can assess the standard required by viewing past papers on the College website (www.rcpath.org) and should obtain guidance from their educational superviser as to when to sit the examination.
Timing of the examinations
There is no specific timing for entry to the examination. Candidates should apply only when they are ready. Some general guidance is given below, but is not intended to be prescriptive.
Part 1 examination
Candidates will usually sit this examination when they have gained about two years of laboratory experience at higher specialist trainee level or equivalent.
Part 2 written options
After they have passed the Part 1 examination, but before entering for the Part 2 oral examination, candidates must have demonstrated laboratory competence by submission of a dissertation, portfolio of papers or evidence of a higher degree.
Candidates intending to submit a dissertation should ensure they obtain agreement for their project proposal from the College. It is advisable to submit the project proposal well in advance of starting the project in case it is not deemed suitable or requires modification. Failure to do so will mean that the work will not be accepted. The College cannot review project proposals, portfolios of papers or evidence of possession of a higher degree in advance of successful completion of the Part 1 examination.
Candidates wishing to submit evidence of a research degree or published papers are advised to do so as soon as possible after obtaining Part 1 to ensure that, should they not be acceptable, they have sufficient time to undertake a dissertation. For further details, please see the section on ‘Guidance for candidates undertaking written options for the Part 2 examination’ above.
Part 2 oral examination
Candidates can only enter for the Part 2 oral when their submission of a dissertation, portfolio of papers or evidence of a higher degree is successful. This will usually be after three or four years in a higher specialist training post or equivalent experience.
Structure and format of the examinations
The Part 1 written examination consists of two essay papers lasting three hours each, which can be taken at a number of centres across the country and abroad. The Part 1 practical examination is a three-day examination, currently based in the laboratories of Nottingham University Medical School. It consists of a two-hour objective structured practical examination (OSPE), a 1½-hour data interpretation and calculation paper, and a three-hour ‘wet’ practical. The examination concludes with a 20-minute oral examination.
The Part 2 examination consists of a written option and an oral examination. The written option requires the candidate to demonstrate competence in the specialty by carrying out a laboratory project that is written up and presented in a dissertation. Alternatively, evidence of experience and competence in the specialty may be presented in the form of a collection of peer-reviewed papers or a research degree (PhD or MD), for which the work was carried out during training. Details of the requirements for these routes of qualification for the Part 2 are given in the section on ‘Guidance for candidates undertaking written options for the Part 2 examination’ above. The Part 2 concludes with a one-hour oral examination held at the College.
Content of the examinations
Part 1 examination
The written examination includes questions on the core curriculum published by the College Advisory Training Team (CATT) for Clinical Biochemistry. The candidates are asked to answer four out of five questions on each paper. The questions cover the following broad areas.
1. Administration and management of laboratory services
2. Basic laboratory instrumentation and automation
3. Analytical methods
4. Biochemistry – may include clinical and general biochemistry
5. Clinical physiology
1. Diagnosis and management of acute biochemical disorders or analytical methodology
2. General biochemical disorder
3. General clinical problem
4. Biochemical basis of disease and relevant laboratory investigation or techniques
5. Broad analytical problems, new or changing technology
The Part 1 practical paper 1 consists of an objective structured examination where candidates move between a series of stations, at which they are provided with laboratory data such as electrophoretic strips, scans, patient information or external quality assurance results and asked questions on these. There is limited time for each question.
Paper 2 consists of six cases where the candidate is provided with a brief history and analytical results and asked to interpret them, and four calculations on typical laboratory data or related topics.
Paper 3 is a ‘wet’ practical where the candidate is given an analytical question that needs to be answered by means of a series of planned experiments. Candidates are asked to write up their results and the paper is marked on this written work.
Part 2 examination
Details of the requirements for the Part 2 written option are given in the section on ‘Guidance for candidates undertaking written options for the Part 2 examination’ above. After the dissertation or equivalent has been assessed, the Part 2 oral completes the examination. In this oral examination, the candidate is examined for one hour. Half the time is spent discussing two laboratory or clinical scenarios, for which the candidate has had 30 minutes to prepare. The remainder of the time is spent in free discussion.
Standards and marking methods
Part 1 examination
The papers are marked by two examiners, who are blinded to the marks awarded by the other. In the case of a discrepancy, a third examiner marks the papers. The mean marks are totalled and the pass mark is 50%. The marking scheme in the practical is as follows.
Paper 1 OSPE Predefined for each question out of 20.
Total mark scaled out of 30.
Paper 2 data and calculations Predefined for each question out of 20.
Total mark scaled out of 40.
Paper 3 practical Predefined and total scaled out of 30.
Overall pass The marks for each paper are totalled and a pass is 50%.
Oral examination This is used to quality control practical examinations.
Additional marks may be allocated to borderline candidates on the papers in the light of a good oral performance.
Part 2 written option
The dissertation is reviewed by two examiners. The attention of candidates is drawn to the advice given in the section on ‘Guidance for candidates undertaking written options for the Part 2 examination’ above. A dissertation is graded as follows.
A – pass
B – modification or additional work required
C – unacceptable.