MRCP. An NHS rota.
And real life.

I knew medicine. But MRCP felt different.

When I started MRCP preparation, I hadn't quite realised how different it would feel from the exams I'd taken back home.

I wasn't preparing in isolation. I was doing IMT, working long days and nights, commuting, looking after patients, completing workplace-based assessments — and trying to have some kind of life outside medicine.

As an IMG, I was also learning the language of UK clinical practice. I knew much of the medicine. But knowing the medicine and choosing the single best answer in an MRCP question are not quite the same skill.

That took practice. So did becoming familiar with NICE guidance, specialist society guidelines and UK prescribing decisions. Over time, the NHS work that made studying difficult also made the knowledge more relevant.

Three months to study. But not three months off work.

There's a big difference between having three months until an exam and having three months while doing IMT.

After a long day, the idea of getting home and doing another 100 MCQs often sounded much easier than it was. Some evenings I was simply too tired to concentrate. At first, I felt guilty. I assumed that a day without revision was a day wasted.

Eventually, I changed how I measured progress. I stopped planning around imaginary free days and started using the time I actually had.

Having a specialty-focused teaching schedule helped me find a rhythm. I could use Intellect Medicos lectures in the time I had, sometimes listening during my commute, rather than expecting every study session to be a long one.

Concepts first. Questions early. Mistakes always.

For Part 1, I relied heavily on concept-building through Intellect Medicos teaching. I also found my Pastest question bank useful. The combination mattered to me.

Questions taught me how the exam asks things. Teaching helped me understand why an answer was right, including questions where the presentation didn't look familiar.

I started to notice recurring clinical presentations, investigations and management decisions. The structured two-week crash course was especially helpful for consolidating material closer to the exam.

My Part 1 result gave me confidence. Interestingly, my scores varied considerably between specialties. I realised I didn't need identical strengths across every system; I needed to know which areas were holding me back.

Being an IMG eventually became an advantage.

At first, moving into a new healthcare system made the exam feel unfamiliar. But I began to recognise some strengths I had developed along the way.

• Adapting to new systems and expectations.
• Asking questions when something wasn't clear.
• Finding my own ways to fill gaps in knowledge.
• Connecting revision with real patients on the ward.

Sometimes a guideline I'd revised appeared in clinical practice the next week. A murmur I'd studied would come up on a ward round. A respiratory presentation became easier to remember after seeing someone with it.

Working in the NHS didn't only compete with my preparation. It also gave the things I was learning a clinical context.

Three things I'd do differently.

One of the hardest parts was accepting the mental fatigue. At work, we're already making decisions, prioritising sick patients, talking to families, documenting care and responding to interruptions. Then we expect ourselves to sit down and do MCQs.

Instead of aiming for a fixed number of hours, I started setting smaller, clear goals: finish a topic, review a lecture, practise a set of questions, or work through mistakes. Some days, the right decision was simply to sleep and start again tomorrow.

Would I do MRCP again?

Yes. Despite the stress, the setbacks and the evenings spent staring at MCQs, I believe it made me a better doctor.

MRCP pushed me to revisit medicine systematically. It exposed gaps I might not have noticed during routine clinical work. It taught me to keep learning while working.

For an IMG doing IMT, preparation won't always look neat. Sometimes progress is 30 questions after a busy shift. Sometimes it's getting enough sleep. Sometimes it's deciding honestly whether a particular exam sitting is right for you.

And sometimes it's passing by a much smaller margin than you expected — and realising that a pass is still a pass.