The premise of the exam is to test the individual’s ability to apply their medical knowledge, not just recall their knowledge. It is split into two parts: Professional Dilemmas and Clinical Problem Solving, both independently timed. The Professional Dilemmas section is limited to 95 minutes and is a ranking test, consisting of 50 scenarios. For each situation presented, the candidate will have to rate the appropriateness of 4-5 independent actions (from 1=most to 5=least appropriate). Following a five-minute interval, the Clinical Problem Solving section will be undertaken, comprising 97 questions and lasting 75 minutes. It includes a mixture of two types of questions: Extended Matching Questions (EMQs) which involve 7-10 scenarios and require the candidate to select the single most appropriate option(s), and Single Best Answer questions (SBA), which ask the candidate to pick the most appropriate option for a single scenario. There is no negative marking; marks can still be rewarded for answers that are not entirely correct but unanswered questions will be given no marks.

For both the PD and CPS sections the candidate will be given a standardised score that comes under a specific band (1-4). For example, those who score <180 in each exam are limited to Band 1, which represents a ‘very poor level of performance’. Scoring over 291 in the exam puts the candidate in Band 4, illustrating a ‘very good level of performance’ in the exam. Additionally, 181-230 is Band 2, representing a ‘below average performance’ and 231-290 puts the candidate in Band 3 or a ‘good level of performance’ in the exam.