Clinical syllabus

This page contains the latest version of the clinical syllabus content for the MRCPsych (full syllabus [DOC]). Here you can see how we have divided our modules from the syllabus, track our progress and find the modules that cover the topics you want to learn. Each time we publish a new module, we will add a link to the relevant area of the syllabus.


Please note that this is not the full syllabus, it is 5-13 only. For 1-4, see our integrated syllabus/module list for the basic sciences. For 14 on the syllabus, see the page for the critical review/evidence based practice syllabus.


You can also view our original module lists for both our first set of basic science modules and our clinical/critical review topics.


According to the new system, Paper A tests 1-5 of the syllabus and Paper B tests 6-14. For guidance, please see the Exams pages on the main College website.





Trainees shall demonstrate knowledge of the assessment and classification of the major psychiatric disorders. This includes:



5.1    Classification systems

5.1.1 a working knowledge of ICD and DSM classification and diagnostic systems

5.1.2 WHO classification of impairments, disabilities, and handicaps.  A working knowledge of “statementing” for special needs education.


TrOn module: Classification systems



5.2    Assessment of the various biological, psychological and social factors involved in the predisposition to and onset, and maintenance of psychiatric disorder

         5.2.1  history taking and examination of the mental state

         5.2.2  Descriptive Psychopathology

          Disorders of self

          Disorders of emotion

          Disorders of speech and thought

          Disorders of perception

          Movement disorders

          Disorders of cognition

          Uncommon psychiatric syndromes

         5.2.3  Dynamic Psychopathology


TrOn module: Psychopathology



5.2.4  assessment of physical factors, including investigations

5.2.5  imaging of the nervous system.

5.2.6 a working knowledge of medicine including physical examination, diagnosis, investigation and treatment of common conditions.


TrOn module: Liaison, including delirium (see also 7.3 and 8.5 below)



5.2.7  Rating Scales in Psychiatry

5.2.8  Risk assessment

 Understanding the principles of risk assessment.

 Working knowledge of at least one recognised risk assessment tool used to assess risk.


TrOn module: Risk assessment (see also 8.6 below)



Trainees shall demonstrate knowledge of the core aspects of service delivery. This knowledge shall include:



6.1    the nature and process of managing psychiatric cases, including the application of multidisciplinary approaches, the special role of the psychiatrist in treatment and the co-ordination of the various treatment processes involved. Physical, psychological and social treatments and their relevance to the management and treatment of psychiatric disorders


6.2    preventative strategies in psychiatric disorder, where these exist



6.3    the provision of specific treatments

         6.3.1  the indications, benefits, risks and outcomes of ECT.

         6.3.2  the practical aspects of ECT administration.

         6.3.3  the indications, benefits, risks and outcomes of DBS, rTMS and psychosurgery


TrOn module: Surgery/Neuromodulation for mental disorder (includes relevant mental health laws)



6.4    the assessment of need for psychiatric services within a community and how to set up and administer such services, including some idea of the costs of major elements of such service provision;


6.5   the essential components of a rehabilitation service and the specific patient needs and disabilities that can be assisted by psychiatric rehabilitation.



6.6    the relationship between psychiatric disorder and civil rights including marriage, divorce, custody of children and management of property and affairs. Ethical issues including use of seclusion, confidentiality and the implications of ‘duty to warn’.


6.7    medico legal issues in psychiatry including abuse of vulnerable adults, management of finance and property, driving and mental disorder, and the assessment of capacity to make health, social care and civil decisions.


TrOn module: Medical ethics and law for psychiatry (includes driving and safeguarding but excludes safeguarding children and ECT/Neuromodulation for mental disorder) (See also 12.4 below)



6.8    the presentation of psychiatric disorder in a range of cultural settings, especially those likely to be encountered in the United Kingdom or the Republic of Ireland.





Trainees shall demonstrate a general knowledge of General Adult Psychiatry. This includes knowledge of the assessment and treatment of disorders presenting in adulthood including sub-specialist areas. In particular:


7.1    The prevalence/incidence, aetiology, presentation, treatment and outcome of psychiatric disorder in adulthood:








Unipolar Depression

Bipolar Disorder


Anxiety Disorders



Somatisation Disorder

Dissociative Disorders

Personality Disorders

Organic psychoses

Other psychiatric disorders

TrOn modules: Personality across the lifespan (see also 8.7 below); Emotionally unstable personality disorder; Schizophrenia (see also 8.5 below); Depressive disorders (see also 8.5 below); Bipolar and schizoaffective disorder (See also 8.5); OCD; Anxiety disorders (see also 8.5 below); Neuropsychiatry (including hypochondriasis, somatisation and dissociative disorders.


7.2    assessment and management of disorders related to pregnancy and childbirth


TrOn module: Perinatal



7.3    General Hospital Psychiatry

         7.3.1  psychiatric assessment of patients with physical illness

         7.3.2  advice to special medical services

7.3.3 the psychiatric consequences and aspects of brain disease, damage (including stroke) and dysfunction.

7.3.4 clinical and theoretical psychiatric aspects of pain and its management.

7.3.5 care of the dying and the bereaved.


TrOn module: Liaison, including delirium (see also 5.2.4-6 above and 8.5 below)



7.4    Emergency Psychiatry

7.4.1           all aspects of suicide, attempted suicide, and self harm including risk assessment and risk management

7.4.2 knowledge of the theory and practice of crisis intervention/home treatment

7.4.3 differential diagnosis in emergency situations

7.4.4 treatment methods in emergency situations including the use of appropriate legislation


TrOn module: Emergency psychiatry



7.5    The prevalence/incidence, aetiology, presentation, treatment and outcome of eating disorders








Anorexia Nervosa

Bulimia Nervosa


TrOn module: Eating disorders, including children



7.6    Psycho-sexual disorders

7.6.1 Non-Organic sexual dysfunction, including lack or loss of sexual desire, lack of sexual enjoyment, and failure of genital response

7.6.2 Gender Identity Disorders, including transsexualism and transvestism


TrOn module: Psycho-sexual disorders (see also 8.11, below)





Trainees will demonstrate knowledge of the particular aspects of psychiatric disorders, their presentation and treatment in late life. This will include:



8.1    Demographic population changes in the UK and worldwide.


8.2    District service provision; need for specialisation, principles of service provision, multidisciplinary working with reference to needs of an older population, relationships with and provision by social services and voluntary bodies. Liaison with geriatricians. Attention to the needs of carers.


8.3    Specialist aspects of assessment of mental health in older people.


TrOn module: Old age psychiatry in the UK (see also 8.5 below - substance misuse in later life)



8.4    Psychological aspects of physical disease; particular emphasis on possible psychiatric sequelae of Parkinson’s disease, cerebrovascular disease, sensory impairment. Emotional reaction to illness and to chronic ill health. Secondary and reversible dementias.


TrOn module: Dementias across all ages and sleep disorder in old age (see also 8.5 and 8.10 below)



8.5    Prevalence/incidence, clinical features, differential diagnosis, aetiology, management and prognosis of the following disorders occurring in late life:








Alzheimer’s disease

Vascular Dementia

Dementia with Lewy Bodies, Parkinsons Disease Dementia

Fronto-temporal Dementia



Bipolar Disorder

Late Life Psychosis

Anxiety Disorders

Substance Misuse

Other Mental Disorders


TrOn modules: Schizophrenia (see also 7.1 above); Depressive disorders (see also 7.1 above); Bipolar and schizoaffective disorder (see also 7.1 above); Anxiety disorders (See also 7.1 above); Liaison, including delirium (see also 5.2.4-6 and 7.3 above); Dementias across all ages and sleep disorder in old age (see also 8.4 above and 8.10 below); Old age psychiatry in the UK (substance misuse in later life - see also 8.1-3 above)



8.6    Suicide and attempted suicide in old age.


TrOn module: Risk assessment (See also 5.2.7 and 5.2.8 above)



8.7    Psychiatric aspects of personality in old age.


TrOn module: Personality across the lifespan (see also 7.1 above)



8.8    Psychotherapy with older adults: adaptations and difference in therapy. Transference - counter-transference issues. Common themes.



8.9    Bereavement and adjustment disorders.


TrOn module: Reaction to severe stress, adjustment disorders (including PTSD) and bereavement (includes old age, where relevant)



8.10  Sleep disorder in later life.


TrOn module: Dementias across all ages and sleep disorder in old age (see also 8.4 and 8.5 above)



8.11  Psychosexual disorders in old age; including sexuality in physically ill/disabled people, sexuality in institutionalised elderly.


TrOn module: Psychosexual disorders (see also 7.6, above)





Trainees will be able to understand the principles and techniques of psychosocial therapies sufficient to treat patients using brief and supportive therapies and to know when and how to make a referral that is indicated. Further to this they will be able to explain to a patient prospective treatment if a referral is made. Thus they will be able to:


  • State the characteristics and techniques of, and common indications for psychodynamic psychotherapy, psychoanalysis, supportive psychotherapy, cognitive and behavioural therapies, group therapies, couples and family therapies and psychoeducational interventions.


  • State the indications for and techniques of combining psychotherapy with psychopharmacology


  • Describe behavioural interventions (e.g. relaxation training, assertiveness training, relapse prevention) and know for which problems they are indicated or contraindicated.


TrOn module: Introduction to psychotherapy, including effectiveness/evidence base (see also 9.5 below)



The knowledge to be demonstrated will include a variety of therapies and their cultural appropriateness:



9.1.1  Dynamic Psychotherapy


Development of psychodynamic concepts by Freud, the Neo-Freudians Klein, Jung and Winnicott. An understanding of the following: therapeutic alliance; transference; countertransference; resistance; negative therapeutic reaction; acting out; interpretation; insight; working through defence mechanisms. Indications for brief, long-term and supportive psychotherapy. Therapeutic factors in groups.


TrOn module: CBT and dynamic psychotherapy (See also 9.3 below)



9.2    Family Therapy


Influence of General Systems Theory. Different models of family therapy: dynamic; structural; strategic; psychoeducational; behavioural. Goals of treatment.


TrOn module: Family therapy



9.3    Cognitive-Behavioural Therapies


9.3.1 Behaviour Therapy. Understanding of systematic desensitisation, operant conditioning, graded and cue exposure, habituation and social skills training. How to conduct a functional analysis, formulate a treatment plan and use measurement to assess change.

9.3.2 Cognitive Therapy. The cognitive model for non-psychotic disorders. The importance of schema, negative automatic thoughts and maladaptive assumptions. These will need to be considered in appropriate cultural contexts.


TrOn module: CBT and dynamic psychotherapy (see also 9.1.1 above)



9.4    Other Therapeutic Models

          Awareness of Interpersonal Therapy, Cognitive Analytical Therapy, Dialectic Behaviour Therapy, Gestalt Therapy, Client Centred Therapy, Transactional Analysis, and Mentalisation.


TrOn modules: Other therapeutic modules (excluding DBT); Dialectic Behaviour Therapy



9.5    Effectiveness of Psychotherapy


Difficulties in defining outcome, understanding of effect size and meta-analysis, specific and non-specific effects in psychotherapy and be aware of contemporary guidelines. Research on outcomes in psychotherapy.


TrOn module: Introduction to psychotherapy, including effectiveness/evidence base (see also 9, intro, above)



9.6    Group Therapy


9.6.1 Psychodynamic.  Historical roots of group therapy; group process; different models of analytic/dynamic group therapy (eg Bion, Foulkes, Yalom).  Therapeutic factors in groups.

9.6.2 Other therapeutic group models. Cognitive Behavioural groups, Expressive therapies, Support groups, Psychoeducational groups, and Skills groups.


TrOn module: Group therapy including therapeutic communities




Trainees shall demonstrate a general knowledge of Child and Adolescent Psychiatry. This includes knowledge of the assessment and treatment of children and adolescents, knowledge of disorders that are usually first diagnosed in infancy, childhood or adolescence and developmental disabilities. In particular:


10.1  The effects of adult mental illness on children including the effects of maternal mental health on children and young people at different developmental stages. As an exemplar the effect of depression on parental functioning and interactions, and the impact of this on child development and functioning. An understanding of cultural variations in aetiology and management.


10.2  Short and long-term effects of negative life events on development and functioning e.g. maternal loss, child abuse, chronic or life-threatening illness.


TrOn module: Overview of child and adolescent psychiatry (see also 10.5 below)



10.3  Description of a typical child mental health service, the role within this service of the psychiatrist and multidisciplinary team members. Basic information on different agencies involved in the care of children and their function.


10.4  Child protection. The needs of developing children and how these change with time. Types of child abuse and their aetiology and recognition. An understanding of what to do if child protection concerns are raised.


TrOn module: Children's services and child protection (see also 10.9-10 below)



10.5  Interaction between psychiatric disorder and physical illness in children and adolescents. Physical presentation of psychiatric disorder and psychiatric presentation of physical disorder.


TrOn module: Overview of child and adolescent psychiatry (see also 10, 10.1-2 above)



10.6 Aetiological influences in child and adolescent psychiatry, including individual, familial and social and environmental influences and their interactions


TrOn module: Attachment disorders, anxiety disorders and OCD in children (see also 10.8 below)



10.7 Evidence based interventions child mental health and developmental conditions (as defined in ICD and DSM) and the care pathways that enable access to those interventions


TrOn modules: ADHD across the lifespan (see also 10.8 below); Affective disorders and psychosis in children (see also 10.8 below); Autism spectrum disorders and tic disorders in children (see also 10.8 below)



10.8  Knowledge of the prevalence/incidence, aetiology, presentation, treatments and outcome of the following conditions including an understanding of how conditions relate to behaviours (e.g. self-harm, refusal to attend school etc) and contexts (e.g. pre-school behaviours):








Attachment disorders

Conduct disorder


Anxiety disorders including OCD

Affective Disorders


Eating disorders

Autism Spectrum disorders

Substance misuse

Tic disorders

Other childhood disorders


TrOn modules: ADHD across the lifespan (see also 10.7 above); Attachment disorders, anxiety disorders and OCD in children (see also 10.6 above); Affective disorders and psychosis (see also 10.7 above); Autism spectrum disorders and tic disorders in children (see also 10.7 above)



10.9    Continuities and transitions of child mental health conditions into adult life.


10.10 Indications and contra-indications for different treatment interventions. Indications for in-patient care.


TrOn module: Children's services and child protection (see also 10.3-4 above)




Trainees are expected to be knowledgeable and competent to a basic degree in sub-specialties of psychiatry. The level of knowledge and practice is to enable the individual doctor to deal with the majority of routine cases and emergencies that may be referred, not the level required to practice as a specialist in the given field



11 Substance Misuse/Addictions



11.1      Basic pharmacology and epidemiology of: alcohol; cannabis: the stimulants (amphetamine, cocaine, phentermine, diethylpropion, pemoline etc.); hallucinogens; solvents and nitrites; Ecstasy and related substances, benzodiazepines and barbiturates; opiates.


TrOn module: Addictions 1 (see also 11.3-5 and 11.9 below)



11.2      Awareness of the arguments for and against the various types of prescribing and treatment modalities. Legal restrictions on prescribing.


TrOn module: Addictions 2 (see also 11.6-8 and 11.10 below)



11.3      Cause, consequences and recognition of heavy drinking: the concept of ‘problem drinking’; the components of the alcohol dependence syndrome; the nature of alcohol-related disabilities; detoxification procedures for in-patients and out-patients.


11.4      Who uses which drugs and why; reasons for initiating and continuing drug use; how to recognise drug use; the concept of problem drug use; patterns of dependence on different drugs; detoxification procedures for inpatients and outpatients. An understanding of cultural factors in the use and abuse of drugs.  Basics of the biological, psychological and socio-cultural explanations of drug and alcohol dependence.


11.5      The interaction of drug and alcohol use with psychiatric illness. Dual diagnosis and co-morbidity (classificatory systems).  Recognition of substance misuse related medical, psychiatric and social complications and their impact on Public Health.


TrOn module: Addictions 1 (see also 11.1 above and 11.9 below)



11.6      The assessment and management of drug and misusers, including symptoms and signs of substance use, and withdrawal phenomena.


11.7      The assessment and management of alcohol misusers, including symptoms and signs of substance use, and withdrawal phenomena.


11.8      Culturally appropriate strategies for the prevention of drug and

alcohol abuse.


TrOn module: Addictions 2 (see also 11.2 above and 11.10 below)



11.9      The assessment and management of non-substance addictive behaviours and related syndromes.


TrOn module: Addictions 1 (see also 11.1, 11.3-5 above)



11.10    Motivational Interviewing.  Fundamental concepts and approaches; general approaches; adaptations of motivational interviewing.


TrOn module: Addictions 2 (see also 11.2 and 11.6-8 above)


12 Forensic Psychiatry



12.1 Relationship between crime and mental disorder

12.1.1 Knowledge of the range of offences committed by mentally disordered offenders.  Specific crimes and their psychiatric relevance particularly: homicide; other crimes of violence (including infanticide); sex offences; arson; and criminal damage.

12.1.2 The relationship between specific mental disorders and crime: substance misuse; epilepsy; schizophrenia; bipolar affective disorder; neuro-developmental disorders; personality disorders.

12.1.3 Special syndromes: morbid jealousy, erotomania, Munchausen and Munchausen by proxy.

12.1.4 Mental disorders and offending in special groups: young offenders; female offenders; offenders from ethnic minorities; offenders who are deaf or have  other physical disabilities.

12.1.5 Effect of victimisation and vulnerability: anxiety states including post-traumatic stress disorder; suggestibility; anger and aggressive behaviour. Effect of compensation on presentation. 


TrOn module: Forensic psychiatry 1



12.2 Psychiatry and the criminal justice system

12.2.1 The role of the psychiatrist is the assessment of mentally disordered offenders: during arrest; prior to conviction; prior to sentencing.

12.2.2 Psychiatric defences: Fitness to plead; mutism and deafness; criminal responsibility; diminished responsibility; amnesia and automatism.

12.2.3 Psychiatric disposals following conviction.

12.2.4 Skills to write a court report in relation to a criminal case.

12.2.5 Skills to provide oral evidence in court as an expert witness and as a professional witness.


TrOn module: Forensic psychiatry 2



12.3  Practicing psychiatry in a secure setting

     12.3.1        The role of security in a therapeutic environment.

12.3.2         The essential components of a forensic service and the specific patient needs and disabilities that can be assisted by such a service provision

12.3.3  Knowledge of the prevalence of psychiatric disorder in prison populations, suicide in prisoners, psychiatric treatment in prison settings. 

12.5.3 Risk management planning in forensic psychiatric practice

     12.5.4 Managing mentally disordered offenders discharged into the community


TrOn module: Forensic psychiatry 3



12.4  Human rights legislation as it affects patients and psychiatric practice.


TrOn module: Medical ethics and law for psychiatry (includes driving and safeguarding but excludes safeguarding children and ECT/Neuromodulation for mental disorder) (See also 6.6 and 6.7, above)



13 Learning Disability


The topics suggested should complement those topics which will be covered in other areas of psychiatry, particularly neuropsychiatry and child psychiatry.



13.1 Services

13.1.1  Normalisation and related social theories and their influence on service development for people with a intellectual disability The change from an institutional to an individualised, needs led approach.

13.1.2  The provision of specialist psychiatric services for people with intellectual disability.


TrOn module: Learning disabilities 2 (see also 13.3 below)



13.2.1 Epidemiology

The prevalence/incidence of intellectual disability in the general population. The prevalence/incidence of superadded behavioural, psychiatric and other impairments within this group. The factors which might account to the observed high rates of psychiatric behavioural disorders in this group.


13.2.2 Aetiology

Biological causes of intellectual disability, including genetic and environmental effects, and the clinical characteristics of reasonably common biological conditions associated with intellectual disability such as Down Syndrome, fragile-X syndrome and foetal alcohol syndrome

The influence of psychological and social factors on intellectual and emotional development in people with intellectual disability, including the concept of secondary handicap.


TrOn module: Learning disabilities 1



13.3 Clinical

13.3.1  Assessment and communication with people with intellectual disability.

13.3.2  The presentation and diagnosis of psychiatric illness and behavioural disorder in people with intellectual disability, including the concept of diagnostic overshadowing

13.3.3  Psychological methods of assessment and an understanding of psychological theories as to the cause of problem behaviours. An understanding of relevant behavioural modification techniques.

13.3.4  The application of psychiatric methods of treatment in intellectual disability including psychotherapy, drug treatments, behaviour therapy and cognitive therapy.

         The application of a multidisciplinary approach to the management of mental health problems in people with intellectual disability

13.3.5  Specific syndromes and their association with particular psychiatric or behavioural disorders (behavioural phenotypes).

13.3.6  The impact of disability on the family and the psychological consequences of having a child with a disability.

13.3.7  The assessment, management and treatment of offenders with Intellectual disability


TrOn module: Learning disabilities 2 (see also 13.1 above)


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