From Dr Raj Joshi, ST6

MRCPsych syllabus 2027: what has changed

Dr Raj JoshiST6 in General Adult Psychiatry. 75% in Paper A, 81% in Paper B.

The College has published a new syllabus for Paper A and Paper B, and it starts in January 2027. I’ve read it side by side with the old one. Here’s what has changed, and what I’d do about it.

Download the new syllabus

The Royal College of Psychiatrists published these on 8 October 2026, and they have been on the College’s sitemap since. They are the College’s PDFs, unchanged.

The short version

It starts in January 2027. Sitting before then? Stick with the 2021 syllabus.
The exam is still three hours and 150 marks a paper: 100 multiple choice questions and 50 extended matching items.
For the first time, you know roughly how many marks each domain is worth.
Psychology and human development is now one domain, about a third of Paper A. Research and statistics are about a third of Paper B.
Most of what you know still counts. What’s new is mainly newer drugs, culture and society, the menstrual cycle and menopause, and more statistics.

When does it start?

Published 8 October 2026

The 2021 syllabusSittings up to 31 December 2026
The 2027 syllabusSittings from January 2027

Your sitting date decides which syllabus you revise from. If you sit before January, use the 2021 syllabus, and for Paper B the 2011 critical review syllabus too. The College confirms the dates on its exam page.

Where did the old sections go?

Most of the content carries over. It has been regrouped, two sections have new names, and critical review is now part of the main syllabus.

Paper A

Behavioural science and socio-cultural psychiatry and Human development became Psychology and human development.
Neuroscience stays Neuroscience.
Clinical psychopharmacology stays Clinical psychopharmacology.
Classification and assessment stays Classification and assessment.

Paper B

20212027

Organisation and delivery of servicesOrganisation and delivery of servicesGeneral adult psychiatryGeneral adult psychiatryOld age psychiatryOld age psychiatryPsychotherapyPsychotherapyChild and adolescent psychiatryChild and adolescent psychiatrySubstance misuseAddictions psychiatryRenamedForensic psychiatryForensic psychiatryLearning disabilityIntellectual disabilityRenamedCritical review (its own 2011 syllabus)Research methods, statistics and critical reviewBuilt in

Organisation and delivery of services stays Organisation and delivery of services.
General adult psychiatry stays General adult psychiatry.
Old age psychiatry stays Old age psychiatry.
Psychotherapy stays Psychotherapy.
Child and adolescent psychiatry stays Child and adolescent psychiatry.
Substance misuse became Addictions psychiatry.
Forensic psychiatry stays Forensic psychiatry.
Learning disability became Intellectual disability.
Critical review (its own 2011 syllabus) is now part of the main syllabus as Research methods, statistics and critical review.

Our question bank and textbooks now follow the 2027 syllabus. Where the College’s PDF repeats a number, we number by section: you’ll see 3.2.1 where the PDF prints 3.3.1.

How much is each domain worth?

The College gives each domain a range. I’ve turned the ranges into marks out of 150, so you can plan your time. The solid part of each bar is the least a domain gets; the paler part runs to the most.

Paper A
Domain	Share of the paper	Marks out of 150
Psychology and human development	30 to 36%	45 to 54
Neuroscience	22 to 28%	33 to 42
Clinical psychopharmacology	22 to 28%	33 to 42
Classification and assessment	14 to 20%	21 to 30

Paper B
Domain	Share of the paper	Marks out of 150
Organisation and delivery of services	4 to 8%	6 to 12
General adult psychiatry	18 to 22%	27 to 33
Old age psychiatry	8 to 12%	12 to 18
Psychotherapy	4 to 8%	6 to 12
Child and adolescent psychiatry	8 to 12%	12 to 18
Addictions psychiatry	4 to 8%	6 to 12
Forensic psychiatry	4 to 8%	6 to 12
Intellectual disability	4 to 8%	6 to 12
Research methods, statistics and critical review	30 to 36%	45 to 54

What’s new?

These are the changes I’d pay attention to. The full detail is in the PDFs.

In Paper A

More psychology. Consciousness, intelligence, language, decision making and cognitive bias each get room of their own.
Culture and society. Racism, cultural formulation, migration, social media and climate change.
Newer drugs. Ketamine, psilocybin, MDMA and orexin antagonists, and prescribing around premenstrual dysphoric disorder and the menopause.
How treatments work in the brain. A new section on ketamine, psychedelics, ECT and brain stimulation, with newer genetics such as polygenic risk scores.
No longer named. Personality theory (trait and type, personal constructs) and hypnosis. I’d still know the basics.

In Paper B

ICD-11 names. Anxiety and fear related disorders, disorders specifically associated with stress, bodily distress and gender incongruence.
New names. Liaison psychiatry (was general hospital psychiatry), addictions psychiatry (was substance misuse) and intellectual disability (was learning disability).
New topics. The menstrual cycle and menopause, frailty, gambling and gaming, human rights and capacity, and cultural competence.
More psychotherapy. The section is more than twice as long: ACT, compassion focused therapy, DBT, EMDR, digital therapies and deprescribing.
Statistics has moved on. Bayesian tests, network analysis, more kinds of regression, quality improvement, research ethics and AI in research.

What I’d do now

Check your date. January 2027 or later: the new syllabus. Before that: the 2021 one.
Plan by the marks. Give each domain time in proportion to its share. Psychology and human development, and research and statistics, each carry about a third of their paper.
Start statistics early. It’s the biggest domain in Paper B. Little and often beats a cram at the end.
Don’t start again. Most of the old syllabus is still there. Add the new topics as you go.
Learn the ICD-11 names. The syllabus uses them throughout.
Use the PDF as a checklist. Tick off each line as you cover it.