The MRCP examination is constantly changing, reflecting the changing pressures on doctors in training. Whilst the MRCP PACES examination has evolved with the times, the core ethos of it, to act as a benchmark for sound clinical examination, logical diagnostic ability, common sense and most importantly, the development of compassionate and ethical physicians has remained unchanged.Whilst this exam has often struck fear into the hearts of junior doctors, we believe it is an assessment of progression during a physician’s training that should be relished as an opportunity to demonstrate these ageless qualities that caring practitioners should possess.This book was born out of the philosophy that all doctors sitting their MRCP PACES already have the knowledge and skill to pass the exam, but just require guidance in the correct logical approach that the Royal College is looking for.The book has, therefore, quite unlike other MRCP PACES books, avoided any attempts at being a definitive text. Rather, it has focused on the key aspects that the authors believe are required to pass the examination, in particular focus on presentation style. Whilst medicine is indeed an ocean, the most commonly examined topics have been selected to reflect the likely scenarios a candidate will face — as the old adage goes — ‘common things occur commonly’.In producing this book, extensive feedback was sought from candidates revising for the examination to reflect their needs. The layout therefore involves a methodical approach with a short introduction, similar to that presented in the exam, followed by clinical findings expected to be found. An example of presentation style has then been produced to allow the candidate to rehearse and practice this essential component of the exam.Doctors preparing for the exam have limited time due to busy work schedules. Therefore, summary books are key for candidates sitting the MRP PACES examination.Most PACES candidates fail the exam based on history and communication stations.Therefore, attention has been paid to: