FCPS Part 1 Paper 2 for Medicine & Allied: what to study

How Paper 2 differs from Paper 1

Paper 1 is shared by all candidates. Paper 2 for Medicine & Allied takes the same sciences and asks them about medical patients: a breathless patient with an abnormal blood gas, a jaundiced patient with a particular bilirubin pattern, a patient on a drug that has just interacted with another.

The depth in physiology, pathology and pharmacology is greater than Paper 1, and immunology, haematology and infection carry more weight.

The areas that matter most

Systemic physiology

• Cardiovascular: cardiac cycle, pressures, ECG basis, control of blood pressure, heart failure physiology.
• Respiratory: lung volumes, V/Q matching, oxygen dissociation, control of breathing, respiratory failure.
• Renal and acid–base: GFR, tubular handling, ABG interpretation, sodium and potassium disorders.
• Endocrine: thyroid, adrenal, pituitary, calcium and glucose control.
• Nervous system: motor and sensory pathways, localisation of lesions, CSF.
• GI and liver: secretion, absorption, bilirubin metabolism and jaundice.

Immunology

Hypersensitivity types with clinical examples, autoimmunity and autoantibodies, immunodeficiency (including HIV), and transplant immunology with amyloidosis.

Haematology

Anaemias and haemoglobinopathies (very relevant in Pakistan), leukaemias, lymphomas and myeloma, bleeding and coagulation disorders, and white cell disorders.

Infection

Tuberculosis and leprosy, viral hepatitis, HIV, rabies, herpes and influenza, malaria and intestinal parasites, hydatid disease, typhoid, cholera, meningitis and pneumonia.

Neoplasia and genetics

Carcinogenesis, tumour markers, paraneoplastic syndromes, inheritance patterns, chromosomal disorders, atherosclerosis and environmental disease.

Pharmacology

The drugs physicians use: antimicrobials (including antituberculous and antimalarial drugs), GI drugs, analgesics, neurological and psychiatric drugs, antihistamines and steroids, cardiovascular drugs, lipid-lowering drugs, anticoagulants, insulins and oral hypoglycaemics, thyroid drugs, autonomic drugs, and vaccines.

A suggested order

1. Physiology system by system, starting with cardiovascular, respiratory and renal.
2. Acid–base and electrolytes, because they connect several systems.
3. Immunology, then haematology.
4. Infection, using local disease patterns as anchors.
5. Pharmacology, grouped by system, alongside the physiology of that system.
6. Neoplasia and genetics to finish, with mixed question sets.

How to use questions

• Work numerically when you can. ABGs, clearance and half-life questions reward a written method.
• Link drug to physiology. If you know how the loop of Henle works, you know where each diuretic acts and what it does to potassium and calcium.
• Keep a "patterns" page: jaundice types, CSF findings, iron studies, coagulation profiles. These tables answer many questions at a glance.

After a wrong answer, read the full topic. One system, such as renal physiology, feeds questions across physiology, pharmacology and pathology.

Common mistakes

• Reading clinical medicine textbooks for treatment detail. Paper 2 tests mechanisms, interpretation and pharmacology, not ward management plans.
• Skipping immunology because it feels abstract. Hypersensitivity and autoantibody questions are reliable marks.
• Learning drugs as lists. Learn mechanism, main use, signature side effect and key interaction for each.

Where FCPS-1 Prep fits

The FCPS-1 Prep question bank has a dedicated Medicine & Allied Paper 2 set alongside the shared Paper 1. Each question explains every option and links to a full topic review, so a missed question opens the whole topic.

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