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FCP Part 1 Guide 2027: Format, Syllabus and How to Pass

By Certiva · Updated 1 October 2026 · ~10 min read

The FCP(SA) Part I is the first written exam of the Fellowship of the College of Physicians of South Africa, run by the Colleges of Medicine of South Africa (CMSA). It is a single 150-question multiple-choice (MCQ) paper written over 4 hours, testing the basic sciences of internal medicine: about half physiology and half pathophysiology.

If you are a community service doctor, a medical officer or between posts and you have your eye on an internal medicine registrar post, the FCP Part 1 (often called the FCP primaries) is the exam that opens the door. This guide sets out what the paper looks like, what it covers, the books behind our questions, and a 12-week plan you can run alongside a full clinical job.

FCP(SA) Part I key facts

Here is everything the CMSA states about the paper, in one place.

Last checked: 1 October 2026. The CMSA can change fees, dates and rules between sittings, so confirm on the official page before you apply.

What is the FCP Part 1 exam format?

The FCP Part 1 is one 4-hour MCQ paper of 150 questions, written online.

All CMSA examinations have been written on an online platform since 2021. That works out to roughly 96 seconds per question, which sounds generous until you meet a long acid-base stem or a pressure-volume loop at question 120. Pacing is a skill, so rehearse it before the day (more on that in the study plan).

The FCP(SA) Part I is sometimes searched as “FCP Part I”, “FCP primaries”, “FCP(SA) primary” or “the physicians’ Part 1”. They all mean the same exam.

What does the FCP Part 1 cover?

The FCP Part 1 tests the basic sciences of internal medicine, split roughly evenly between physiology and pathophysiology.

That 50/50 split is the most useful thing to know about the paper. You need the normal mechanism (how the nephron handles sodium, how the cardiac cycle generates the heart sounds) and what goes wrong in disease (why nephrotic syndrome causes oedema, how rheumatic fever damages the mitral valve). Physiology alone is not enough, and neither is clinical recall from the wards.

The CMSA does not publish a section-by-section blueprint with weights on the page we checked. Certiva organises its FCP Part 1 question bank by organ system, with equal weight per section:

A few themes recur across sections and deserve extra attention in a South African context: TB and HIV appear in the respiratory, infectious diseases and nervous system sections, and rheumatic heart disease sits alongside ischaemic disease in cardiology.

How many questions are in the FCP Part 1?

There are 150 questions in a single MCQ paper.

Because there is one paper, every section competes for the same 150 slots. You can’t write off a whole system and hope to make it up in a second paper. Broad, even coverage matters more than deep expertise in one area.

When is the FCP Part 1 written?

The FCP Part 1 is written in one of the CMSA’s two exam semesters each year.

• First semester: written papers usually in February or March.
• Second semester: written papers usually around July or August.

Exact dates, application deadlines and venues are published in the CMSA written examination timetable. Work backwards from your sitting: the 12-week plan below starts three months before the paper.

Who can write the FCP Part 1?

The CMSA lists a post-internship qualification to practice medicine as the requirement for the FCP(SA) Part I.

You don’t need to be a registrar first. Many doctors write the FCP Part 1 as a community service doctor or medical officer. A pass on your CV shows a selection panel that you have already cleared the first academic hurdle of the fellowship. For full admission rules, read the regulations on the CMSA FCP(SA) page.

Are there FCP Part 1 past papers?

No. The CMSA no longer publishes past papers.

Since the move to the online platform in 2021, questions stay in a secure bank and are not released after the sitting. Any older papers still in circulation predate that change. The honest alternative is a question bank mapped to the syllabus, where every answer explains the mechanism and cites a reference you can check.

Which textbooks should I use for the FCP Part 1?

Two core books cover almost everything: one for physiology, one for pathophysiology and clinical medicine.

These are the references used in Certiva’s bank, cited on every answer:

• Naish & Court, Medical Sciences, for physiology, cell biology and the basic-science side of each system. It is the reference across all 11 sections.
• Kumar & Clark, Clinical Medicine, for pathophysiology, disease mechanisms, therapeutics and toxicology.
• Harris & Taylor, Medical Statistics Made Easy, for the research and statistics subtopics: hypothesis testing, diagnostic test statistics, RR/OR/NNT, study design, and bias and confounding.

The infectious diseases section also draws on South African disease epidemiology, so make sure you know the local burden of TB, HIV and tropical infections and not only the textbook overview.

How should I study for the FCP Part 1?

Study one organ system a week, physiology first and then pathophysiology, with questions every day and two timed mocks at the end.

This plan assumes 12 weeks and roughly 15 questions a day alongside a full clinical job. It follows the equal section weights in Certiva’s bank. Start with cell biology because it underpins everything after it, and leave the last two weeks for mocks and closing gaps.

Make the plan work

1. Read the explanation every time. Right or wrong, read why, and check the reference. A good explanation teaches the mechanism behind three questions, not one.
2. Pair the books by system. Read the Naish & Court chapter early in the week and the matching Kumar & Clark disease chapters later, so physiology and pathophysiology land together.
3. Track subtopics, not just your total. A respectable overall score can hide a weak spot in acid-base or coagulation. Revision time should go where the gaps are.
4. Rehearse the four hours. Sit both mocks in one go, under exam conditions, so your pacing at question 140 is as steady as at question 10.

Starting later than 12 weeks out? Double up the systems you already feel strong in, but keep both mocks. If you start earlier, run the cycle twice and use the second pass for weak subtopics only.

How Certiva helps you prepare for the FCP Part 1

Certiva gives you 1,100 FCP Part 1 questions across 11 organ-system sections, each with a full explanation and a textbook reference.

• Explained and referenced answers: every answer explains the mechanism and cites Naish & Court, Kumar & Clark or Harris & Taylor, so you can check it yourself.
• Smart revision: brings back the questions and subtopics you found hardest, so weak areas get attention.
• Weakness tracker: performance by section and subtopic shows where to spend your next study session.
• Two timed mocks: rehearse pacing and stamina before the real paper.
• Free 5-question sample: try FCP Part 1 questions free, with no account or card.
• Refund or more time: if you complete the question bank and both timed mocks before your sitting and don’t pass, an eligible once-off Exam Pass gives you the choice of a full refund or another access period of the same length. Conditions apply; read the exam refund policy.

Compare the Exam Passes on the pricing page, or explore the FCP Part 1 sections and mocks. Two free extras help with the bigger picture too: the free CV builder for registrar applications, and free ethics CPD courses.

Writing a different fellowship? See our guides to the FCPsych Primaries, FCS Primary, FCPaeds Part 1, FCOG Part 1 and Dip PEC.

Frequently asked questions

Certiva is independent and not affiliated with the Colleges of Medicine of South Africa. Exam facts on this page come from the official CMSA page and were last checked on 1 October 2026.

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