Official Source
This article is based on the official Physician Associate Registration Assessment – Knowledge-Based Assessment Blueprint (June 2025), published by the Royal College of Physicians. If you want to revise strategically, you must understand this document.
📝 Exam Structure & Scoring
The KBA is designed for candidates who have completed the Physician Associate Curriculum.
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Format: 200 single best answer (SBA) questions.
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Delivery: Split into 4 papers, each containing 50 questions.
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Timing: 1 hour per paper, with all four completed in a single day.
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Location: Sat online at an appropriate location, such as a home or office.
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Scoring: One mark (+1) is awarded for each correct answer.
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No Penalty: No marks are deducted for incorrect or unanswered questions (no negative marking).
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The Pass Mark: Calculated using the Angoff method. One standard error of measurement (SEM) is added to the total score, and any non-integer result is rounded up to the next whole number.
PARA KBA Exam Weighting by Specialty
Based on the official KBA Blueprint.
Highest-Weighted Specialties
| Specialty | % of KBA |
|---|---|
| Cardiovascular | 8% |
| Acute & Emergency Care (inc. toxicology) | 7% |
| Gastrointestinal | 7% |
These are your highest-return revision areas.
Major Core Systems (6%)
| Specialty | % of KBA |
|---|---|
| Endocrine & Metabolic | 6% |
| Mental Health | 6% |
| Neurosciences | 6% |
| Respiratory | 6% |
| Surgery | 6% |
Together, these represent a substantial proportion of the exam.
Mid-Weight Systems (5%)
| Specialty | % of KBA |
|---|---|
| Child & Adolescent Health | 5% |
| Infection (inc. STIs) | 5% |
| Musculoskeletal | 5% |
| Obstetrics & Gynaecology | 5% |
| Renal & Urology | 5% |
These are common, predictable exam areas.
Lower-Weight but Exam-Relevant (2–4%)
| Specialty | % of KBA |
|---|---|
| Dermatology | 4% |
| Clinical Haematology | 3% |
| Ear, Nose & Throat (ENT) | 3% |
| Medicine of Older People | 3% |
| Healthcare Service, Structure & Legal/Ethics | 2% |
| Health Promotion | 2% |
| Ophthalmology | 2% |
| Palliative & End of Life Care | 2% |
| Research & Evidence-Based Medicine | 2% |
Lower weighting does not mean low importance — these are often easier marks if prepared well.
Exam Composition by Task
This is the most critical area for your revision strategy. The exam focuses heavily on what you do with information, not just what you know.
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Clinical Management (40%): The largest portion of the exam focuses on how you manage a patient’s condition.
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Diagnosis: Choice of Investigations (20%): Knowing which test to order next.
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Diagnosis: Interpretation (20%): Understanding results like ECGs, bloods, or imaging.
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Biomedical Knowledge (20%): This covers anatomy, physiology, pathology, and microbiology.
Strategic Note: 80% of the exam is clinically applied (Management and Diagnosis), while only 20% is pure biomedical theory
Strategic Insight: Maximising Your Score
To revise effectively, you must align your study time with the official weightings. If you prioritize the highest-weighted specialties, you can secure a significant portion of the marks with a focused effort.
The “Power Three”
Combining the top three specialties alone accounts for 22% of the entire assessment:
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Cardiovascular: 8%
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Acute and Emergency Care (inc. toxicology): 7%
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Gastrointestinal: 7%
Expanding to the High-Yield Territory
When you add the 6% systems, you cover a total of 52%—over half the exam—across just eight subject areas:
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Endocrine and Metabolic: 6%
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Mental Health: 6%
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Neurosciences: 6%
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Respiratory: 6%
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Surgery: 6%
Why This Matters
Revision must mirror blueprint weighting because the KBA focuses heavily on Clinical Management (40%) and Diagnosis (40%). By mastering the “Power Three” and the 6% systems through the lens of management and investigation, you are studying exactly what the Royal College of Physicians intends to test.
Last reviewed: 22 February 2026
Source document: Physician Associate Registration Assessment – Knowledge-Based Assessment Blueprint (June 2025)
Next scheduled review: June 2026
This article is reviewed periodically to reflect updates issued by the General Medical Council and changes to the PARA blueprint.