Exam Prep · CPST · 2027 Cycle
ICGP CPST 2027: Format, Standard, Pass Mark and How to Pass
Worth 10% of your ranking, and a pass/fail hurdle before that 10% counts for anything
The CPST is the most misunderstood part of the ICGP process, because candidates assume it works like the SJT. It doesn't. This guide covers what it tests, the standard the ICGP sets it at, how the pass mark is decided, and how much preparation it actually deserves.
Situational Judgement Test
Plus a pass mark you must clear before it counts at all
Scenario Based Competency Assessment, renamed from “interview” for 2027
The ICGP Clinical Problem-Solving Test (CPST) is an online test of 50 single best answer questions, taken immediately after the SJT and lasting 60 minutes. It assesses clinical knowledge at the standard of a current intern. Two things are both true of it at once: it contributes 10% to your final ranking, and before that 10% ever counts, you must first clear a pass mark, applicants who fall short are not shortlisted at all, whatever the rest of their application looks like.
That single fact changes how you should prepare, and most candidates get it backwards. They either dismiss the CPST as a formality worth a tenth of their score, or they revise for it like a membership exam. Both are expensive mistakes, in opposite directions.
The CPST works on two levels, and missing either one is a mistake. First, it is a pass/fail gate: fall short of the standard and you are not shortlisted, regardless of your SJT score. Second, for everyone who clears that gate, the CPST score itself carries 10% weight in your final ranking, a smaller share than the SJT's 50% or the Scenario Based Competency Assessment's 40%, but real. Your objective is a reliable pass achieved efficiently, not a perfect score bought with hours the SJT needed more.
CPST at a Glance: 2027 Intake
- 50 single best answer (SBA) questions
- 60 minutes
- Five possible responses per question, one best answer
- Online and invigilated, sat at home
- Wed 4 – Thu 5 November 2026, immediately after the SJT
- 10% of your final ranking, once you clear the pass mark
- Standard: that of a current intern
- Pass mark set by the Ebel criterion-referenced method
Sources: ICGP, SJT and CPST and ICGP 2027 Recruitment Process, Key Dates. Dates may be subject to change; always confirm on icgp.ie.
The CPST is the clinical half of the ICGP's two-test assessment day. Where the SJT asks how you would behave, the CPST asks what you know. Each question describes a common clinical presentation that a recently qualified doctor might realistically meet, then asks you to select the single most appropriate response from five options. The ICGP describes the questions as exploring your ability to diagnose, investigate and manage those presentations.
The College is unusually candid about why the test exists. Its stated purpose is to protect the public from practitioners who are not clinically competent to occupy training posts, while making sure the bar is not set so high that it excludes candidates who do have the necessary knowledge and skills. Read that sentence twice, because it tells you exactly what the CPST is trying to do: it is a safety net, not a competition.
One practical detail worth knowing early: the ICGP publishes a free sample CPST paper on its own website. It is a short PDF, it costs nothing, and in our experience most candidates never open it. If you do one thing after reading this guide, download the official sample and sit it properly.
A safety net, not a competition. Prepare accordingly.
Yes. The ICGP’s official Guide to Applicants states it directly: CPST scores contribute towards final ranking and assignment of training places. Its selection flowchart shows the split plainly: SJT 50%, CPST 10%, and 40% for the Scenario Based Competency Assessment (SBCA), combined into one overall score. The 2027 Prospectus flowchart confirms the same structure: CPST sits inside Rank & Match as a scored input, right alongside the SJT and the SBCA.
But scoring 10% is only half the story, and it is the half candidates fixate on. Before that 10% ever reaches your ranking, you have to clear the Ebel pass mark. Miss it, and the 10% never gets calculated at all, because you are not shortlisted. So the CPST is really two separate hurdles stacked on top of each other: pass it, then let it score.
How the CPST Score Is Actually Used
- Step one, pass or fail: reach the Ebel-set standard or you are not shortlisted, whatever your SJT score.
- Step two, ranking: once you have passed, your CPST score contributes 10% to your overall ranking, alongside 50% for the SJT and 40% for the SBCA.
- Confirmed by: the Guide to Applicants selection flowchart and the 2027 Prospectus flowchart, both showing CPST as a scored Rank & Match input.
Sources: ICGP, GP Trainee Recruitment Guide to Applicants and the ICGP 2027 GP Training Prospectus
Treat the CPST as two separate tasks stacked on top of each other. Task one is clearing the Ebel pass mark, non-negotiable, and failing it ends your application regardless of anything else. Task two is the 10% your score contributes once you have cleared it. Task one deserves real, structured preparation. Task two deserves some, but a fraction of what the SJT’s 50% earns, because the return per hour is smaller by design.
In practice this changes very little about how you should spend your time, and that is the useful takeaway. The CPST still deserves enough preparation to make failure genuinely improbable. It is worth a further, smaller effort beyond that to protect the 10%, but it is not worth matching the hours you put into the SJT. Ten percent of your ranking is real. Fifty percent is five times more real.
The ICGP sets the CPST at the standard of a current intern. Not a GP. Not a registrar. Not a specialist. That one line, published on the College's own assessment page, should govern every decision you make about what to revise and which resources to use.
This has concrete consequences. You do not need GP-specific management: primary care prescribing, chronic disease reviews in the community, or the referral thresholds a GP registrar works to. You do not need registrar-level depth in any specialty. What you do need is breadth at intern level across the presentations any recently qualified doctor meets, and above all the ability to recognise the acutely unwell patient and know when to escalate.
Candidates routinely prepare for the CPST using MRCGP or MICGP membership resources, on the theory that aiming higher is safer. It isn't. Membership material is pitched years above the tested standard, it is built around general practice rather than intern-level hospital medicine, and it burns time you needed elsewhere. Preparing above the standard is not a safety margin. It is a misallocation.
If you want a single mental calibration: the question should feel like something you could have been asked on a ward round during your intern year by a registrar who was teaching rather than testing. Common presentation, clear decision point, five plausible options, one that is clearly the most appropriate next step.
Breadth at intern level beats depth anywhere. That is the whole calibration.
The ICGP uses the Ebel method, a criterion-referenced standard-setting approach it names explicitly on its assessment page. In plain terms: a panel of experts reviews each question in the paper and judges how a borderline-competent candidate should perform on it. Those judgements are aggregated to produce the pass mark for that specific paper.
Two things follow, and both matter to you. First, the pass mark is not a fixed percentage. A harder paper produces a lower pass mark and an easier paper a higher one, which is precisely why candidates from different years report different figures and why chasing a specific number is pointless. Second, it is criterion-referenced, not norm-referenced: you are measured against a defined standard of competence, not against the other candidates in the room. There is no fixed quota of passes.
What Criterion-Referenced Actually Means for You
- You are not competing against other candidates for a limited number of passes
- Everyone who meets the standard passes; a strong cohort does not raise the bar
- The raw percentage needed shifts with paper difficulty, so it is not published as a target
- Preparing to a consistent standard of competence is the only strategy that works
Source: ICGP, Clinical Problem-Solving Test, standard setting
The practical upshot is reassuring for the pass/fail element. You cannot be unlucky enough to be beaten to a pass by a strong year group, and you cannot game the mark by guessing what percentage is needed. Reliable coverage of common presentations across the intern-level curriculum is what clears the bar. Above that bar, your actual score still feeds the 10% ranking weight, so there is a modest, genuine reason to aim a little beyond a bare pass, just not a reason to over-invest.
Every CPST question is a single best answer item: a clinical stem, then five options, of which you select the one most appropriate response. The ICGP groups what these questions test into three things, and it is worth holding them separately in your head, because they demand different reasoning.
Diagnostic Items
A presentation is described and you identify the most likely diagnosis. The discriminating detail is usually one specific feature in the stem: the timeline, an age, a vital sign, a single examination finding.
Investigation Items
You choose the most appropriate next investigation. The trap is that several listed investigations would be reasonable at some point in the patient's journey; only one is right as the immediate next step.
Management Items
You select the most appropriate immediate management step. These questions frequently hinge on sequencing: resuscitation before diagnosis, stabilisation before referral, senior escalation before definitive treatment.
On timing: 50 questions in 60 minutes gives you around 72 seconds per question. That is comfortable for a question you know and unforgiving for one you don't. The discipline that protects your score is simple. If a question is not yielding within about 90 seconds, choose your best option, move on, and come back if time allows. Two minutes spent rescuing one uncertain answer routinely costs two straightforward marks later in the paper.
Here is where we have to be careful, and where you should be sceptical of any site that isn't. The ICGP does not publish a specialty breakdown or a topic blueprint for the CPST. What it publishes is the standard (that of a current intern) and the description (common clinical presentations a recently qualified doctor might encounter).
So the table below is not an official syllabus. It is an inference from the tested standard: the presentations that a broad Irish intern year actually exposes you to, and that any competent intern would be expected to handle. Treat it as a sensible revision map, not as a leaked blueprint.
High-Yield Presentations at Intern Level
- Acute medicine: chest pain and ACS, pulmonary embolism, acute severe asthma, DKA and hypoglycaemia, AKI, sepsis recognition, stroke and the FAST pathway
- Emergency presentations: anaphylaxis and adrenaline dosing, the acutely breathless patient, altered consciousness, overdose and poisoning
- Surgery: the acute abdomen, appendicitis, bowel obstruction, testicular torsion and other time-critical diagnoses
- Paediatrics: the febrile child, red flags for meningism, dehydration assessment, common childhood rashes
- Obstetrics and gynaecology: ectopic pregnancy, pre-eclampsia, postpartum haemorrhage
- Psychiatry: structured suicide risk assessment, acute agitation, capacity in an emergency
Inferred from the ICGP's stated standard (that of a current intern) and description of the CPST. Not an official ICGP syllabus: the College does not publish a topic blueprint. Source: ICGP, Clinical Problem-Solving Test
The pattern in that list is deliberate: almost everything on it is either common, time-critical, or both. If you want a prioritisation rule that works, revise the presentations where a missed or delayed diagnosis harms the patient quickly. That is the intersection of what interns see and what a test built around clinical safety is going to ask about.
One more piece of self-assessment worth doing honestly. Rank the six areas above by how confident you feel, then spend disproportionate time on your weakest two. Most candidates fail to do this and revise what they enjoy, which usually means more of what they are already good at. The gaps that show up most often are the rotations candidates simply didn't get: a missed paediatrics or obstetrics placement tends to leave the biggest hole in exactly the areas this test rewards.
The CPST is the most straightforwardly preparable part of the ICGP process, and that is genuinely good news. The SJT asks you to build new professional instincts. The Scenario-Based Competency Assessment in February asks you to construct and rehearse personal examples. The CPST mostly asks you to recover and organise knowledge you already have, which is a far more predictable task, and unlike the Scenario-Based Competency Assessment, a strong CPST score also banks you a small, direct addition to your ranking.
Sit the official ICGP sample paper cold.Before any revision, do the free sample under timed conditions. It calibrates you to the level far better than any commercial question bank, and it usually reassures candidates who have talked themselves into thinking the CPST is a membership exam.
Work SBA questions at intern level, in short sets.Fifteen to twenty questions per session. Read every explanation, including the ones you answered correctly, because a right answer for the wrong reason will not hold up under time pressure. Log the reasoning patterns you keep getting wrong, not just the topics.
Target your two weakest specialties.Use the self-ranking from the previous chapter. Basic familiarity with high-yield presentations in an unfamiliar specialty improves your score far more per hour than polishing an area you already know well.
Two full timed sets of fifty, then stop adding.Practise the pacing under real conditions so 72 seconds per question feels normal. Do not introduce new material in the final week; consolidate what you have. At this point your remaining preparation hours belong to the SJT.
Light review and logistics.Short recall sessions only. Complete the mandatory pre-test check if you somehow have not, confirm your ID and test codes, and protect your sleep. Clinical reasoning under fatigue is measurably worse, and the CPST comes second on a long day.
On resources, one clear opinion: use question banks pitched at intern or early core training level, and be suspicious of anything marketed as covering both the SJT and the CPST with the same material. The two tests share a day and nothing else. One is professional judgement benchmarked against a panel, the other is clinical knowledge benchmarked against a standard. Material that claims to prepare you for both at once is usually doing neither well.
Both tests are online and invigilated, taken consecutively in a single sitting, with the SJT first and the CPST second. The ICGP advises allowing approximately three hours in total. You select a preferred test time on Application A, though the College is explicit that popular slots cannot be guaranteed and applicants may be allocated randomly, so plan for any time within the window.
There is a mandatory pre-test check, completed in advance on the same device and in the same location you will use on test day. The ICGP states that applicants who do not complete it will not be issued with a link to the live test and will be removed from the remainder of the process. That is the entire application gone, on a checkbox, before a single clinical question is asked. Do it the day it opens.
At the start of the test there is an identity validation step, so have government-issued photo ID (ID card, passport or driving licence) and a copy of your test codes to hand. A compatible device, a reliable internet connection and a quiet, uninterrupted space are explicitly your responsibility, not the College's.
On the break between the tests, the ICGP's own page is inconsistent: the general process section says applicants are required to take a 10-minute break, while the CPST section describes an optional break. Either way, plan for a short one and use it properly. Stand up, leave the screen, eat and drink something. Do not spend it re-running SJT answers in your head, because it cannot change anything and it depletes exactly the concentration the CPST needs.
You are not chasing a number. You are clearing a bar that the ICGP has deliberately set at the level of a competent intern, and that it has explicitly said it does not want to set too high. Answer as the safe, sensible intern you were: recognise the sick patient, choose the next step that changes management, escalate when escalation is right. That is what passes.
GP Journey · CPST Practice
Pitched at the level
the ICGP actually tests.
Intern-level SBA questions across the presentations that matter, with explanations that teach the clinical reasoning rather than just naming the answer.
Frequently Asked Questions
What is the ICGP CPST?
The Clinical Problem-Solving Test is an online test of 50 single best answer questions taken immediately after the SJT. It assesses clinical knowledge at the standard of a current intern and takes 60 minutes. For the 2027 intake it is sat on 4 and 5 November 2026.
Does the CPST count towards your GP training ranking?
Yes. Per the ICGP's official Guide to Applicants, the CPST is worth 10% of your final ranking, against 50% for the SJT and 40% for the Scenario Based Competency Assessment (SBCA, the renamed interview stage). It is also a pass/fail hurdle first: applicants who do not reach the required standard are not shortlisted, whatever their SJT score, so the 10% only counts once you have passed.
What standard is the ICGP CPST set at?
The ICGP sets the CPST at the standard of a current intern. It is not pitched at GP, registrar or membership level. Questions describe common clinical presentations a recently qualified doctor might encounter, and test the ability to diagnose, investigate and manage them.
How is the ICGP CPST pass mark set?
The ICGP uses the Ebel method, a criterion-referenced standard-setting approach. A panel judges each question against what a borderline-competent candidate should achieve, so the pass mark reflects a fixed standard of competence rather than a fixed percentage or a quota of candidates.
How many questions are in the CPST and how long is it?
The CPST consists of 50 single best answer questions and takes 60 minutes, giving you around 72 seconds per question. Each question offers five possible responses and you select the single most appropriate one.
When is the ICGP CPST in 2026?
For the 2027 intake, the SJT and CPST are sat over two days, Wednesday 4 and Thursday 5 November 2026. Both tests are taken consecutively in one sitting and the ICGP advises allowing approximately three hours. Dates may be subject to change.
What happens if you fail the ICGP CPST?
Applicants who do not attain the required standard are not shortlisted for the Scenario-Based Competency Assessment in February. There is no compensation mechanism: a high SJT score cannot rescue a CPST fail, because the CPST is assessed as a separate pass or fail hurdle.
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