The Council's 90 Sample Questions and the Level 2 Blueprint: How to Use Them

What the Council gives you

The Level 2 information page tells candidates to do two things: download and review the Blueprint, and review the 90 sample questions. The Handbook of May 2023 is also linked. The three together are the whole of the official preparation material for the exam, and it is worth knowing exactly what each does and does not tell you.

How to read the Blueprint

The Blueprint is a working document, not a syllabus in the textbook sense. Download the current version from the Council and read it with a clear aim: to build a topic checklist. Go through it line by line and mark each line green (I can answer questions on this), amber (partly) or red (no). The red and amber lines are your study plan.

The Council says the PRES examinations are based on the Eight Domains of Good Professional Practice, and the Blueprint is where those domains meet clinical content. Expect lines that describe behaviours, such as communication, record keeping and acting on safety concerns, as well as lines that describe clinical knowledge. Treat both as examinable.

What the 90 sample questions show

We read the sample paper to see its topic mix. It is a subset, so the proportions are indicative only. In broad terms it contains:

• Gastroenterology and hepatology, including coeliac disease, H. pylori, inflammatory bowel disease, obstructive jaundice and dysphagia.
• Toxicology, including paracetamol and lithium.
• Psychiatry and addiction, including alcohol withdrawal, self-harm, antidepressant-induced mania and perinatal depression.
• Paediatrics, including vomiting in infancy, failure to thrive, milestones, haemolytic uraemic syndrome and asthma.
• Obstetrics and gynaecology, including abruption, eclampsia, amenorrhoea, polycystic ovary syndrome, and cervical screening with HPV.
• Surgery and urology, dermatology (impetigo, scabies, eczema herpeticum, melanoma) and ophthalmology.
• Interpretation of ECG and chest X-ray, and pharmacology such as warfarin interactions and ACE inhibitor monitoring.
• About ten items on ethics and professionalism: capacity, confidentiality and photography, social media boundaries, colleague conduct, restricting liberty and best interests.

Two observations follow. The paper is broad general medicine, not a specialist exam: no area is deep, and many areas are present. And the ethics strand is large and distinctive. One item in nine is a high share for judgement questions that do not depend on drug names or investigation results, which is why we treat professionalism as a strand and not a footnote.

How we turned this into the domain weights

Because the Blueprint weights were unreadable, we built ten domains from three inputs: the five subject areas the Council names (obstetrics and gynaecology, paediatrics, psychiatry, surgery, and medicine including general practice), the Eight Domains, and the sample paper's mix. Medicine is split across several domains because it is the largest area, so no single medicine domain looks large on its own. The weights are shown on the hub, labelled as editorial estimates.

If you can read the Blueprint spreadsheet and it contradicts our estimates, trust the Blueprint. We would rather be corrected by the source than defend a guess.

Using the sample questions well

The sample paper is most useful when used twice, at the start and near the end.

1. Early, untimed. Work through a block of 30 questions with no clock. For each, write your answer before looking at the options, then check. Note the question type: next step, diagnosis, drug choice or ethical response.
2. Classify your misses. Sort wrong answers into knowledge gap, misread question or local-practice error. The proportions tell you which kind of preparation you need.
3. Find the style. Note how stems are built: what information is included, how long they run and how options are phrased. Use that to read your own practice questions more accurately.
4. Late, timed. Return to a block under time, near the end of your preparation, as one check among others. Do not treat a good score on 90 published items as evidence of readiness, because you may remember answers.

Building your own topic grid from the Blueprint

A topic grid turns a long document into a working tool. Make a table with one row per Blueprint line and five columns: topic, domain (using our ten), confidence, last reviewed and number of questions done. Fill in confidence honestly on day one. Each week, sort by lowest confidence and oldest review date, and take your next study session from the top of the list. When a topic reaches green and stays green across two timed blocks, tick it off. At the end of eight to twelve weeks you will have a record of exactly what you covered, which is more useful than a feeling that you have covered everything.

Add a column for Irish context. Next to each topic, note whether there is a local guideline, a local programme or a local law. That column feeds the Irish guidelines week and stops you answering with a home-country reflex.

Reading questions the Council's way

The Council describes each item as a short scenario followed by a question with options to choose from. Study how that is done in the sample paper. Notice which details the scenario includes and which it leaves out. Notice whether the question asks for a diagnosis, an investigation, a treatment or a professional response, and notice how often the correct option is the safe, proportionate one rather than the dramatic one. These are habits of the paper, and you can learn them from ninety items. They will also help you spot weak practice questions elsewhere, such as stems that give away the answer or options that are obviously wrong.

If you find the Blueprint hard to read

A spreadsheet can be awkward on a phone or in some programs. Download it to a computer, open it in a spreadsheet application, and widen the columns. If the content still does not open, write to the Council and ask for another format. Do not rely on a third party's summary of the Blueprint unless it quotes the Council and gives the version date. Until you have read it yourself, treat every summary, including ours, as a guide to be checked.

What not to do with them

• Do not memorise the answers. The live exam is not the sample paper.
• Do not infer scoring. The sample paper tells you the format of an answer, not how the paper is marked.
• Do not infer weights from counts. A subset of 90 is not the exam. A topic being absent from the sample does not make it absent from the live paper.
• Do not trade for recalls. Candidate-recalled questions are different from the Council's published sample. Copying or removing questions is misconduct under the Handbook.

Free practice and the sample bank

MedPass Exams writes its own original questions from guidance, with Irish settings, so you can practise the same types of decision without using recalls. The free sample questions on the hub show the style. We do not copy the Council's 90 questions, and we do not claim that our questions are the exam's. They are practice, written to be similar in difficulty and type.

A one-page checklist

Before you book, check that you have: downloaded the Blueprint and written the version date on it; worked one untimed block of the sample paper; made a red, amber and green topic list; read the high-yield topics and compared them with your list; and chosen a plan from the study plan guide. That is an afternoon's work and it makes every later week more efficient.

Summary

Use the Blueprint to decide what to study, the sample paper to learn how the Council asks, and original practice questions to build speed. Keep the Council's documents as your reference, label every estimate as an estimate, and never treat a subset of ninety questions as a map of the whole exam.