High-Yield Topics for the GPhC Registration Assessment, Ranked

How we ranked these topics

We used three inputs, all from GPhC documents. First, the framework statements about what each assessment is likely to include. Second, the weighting bands for learning outcomes and therapeutic areas. Third, the Part 1 topic list. We then added current UK rules that are easy to get wrong because they changed recently. The ranking is editorial. It is a revision priority, not a forecast of questions.

Tier 1: the twelve high-risk drug groups

The framework says each assessment is likely to include at least one question on each of these groups. Learn the safety rule for each, not just the indication.

Pair each group with a child's version. The BNFc gives different doses, bands and cautions, and children make up about one question in five.

Tier 2: the four high-weighted therapeutic areas

The framework puts cardiovascular, nervous system, endocrine and infection in the high band. Revise them first and in the most depth.

• Cardiovascular. Hypertension pathway and monitoring, heart failure therapy, atrial fibrillation and anticoagulation, antiplatelets after acute coronary syndrome or stroke, lipid management, nitrates and venous thromboembolism. See cardiovascular.
• Nervous system. Epilepsy and valproate, Parkinson's disease and time-critical doses, antidepressants and serotonin syndrome, antipsychotics, lithium, opioids and gabapentinoids, migraine, and substance misuse. See nervous system.
• Endocrine. Type 2 diabetes pathway, insulin regimens, diabetic ketoacidosis and sick-day rules, thyroid disease, corticosteroids and steroid cards, osteoporosis, contraception and menopause. See endocrine.
• Infection. Stewardship, penicillin allergy, urinary tract and respiratory infections, sepsis recognition, antibiotic interactions, the routine immunisation schedule and Pharmacy First pathways. See infection.

Tier 3: the calculation topics

The framework says each assessment will include at least one calculation on each of twelve topics. Part 1 is a separate pass requirement, so these belong in daily practice.

• Doses and dose regimens
• Dosage and unit conversions
• Estimation of kidney function
• Displacement volumes and displacement values
• Concentrations (percentage w/v, w/w, v/v and 1 in x)
• Dilutions
• Molecular weight and millimoles
• Using formulae provided in the question
• Infusion rates
• Pharmacokinetics
• Health economics
• Quantities to supply

The method for each is in the calculations paper guide and on the calculations domain page.

Tier 4: current UK rules with exact numbers

These are areas where a recent change, or a specific number, decides the answer. Learn them from primary sources and recheck before the exam.

Pharmacy First

Launched on 31 January 2024, with the Community Pharmacist Consultation Service running since October 2019. Seven clinical pathways, each with an age or sex eligibility: acute otitis media (1 to 17 years), impetigo (1 year and over), infected insect bites (1 year and over), shingles (18 years and over), sinusitis (12 years and over), sore throat (5 years and over) and uncomplicated urinary tract infection (women aged 16 to 64). Distance-selling pharmacies do not complete acute otitis media consultations.

Controlled drug prescriptions

Schedule 2, 3 and 4 prescriptions must be dispensed within 28 days of the appropriate date. Schedule 5 prescriptions are valid for 6 months. Schedule 2 and 3 prescriptions need the total quantity in words and figures, and the dose cannot be "as directed". Schedule 2 and 3 controlled drugs cannot be on repeat prescriptions. DHSC strongly recommends limiting Schedule 2, 3 and 4 supplies to up to 30 days of treatment.

Valproate

From January 2024, valproate must not be started in new patients younger than 55 years unless two specialists independently document that no other treatment is effective or tolerated, or that the reproductive risks do not apply. Girls and women who could become pregnant must be on a pregnancy prevention programme.

Immunisation schedule

The UKHSA schedule was revised from 1 January 2026, so older notes may be wrong. Note the infant schedule at 8, 12 and 16 weeks, the 18-month 6-in-1 and MMRV for children born on or after 1 July 2024, HPV at 12 to 13 years, and the older-adult programmes (flu, shingles, pneumococcal and RSV). Our UK law and guidelines guide sets out the detail we verified.

Emergency contraception

Know the three options and their windows: copper IUD within 5 days (120 hours), levonorgestrel within 3 days (72 hours) and ulipristal acetate within 5 days (120 hours). Dose adjustments for weight or enzyme inducers must come from the current BNF and FSRH guidance.

Tier 5: skills that cross every topic

• Renal and hepatic impairment. Know which commonly used drugs need adjustment or avoidance, and how to estimate kidney function.
• Pregnancy and breastfeeding. Safe and unsafe medicines, with the pregnancy prevention programmes.
• Interactions. Enzyme inducers and inhibitors, QT-prolonging drugs, serotonergic combinations and additive bleeding risk.
• Red flags and referral. Which symptoms in a minor-ailment request should end the consultation and send the patient on.
• Counselling. Inhalers, injectables, patches, eye drops and the specific points a patient must hear.
• Evidence. Reading a trial summary, number needed to treat, and what NICE evidence levels mean.

How high-risk knowledge gets tested

The framework tells you the drug groups, not the question styles. From the learning outcomes, three styles are likely, and each calls for a different kind of preparation.

• Spot the unsafe prescription. A prescription or a medication list contains an error: a daily dose for a weekly drug, a duplicated anticoagulant, a nephrotoxic drug in a patient with a low kidney function estimate. You need to know the usual dose pattern and the major cautions well enough to notice that something is off.
• Counsel the patient. A patient starts a medicine or a device, and the question asks what the key counselling point is. For high-risk drugs the key point is usually a safety one: missed doses, bleeding signs, sick-day rules, the weekly schedule, contraception.
• Choose the next action. A result, symptom or interaction appears, and you must decide whether to supply, refer, ask the prescriber or stop. The best answer protects the patient and stays within the pharmacist's role.

For each drug group, prepare one safety rule in each style. For methotrexate, for example, you should be able to recognise a daily prescription as an error, say what a patient must be told about dosing and symptoms of infection, and know when to contact the prescriber. That three-way preparation is more useful than a long monograph.

Paediatric content: one question in five

The framework says around 20% of questions relate to paediatric patients. That is about 32 items out of 160, spread across both parts and every topic. They are not a separate domain, so revise them inside each topic.

• Dosing. Weight-based and age-band doses from the BNFc, maximum daily doses, and the difference between a dose and a daily total.
• Formulations. Suspensions, sachets, dispersible tablets and what can be crushed or split.
• Safety. Medicines that should not be used in children or need specialist input, and the age cut-offs in Pharmacy First pathways.
• Prevention. The routine immunisation schedule from 8 weeks to adolescence.
• Calculations. Weight-based and body-surface-area problems, with a sense-check against the adult dose.

What we rank lower, and why

Low-weighted outcomes make up up to 10% of the paper, so an hour spent there returns less than an hour on a high-weighted topic. In the framework these include clinical governance, audit, patient data, procurement and storage of medicines, disposal, error reporting and prevention, and the characteristics of a prospective professional. They are low-weighted, not absent. A short, accurate summary of each is enough, and the law domain page covers the overlap with legal requirements.

The same logic applies within therapeutics. Musculoskeletal, eye, ear, nose and oropharynx, skin, vaccines and anaesthesia sit in the low band, but they feed medium and high items through interactions (for example NSAIDs with anticoagulants) and through the immunisation schedule. Learn the safety-relevant points and skip the rare details.

What to do with this list

Convert each tier into a checklist and tick items off only when you can answer a question on them under time. In the 16-week plan, that means Tier 2 in weeks 3 to 6. In the 8-week plan, it means starting with Tier 1 and Tier 4 because they are compact and high-yield. The study plan shows where each fits.

For the full blueprint, return to the GPhC registration assessment hub.