The practical assessment of clinical skills exam (PACES) is a crucial step in the journey of becoming a healthcare professional. These exams not only test the knowledge and skills of the candidates but also prepare them for the practical challenges they will face in their future careers. The frames the PACES exam as a critical hurdle that candidates should pursue to endeavor their medical career and healthcare credentials. As a result, passing the clinical exam can be a daunting task, requiring candidates to demonstrate their expertise in clinical decision-making and patient communication. To pass this exam, candidates must not only have a strong theoretical foundation but also be able to apply their knowledge to real-world scenarios. The Last Second MRCP PACES sixth edition, is designed to help candidates prepare for their clinical exam by providing a comprehensive guide to the key concepts and skills required to succeed. It covers a range of clinical scenarios, from basic assessments to complex diagnoses, and provides practical tips and strategies for managing patient interactions. Our aim is to equip candidates with the knowledge and confidence they need to tackle any clinical challenge that comes their way. This book is written by experienced healthcare professionals who have been through the clinical exam process themselves and understand the difficulties and uncertainties that candidates face. For convenience we have split the book into two We hope that this book will serve as a valuable resource for candidates preparing for their PACES exam and help them achieve their goals of becoming competent and compassionate healthcare professionals.