5. The registration assessment

5.1  The registration assessment explained

The registration assessment is one of the ways we test whether you can demonstrate that you understand how to apply knowledge appropriately and in a timely way, to make professional judgements in pharmacy practice. It also tests your number sense and that you are able to perform the calculations needed to practise as a pharmacist.

The assessment makes sure that all trainees have reached the same minimum standard of ability, no matter where they have trained in Great Britain. Passing the assessment is part of the overall criteria for registration as a pharmacist.

The registration assessment regulations set out key information and rules that cover the assessment. They are updated every year and issued before the first sitting of the year.

The registration assessment specification sets out how the assessment will be run and will help you decide if you need to request a reasonable adjustment.

The registration assessment framework sets out the outcomes that will be tested and gives an idea of some of the topics this may cover.

The registration assessment is set and moderated by an independent board of assessors.

5.2  Qualifying for the registration assessment

You can only be considered for entry to the registration assessment once you have achieved a week-39 progress report that is marked as satisfactory. If you are marked as unsatisfactory at the week-39 point, you may need to take the assessment at a later date. You should develop an action plan – including SMART objectives – to help you deal with your shortfalls against the performance standards.

You will be judged against the same principles in your week-39 review as in the previous reviews. This judgement will be based on the quality of your evidence and performance, and must not be made more lenient so that you can enter the registration assessment.

You will need to submit an application form to sit the assessment through your myGPhC account by the deadline given and show that you meet the eligibility criteria to sit the assessment.

Visit the main GPhC website to find out about applying for the registration assessment, including the full eligibility criteria.

5.3 Structure of the registration assessment

The topics covered by the assessment are set out in the registration assessment framework.

The standard a pre-registration trainee must achieve to pass the registration assessment remains the same across each sitting. The pass mark for each paper varies from sitting to sitting depending on the combined difficulty of the questions.This is to make sure that the assessment is fair and that the standard is maintained. Candidates must achieve the pass mark or above for each paper in order to demonstrate that they have achieved the required standard for safe and effective practice.

The pass mark for the assessment is arrived at using evidence-based standard setting processes - recognised methods used by examination bodies to derive pass marks for papers in order to apply a set standard across sittings. When preparing assessment papers, a standard-setting panel of pharmacists assesses the standard of each question in each of the papers. The standard setting panel reviews each question in relation to difficulty and this process produces a provisional pass mark for each paper.

Before agreeing pass marks for each paper, the Board of Assessors undertakes a full review of the performance of the questions, and the papers as a whole. This includes statistical analysis of the relative level of difficulty.

Reference sources

You won’t need to bring reference sources to the assessment. You will use only the reference sources provided.

Examples of possible reference sources include:

  • extracts from a British National Formulary (BNF)
  • a Summary of Product Characteristics (SPC)
  • diagrams and photographs
  • a medication chart

Part one paper

Part one of the assessment is amde up of 40 calculation questions. You will have two hours to complete these, and you will be able to use a calculator.

An example of a calculation question is below:

Example of a calculation question. A 6-year-old is taking Gaviscon Original Aniseed Relief suspension 10 ml. four times a day. Gaviscon Original Aniseed Relief suspension contains 3.1. mmol Na */5 mL. The recommended daily allowance (RDA) of salt for a 6 year-old child is 3 g (equivalent to 1.2 g sodium) per day. The relative atomic mass of sodium is 23. What percentage of this child's recommended daily salt allowance is contained in the total daily dose of Gaviscon Original Aniseed Relief suspension? Give your answer to the nearest whole number. (percentage)

Part two paper

Part two of the assessment is made up of 120 questions: 90 'single-best-answer' questions, and 30 'extended-matching' questions. You will have 2.5 hours to complete these, and you will not be able to use a calculator. 

Single best answer questions

Here is an example of a single best answer (SBA) question:

 Aspirin 75mg once daily. Atorvastatin 40 mg once daily. Ramipril 10 mg once daily. Co-codamol 30/500 mg - 2 tables up to 4 times a day as required. No known drug allergies. Which of the following is the most suitable drug treatment for his current condition? Allopurinol. Colchicine. Diclofenac sodium. Etoricoxib. Febuxostat

An SBA question has three parts: a scenario, a question and five answer options.

For this type of question, select the single best answer from the five options. Each question has one best answer, but there may be other answers that are plausible but are not the best answer – these are, therefore, incorrect.

Extended matching questions

Here is an example of an extended matching question (EMQ):

 Theme - Drug interactions. The next 4 questions are based on the same list of options, but different scenarios. Each option may be used once, more than once, or not at all. A 49-year-old woman has bipolar disorder and has taken lithium carbonate 800mg (Camcolit) daily for five years. She has been newly prescribed ramipril 2.5 mg daily for hypertension. Select the most likely possible consequence of the drug interaction from the list. Bleeding risk increased. bradycardia. diarrhea. hypertensive crisis. myopathy. QT interval prolongation. reduced eGFR. thrombosis

An EMQ has four parts: a theme, a list of answer options, an instruction and a number of scenarios.

For this type of question, choose the best option from the list provided. Each option may be used once, more than once or not at all.

Registration assessment preparation

5.4  Preparing for the registration assessment

After each assessment sitting, the board of assessors - who are responsible for setting and assuring the registration assessment - produce feedback about the topics that candidates found difficult. Use the latest feedback documents below to help you prepare for your attempt:

The registration assessment framework  [PDF 209.46 KB] sets out the outcomes that will be tested and gives an idea of some of the topics this may cover.

Sometimes there are changes in practice close to the assessment day. You should answer any questions in the assessment as you would in practice on that day. If there has been a change in practice that affects a question after it has been written, this will be considered by the Board of Assessors after the sitting.

Make sure that if you attend any study days, or use any study materials, that they are up to date.

5.5  Requesting a reasonable adjustment for the registration assessment

If you have a specific need which you feel could disadvantage you when sitting the registration assessment, you can request a ‘reasonable adjustment’ to the assessment conditions. The specific need can be a temporary or permanent one.

You can find out more about requesting an adjustment on the registration assessment application page of the main website.

When you request an adjustment, you must tell us:

  • the nature of your specific need
  • how this specific need would affect your ability to sit the assessment
  • what reasonable adjustment you are requesting and how it will support you during the assessment

You also need to include evidence to support your request. This evidence must be from a doctor or another appropriately qualified person, and must give details of how your specific need would affect you during the assessment. The person providing supporting evidence will need to have read and understood the assessment specification.

It is important that the evidence relates directly to the reasonable adjustment you are requesting.

Your request will be considered by the GPhC’s adjustment panel. This is an independent panel made up of an educational disability specialist and two members of the GPhC board of assessors (which sets and moderates the registration assessment).

If your request for an adjustment is not granted you have the right to appeal the decision. You must do this by the deadline given for the sitting. 

5.6  Making a decision to sit the registration assessment

Am I ‘fit to sit’?

It is very important that you only sit the registration assessment if you are fit to do so. Being ‘fit to sit’ means that you do not know of any reason why your performance would be adversely affected on the day of the assessment.

If you are aware of anything that might affect your performance on the day, you should not sit the assessment – even if it is a difficult decision to make.

You are eligible to withdraw from a sitting at any time up until the assessment begins. Once you have decided to withdraw, you will not be able to attempt the assessment. The final point at which you are able to withdraw from the sitting will be made clear to you. By continuing with the sitting after this point, you have declared yourself 'fit to sit'. This means that we will not consider as grounds for an appeal any reason that was known to you before your decision to sit the assessment.

You can find more information about deciding if you are fit to sit in the registration assessment application section of the main website.

5.7 Nullification requests

If you start the assessment and then have problems during the sitting which significantly affect your performance, you can request that your attempt is ‘nullified’ under the registration assessment regulations that apply to the sitting. You must let an invigilator know as soon as possible if you have problems during the sitting. They will fill in a report form to verify your problem. It is very important that you do not wait until receiving a 'fail' notification before contacting us to tell us anything that has affected your performance.

If your attempt is nullified, it will not count towards the three attempts you can have to pass the assessment, and you will not find out your result.

The decision to grant the nullification will be made by the board of assessors based on your request, and is not guaranteed to be accepted. They will not know what your marks were.

You cannot request a nullification after you have received your results.

If you decide to sit the assessment again, you must apply as normal and you will need to pay another entry fee.

You can find more information about nullification requests in the registration assessment section of the main website.

Registration assessment framework


5.8  Registration assessment framework

The registration assessment framework explains what we are testing in the registration assessment. You can download a PDF copy of the framework here.

The registration assessment tests some, but not all, of the learning outcomes set out in Future pharmacists: standards for initial education and training of pharmacists. The other outcomes will be tested as part of your MPharm degree and pre-registration training placement - some may be tested in more than one way.

In the framework, each of the learning outcomes tested by the registration assessment has been linked to ‘indicative assessment topics’. This will help you better understand how learning outcomes are applied.

The assessment topics give an idea of what will be tested – there will be other topics included in an assessment paper. Pharmacy is a very broad subject, so it is not realistic to provide a framework that covers every topic in detail.

You can find out more about the framework in our YouTube video presentation.

To help you understand the relative importance of each outcome to the registration assessment, we have given them a weighting of high, medium or low:

Outcome weightings

Proportion of questions  


high weighting

 60% to 70%  

medium weighting

25% to 35%

low weighting

up to 10%


5.9 Registration assessment outcomes

10.1     Expectations of a pharmacy professional

Future pharmacists outcome

Indicative assessment topics


Recognise the duty to take action if a colleague’s health, performance or conduct is putting patients or the public at risk

  • Regulatory standards and guidance documents
  • Action to take if a colleague’s conduct has the potential to affect patient or public health


Apply the principles of clinical governance in practice

  • Purpose and principles of clinical governance
  • Risk management in pharmacy and other healthcare contexts
  • Systems to reduce medication errors


Demonstrate how the science of pharmacy is applied in designing and developing medicines and devices

  • Factors affecting the stability of medicinal products
  • Procedures for the dilution of solid, semi-solid and liquid dosage forms


Respond appropriately to medical emergencies, including providing first aid

  • Appropriate responses to medical emergencies



The skills required in practice


Implementing health policy

Future pharmacists outcome

Indicative assessment topics


Access and critically evaluate evidence to support the safe, rational and cost-effective use of medicines

  • Principles of obtaining and applying evidence for use in current practice
  • Interpreting and applying information to improve patient care


Apply knowledge of current pharmacy-related policy to improve health outcomes

  • Principles of promoting healthy lifestyles including current pharmacy-related policy
  • Collaboration across the healthcare professions to improve patient outcomes
  • Purpose of prescribing guidelines



Validating therapeutic approaches and supplying prescribed and over-the-counter medicines

Future pharmacists outcome

Indicative assessment topics


Identify and employ the appropriate diagnostic or physiological testing techniques in order to promote health

  • Selecting appropriate diagnostic or physiological testing techniques for use in clinical decision-making and to promote health
  • Normal ranges for test results, and actions to take when results are out of the normal range


Identify inappropriate health behaviours and recommend suitable approaches to interventions

  • Concepts of health promotion, health education and health improvement programmes, based on national and local health priorities and parameters
  • Role of pharmacists and pharmacy support staff in promoting health and preventing disease
  • Behavioural change as a tool to support health promotion
  • Social, environmental and dietary factors that influence health


Instruct patients in the safe and effective use of their medicines and devices

  • Identifying appropriate advice on the use of medicines


Analyse prescriptions for validity and clarity

  • Legal and professional requirements for prescriptions, to enable the safe and legal supply of medicines


Clinically evaluate the appropriateness of prescribed medicines

  • Appropriateness of prescribed medicines, for example in the context of presenting conditions, associated diseases, and test results
  • Circumstances in which prescribed medicines are contra-indicated
  • Interactions that occur between medicines (either prescribed or purchased), and between these medicines and food or other substances
  • Use of licensed, off-label and unlicensed medicines including providing information to patients


Provide, monitor and modify prescribed treatment to maximise health outcomes

  • Principles of medicines management, medicines optimisation and pharmaceutical care
  • Dosages and dose adjustments, especially for people with particular needs due to, for example, age or health conditions
  • Reasons for treatment failures
  • Recognising and managing adverse effects of medicines
  • Mechanism of action, administration, absorption, distribution, metabolism and excretion of medicines


Record, maintain and store patient data

  • Maintaining confidentiality, and disclosing information both with and without the subject’s consent
  • Information governance
  • Requirements for recording, maintaining and storing data


Supply medicines safely and efficiently, consistently within legal requirements and best professional practice. NB: This should be demonstrated for both human and veterinary medicines

  • Statutory regulations and professional requirements for the supply of human and veterinary medicines



Ensuring that safe and effective systems are in place to manage the risk inherent in the practice of pharmacy and the delivery of pharmaceutical services

Future pharmacists outcome

Indicative assessment topics


Ensure the quality of ingredients to produce medicines and products

  • Quality assurance processes for medicines and ingredients
  • Storage requirements for medicines and ingredients


Apply pharmaceutical principles to the formulation, preparation and packaging of products

  • Formulation, preparation and packaging of products


(Part 1)

Use pharmaceutical calculations to verify the safety of doses and administration rates

  • Accurately perform calculations affecting patient care


Procure and store medicines and other pharmaceutical products working within a quality assurance framework

  • Procurement and storage of medicines
  • Additional precautions necessary for particular formulations


Dispose of medicines safely, legally and effectively

  • Statutory regulations covering the safe, legal and effective disposal of medicines
  • Procedures for the disposal of special and controlled waste from the pharmacy


Identify, report and prevent errors and unsafe practice

  • Supervising others involved in service delivery
  • Identifying, reporting and preventing errors and unsafe practices
  • Responding to complaints and concerns



Working with patients and the public

Future pharmacists outcome

Indicative assessment topics


Identify and employ the appropriate diagnostic or physiological testing techniques to use in clinical decision-making

  • Identifying appropriate diagnostic or physiological testing techniques, and interpreting results
  • Identifying conditions that need referring to another healthcare professional
  • Identifying conditions that may be treated by non-prescription medicines



Maintaining and improving professional performance

Future pharmacists outcome

Indicative assessment topics


Demonstrate the characteristics of a prospective professional pharmacist as set out in relevant codes of conduct and behaviour

  • Characteristics and expected behaviours of a pharmacist as set out in the relevant standards and guidance
  • Principles and application of the professional duty of candour


Participate in audit and in implementing recommendations

  • Purpose of audit and principles of audit procedures
  • Principles of change management


Contribute to the development and support of individuals and teams

  • Principles of identifying, and responding to, the learning and development needs of professional team members
  • Principles of revalidation and regulatory requirements

Therapeutic areas

Questions in part two that relate to clinical care are linked to key therapeutic areas. An individual question may link to multiple therapeutic areas: for example, a patient may be described who has hypertension and type 2 diabetes. The weighting given to individual therapeutic areas is shown in the table below.

Therapeutic area


Cardiovascular system


Nervous system


Endocrine system




Genito-urinary tract system


Gastro-intestinal system


Respiratory system


Immune system and malignant disease


Blood and nutrition


Musculoskeletal system




Ear, nose, and oropharynx









High-risk drugs

Each assessment is likely to include at least one question on each of the following drugs or drug groups:

  • antibiotics
  • anticoagulants
  • antihypertensives
  • chemotherapy
  • insulins
  • antidiabetic drugs
  • drugs with a narrow therapeutic index
  • non-steroidal anti-inflammatory drugs
  • methotrexate
  • opiates
  • parenteral drugs
  • valproate


Around 20 per cent of questions in the assessment will relate to paediatric patients.


Each assessment is likely to include at least one calculation question involving each of the following in part 1:

  • doses and dose regimens
  • dosage and unit conversions
  • estimations of kidney function
  • displacement volumes and values
  • concentrations (e.g. expressed as w/v, % or 1 in x)
  • dilutions
  • molecular weight
  • using provided formulae
  • infusion rates
  • pharmacokinetics
  • health economics
  • quantities to supply

Some questions in part 2 will require some calculation.

Additional resources
Additional resources are provided for up to 25% of questions in part 1 and part 2 of the registration assessment. Examples of additional resources include photographs and dosing information.