GPhC Part 2: How Single Best Answer and Extended Matching Questions Work

Part 2 of the GPhC registration assessment is 120 questions in 2½ hours on the safe and effective pharmacy care of the public. Every question is multiple choice, in one of two formats: single best answer (SBA) and extended matching (EMQ). Both test the same skill, reading a scenario closely and choosing the best of several plausible answers, but they are built differently and paced differently.

This guide covers how each format works, the timings the GPhC suggests, what a question gives you and what it does not, and how to read a stem. It ends with a worked example of each format, reproduced word for word from our free question bank.

Part 2 at a glance

	Section 1	Section 2
Format	Single best answer	Extended matching
Questions	90	30, in 15 sets of two
Options	Five per question	Eight per set, shared by both questions
Answer	One best option	One most appropriate option per question
Suggested time	About 1 minute each	About 2 minutes each

A few rules apply to both sections:

• One mark for each correct answer, and nothing taken off for a wrong or blank one. Answer every question.
• The order is randomised within each section, but the two questions of an EMQ set always appear together.
• You can move freely between the sections, go back to earlier questions, and flag any question to return to.
• Part 2 is passed on its own. You need the pass mark in Part 1 and in Part 2 at the same sitting, and there is no fixed pass mark. We explain why in how the GPhC assessment is marked.

How a single best answer question works

The framework describes an SBA as a stem, such as a scenario with a clinical case, then a focused lead-in question, then five options. There is one best answer and four plausible alternatives, and the framework is specific about the alternatives: they are closely related to the preferred option but less correct.

So in a well-written SBA, more than one option can be defended on its own. What is tested is choosing the best one for this patient, in this setting, given everything the stem tells you.

Lead-ins are short and specific. The framework's examples include:

• Which is the most likely diagnosis?
• Which is the most appropriate management?
• Which is the most appropriate first-line antihypertensive drug treatment for this patient?
• Which is the most appropriate advice to communicate to the GP?

How an extended matching question works

An EMQ has four parts: a theme, a stem, an instruction and a list of options. The theme is the topic the options cover. One of the GPhC's own example sets is themed "Electrolyte imbalance", and its eight options are eight electrolyte disturbances.

Section 2 is 15 sets of two questions. Both questions in a set share the theme and the same eight options, and each has one most appropriate answer and seven alternatives. On screen, each question has its own page: the theme as a heading, then the scenario, the instruction and the eight options.

The instruction takes the place of the SBA's lead-in question and is written as a command. The framework's examples are Select the most appropriate management and Select the most appropriate counselling point.

One rule is easy to miss, because the GPhC states it once, on the introduction screen, rather than in each set: within a set, each option may be used once, more than once, or not at all. So answer each question on its own merits. An option you chose for the first question is still open for the second, and the two answers can be the same.

Because all eight options come from the theme, most of them will be right for somebody. The scenario decides which one is right for this person.

One discrepancy to know about: the framework says EMQs come in sets of "two to three questions". The regulations and the specification for 2026, both published after it, say 15 sets of two, and the GPhC's own example questions are pairs. Expect pairs.

Pacing: a minute per SBA, two per EMQ

The framework gives approximate time guidance for Part 2: 1 minute per single best answer question and 2 minutes per extended matching question. Add it up and it fills the allowance exactly:

Section	Questions	Suggested time	Total
Section 1: single best answer	90	1 minute each	90 minutes
Section 2: extended matching	30 (15 sets of two)	2 minutes each	60 minutes
Part 2	120		150 minutes

So the guidance leaves no spare time at all. Any time you want at the end for flagged questions has to be banked earlier, by moving faster through the questions you can answer quickly. Some checkpoints, if you work through in order:

• After 45 minutes, about halfway through Section 1, at around question 45.
• After 90 minutes, starting Section 2. If you want ten minutes at the end to revisit flagged questions, aim to get there by about 80.
• Each EMQ set gets about 4 minutes. Read the theme and the eight options once: they serve both questions.

The guidance is an average. A question you know cold takes seconds; one with an SmPC extract to search can take two minutes or more. What matters is the running total.

The assessment helps with the clock. A timer is on screen throughout, and a message appears 30, 15 and 5 minutes before the end of the part. When time runs out you cannot submit or change any more answers. You can use pen and paper for rough working, but the GPhC warns against leaving answers on paper to transfer at the end, because no extra time is given.

What the question gives you, and what it does not

You cannot bring any reference sources into the assessment: the regulations allow only the resources the GPhC provides during the sitting. Instead, a question that needs a reference supplies one. The framework's list of resources that may appear, which it says is not complete:

• a controlled drug or prescription-only medicine register
• a dispensing label
• extracts from the BNF and BNF for Children
• a medication administration record (MAR) chart
• a national or local guideline
• a prescription
• a summary of product characteristics (SmPC)
• a treatment algorithm

A supplied resource opens from a View resource button, in a PDF viewer that docks beside the question. You can zoom, search the document for a word, and open it as many times as you like.

Two things are not supplied, and both catch people out:

• Common guidelines. The framework expects you to have a working knowledge of them.
• Normal ranges for everyday physiological measurements, such as blood pressure and heart rate. Normal reference ranges for laboratory results are given; the physiological ones you are expected to know.

The list of abbreviations and acronyms the assessment uses, from Appendix A of the framework, can be opened from the introduction screen at any time. In Part 2 the on-screen calculator appears only on questions that need a calculation, and you can use your own approved calculator instead. The on-screen highlighter is useful but does not last: highlighting is lost when you move to another question, even if you come back to it.

The framework's advice on resources is to be familiar with the structure of those used often in practice, so that you can find information easily. In revision, that means knowing where the dose, cautions, interactions and advice in renal impairment sit in a BNF monograph, and how an SmPC is laid out, so that an extract on screen looks familiar. In the assessment, read the lead-in before you open a resource, so you know what you are looking for.

How to read a stem

The framework says the assessment puts applying knowledge to realistic scenarios ahead of factual recall, and most of Part 2 is clinical knowledge applied to patient scenarios, with the rest on law, governance and regulation. So the stem is where marks are won and lost. A method that works for both formats:

1. Read the lead-in first. It tells you what kind of answer you need: a diagnosis, a management step, a piece of advice, a person to contact. Then note its qualifiers. Most appropriate means more than one option may be reasonable and you want the best. Most likely asks for probability, not certainty. First-line or initial rules out what comes later. For this patient means the patient's details decide it.
2. Read the stem for the facts that change the answer. Age, weight, pregnancy or breastfeeding, kidney or liver function, other medicines, how long the problem has lasted, what has already been tried, and where you are. A stated absence matters as much as a presence: "no vomiting", "no blood in his stools" and "takes no other medicines" are usually there to rule something out.
3. Answer before you look at the options, if you can. With four alternatives written to sit close to the best one, reading the options first lets them steer you.
4. Eliminate, then compare. Strike out what is wrong for this patient. Then test what is left against every fact in the stem, not only the one that caught your eye. Watch for an option that would be right for a slightly different patient, or that was right under older guidance.
5. Answer as a pharmacist. The GPhC's instructions ask you to answer every question as though you are a pharmacist: choose what you would actually do in that setting, with what is in front of you. Questions avoid content that varies between the four UK nations, so the answer will not depend on one nation's local services.
6. Flag and move on. If you are still between two options when your minute is up, pick the better one, flag the question and go. An answered, flagged question can still score; a blank one cannot. Near the end, the review screen filters to flagged or unattempted questions. Because highlighting does not survive leaving a question, the GPhC suggests noting which questions you want to go back to as you go: jot the question number and the two options you were torn between.

Worked example 1: a single best answer question

Both examples come from our free question bank, the questions we write only to give away, so neither appears on our mock papers. Each was approved by two of our pharmacist reviewers, and both are reproduced word for word. Try each one before reading on.

A 23-year-old woman takes Microgynon 30 (ethinylestradiol 30 micrograms with levonorgestrel 150 micrograms) for contraception, one tablet daily for 21 days followed by a 7-day pill-free break. She is on day 18 of her current pack and has taken every tablet on time.

Her GP has prescribed amoxicillin 500 mg three times daily for 5 days for a chest infection. She has no vomiting or diarrhoea and takes no other medicines.

Which of the following is the most appropriate advice about her contraception?

• A Continue as usual, with no extra precautions
• B Continue, but omit the next 7-day pill-free break
• C Use condoms during the course and for 2 days after
• D Use condoms during the course and for 7 days after
• E Use condoms until 28 days after the course ends

Reading it

• The lead-in asks for advice about her contraception: not how to treat the chest infection, and not whether amoxicillin is the right choice. "Most appropriate" warns you that several options will look reasonable.
• The antibacterial is amoxicillin. Whether it induces liver enzymes is the fact the question turns on.
• "Has taken every tablet on time" removes any missed-pill problem.
• "No vomiting or diarrhoea" is the exception the guidance makes, and the stem rules it out.
• Day 18 plus a 5-day course runs past day 21, into her pill-free break. That detail is what makes option B tempting.
• "Takes no other medicines" means there is no second medicine to change the picture.

Then eliminate. Option E is the rule for short courses of enzyme inducers, and amoxicillin is not one. Option C is a progestogen-only pill rule, and she takes a combined pill. Options B and D are older advice for antibacterials like amoxicillin that current guidance no longer gives. That leaves A.

The answer: A

Our approved explanation:

The correct answer is A. Amoxicillin does not induce liver enzymes. The old concern that such antibacterials reduce the effect of combined oral contraceptives, by disturbing the gut bacteria that recycle ethinylestradiol, is not supported by evidence. The BNF, following College of Sexual and Reproductive Healthcare guidance, says no additional contraceptive precautions are needed with antibacterials that do not induce liver enzymes, unless vomiting or diarrhoea occur. She has neither, so she continues Microgynon 30 as normal, including her usual pill-free break.

• Omit the next pill-free break: the old advice for a course that runs into the break. It no longer applies to non-enzyme-inducing antibacterials.
• Condoms for 2 days after: the missed-pill rule for a progestogen-only pill.
• Condoms for 7 days after: the old advice for non-enzyme-inducing antibacterials.
• Condoms until 28 days after: the rule for short courses of enzyme inducers, such as some anticonvulsants.

Key point: no extra contraception is needed with antibacterials that do not induce liver enzymes, unless she has vomiting or diarrhoea.

What to take from it

Each of the four wrong options is the right answer to a different question: a different pill, a different kind of drug, or older advice. That is what the framework means by alternatives closely related to the preferred option but less correct, and it is why reading the stem for every fact matters more than recognising the topic.

Both themes are worth the practice. Among the areas where performance at the June 2026 sitting suggested further development was needed, the GPhC's key insights from that sitting name identifying clinically significant interactions and advising on the suitability of different methods of contraception.

Worked example 2: an extended matching pair

Theme: Responding to gastro-intestinal symptoms

The eight options, shared by both questions:

• A Hyoscine butylbromide 10mg tablets
• B Loperamide 2mg capsules
• C Mebendazole 100mg chewable tablet
• D Omeprazole 20mg gastro-resistant tablets
• E Oral rehydration salts
• F Refer to the GP urgently
• G Senna 7.5mg tablets
• H Sodium alginate and antacid liquid

Question 1

A mother asks for something to stop her 3-year-old son's diarrhoea. He has had four watery stools in the last 24 hours and vomited once this morning. She has been giving him extra drinks, which he keeps down. There is no blood in his stools.

He is alert and playful, is drinking, and has passed urine normally today. He has no medical problems and takes no medicines.

Select the most appropriate response.

Question 2

A 63-year-old man asks to buy something stronger for indigestion. For 5 weeks he has had heartburn after meals, and for the last 2 weeks food has felt as though it sticks behind his breastbone when he swallows.

Sodium alginate and antacid liquid has eased the burning a little. He takes no regular medicines.

Select the most appropriate response.

In the assessment, each of these would sit on its own page, under the theme, with all eight options below it.

Reading the set

Read the theme and the eight options once, before either scenario. Seven options are medicines and one, F, is a referral. A theme like this asks two things of every scenario, in order: does this person need referring, and if not, what is the safest choice for them?

Question 1. The mother asks for something to stop the diarrhoea, which points at loperamide (B). But the instruction asks for the most appropriate response, not for what she asked. Then the details: he is 3 years old; he keeps his drinks down, is alert and playful, and has passed urine normally; there is no blood in his stools. Together they say he can be looked after at home, so referral (F) is not needed, and his age rules out loperamide. The answer is E.

Question 2. Another request, this time for "something stronger", which points at omeprazole (D). The detail that changes everything is the second half of the first paragraph: for the last 2 weeks, food has felt as though it sticks when he swallows. That is dysphagia, an alarm feature. Stop reading at "heartburn after meals" and you choose D. The answer is F.

The two answers here differ, E and F, but they did not have to: within a set, each option may be used once, more than once, or not at all.

The answers: E, then F

Our approved explanations:

Question 1. The correct answer is E, oral rehydration salts. He has no signs of dehydration, no red flags and no risk factors for dehydration, so he can be cared for at home with plenty of fluids. Oral rehydration salts replace the fluid and electrolytes lost in diarrhoea; the BNFC dose for a child aged 1 to 11 years is 200 mL after every loose motion. Loperamide (B) is the closest wrong answer: CKS advises that antidiarrhoeal drugs are not recommended for children with gastroenteritis, the BNF gives no dose under 4 years, and it may be sold only for people over 12. Referral (F) is not needed while he is alert, drinking and passing urine normally.

Question 2. The correct answer is F, refer to the GP urgently. Food sticking on swallowing is dysphagia, an alarm feature. NICE NG12 recommends referral on a suspected cancer pathway for anyone with dysphagia, at any age, to assess for oesophageal or stomach cancer. Selling a stronger product would delay that assessment. Omeprazole (D) would be reasonable for simple reflux symptoms without alarm features, but it could mask symptoms here. Continuing sodium alginate and antacid liquid (H) has the same problem, and it has not controlled his symptoms.

Responding to gastro-intestinal symptoms means first spotting who needs referral (dysphagia is always an alarm feature), then choosing the safest product for those who can self-care. For children with diarrhoea, that is oral rehydration rather than an antidiarrhoeal.

What to take from it

In both scenarios the person asks for something, and in both the request is not the answer. When a scenario opens with a request, treat it as context rather than as the question, read on to the facts, and check for referral before you choose a product.

Practise both formats under the clock

The pacing above becomes instinct only with practice at the real timings. Each of our GPhC mock papers has a full Part 2: 90 single best answer questions, then 15 extended matching pairs, against a 2½-hour countdown, with a flag on every question, a review list and supplied resources behind a View resource button. For untimed practice first, the free GPhC practice questions cover both parts, with no account needed.

For the rest of the assessment, see what changed in 2026, how to prepare for Part 1 calculations, the dates, format and what to bring and a week-by-week plan for the last three weeks.

From the GPhC's Common Registration Assessment framework, regulations and specification for sittings in 2026, its example questions guide and the introduction screen of its Part 2 example questions, its Sitting the November 2026 guide, and its key insights from the June 2026 sitting, read on 28 October 2026. The worked examples are from Dose Up's free question bank. Dose Up is independent and is not endorsed by the GPhC.