<p>Barriers to success in MRCPsych written examinations remain an important concern in postgraduate psychiatric training. This qualitative study explored trainees’ perspectives on factors influencing preparation for MRCPsych Papers A and B, with attention to differential attainment including international medical graduates (IMGs). Thirty-eight trainees participated in three online focus groups (<i>n</i> = 36) and two one-to-one semi structured interviews (<i>n</i> = 2) conducted via Microsoft Teams and transcribed verbatim. Data were analysed using Braun and Clarke’s reflexive thematic analysis. Four themes were identified: (1) structural pressures that constrain exam preparation, including workload and limited protected study time; (2) a misaligned and disconnected learning system, where teaching was perceived as insufficiently aligned with exam demands; (3) disruption, isolation, and reduced motivation, particularly in the context of the COVID-19 pandemic; and (4) the need for relational and tailored support, including mentorship and clearer guidance. Findings suggest that improved alignment between teaching and assessment, structured guidance, and supportive learning environments may enhance trainee experience and progression. Key perceived barriers included limited protected study time, work pressures, financial costs, variable relevance of local teaching to exam format, and reduced motivation/social connection during COVID-19 remote working. Participants recommended additional early support for trainees who perceive increased barriers to preparation, including some IMGs, to promote equitable progression.</p>