Here in Italy the first MOT exam is at four year, and every two years after that, but if a car is well kept I have never heard about it being refused...
Most Uk cars dont have an MOT till there 3 years old (however most manufactors off a ""Service"" which does things for you - usually to keep warrenty going)
After the 3 year period, your car has to have a MOT every-year
And its not about how its kept - it could be a big dint and no paint whatsoever
But if its structurly sound - Emmisions between certain range and other things dont have excess wear and tear then it gets a pass
Should 1 thing be wrong with it - like a tyres been illegal - u have to pay for a retest after you've sorted it