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Overview of MRCPCH

  • October 08, 2020

The Royal College of Paediatrics runs two exams. The first is The Membership of the Royal College of Paediatrics and Child Health (MRCPCH). This qualification allows doctors to enter into specialist training, and it is also GMC recognised, which means IMG’s who hold this qualification will satisfy the knowledge and skills element of registration.

The second exam offered by the Royal College is the Diploma of Child Health. The DCH is designed primarily for general practitioners but is also suitable for any doctor involved in looking after children – for example, child psychiatry, or ear, nose and throat surgery. DCH is not a requirement, but an additional qualification. Thus, in this article we are going to focus on MRCPCH, as this is the qualification needed for Paediatricians to qualify for GMC Registration, that or PLAB.

What is in the MRCPCH?

The MRCPCH has three theory exams: Foundation of Practice (FOP), Theory and Science (TAS), Applied Knowledge in Practice (AKP) and one clinical exam.

Please visit the College website for regular updates and important changes to the exams.

Register for your exam

If you have not sat an exam with the Royal College of Paediatrics before or you do not have a Royal College number, you will need to register online to take the MRCPCH exam. Once your registration is accepted and you have received your number you can apply for the exam during the relevant application period.

Foundation of Practice (FOP)

The aim of FOP is to assess your knowledge, understanding, your clinical decision-making abilities, and to ensure that you have reached the standard of someone entering their core specialist training.
This exam costs £320 (in UK), lasts 2.5 hours and there are 79 Single Best Answer questions and 6 Extended Matching questions.

Questions will cover one aspect of the topic. For example:

  • choose the most likely diagnosis from the following
  • choose the best treatment for each of these children
  • choose the organism which matches most closely each of the following case scenarios.

What are Single Best Answer questions?

These questions will test your experience and clinical judgement. A simple statement or clinical scenario will typically lead into five options, all options could be possible but only one is completely correct, or more correct than others. Examples include ‘what is the most likely diagnosis?’ and ‘what is the best advice to give to the parents?’

What is extended matching?

These questions are used in the same way as the best of five questions. But in this case, a list of 10 possible answers is offered with three statements or clinical scenarios. And you will be expected to choose the best option from the introductory list. All could be possible but only one answer is completely correct or more correct than the others. Often extended matching questions are often accompanied by laboratory results.

FOP Exam Advice

For this exam it is important that you have the right revision technique – reading a textbook from front to back will not help you pass the exam. The exam is based on pattern recognition as certain topics repeat themselves each exam sitting. Try and use a variety of revision resources from books, websites, and testing your knowledge with colleagues. Furthermore, you should have an in-depth understanding on trickier subjects.
Fundamental topics to cover:
-Illnesses that kill a child: meningococcal/meningitis/sepsis
-Common Syndromes: Down’s Syndrome and Turner’s Syndrome
-Development and Growth

Theory and Science (TAS)

This test focuses on testing your knowledge of scientific, physiological and pharmacological principles upon which clinical practice is based, and to test the principles of evidence-based practice.
This exam costs £320 (in UK) and will last 2.5 hours.
Like the FOP exam, the test questions will be a combination of single best answer and extended matching questions – 70 SBA & 10 EMA

TAS Exam Advice

The focus on this exam is not on general knowledge but on the specifics of anatomy, physiology, pathophysiology and immunology underpinning everyday medicine and side effects and actions of drugs. This exam is considered to be one of the harder exams making up the MRCPCH as it involves complex problem solving questions requiring in-depth and often esoteric knowledge. Our tip is to make sure you revise specifics including receptors and pathways which do not come up in clinical exams, in addition to statistical data and interpretation of data.

Applied Knowledge in Practice (AKP)

This exam will assess your knowledge, understanding and clinical decision-making abilities, who have reached the standard of someone entering their specialist training.

The AKP, comprises of 2 exams, each lasting for 2.5 hours and you will have to take both exams on the same day. The cost of this exam is £540 (in UK).

The question types will be a combination of best list/single best answer, extended matching questions, photographic material, data interpretation and case histories.

Each question of the AKP carries its own weighting. You will see how many marks each question is worth in the test. The maximum score per question will be based on the number of correct responses required. Incorrect responses will gain a score of zero. Your marks will be combined from the two AKP exams for an overall mark and each exam will carry approximately the same amount of marks.

APK Exam Advice

This exam is more clinically based, and therefore some enjoy revising for this exam the most. We advise for you to focus on your weaker areas, which for most candidates is statistical data. When revising for this exam a popular technique is to use flow charts and diagrams for difficult areas such as metabolic medicine, heart murmurs and immunology.

MRCPCH Clinical

MRCPCH Clinical is the final element of the MRCPCH. This exam will assess whether you have reached the standard in clinical skills expected of a specialised doctor at ST4 level.

Candidates are expected to demonstrate proficiency in;

  • communication
  • history taking and management planning
  • establishing rapport with both parents and children
  • physical examination
  • child development
  • clinical judgement
  • organisation of thoughts and actions
  • recognition of acute illness
  • knowledge of paediatrics and child health
  • professional behaviour
  • ethical practice

The exam costs £773 (in UK), it comprises of ten stations which will test your skills in: child development, communications skills, history-taking and management planning, recognition and diagnosis of clinical signs and symptoms and physical examination skills.

Clinical Exam Advice

This is the only exam which follows a curriculum so it is important that you utilise the standard examination circuit, which gives details on station topics, length of each station and how many examiners – so exploit this information.
An excellent resource for further guidance on this exam can be found here.

Please note that that Royal College allows the FOP and TAS to be purchased together at a cheaper price than buying them individually, this will cost you £540.

Availability of test centres

Not all of the test centres/cities/countries listed will offer the exam at each sitting. If you do not see the country below that you wish to take your exam in then contact the MRCPCH Examinations Team on [email protected]

The RCPCH currently delivery theory exams in the following countries (candidates in other countries may also apply to sit at a test centre of their choice, or via online delivery - but any technological or travel restrictions are at their own risk):

  • Europe
    • UK - test centres across the country
    • Republic of Ireland
    • Malta
  • Middle East and North Africa
    • Bahrain
    • Egypt (online invigilation not available)
    • Jordan
    • Kuwait
    • Oman
    • Qatar
    • Saudi Arabia
    • Sudan (online invigilation not available)
    • United Arab Emirates (online invigilation not available)
  • South Asia and Far East
    • Hong Kong
    • India
    • Malaysia
    • Nepal
    • Pakistan
    • Singapore
    • Sri Lanka
  • Caribbean
    • Trinidad

What happens on the day of my exam?

Before the exam you will receive address details of your test centre including registration time. Check the address of the test centre prior to the day and use Google Maps to see what the building looks like form the outside to make it easier to find on examination day.
You will need to bring a form of ID to the test centre. This can be a valid passport, valid driving licence or a national identity card – only original documents will be accepted.

What happens after my exam?

You will receive an email notification informing you your exam results are ready five to six weeks after you have sat the exam. You can view your results via your account on the MRCPCH website.

Suggested website of MRCPCH revision books:

If you are a Paediatrician who wants to relocate to the UK and work for the NHS then get in contact with us by sending your CV to [email protected].

Originally Posted: 23/04/2018
Updated: 08/10/2020


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