Blogs > Postgraduate Qualifications

Top Tips for MRCPCH

  • March 11, 2020

If you are an international doctor aspiring to practice as a Paediatrician or Neonatologist within the NHS, then MRCPCH is arguably the best route for you.

The MRCPCH has three theory exams, Foundation of Practice (FOP), Theory and Science (TAS), Applied Knowledge in Practice (AKP) and one clinical exam. This article outlines BDI Resourcing’s top tips for your studies, explaining the types of questions and the exam formats:

Theory Exams:

Foundation of Practice (FOP) Exam Tips

The aim of the FOP Exam is to assess basic paediatric knowledge, understanding and clinical decision making early in specialist training. The exam has 80 questions, formatted as follows:

  • Best of five - 70 questions (4 marks per item)
  • Extended Matching Questions- 10 questions (3 marks per item)

In regard to revision and preparation tips, do try and use a variety of revision sources from books, websites and testing your knowledge with colleagues as reading a textbook from front to back will not help you pass the FOP Exam. Passing the exam is based on pattern recognition; the same areas come up again and again. The only way this can be learnt is by repeatedly practising questions and backing them up with solid grounding in each subject from book work. Please note, that there are no negative marks given in any of these exams, so make sure you answer all of the questions.

Make sure you cover certain fundamental topics extremely well, such as:

  • Illnesses that can kill (i.e Meningitis, coarctation of the aorta and other duct-dependent cardiac defects, non-accidental injury).
  • Common syndromes (i.e Down’s syndrome, Turners Syndrome)
  • Development and Growth
  • Immunisations
  • Failure to thrive/faltering growth
  • Go back to basics! – Make sure you study basic science and stats. Whilst these are arguably ‘boring’ areas to revise, it is important that you do not miss out on these marks when/if they come up in the exam.

It is more important to cover all areas of the curriculum quite well than know some areas very well and others not at all. People often have a tendency to focus on areas they find interesting or good at – this approach may not be helpful for passing the exam. We recommend using all the resources available to you. The RCPCH have a variety of practice papers and answers which can be found here.

Theory and Science (TAS) Exam Tips:

The aim of the TAS Exam is to test the basic scientific principles upon which clinical practice is based. The format of the exam is identical to that of the FOP, as follows:

  • Best of Five – 70 Questions (4 marks per item)
  • Extended Matching Questions- 10 questions (3 marks per item)

The exam itself is considered to be one of the harder exams of MRCPCH as it involves more complex solving questions, requiring more complex and in-depth answers. 

When revising for the TAS Exam, make sure you revise specifics including receptors and pathways that do not come up in more clinical based exams. Below is a list of common themes that come up in TAS, we advise that you do a set amount of revision on each:

  • Renal Disorders
  • Calcium, Vitamin D and Bone Metabolism
  • Genetics in Common Syndromes and Genetic Testing
  • Immunology
  • Allergy
  • Statistical Analysis
  • Hormone Synthesis 
  • Cardiac Lesions
  • Haematology and Oncology
  • Diabetes Insipidus
  • Blood gasses and Ventilator Settings
  • Gut absorption
  • Clotting Disorders

Applied Knowledge in Practice (AKP) Exam Tips:

The aim of the AKP Exam is to test clinical decision making and management, asking questions about differential diagnosis investigation and management decisions. The AKP is made up of two exams, each 2.5 hours in duration, both with 60 questions. There are a variety of question types within these exams, as follows:

  • Best of Five Questions:
  • Extended Matching Questions
  • “N from many” Questions

Questions may be based on:

  • Photographs
  • Data Interpretation
  • Case Histories

Before you start revising for this exam, consider printing the exam syllabus and working through the outcomes in topics. Additionally, print off a variety of examples of photographs, data and case histories. When answering the questions, eliminate answers that are definitely incorrect and you will probably be left with two or three answers.

Clinical Exam:

The aim of the clinical exam is to test your ability to work at the level of a junior registrar. 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
  • Professional behaviour
  • Ethical practice

The best way to revise for this is to read through all of the guidance documents found on the RCPCH website, found here. Remember, the clinical examination stations and communication stations are 9 minutes long. BDI Resourcing’s top tips for the day of your Exam are as follows:

  • If something goes wrong in one station when you come out, don’t panic. Forget about that station and move on with a clear mind. Don’t let one bad station ruin the whole exam for you
  • Smile at the examiners
  • Talk to both the parents and the patient
  • Wash your hands between each station

Types of Questions explained:

  • Best of Five Questions are designed to test judgement and experience. They start with a statement followed by 5 answers. One of the answers will be correct, but only one will be the most appropriate answer to the statement. Take your time reading and answering the question and if in doubt go with your gut instinct rather than over thinking the question and second-guessing yourself. Possible stems might be:

“What is the most Likely Diagnosis?”
“What is the next best step?”
“What is the most common cause of this?”
“What is the best advice to give to parents?”

  • Extended Matching Questions require you to choose the best option from a list of 10 possible options, all are feasible, but only one is completely correct. These are similar to the best of five questions. Possible stems might be:

“Choose the most likely diagnosis from the following results”
“Choose the organism which matches most closely each of the following case scenarios”

  • N from Many questions require you to choose a number of options from a longer list, such as treatment options.

Other Online Resources:

  • RCPCH practice papers – found on RCPCH website.
  • Pastest – Online revision pack for both TAS and FOP. It’s good value for money and easy to use, providing lectures and clinically based questions.
  • Oneexamination – Online resource providing core questions, detailed analysis and feedback.

Relocating to the UK

If you have just passed your MRCPCH or you are an international doctor who would like to relocate to the UK, email your CV to [email protected] and we can support you in securing an NHS post and on your journey to relocate to the UK.

Are you a member of our Facebook group? When you join IMG Advisor, you join a community of doctors all looking to relocate to the UK and join the NHS. We post a series of blogs and vlogs to the group each day. We will also be on hand to answer all of your relocation queries.

Subscribe to our YouTube channel! We have over 60 videos covering everything you need to know about relocating to the UK and joining the NHS.

Listen to BDI Resourcing on the go with IMG Advisor the Podcast! You can listen to us on Apple Podcasts, Spotify, Stitcher and Buzzsprout. We have a number of episodes with tips and advice on relocating to the UK and the routes you can take to achieve this.

Finally, we have just launched our new Instagram, so if you are a member, feel free to follow us to view our posts and IGTV: @bdiresourcing


Rob Primhak, A. (2020). Foundation of Practice (FOP) | MCQ writing for the MRCPCH. [online] Available at: [Accessed 17 Feb. 2020].

AKP, M. (2020). MRCPCH: AKP. [online] BMJ OnExamination. Available at: [Accessed 17 Feb. 2020].


Get Email Job Alerts

Get email alerts tailored to just the jobs you're interested in.


Register With Us

Help us match you with jobs that are perfect for you.


Send Us Your Resumé

Upload it from your computer or via your phone from your cloud storage.

error: Content is protected !!