Understanding the MRCPCH Exams
The MRCPCH (Membership of the Royal College of Paediatrics and Child Health) exams are a series of assessments designed to evaluate the knowledge, skills, and competence of paediatricians in training. Passing these exams is a key milestone for those seeking to become certified paediatricians in the UK and other countries that recognize this qualification.
The MRCPCH Exams are important to those aiming to go into paediatrics because they give you:
- Certification: They are a requirement for obtaining membership in the Royal College of Paediatrics and Child Health, which is recognised internationally.
- Competence: They ensure that paediatricians have the necessary knowledge and skills to provide high-quality care to children.
- Career Progression: Passing these exams is often necessary for career advancement and specialization in paediatrics.
Exam Structure
The MRCPCH exams are divided into four parts:
- Foundation of Practice (FOP)
- Theory and Science (TAS)
- Applied Knowledge in Practice (AKP)
- Clinical Examination
Each part of the MRCPCH exams evaluates different aspects of paediatric knowledge and clinical skills. The theory exams have used their current format since the 2024.3 diet (September 2024). They are computer-based on the TestReach platform, taken at a test centre or, for eligible candidates (for example those with no test centre in their country or more than 200 miles from one), by remote invigilation at home.
Here's a summary of the four exams:
1. Foundation of Practice (FOP)
- Objective: To assess the candidate's understanding of clinical paediatrics, including patient management, ethics, and communication skills.
- Format: 100 best-of-five single-best-answer questions, each worth one mark, with no negative marking. The exam lasts 2 hours. You can apply to sit FOP and TAS on the same day (FOP in the morning, TAS in the afternoon).
- Content: Covers a wide range of topics such as growth and development, nutrition, immunization, common illnesses, and their management.
2. Theory and Science (TAS)
- Objective: To test the candidate’s knowledge of the basic and applied sciences relevant to paediatrics.
- Format: 100 best-of-five single best answer questions, each worth one mark, with no negative marking. The exam lasts 2 hours.
- Content: Includes topics like physiology, pharmacology, genetics, biochemistry, and epidemiology.
3. Applied Knowledge in Practice (AKP)
- Objective: To evaluate the candidate’s ability to apply their knowledge to clinical practice.
- Format: 120 best-of-five single best answer questions, split into two papers of 60 questions, each lasting 2 hours 30 minutes (morning and afternoon on the same day). Each question is worth one mark, with no negative marking.
- Content: Focuses on clinical scenarios, problem-solving, and decision-making in paediatric practice.
4. Clinical Examination
- Objective: To assess the candidate’s practical skills in a clinical setting.
- Format: Objective Structured Clinical Examination (OSCE) with several stations. RCPCH announced a review of the Clinical exam in October 2026: children and young people will no longer take part, and a 12-station format of 10-minute stations is proposed, with a consultation opening on 13 October 2026. You will still need to pass all three theory exams first.
- Content: Includes communication skills, clinical examination techniques, data interpretation, and patient management.
10 Tips for Preparing MRCPCH Written Exams
Understand the Exam Structure
RCPCH has provided a recommended syllabus for the MRCPCH Theory examination, which outlines the topics that candidates need to study for the exam.
- FOP: Focuses on clinical practice, patient management, ethics, and communication.
- TAS: Covers the basic and applied sciences relevant to paediatrics, including physiology, pharmacology, genetics, and epidemiology.
- AKP: Evaluates the application of knowledge in clinical scenarios, problem-solving, and decision-making in paediatric practice.
Create a Study Plan
Developing a structured study plan is crucial. Allocate time for each topic and stick to your schedule.
- Time Management: Plan daily and weekly study goals.
I took around 2-3 months for preparation of each exam and also did the FOP and TAS on separate days (RCPCH lets you apply to sit both on the same day if you prefer).
As a paediatric trainee, you are eligible to request 4 study leaves for each exam and 1 leave on the day of the exam. This is applicable once per exam.
- Balanced Approach: Divide your time between reading, practicing questions, and revising.
I found it useful to go through question banks, noting incorrect answers, and creating a revision plan focused on those questions.
Gather Study Materials
Use a mix of textbooks, online resources, and question banks to cover all necessary topics. It is quite important to cover the Clinical Cases for each exam by RCPCH which contains some sample questions in exam.
Textbooks
- "Illustrated Textbook of Paediatrics" by Lissauer and Clayden
- "Nelson Textbook of Pediatrics"
Guidelines
Question Banks
- PassMedicine
- BMJ OnExamination
- Pastest
- RCPCH sample questions
- Clinical Cases for MRCPCH (FOP/TAS/AKP) by RCPCH
Practice Questions
Regular practice with MCQs is essential for familiarization with the exam format and timing.
- Daily Practice: Integrate daily question practice into your routine.
- Mock Exams: Simulate exam conditions with timed practice exams.
Focus on Weak Areas
Identify your weak subjects and allocate more time to them. Use practice questions to assess your knowledge and understanding.
Group Study and Discussion
Study groups can be highly beneficial for discussing difficult topics, sharing resources, and providing moral support.
- Peer Discussions: Discuss challenging cases and topics.
- Teaching: Teach topics to peers to reinforce your understanding.
Use Clinical Scenarios
Relate theoretical knowledge to clinical practice by reviewing case studies and scenarios.
- Case Studies: Review and discuss case studies regularly.
- Clinical Practice: Apply theoretical knowledge to clinical practice during rotations.
Attend Courses and Workshops
Enrol in preparatory courses and workshops offered by professional bodies.
- Courses: Attend MRCPCH preparatory courses.
- Workshops: Participate in paediatric workshops and seminars. Details can be found on the RCPCH website.
Take Care of Yourself
Maintaining good physical and mental health is vital during your preparation.
- Rest: Ensure adequate sleep and rest periods.
- Exercise: Regular physical activity to relieve stress.
- Nutrition: Eat a balanced diet to maintain energy levels.
Exam Day Preparation
- Documentation: Ensure all necessary documents and identification are ready.
- Rest: Get a good night's sleep before the exam day.
- Relax: Stay calm and composed. Trust your preparation.
Melvin's Experience
I found that it's more effective to spread your study time evenly over the 2-3 months leading up to the exam. A good approach is to tackle about 20-30 questions from a question bank each day. You can even download the Pastest app on your phone and work through questions during your free time, like during on-call shifts or quiet night shifts.
I'll be keeping a notebook of any questions I get wrong and doing some background reading on those topics. As the exam date approaches, I'll focus on reviewing this notebook. It's important not to cram all your studying at the last minute since you'll need time for background reading, and cramming can increase stress.
Remember, this is a specialist examination, and many people have taken it multiple times before passing. If you don't pass part of the exams initially, don't lose confidence in yourself. Instead, identify areas of weakness and focus on those for your next attempt. I believe you all will all do well.
Just prepare thoroughly and try to relax before the exam.