Membership of the Royal College of Paediatrics and Child Health (MRCPCH) Exam Guide

The Royal College of Paediatrics and Child Health (RCPCH) awards MRCPCH after candidates pass three theory examinations and one clinical examination. The theory examinations are non-sequential. Candidates must pass all three before applying for MRCPCH Clinical.

RCPCH’s current theory page calls TAS “Theory and Science”; the February 2026 syllabus gives the fuller name “Theory and Science of Practice.” The separate Diploma of Child Health (DCH) is a different qualification route: it uses FOP and DCH Clinical, not the three MRCPCH theory examinations.

Theory examinations

The three theory exams are computer-based and use five-option SBAs. FOP and TAS each have 100 questions and a 2-hour time limit. Candidates may take FOP and TAS on the same day, with FOP in the morning and TAS in the afternoon. AKP consists of two papers on the same day, each with 60 questions and a 2-hour-30-minute time limit. AKP may include short histories, images, X-rays, data interpretation, ECG-related data and evidence-based medicine questions. Each question is worth one mark; RCPCH does not use negative marking.

Current face-to-face MRCPCH Clinical circuit

RCPCH’s current station materials describe this 10-station normal circuit:

The face-to-face exam is delivered in person in UK and overseas centers. Patients are used in the four Short Clinical stations; the Development station is scenario-based. The History and Communication stations use role-players, while Video stations use recorded scenarios. Consult the current RCPCH dates and Clinical application pages for available centers, event details, allocation, fees and application windows.

The current theory syllabus is Version 3, issued in February 2026. It lists minimum-to-maximum percentage ranges for each examination’s syllabus areas. Treat the ranges as blueprint guidance, not as a prediction of the exact subject mix in a particular sitting.

AKP uses different percentage bands:

For Clinical, current candidate materials describe station tasks and assessed domains rather than a comparable subject-percentage table. The circuit assesses physical examination, recognition and interpretation of signs, clinical reasoning, management planning, history-taking, development, communication and video interpretation.

Theory registration

RCPCH lists a valid primary medical qualification (PMQ) from a registered institution as the theory-registration criterion. For an overseas qualification, the College’s definition refers to recognition by the UK General Medical Council. Candidates need to register an RCPCH exam account before booking; the theory guidance says to do this at least 10 days before an application window opens.

Applying for MRCPCH Clinical

Candidates must pass FOP, TAS and AKP before applying for Clinical. RCPCH strongly recommends completing two and a half years of training from the graduation date on the medical qualification and spending at least 12 months in posts involving emergency pediatric care in the five years before the exam. It also recommends six months of work as a house pediatrician in the first post-graduation year, or an additional six months in emergency pediatric care if that experience is absent. These are Clinical preparation recommendations, distinct from the theory-registration criterion.

Clinical applicants must provide sponsor details. RCPCH describes the sponsor as someone who knows the candidate and can support their readiness for the exam.

Delivery varies by location

Theory exams are offered in UK and international locations, but availability varies by diet. Remote invigilation is conditional: RCPCH lists criteria including no test center in the candidate’s country of residence for that exam, living more than 200 miles from a test center, or an approved reasonable adjustment. Evidence is required, and RCPCH’s theory guidance lists the UAE as an exception to remote invigilation.

MRCPCH Clinical is delivered in person in the UK and overseas, but available locations and allocation procedures vary. Check the live RCPCH theory dates and Clinical application pages for the relevant country and exam event; do not rely on copied dates, fees or deadlines.

1. Use the official syllabus as a coverage checklist. Track each theory domain, your revision progress and recurring errors. The published ranges help organize coverage, but they do not predict the precise content of an individual paper.

2. Practice timed SBA questions for FOP and TAS. Review why the best answer is superior to the alternatives, including the scientific or clinical distinction being tested. Since RCPCH does not use negative marking, make a considered selection rather than leaving an item unanswered.

3. Add integrated interpretation practice for AKP. Include case histories, images, X-rays, laboratory and graphical data, ECG-related material and evidence-based medicine, matching the question types described in the syllabus.

4. Prepare separately for each Clinical station type. For Short Clinical, practice systematic pediatric examinations, concise description and interpretation of signs, and discussion of reasoning and management. For Development, rehearse a focused developmental history and a clear description of how you would assess development and respond to cues. Use role-player practice for History and Communication, and video interpretation practice for the Video stations.

5. Use the exam’s stated conventions. RCPCH says medication names will almost invariably be UK-approved names and measurements will use SI units. Build familiarity with those conventions during theory revision.

6. Plan logistics from the current College pages. Confirm the applicable theory delivery method, center availability, remote-invigilation requirements, Clinical event instructions and sponsor information through the live RCPCH dates and application guidance.

Clinical assessment review

As of October 18, 2026, RCPCH’s assessment-review page describes a revised 12-station Clinical circuit as proposed and piloted, not as the current candidate requirement. The page’s provisional timeline lists consultation for Clinical changes in October–November 2026 and a planned GMC submission in December 2026. Follow the current face-to-face candidate guidance unless RCPCH confirms an implemented change.

Theory currency before Clinical

RCPCH’s regulations state that candidates are required to pass Clinical within seven years of having passed all three theory examinations. The Clinical eligibility section also states that at least one completed theory exam must have been passed within the previous seven years; if seven years have elapsed since the last theory pass without passing Clinical, the candidate must pass AKP again before applying for further Clinical attempts. Check the current regulations for individual circumstances.

Attempt limits

RCPCH’s rules provide a six-attempt limit for each MRCPCH component. For candidates outside the UK pediatric training program and international candidates, transitional rules exclude attempts before September 1, 2024; the exact treatment depends on candidate history. As of October 18, 2026, the additional-attempt provision is still future-dated: from November 1, 2026, a candidate who has failed six times may be permitted one additional attempt with evidence of further educational experience. Candidates who have already taken seven or more attempts by that date may be eligible for one final attempt under the stated evidence conditions.

Keep DCH separate

MRCPCH requires FOP, TAS, AKP and MRCPCH Clinical. DCH is a separate qualification route using FOP and DCH Clinical. Passing FOP alone does not complete the MRCPCH examination route.