MRCPCH - a guide for overseas paediatrics doctors

  • April 10, 2020

Overseas paediatricians taking the postgraduate route to GMC Registration must attain full MRCPCH.

Membership of the Royal College of Paediatrics and Child Health (MRCPCH) can be sat by international doctors from any country in the world provided certain eligibility criteria are met. These are summarised below along with a broad look at the following topics:

The Royal College of Paediatrics and Child Health is the professional body responsible for the specialty of Paediatrics throughout the UK. Amongst many other duties, its role is to set and monitor the educational curriculum for those training to enter the profession.

What is MRCPCH? 

Paediatricians become full members of the Royal College of Paediatrics and Child Health and achieve the designation MRCPCH once they have passed four separate postgraduate medical exams. 

The MRCPCH examinations consist of 3 theory exams and 1 clinical exam:

  • Foundation of Practice (FOP) - theory examination (basic child health)
  • Theory and Science (TAS) - theory examination (basic scientific, physiological and pharmacological principles upon which clinical practice is based)
  • Applied Knowledge in Practice (AKP) - theory examination (knowledge synthesis/evaluation, clinical decision making and management)
  • MRCPCH Clinical examination - multi station OSCE

* Theory exams can be taken in any order of preference.

For overseas doctors relocating to the UK, the MRCPCH is one of two options to support full GMC registration (postgraduate qualification or PLAB route). For doctors who wish to take on more senior roles reflective of their current practice, IMG Connect advise that the MRCPCH would be the best route to securing their dream job in the NHS. 

Am I eligible for the MRCPCH exams? 

Theory Exams: 

To be eligible you must hold a Primary Medical Qualification (PMQ) that is recognised by the GMC for registration purposes.

MRCPCH Clinical: 

You must pass the 3 theory exams in order to be eligible for the final MRCPCH clinical examination. 

All MRCPCH clinical candidates must be proposed by 2 sponsors, who will certify that you have a good period of training in paediatrics and can be considered as ready to take the exam. You can take the exams at any stage in your career, however current advice is that in order to optimise your chances of success in the MRCPCH Clinical examination you should have: 

  • completed a period of training lasting two and a half years 
  • spent no less than 12 months in posts involving the care of emergency paediatric patients 
  • spent six months of your first year after graduation as a house paediatrician; if not, an additional six months in a post involving the care of emergency paediatric patients.

Sponsors for the clinical exam:

As we mentioned above, candidates for the clinical examinations must have two sponsors who will declare you have covered the required amount of training in paediatrics which matches the exam syllabus and consider you ready to take the exam. You will be asked to provide each sponsors personal and work details, and they will be notified if you receive a poor mark. 

The examination is conducted in English and candidates are advised that IELTS Level 7 is the expected standard for completion of the MRCPCH examinations. Remember, you will need to have a pass of 7.5 average in all areas of IELTS to complete your GMC registration.

What is the structure and content for MRCPCH examinations? 

As above, the MRCPCH examinations consists of 4 parts: 

  • 3 theory exams 
  • 1 clinical exam

Theory exams:

Candidates will sit 3 theory examinations; each test is administered on a computer and the tests can be taken in any order. 

There are usually 3 sittings for each exam per year. 

Each exam is 2 hours and 30 minutes, unless you have been allocated additional time.

Foundation of Practice (FOP) theory exam: 

This exam assesses a candidate’s knowledge, understanding and clinical decision making. It aims to ensure that you have reached the same standard as someone entering core training (ST1 equivalent) 

Questions are typically a combination of: 

  • Single Best Answer Questions (SBAs) – 70 questions
  • Extended Matching Questions (EMQs) – 10 questions

Extended Matching Questions (EMQs) require you to choose the best option from a list of ten possible options, all are feasible, but only one is completely correct. 

Theory and Science (TAS) theory exam: 

This tests basic scientific, physiological and pharmacological principles of clinical and evidence-based practice. 

It uses the same format for questioning as the FOP exam. 

Applied Knowledge in Practice (AKP): 

This tests your knowledge, understanding and clinical decision making based on a standard of someone entering their core specialist training (ST1 equivalent). 

The exam uses the format N of Many - giving two or three answers that are required from a longer list. 

For example, there can be more than one answer from a scenario since there may be two equally important investigations that should be complete, or three abnormalities from a scan or x-ray. 

When sitting the AKP using the format N of Many, remember that each question carries its own weighting – pay attention to how many marks each question is worth in the test and answer accordingly.

Clinical examination:

The MRCPCH clinical examination forms the final part of the exams. Remember, you must have passed all 3 theory tests in order to be eligible to sit this test. 

This test will be taken in a hospital setting and you will follow a circuit of 12 scenarios. You should be familiar with this type of test (OSCE) from your medical training. Examiners will assess performance during each scenario, which will include actors (children, young people and adults). 

The aim of the clinical examination is to assess whether candidates have reached the standard in clinical skills expected of a newly appointed ST4 in the UK. 

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 Clinical Exam is guided by important educational principles while holding to the considerable standards of a clinical examination, including the examination of real children.

The Clinical Exam includes 10 objective assessments of each candidate. In most circumstances’ assessment is conducted by a different examiner at each clinical station, so performance at one station does not influence the next station. The test will include six ‘short case’ assessments, emphasising clinical examination. Stations are as follows: 

Station 1: Child development – clinical assessment

Station 2 & 5: Communication skills 

Station 3: History taking and management planning

Station 4: Clinical video scenarios

Station 6 – 10: Clinical examinations

The order in which candidates will take the circuit will vary. There are 4-minute breaks between stations, the entire circuit takes 152 minutes in total.

Where and when can I sit the exams? And how much do they cost? 

Each country fee is different, please see below current exam fees (as of April 2019). 

Theory exams: 


Theory Exams

Exam fee 2019

India, Malaysia, KSA, UAE, Oman, Myanmar, Sudan, Singapore, Jordan, Kuwait, Malta, Qatar, Sri Lanka, Trinidad

FOP - single paper


TAS - single paper


FOP and TAS - both papers




Egypt and Nepal

FOP - single paper


TAS - single paper


FOP and TAS - both papers




Hong Kong (HK)

FOP - single paper


TAS - single paper


FOP and TAS - both papers




*Not all countries will offer the exam at each sitting. If you would like to request an exam in another country, you can contact the MRCPCH 

Clinical examinations: 

















Singapore (Conjoint MMED - MRCPCH Clinical fee)






Hong Kong


How do I apply for the exams? 

To apply for the MRCPCH, you first need to register online for exams. You need an RCPCH online account (with an RCPCH number). Then you can complete a short registration form – you will require evidence of your primary medical qualification.

How do I register for exams? 

You can register for exams at any time throughout the year. After your registration is accepted, you can apply for an exam but only during relevant open application periods. It takes at least 10 working days to process registration.During exam application periods the Royal College are not able to process registrations. 

Register three to four weeks before exam application period opens to help ensure you do not miss your preferred exam diet. The best dates to register for exams are usually January, May and September.

How do I book an exam? 

  • Log in to your RCPCH account
  • Go to My Account 
  • From your dashboard, go to the Exams panel, and from your exam dashboard, follow links to apply

What do I need to bring to the exam?

You will need to bring one of the following forms of ID:

  • passport with photograph and signature - this must be current or no more than six months expired
  • valid driving license with photograph and signature
  • national identity card with photograph and signature.

Please note, only original documents will be accepted as proof of identification.

How can I prepare for the exams? 

With lots of materials online we have discussed with IMGs the best place to start looking for resources and materials relating to the exams. Most IMGs recommended starting with the Royal College, who have created useful resources to help you to prepare for the exams. See below: 

Theory Examination:

Theory Examination Syllabi: This document outlines the syllabus for MRCPCH theory examinations - MRCPCH Theory Examination Syllabi.

Theory exams structure and syllabus: Further information on FOP, TAS and AKP can be found in the theory exams structure and syllabus. This is to be read in combination with the Royal College’s Curriculum for Paediatrics. Within the Curriculum for Paediatrics you can read about the 11 domains and are able to download assessment strategy and generic syllabi for each training level.

Sample Papers: We recommend becoming familiar with the exam format and software, and you can practice with some sample papers here.

Clinical Examination:

Clinical Examination candidate guide: This is a comprehensive guide from the Royal College specifically covering the Clinical Examination. This includes station break downs, clinical video scenarios, general instructions and downloads amongst many other resources. 

Anchor Statements: The Anchor Statements outline the expected standard for each station against which candidates are marked. We recommend you familiarise yourself with the criteria points for expected standards before sitting the exam.

Clinical Exam Technique: This guide covers the clinical examination in considerable depth, including:

  • examination technique 
  • specifics on clinical areas 
  • detail on short-cases

User guide for video station: A guide for Station 4: Clinical video scenarios can be downloaded here.

Clinical Exam: hints and tipsHints and tips specific to the clinical exam can be found on the MRCPCH clinical examination candidate guide (scroll down to find them). 

As ever at IMG Connect, we believe in preparation. In order to succeed in the clinical exam, IMGs have told us that it is vital that you practise your clinical examinations as frequently as possible, preferably under the supervision of a senior colleague. This will give you confidence in approaching and examining children with examiners present.

Passed? What next?

First of all, congratulations! After you have passed all four parts of your MRCPCH examinations, you can apply for a full registration with a license to practice. Once the GMC have approved your application, you can work as a doctor in the UK. 

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