This workflow is for paediatric trainees preparing for MRCPCH Foundation of Practice — the first written stage, often sat alongside Theory and Science — who want to use BMJ OnExamination without letting a rising overall percentage hide unattempted syllabus areas. It addresses the single one-hundred-question SBA paper. The principal limitation to state plainly: BMJ OnExamination is written-SBA only and runs no proprietary adaptive engine, so it does not reproduce the MRCPCH Clinical examination, and its "adaptive" feel is really you steering the feed.
What BMJ OnExamination offers for MRCPCH FOP right now
BMJ OnExamination lists a dedicated MRCPCH: FOP product and a combined FOP/TAS product. As of 19 July 2026 the standalone FOP bank advertises a vendor-reported 930+ questions, while the combined FOP/TAS bank advertises around 1,722 questions covering both first-stage papers (vendor-reported, 19 July 2026); verify the current counts on onexamination.com. Standalone FOP access runs from roughly £34.99 for one month to about £149.99 for twelve months, with the combined product priced higher, and a free trial of ten questions a day. The feature set includes answer explanations, mock tests curated by the BMJ editorial team, difficulty-level selection, a revision plan targeting weaker areas, peer comparison, group leaderboards and an offline mobile app.
Two honest qualifications shape the plan below. First, the product is written-SBA only: it maps to the FOP paper and contains no clinical-OSCE practice. Second, BMJ OnExamination does not advertise a proprietary adaptive-difficulty algorithm; the personalisation is candidate-directed. You choose the domain and difficulty and recap your misses, which is a strength for a disciplined plan but means the coverage floors are yours to set. No proprietary-algorithm claims are made or needed.
MRCPCH Foundation of Practice: the official shape
FOP is the first written stage of the MRCPCH, and it can be sat on the same day as Theory and Science, with FOP in the morning and TAS in the afternoon. It comprises 100 single-best-answer questions in two hours, every item worth one mark, with no negative marking, delivered computer-based at an exam centre or online. That pacing is about seventy-two seconds per question — tighter than the later AKP papers — so FOP rewards secure recognition of common and important paediatric presentations, safeguarding, growth and development, the acutely unwell child and core management, rather than the deep synthesis reserved for AKP.
Keep the official requirement separate from third-party claims. The RCPCH publishes the FOP syllabus and official sample questions; those define the blueprint and the house style. A commercial bank's difficulty labels and topic tags are useful but are the vendor's interpretation, not the exam standard, and where they disagree the RCPCH material wins. For any prescribing or dosing item, the UK medicines reference is the Summary of Product Characteristics via the electronic medicines compendium (eMC), read with NICE and CKS — never a half-remembered number.
Baseline week: measure before you personalise
Before you let difficulty selection or topic filters shape the feed, sit a small, blueprint-stratified, unseen sample under timed conditions. Around forty questions spread across the major paediatric domains — neonatology, cardiology, respiratory, gastroenterology, neurology, infectious disease, endocrinology, nephrology, dermatology, safeguarding and the acutely unwell child — gives you a first-attempt profile by domain. Record first-attempt accuracy and pace, not cumulative percentage. This baseline is the reference against which the rest of the plan is judged, and it prevents you optimising a number that mostly reflects your strong topics.
First pass: set domain floors the score cannot hide behind
The named failure mode is real. Let a comfortable domain drive your practice and the overall percentage rises while whole syllabus areas go under-attempted. Set explicit domain floors — a minimum number of unseen questions you will attempt in each weak or low-volume area each week — and hold them regardless of the headline. A rising overall score with a thin safeguarding, genetics or child-development column is not readiness; it is an averaging artefact. Our guide on why completion is not coverage shows how to build the matrix these floors sit inside.
Error taxonomy: name the failure before you fix it
Sort every miss into one category, because the fix differs by type:
- Knowledge gap — you did not know the fact or mechanism.
- Misread stem — you missed a qualifier, an age band, a unit or a negative.
- Premature closure — you committed before reading all five options.
- Guideline error — you applied an outdated or non-UK standard.
- Calculation error — you slipped on a weight-based dose, a fluid rate or a centile.
- Time-pressure error — you would have got it with another twenty seconds.
At FOP the tighter clock makes time-pressure and misread-stem errors more common than at AKP, so tag them faithfully. A month of tagged misses tells you whether you have a content problem or a test-craft problem, and each needs a completely different intervention.
Review interval: not everything deserves an immediate repeat
Match the response to the error type. A knowledge gap earns a short primary-source read plus a new transfer question, not a re-sit of the same item. A misread stem or a time-pressure error earns timed mixed practice, because the deficit is process. A guideline error earns a check against the current NICE, CKS or SmPC/eMC source and a dated note. Reserve immediate repeats for almost nothing — re-sitting an item you have just seen mostly measures recognition, which is exactly what inflates a bank percentage without moving your real score.
Mixed-block switch: when to stop filtering
Topic-filtered practice is right early, when you are building coverage. Switch toward timed, random, full-length blocks once every domain sits above its floor and your first-attempt accuracy in your weakest domain has stabilised across at least two separate sittings. The trigger is objective — floors met, weakest-domain first-attempt stable, pace within the seventy-two-second target — not a feeling of having done enough. Random hundred-item blocks then rehearse the interleaving and endurance the real paper demands.
Exit criteria: what "ready" looks like, and what it does not
You are ready to ease off the bank when five things are simultaneously true: every blueprint domain is above its coverage floor; first-attempt accuracy is stable across mixed unseen blocks; your pace holds near seventy-two seconds per item under time; your retest misses are new rather than repeats of the same misconceptions; and your performance holds on the official RCPCH FOP sample material, which is the calibration standard the finite bank cannot replace. "Finished the bank" is deliberately absent — completion is an activity metric, not a readiness signal, and if you sit FOP and TAS the same day you also need the endurance to hold accuracy across both papers.
A seven-day plan: BMJ OnExamination for one job, iatroX for transfer
Give BMJ OnExamination one job — structured domain practice with its filters and mock tests — and give iatroX a different job: unseen, timed transfer measurement on items it has never seen you attempt. No proprietary-algorithm claims are needed.
- Day 1 — baseline. Sit a mixed, timed, unseen block of forty items in the iatroX UK bank with no assistance. Record first-attempt performance by domain.
- Days 2–4 — targeted first pass. In BMJ OnExamination, work your weakest three domains to their floors, tagging every miss by error type and writing a one-line corrected rule for each.
- Day 5 — calibration. Attempt the official RCPCH FOP sample questions under time and compare your reasoning against the model answers.
- Day 6 — fresh transfer. Sit a new timed iatroX block on different topics and track your first-attempt trend, because your Q-bank percentage is not your exam score.
- Day 7 — review and plan. Space this week's misses, retest last week's, and set next week's floors.
Continue, supplement, switch or stop
Decide on measurable gaps, not novelty or sunk cost. Continue with BMJ OnExamination if your domains are moving toward their floors and your tagged misses are shrinking. Supplement with unseen iatroX measurement if your bank percentage feels high but you have no timed, unseen evidence of transfer, using the two-Q-bank rule so you never repeat an item. Switch or add a second bank if a whole domain stays thin and you cannot get above its floor. Stop topic-drilling a domain once you can answer fresh mixed items in it under time without assistance.
The bottom line: BMJ OnExamination is a well-explained SBA bank worth including in a FOP revision stack, but it does not adapt for you and it does not measure you against unseen items. You supply the discipline and keep a separate unseen block for honest measurement. Used that way it earns its place; used as a percentage to maximise, it flatters you.
FAQ
Is BMJ OnExamination enough for MRCPCH Foundation of Practice on its own? It is a strong single bank but not a complete preparation on its own. FOP tests broad recognition across the whole of paediatrics under a tight clock, so you also need the official RCPCH sample questions to calibrate house style and a separate pool of unseen, timed items to prove the knowledge transfers rather than being recognised. Use BMJ OnExamination as the domain-practice engine and verify its current question count on onexamination.com before relying on it.
Which MRCPCH Foundation of Practice component does BMJ OnExamination not reproduce well? It does not reproduce the MRCPCH Clinical examination at all, because it is a written-SBA product. Even within the written stage, a bank you have partly worked through cannot reproduce the fully unseen, seventy-two-second-per-item pressure of the real paper, where recognising a previously seen stem quietly inflates your accuracy. Keep an unseen block in reserve for that exact rehearsal, especially if you plan to sit FOP and TAS on the same day.
How many BMJ OnExamination questions should I complete per day for MRCPCH Foundation of Practice? Daily volume matters less than mix and review, but a sustainable target around clinical work is roughly twenty to forty questions a day in timed blocks, with every miss tagged and reviewed the same day. Two carefully reviewed blocks beat a hundred rushed items, because unreviewed volume trains speed without accuracy and consumes the finite bank you will later want for mock conditions.
When should I stop using BMJ OnExamination and move to mixed mocks? Move to timed mixed blocks and full mocks once every blueprint domain is above its coverage floor and your first-attempt accuracy in your weakest domain has stabilised across at least two separate sittings. After that, single-topic practice gives diminishing returns, and the pacing and endurance data from mixed hundred-item blocks sat at the real pace become the information you actually need to judge readiness.
How should I combine BMJ OnExamination with iatroX without duplicating practice? Apply the two-Q-bank rule: give BMJ OnExamination the job of structured domain practice and give iatroX the separate job of unseen, timed measurement, and never run the same item through both. Duplicating items turns measurement into recognition and inflates your apparent readiness, so keep one bank for learning and one, unseen, for honest transfer scoring.
Editorial notes and references
Written by Dr Kolawole Tytler, NHS GP and founder of iatroX. Last checked 19 July 2026; product figures described as vendor-reported were taken from public product listings on that date and change without notice — verify the current count, price and feature set on the vendor's own page. Disclosure: iatroX operates a competing UK question bank, so this article confines the iatroX role to unseen transfer measurement — a job the audited SBA bank does not claim to replace. Corrections are welcome via the feedback route on iatrox.com. References: RCPCH examinations (rcpch.ac.uk/education-careers/examinations) and the official FOP sample questions; the BMJ OnExamination MRCPCH: FOP product page (onexamination.com); the iatroX comparison hub and the iatroX UK bank.
Run a fresh timed MRCPCH Foundation of Practice block in iatroX →