The Diploma of Child Health (DCH) is awarded by the Royal College of Paediatrics and Child Health and recognises competence in the care of children for clinicians in specialties allied to paediatrics — most commonly GPs. It comprises two non-sequential exams that can be taken in either order: the Foundation of Practice (FOP) theory exam, which is shared with the MRCPCH membership route, and the DCH Clinical. This guide covers the format of both, the eligibility, the syllabus, and how to prepare.
What the DCH is and who sits it
The DCH is an internationally recognised RCPCH diploma for clinicians who care for children without specialising in paediatrics — GPs above all, but also others wanting to upskill and gain a formal postgraduate qualification. It has its own syllabus, developed by a range of paediatricians and GPs, pitched at the level of a GP with a special interest in paediatrics rather than at specialist level. For a GP it is a way to formalise and deepen the paediatric competence that a typical training rotation only begins to build, and it carries weight internationally as well as in the UK. That international portability is part of its appeal: the DCH is recognised in many health systems where a structured paediatric credential is valued.
The two exams
The Foundation of Practice (FOP) theory exam is a computer-based paper testing the knowledge needed to provide clinical care for children, covering the conditions commonly encountered; it is the same FOP sat by MRCPCH candidates and is standard-set using the modified Angoff method. The DCH Clinical has been delivered remotely via an online platform since October 2020; it assesses clinical skills to the standard of a newly appointed GP who has completed a short paediatric placement and shows a special interest in paediatrics, and its scenarios are written with the candidate cast as a GP. The two exams are non-sequential, so you can sit them in any order, and where their application windows align you can apply for both together. Pass both and you receive the Diploma of Child Health (RCPCH).
One distinction worth being clear about: for the DCH you sit only the FOP theory exam, not the Theory and Science of Practice (TAS) or Applied Knowledge in Practice (AKP) papers, which belong to the fuller MRCPCH theory route.
Eligibility
You need a primary medical qualification or GMC registration. English-language tests are not required in order to sit, though the RCPCH recommends proficiency equivalent to IELTS level 7. It also recommends four to six months of paediatric experience — six months if sitting overseas — although this is not mandatory. In practice, candidates who have spent time in paediatrics, or in general practice with a paediatric caseload, find both exams considerably more approachable, since the DCH is explicitly pitched at applied, primary-care-level child health.
The syllabus
The DCH syllabus covers the common paediatric presentations a GP actually meets: childhood infections and the febrile or unwell child, respiratory and ENT problems, and gastroenterology, alongside child development and developmental assessment, child health surveillance and immunisation, neonatal and newborn issues, safeguarding, and behavioural and emotional health. The emphasis throughout is safe assessment, management and appropriate referral in a primary-care context. Expect the common infections and the assessment of the febrile child, asthma and wheeze, allergy, constipation and faltering growth, the recognition of the seriously unwell child, and the developmental and behavioural presentations — from delayed milestones to ADHD and autism — that GPs are often first to see. Safeguarding runs throughout, as does the routine of immunisation and child health surveillance.
2026 dates and fees
The FOP theory exam runs in computer-based sittings across the year, while DCH Clinical diets provide several days of exams over roughly a two-week period. Confirm the current 2026 sitting and application dates, and the fee for each component, on the RCPCH site. Last reviewed June 2026.
Pass rates
The RCPCH publishes results and feedback for each diet; consult the current data rather than relying on estimates, and note that the FOP standard is the same whether the paper is sat for the DCH or the MRCPCH.
How to prepare
For the FOP, work through paediatric theory questions mapped to the curriculum and review each miss back to the underlying condition or guideline. For the DCH Clinical, rehearse the GP-framed scenarios — focused history, examination, communication with parents and children, and safe management or referral — because clinical and communication skills cannot be learned from a question bank alone, and structured practice with peers is essential. It helps to treat the two exams as different skills: the FOP rewards systematic knowledge revision against the curriculum, while the DCH Clinical rewards repeated, timed rehearsal of focused paediatric consultations and examinations until the structure is second nature. Many candidates pass the FOP to lock in the knowledge base, then concentrate on clinical rehearsal; others do the reverse to get the harder-to-arrange clinical diet booked early. Either order works, so plan around exam availability and your own readiness.
Where iatroX fits
The FOP is a knowledge exam, and iatroX's paediatric (MRCPCH FOP) bank — on iatroX's subscription (£29/month or £99/year) — maps directly to it. It leads with a Socratic tutor that works back through the reasoning behind a miss; questions mapped meticulously to the curriculum; spaced repetition; adaptive sequencing that targets your weak areas; and a mobile app. Pair it with structured clinical practice for the DCH Clinical.
A few common questions
How many exams is the DCH? Two — the FOP theory and the DCH Clinical, taken in either order.
Do I need the TAS and AKP papers? No — only the FOP theory exam, plus the DCH Clinical.
Is the DCH Clinical in person? No — it has been delivered remotely online since October 2020.
Is iatroX's paediatric bank free? Not in full — the bank is on iatroX's subscription (£29/month or £99/year), with free sample questions to try first.