This checklist is for basic trainees preparing for the RACP Divisional Written Examination in Paediatrics & Child Health who have worked through most of a question bank and want to know whether they have genuinely covered the exam — rather than simply exhausted a product. The principal message is straightforward: coverage is an evidence claim, not a completion percentage. What follows is the minimum evidence you should be able to produce before you decide to stop doing new questions.
The minimum evidence, stated as a checklist
You can reasonably say you have covered RACP Paediatrics when, for every major blueprint domain, you can show five things. First, a meaningful sample of unseen questions attempted — not re-attempts of items you have already seen and half-remember. Second, first-attempt accuracy at or above your personal target, measured on those unseen items rather than on review. Third, a recent review date, so retention is demonstrated rather than assumed. Fourth, evidence that you can work at exam pace, not only untimed. Fifth, at least one exam-specific clinician sign-off on the domains most exposed to hidden gaps. If any one of those is missing for a domain, that domain is not yet covered — however green your bank's dashboard happens to look. Treat the checklist below as a set of columns to fill in, not a timetable to follow.
Current exam snapshot
The RACP Divisional Written Examination in Paediatrics & Child Health is the knowledge gate of basic training. It is sat as two computer-based papers at Pearson VUE test centres across Australia and New Zealand, usually in February, on a single day. Together the papers total approximately 170 questions — a larger Clinical Applications paper of around 100 questions and a shorter Medical Sciences paper of around 70 (verified against racp.edu.au and the Pearson VUE RACP page, 20 July 2026; confirm the current count, paper composition and timing before you sit). The items are predominantly four-option single-best-answer multiple-choice, with a smaller extended-matching component in each paper; there is no negative marking and one mark per correct answer. The authoritative sources for what is examinable are the RACP examination guides and the Paediatrics & Child Health basic training curriculum, not any third-party product. Passing the written examination admits you to the separate Divisional Clinical Examination (a long case and short cases); this checklist addresses the written knowledge layer only, and no question bank — including iatroX — reproduces the clinical exam.
Build a blueprint coverage table
The single most useful artefact you can build is a coverage table with one row per domain and five columns. Filling it in converts a vague sense of readiness into an auditable record. Copy the structure below and populate it from your bank's analytics plus your own notes.
| Domain | Official weight (illustrative — map to the RACP curriculum) | Unseen questions attempted | First-attempt accuracy | Last reviewed | Confidence (R/A/G) |
|---|---|---|---|---|---|
| Neonatology & perinatal medicine | High | ||||
| Cardiology | Medium | ||||
| Respiratory & sleep | Medium | ||||
| Gastroenterology, hepatology & nutrition | Medium | ||||
| Nephrology & fluid/electrolyte | Medium | ||||
| Endocrinology & diabetes | Medium | ||||
| Neurology & neurodevelopment | High | ||||
| Infectious diseases, immunology & allergy | Medium | ||||
| Haematology & oncology | Medium | ||||
| Genetics, metabolic & dysmorphology | Medium | ||||
| Developmental & behavioural paediatrics | High | ||||
| Child protection, community & disability | Medium | ||||
| Emergency, acute care & toxicology | Medium | ||||
| Pharmacology, therapeutics & prescribing | Medium | ||||
| Ethics, statistics & evidence (Medical Sciences) | Medium |
The weights above are illustrative prompts, not published RACP percentages; the college does not release a fixed public per-domain breakdown, so map each row to the current curriculum and adjust. The point of the table is the empty columns: a domain with no unseen attempts, or a last-reviewed date measured in weeks, is a gap even if you "feel" comfortable with it.
Ten domain-level blind spots self-selected practice tends to hide
Left to our own devices, we practise what we enjoy and avoid what we find aversive. These ten areas most reliably stay hidden when you choose your own questions, and each deserves deliberate, exam-specific clinician review before you conclude it is covered:
- Neonatal resuscitation thresholds and the sick term infant — algorithm detail decays fast between neonatal rotations.
- Inborn errors of metabolism and the acutely encephalopathic child — rare, pattern-based, and easy to skip.
- Developmental assessment and red flags across age bands — frequently under-tested in banks yet heavily weighted.
- Child protection, non-accidental injury and the medico-legal interface — uncomfortable, so avoided.
- Genetics and dysmorphology recognition — image- and pattern-dependent, poorly served by text revision.
- Fluid, electrolyte and acid–base problems in small children — calculation-heavy and weight-based.
- Paediatric pharmacology and weight-based dosing safety — where adult thresholds are wrongly transferred.
- Immunisation schedules, contraindications and the immunocompromised child — jurisdiction-sensitive and updated periodically.
- Adolescent health, consent (Gillick/mature-minor), confidentiality and mental health — cross-cutting and easy to under-sample.
- Statistics, study design and evidence interpretation in the Medical Sciences paper — the domain most candidates least enjoy and least practise.
For each, the test is not "have I read it" but "has an exam-experienced paediatrician confirmed my reasoning on unseen items in this area." That review requirement is the difference between covered and merely visited.
Format checklist
The written exam does not directly assess long cases, short cases, developmental examination or communication — those belong to the Divisional Clinical Examination. But the knowledge that underpins them is examinable in written form, so verify that you have practised the written correlates deliberately: the reasoning behind a structured developmental assessment, the differential logic a short-case examiner is probing, and the management-communication judgement (breaking bad news, consent, safeguarding escalation) that appears as single-best-answer stems. Tick this box only when you have tested that knowledge under written conditions, and keep separate, honest track of the fact that the clinical exam still needs its own supervised, in-person preparation.
Interpretation checklist
Paediatric written papers lean heavily on data and images. Confirm you have deliberately practised: growth charts and centile interpretation; developmental milestones as data; paediatric ECGs and the age-specific normal ranges; chest and abdominal radiographs, plus common neuroimaging patterns; laboratory trends including blood gases, renal and liver panels and haematology films; and calculation items — weight-based doses, fluid maintenance and correction, and unit conversions. Add ethics, consent and statistics interpretation for the Medical Sciences paper. A domain is not covered if you can recall the fact but stall when the same point arrives as a chart, film or trend.
Recency checklist
Paediatric practice is guidance-sensitive, and Australasian guidance can differ from UK or US sources. For every guidance-dependent topic — immunisation schedules, bronchiolitis and asthma management, sepsis and fever pathways, and safeguarding thresholds — record the date and jurisdiction of the source you learned it from. Prefer current Australasian and RACP-aligned guidance for management specifics, and where a medicine detail matters, anchor it to the approved product information (the SmPC/eMC equivalent) and to national paediatric formulary guidance rather than to a bank's undated explanation. A green domain built on a three-year-old, wrong-jurisdiction guideline is a hidden red.
Performance checklist
Coverage is also a performance claim. Before stopping, confirm: you have completed unseen, timed, mixed blocks (not single-topic sets) that resemble the paper's breadth; your pace leaves you time to review flagged items within the real duration; you have specifically hunted your high-confidence errors — the questions you were sure of and got wrong, which are the most dangerous; your accuracy holds on spaced re-tests weeks after first exposure; and you have calibrated against official or official-style material at least once, sitting it unseen and timed. Your overall bank percentage is the weakest of these signals — it blends seen and unseen, easy and hard, recent and stale. Read "Your Q-Bank Percentage Is Not Your Exam Score" before you trust a single headline number.
Stop or continue: a decision tree
Use the measured gap, not novelty or fatigue, to choose the next activity:
- Continue new questions when whole domains still show few or no unseen attempts, or first-attempt accuracy on unseen items sits below target. New volume is buying you information.
- Consolidate (stop new, review misses) when coverage is broad but retention is shaky — accuracy falls on spaced re-tests. Space and review your misses; do not add breadth you cannot hold.
- Simulate when per-domain accuracy is adequate but you have never assembled it under full timed, mixed conditions. Sit complete mock papers.
- Seek teaching when a specific domain resists improvement despite volume, or when high-confidence errors cluster — that is a reasoning fault a tutor or study group fixes faster than more questions.
- Rest when performance is plateaued or declining from fatigue rather than gaps. Diminishing returns are real; a recovered candidate outperforms an exhausted one.
The one-page checklist and a worked example
Printed as a single page, the checklist is: every domain has unseen attempts logged; first-attempt unseen accuracy is at or above target per domain; last-reviewed date is recent for every green; at least one timed mixed mock completed at full length; high-confidence errors reviewed; guidance-sensitive topics dated and jurisdiction-checked; official-style material sat once, unseen; and the ten blind spots each clinician-reviewed. Eight boxes; all must be ticked per domain, not overall.
Consider an illustrative candidate, "Priya" (invented data). Her bank shows 78% overall, which feels reassuring. Filling the table tells a different story: neurology and neurodevelopment sit at 61% first-attempt on unseen items and were last reviewed five weeks ago; genetics has only 12 unseen attempts logged; statistics is green at 74% but every attempt is untimed. Her overall 78% is masking three red domains. The decision tree sends her to continue new questions in genetics, seek teaching in neurodevelopment, and simulate the Medical Sciences content under timed conditions — not to stop. Two weeks later her overall number has barely moved, but her three weak domains are green on unseen, timed re-tests. That is what covered looks like.
Three mistakes this checklist is designed to stop
The first is banking a reassuring overall percentage and calling it coverage. A single blended number rises steadily while whole domains stay unmeasured beneath it; the coverage table exists to break that number apart so the reds cannot hide. The second is treating "I have read it" as "I have covered it." Reading builds recognition, which feels like knowledge until an unseen stem asks you to reason under time; only first-attempt performance on questions you did not choose tells you whether the learning transfers. The third is leaving the aversive domains — genetics and dysmorphology, statistics and evidence, safeguarding — until last, then running out of runway. Because these are precisely the domains self-selected practice avoids, they need to be scheduled first, not fitted in around the topics you already enjoy. Each mistake shares a root cause: substituting a comfortable proxy — a percentage, a read-through, a favourite topic — for the harder evidence that actually predicts performance. This checklist is deliberately built from the harder evidence, so that "covered" means demonstrated rather than felt.
Frequently asked questions
How do I know whether I have covered the full RACP Paediatrics blueprint? You know when you can produce the coverage table above with every domain populated: unseen questions attempted, first-attempt accuracy at target, a recent review date, evidence of exam-pace performance, and clinician review of the high-risk blind spots. Coverage is demonstrated per domain, not claimed overall. Map your rows to the current RACP examination guides and Paediatrics & Child Health curriculum, because those — not any product's module list — define what "full" means.
Can one question bank be enough for RACP Paediatrics? One bank can be your core if it is broad, current, Australasian-aligned and honestly analysed, but "enough" is a property of your evidence, not of the product. The practical risk with a single bank is that its blind spots become yours: if it under-covers genetics or developmental assessment, self-selected practice will hide that gap. The two-Q-bank approach exists precisely so you can measure coverage on unseen items a second source wrote. If your table has thin domains, a second bank — used for measurement rather than duplication — is usually the fix.
What should I measure instead of my overall Q-bank percentage for RACP Paediatrics? Measure per-domain first-attempt accuracy on unseen items, retention on spaced re-tests, pace under full timing, and the size and pattern of your high-confidence errors. The overall percentage blends seen and unseen, easy and hard, fresh and stale, so it moves reassuringly while real gaps persist. The four measures above are harder to fake and far more predictive of how you will perform on an unseen paper.
When should I stop doing new RACP Paediatrics questions? Stop adding new questions when every domain has adequate unseen coverage at target accuracy, retention holds on spaced re-tests, and you have proven exam-pace performance on full mixed mocks — and redirect the remaining time to consolidation, simulation or rest. Stopping earlier leaves domains unmeasured; stopping later, out of habit, buys diminishing returns while fatigue accumulates. The trigger is the measured gap closing, not the bank's progress bar reaching 100%.
Which RACP Paediatrics resource should I use for my weakest component? Match the resource to the fault. If the gap is knowledge breadth, use a broad question bank and log unseen attempts. If it is reasoning on a specific domain, use focused teaching, a study group or exam-experienced clinician review rather than more solo questions. If it is the clinical examination — long and short cases, developmental examination, communication — no written bank suffices; you need supervised, in-person practice with feedback. Use iatroX and other written banks for the unseen-knowledge measurement layer, and reserve dedicated clinical preparation for the Divisional Clinical Examination.
Editorial notes and references
Written by Dr Kolawole Tytler, NHS GP and founder of iatroX. Last checked 20 July 2026. Exam-format figures are verified against the RACP and Pearson VUE pages as at that date and may change — confirm the current question count, paper composition, timing and delivery on racp.edu.au before you sit; per-domain weights in the table are illustrative prompts, not published RACP percentages. Disclosure: iatroX operates a competing question bank and clinical-knowledge platform; in this article iatroX is positioned only as an unseen-knowledge measurement layer for the written examination, a job the RACP curriculum and clinical exam do not fill, and it does not reproduce the Divisional Clinical Examination. Corrections are welcome via the feedback route on iatrox.com. References: RACP Divisional Written Examination and Paediatrics & Child Health basic training curriculum (racp.edu.au); RACP certification testing information (pearsonvue.com); iatroX, "Your Q-Bank Percentage Is Not Your Exam Score" (https://www.iatrox.com/blog/qbank-percentage-not-your-exam-score); iatroX, "Question-bank completion is not coverage" (https://www.iatrox.com/blog/question-bank-completion-is-not-coverage-how-to-build-a-blueprint-coverage-matrix-for-any-medical-exam); iatroX comparison hub (https://www.iatrox.com/compare).