DCH: question practice and revision.

Choose a topic for focused revision and check your plan against the official specification.

• Acute paediatric presentations — sepsis, deteriorating child, anaphylaxis, status epilepticus
• Respiratory paediatrics — asthma, bronchiolitis, croup, viral wheeze, pneumonia
• Infectious diseases — common childhood infections, immunisation schedule, fever in under-5s (NG143)
• Neonatology — neonatal jaundice, common newborn conditions, breastfeeding troubleshooting
• Gastroenterology, nutrition, feeding and growth
• Cardiology — congenital heart disease basics, innocent murmurs, recognising heart failure
• Endocrinology and metabolic — Type 1 diabetes, DKA recognition, growth and puberty disorders
• Renal and urology — UTI, AKI, nephrotic syndrome basics, enuresis
• Neurology and neurodisability — seizures, headache, neurodevelopmental disorders (ADHD, ASD)
• Mental health, behavioural and emotional — anxiety, depression, eating disorders, self-harm
• Safeguarding — recognition of NAI, neglect, sexual abuse, fabricated/induced illness
• Dermatology — eczema, viral exanthems, urticaria, common rashes (including on darker skin)
• Ethics, consent, capacity, statistics, professional behaviours

Mapped to the published RCPCH DCH curriculum and prioritised using item-density signals across the iatroX bank.

• Fever in under-5s — NICE NG143 traffic light system (green/amber/red features), sepsis screening thresholds, empirical antibiotic choices by age, when lumbar puncture is mandatory. The single most examined topic.
• Bronchiolitis vs viral wheeze vs asthma — distinguishing features, NICE NG9 bronchiolitis admission criteria, BTS/SIGN asthma severity ladder, when to use IM adrenaline for anaphylaxis vs nebulised salbutamol
• UK Immunisation Schedule (Green Book) — primary course, pre-school boosters, HPV (universal from age 12-13, 1 dose since Sept 2023), MenACWY, MenB, RSV maternal vaccine (2024 introduction) and RSV infant nirsevimab/clesrovimab. Recent changes commonly tested.
• Safeguarding red flags — recognising NAI patterns (TEN-4-FACESp bruising rule, fractures inconsistent with developmental stage), fabricated/induced illness, sexual abuse presentations (anogenital findings), neglect indicators. Escalation pathways.
• Growth and feeding — failure to thrive workup, breastfeeding troubleshooting, formula choices, weight loss thresholds in newborns (>10% birth weight requires assessment), centile crossing rules
• Status epilepticus algorithm — paediatric APLS (lorazepam 0.1 mg/kg IV, buccal midazolam 0.5 mg/kg, then phenytoin/levetiracetam, thiopentone induction). Sodium valproate avoidance in girls of childbearing potential.
• Recognition on darker skin — meningococcal rash, jaundice (visible later on darker skin), eczema, erythematous conditions. RCPCH OSCE scenarios now include patients with varied skin tones.
• Capacity, consent and Fraser/Gillick — providing contraception/sexual health advice to under-16s (Fraser), broader medical decision-making (Gillick competence), parental responsibility, child protection legal framework.

Observations from UK GP trainees and recent DCH candidates. Verify against current NICE, RCPCH and BNFc guidance.

Candidate-reported observations — not official guidance.

1. Recent immunisation schedule changes — RSV maternal vaccine introduced 2024, RSV infant nirsevimab/clesrovimab, HPV reduced to 1 dose schedule (Sept 2023). Older revision sources lag and teach outdated schedule.
2. TestReach platform unfamiliarity for FOP — RCPCH switched to TestReach in 2025. The platform has its own quirks (question flagging, navigation, calculator access). Use the RCPCH practice run before exam day.
3. DCH Clinical 2020 onwards is remote-delivered — preparation needs to include practice on the actual online platform, not in-person OSCE practice alone. Setting up tech, lighting, audio matters.
4. BNFc paediatric weight-based dosing — fluids (Holliday-Segar 4-2-1 rule for maintenance, 10 mL/kg trauma vs 20 mL/kg sepsis), paracetamol 15 mg/kg, ibuprofen 5-10 mg/kg, common antibiotics by weight. Speed under time pressure matters.
5. Format change from 2024.3 — FOP is 100 SBAs in 2 hours (was longer). Older revision materials use the previous timing.
6. OSCE communication framework — RCPCH examiners specifically assess data gathering, clinical decision-making, patient/parent-centred communication, safety-netting. Practising structured consultation models matters as much as clinical knowledge.
7. Safeguarding scenarios — when to break confidentiality, parental responsibility allocation, sexual abuse age cutoffs, Fraser vs Gillick application. Routinely tested in both FOP and OSCE.
8. Newborn examination — recognising developmental dysplasia of the hip (Ortolani/Barlow), cardiac murmurs differentiating innocent from significant (4 Ss + still + soft), red reflex, congenital cataract, anal patency.

A pragmatic phased approach used by recent GP trainees who passed the DCH first time, sitting FOP and Clinical sequentially.

1. Weeks 1–4

   Foundation pass across all 13 blueprint topics for FOP. 30 questions/day with the iatroX adaptive engine. Review current authoritative paediatric and immunisation guidance alongside weak topics. Use a common-rashes atlas with varied skin tones.

2. Weeks 5–8

   Targeted weak-area drilling using spaced repetition. Daily BNFc paediatric drug calculation practice. Safeguarding scenarios. Begin DCH Clinical preparation — paediatric OSCE history-taking and examination videos.

3. Weeks 9–10

   Two timed 100-SBA mock FOP papers under exam conditions per week. Practise the TestReach platform if you have access. DCH Clinical: practise 6-minute paediatric consultations with peers (data gathering, examination, parent communication).

4. Weeks 11–12

   Bookmark review only for FOP. Targeted DCH Clinical OSCE practice — safeguarding scenarios, recognising the unwell child, breaking bad news to parents. Confirm RCPCH bookings. Sleep, hydrate, do not learn new material.

Dedicated DCH question practice with answer explanations, guided Tutor review and study planning.

• Focused question practice — Choose the relevant bank and use your answers to identify what to study next.
• Guided reasoning — Explore a difficult answer with Tutor, then apply the distinction independently.
• Review and timed practice — Return to important mistakes and choose a timed practice set where available.

Choose the relevant bank and use the official exam guidance to plan your preparation.

Any registered medical practitioner with a primary medical qualification recognised by the GMC (or equivalent verifiable by RCPCH). The DCH is designed for clinicians, including GPs and trainees, who want to provide evidence of their experience in child health. RCPCH recommends at least 4-6 months of paediatric clinical experience before the exam.

FOP theory exam (shared with MRCPCH): three diets per year — 18 February, 24 June, 14 October 2026. DCH Clinical: typically two exam periods per year (spring/summer and autumn). The Clinical exam is delivered remotely since October 2020. Confirm exact 2026 Clinical dates on the RCPCH DCH page.

Two non-sequential exams: (1) FOP — 100 best-of-five SBAs in 2 hours delivered via TestReach; (2) DCH Clinical — 8-station OSCE circuit delivered remotely via an online platform. Both must be passed for the DCH award. FOP and Clinical can be taken in any order.

DCH candidates take ONE theory exam (FOP) plus the DCH Clinical OSCE — a shorter pathway designed for GPs and clinicians who want a recognised paediatric credential. MRCPCH candidates take THREE theory exams (FOP + TAS + AKP) plus the MRCPCH Clinical (10-station OSCE) — the membership exam for paediatric specialty trainees aiming for CCT.

FOP and DCH Clinical have their own attempt provisions. Use the current RCPCH regulations and additional-attempt process for your individual record before applying.

The DCH validates a structured level of paediatric competence that is increasingly recognised by employers and patients. It supports GPs with a special interest in paediatrics, those running children's clinics or working in mixed-age practice settings. It is also recognised internationally and provides post-nominals (DCH).

Full DCH bank access is included in all-access. Up to 10 new sample questions per day are shared across exams, with no account required. A verified free account includes one guided Tutor session; continued Tutor use is included in all-access.