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The advanced clinical-application theory paper of MRCPCH — 120 SBAs across two 2.5-hour papers, pitched at ST3-equivalent decision-making. Verified 2026 diet dates, candidate-reported pitfalls, and an AI-adaptive question bank covering acute, neonatal and subspecialty paediatrics.
Full MRCPCH AKP bank, AI Tutor and timed mocks — $29/month or $99/year. All paid exam banks included.
60 best-of-five SBA questions · 2.5 hours · delivered by TestReach
60 best-of-five SBA questions · 2.5 hours · same day, after a break
Pitched at the middle of paediatric training (ST3-equivalent). Items demand applied clinical reasoning rather than recall — recognising the deteriorating child, complex condition management, multidisciplinary decisions.
6 attempts at each part of the MRCPCH theory (FOP, TAS, AKP) — introduced from the 2024.3 diet onwards.
2026/01: 22 January. 2026/02: 20 May. 2026/03: 16 September. AKP is sat on a different day from FOP/TAS within each diet window — typically ~4 weeks earlier. Applications open ~10 weeks before each diet and close ~3.5 months before.
Approximate question distribution across the RCPCH AKP blueprint. Used to drive iatroX adaptive sequencing.
Source: official Royal College of Paediatrics and Child Health (RCPCH) blueprint
Mapped to the published RCPCH AKP blueprint and prioritised using item-density signals across the iatroX bank.
Paediatric DKA — fluid resuscitation per BSPED 2021 update (10ml/kg if shocked, deficit calculation, insulin starting after 1 hour), cerebral oedema risk factors, hyperosmolar HHS variant
Status epilepticus — APLS 2021 (lorazepam 0.1mg/kg, then phenobarbitone vs phenytoin vs levetiracetam vs sodium valproate based on epilepsy diagnosis, thiopentone induction)
Severe asthma escalation — IV salbutamol vs IV magnesium vs aminophylline, NIV indications in children, intubation thresholds, post-arrest care
Cystic fibrosis — newborn screening pathway, elexacaftor-tezacaftor-ivacaftor (Kaftrio/ETI) age and mutation eligibility, pulmonary exacerbation management, transplant referral indications
Acute leukaemia presentation in children — recognising patterns (cytopenias, bone pain, organomegaly), urgent referral pathways, oncological emergencies (TLS, mediastinal mass)
Inborn errors of metabolism in the unwell neonate — recognising acid-base patterns (organic acidaemia), hypoglycaemia patterns (MCAD, GSD), hyperammonaemia (urea cycle), initial stabilisation
Congenital heart disease — duct-dependent lesions (prostaglandin E1), recognising cyanotic vs acyanotic, post-Fontan circulation considerations
Safeguarding in MRCPCH — fabricated/induced illness (FII), recognition patterns, escalation framework, complex social-medical decisions, MCA-equivalent for under-16s
Observations from UK paediatric trainees and recent AKP candidates. Verify against current NICE, BSPED, APLS and BTS-paediatric guidance.
Candidate-reported observations — not official guidance.
A pragmatic phased approach used by recent ST3–ST5 paediatric AKP passers.
A live item from the iatroX bank. Try it before launching a full session.
A 6-year-old presents with a 3-week history of bone pain, progressive pallor and easy bruising. Examination shows hepatosplenomegaly. His haemoglobin is 68 g/L, white cell count 85 × 10⁹/L and platelet count 22 × 10⁹/L; the blood film contains blasts. Chest radiography shows mediastinal widening. He is clinically stable, and urgent transfer to a paediatric oncology centre is being arranged. Before corticosteroids, procedural sedation or cytotoxic treatment, which investigation has the highest immediate priority?
Why iatroX is built differently for MRCPCH AKP.
Every iatroX item is tagged to a blueprint topic, so your performance dashboard mirrors the structure of the exam itself.
The engine surfaces your weakest topics first, in real time, instead of marching you through a static syllabus.
Incorrect items return at increasing intervals to interrupt the forgetting curve and lock knowledge into long-term memory.
Timed full-length simulations that mirror the official exam structure under realistic conditions.
One iatroX subscription includes the MRCPCH AKP bank, the Socratic Tutor inside supported sessions, and every other premium iatroX exam bank.
Cancel anytime · 7-day money-back guarantee on annual
FOP (Foundation of Practice) is the entry-level theory paper covering core paediatric medicine — pitched at ST1-equivalent. TAS (Theory and Science) covers basic sciences applied to paediatrics — pitched similarly. AKP (Applied Knowledge in Practice) is the most advanced theory paper covering complex applied clinical paediatrics — pitched at middle paediatric training (ST3-equivalent).
Three diets per year. 2026/01: 22 January. 2026/02: 20 May. 2026/03: 16 September. AKP runs on a different day from FOP/TAS within each diet window — typically about 4 weeks earlier than FOP/TAS.
Two papers of 60 best-of-five SBA questions each, 2.5 hours per paper, sat on the same day with a break between. Total 120 questions across the day. Delivered via TestReach (since 2025). The time allowance is longer per paper than FOP/TAS because AKP questions are more complex.
There's no formal restriction — the three theory papers can be sat in any order. Most candidates sit AKP last because of its higher difficulty and clinical-application focus. AKP is typically taken in ST3 once the candidate has substantial clinical exposure.
From the 2024.3 diet onwards, candidates have a maximum of 6 attempts at each of the four MRCPCH parts (FOP, TAS, AKP, Clinical). Previously there was no formal limit.
Both. NICE paediatric guidelines (NG143 fever, NG9 bronchiolitis, NG217 sepsis, NG7 osteoporosis) are core. RCPCH-specific position statements (mental health in paediatrics, transition to adult services) are also examined. APLS 7th edition is essential for resuscitation algorithms.
Yes. A single iatroX subscription (£29/month or £99/year for UK users; $29/$99 elsewhere) includes the MRCPCH AKP bank alongside MRCPCH FOP, TAS and every other premium iatroX exam bank. No add-ons or per-exam fees.
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Reviewed by Dr Kola Tytler MBBS CertHE MBA MSt MRCGP · Last reviewed 12 May 2026
See our methodology and editorial policy.