MRCPCH FOP: question practice and revision.

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

• Acute paediatric presentations and emergency management
• Neonatology — neonatal resuscitation, common neonatal conditions
• Respiratory paediatrics — asthma, bronchiolitis, pneumonia, croup
• Infectious diseases — common childhood infections, immunisation schedule, sepsis
• Gastroenterology, nutrition, feeding and growth
• Cardiology — congenital heart disease basics, common acquired conditions
• Endocrinology and metabolic — DKA, congenital adrenal hyperplasia, growth
• Renal and urology — UTI, AKI, nephrotic syndrome basics, enuresis
• Neurology — seizures, status, headache, neurodisability basics
• Haematology and oncology basics — anaemia, presentation of malignancy
• Development, behaviour and mental health
• Safeguarding, ethics, consent, statistics, professional behaviours

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

• Neonatal resuscitation — Newborn Life Support (NLS) 2021 algorithm, drying and warming, when to escalate, oxygen targets by age (60% then titrate)
• Fever in under 5s — NICE NG143 traffic light system, sepsis screening thresholds, empirical antibiotics by age, when lumbar puncture is mandatory
• Bronchiolitis vs viral wheeze vs asthma — distinguishing features, NICE NG9 bronchiolitis criteria for admission, BTS/SIGN asthma severity ladder
• 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/infant programmes (added 2024)
• Safeguarding — recognising NAI patterns (TEN-4-FACESp bruising rule, fractures inconsistent with developmental stage), fabricated/induced illness, escalation to social care
• Growth and feeding — failure to thrive workup, breastfeeding troubleshooting, formula choices, weight loss thresholds in newborns (>10% birth weight)
• Common childhood rashes — meningococcal (non-blanching petechial), HSP purpura, atopic eczema, viral exanthems (chickenpox, hand-foot-and-mouth, slapped cheek)
• Status epilepticus — paediatric APLS algorithm (lorazepam → buccal midazolam → phenytoin/levetiracetam → thiopentone induction), timing matters

Observations from UK paediatric trainees and recent FOP candidates. Verify against current NICE and BNFc guidance.

Candidate-reported observations — not official guidance.

1. Format change — from 2024.3 (September 2024) FOP is 100 SBAs in 2 hours (was longer). Older revision sources cite the old format and timing. Newer pace = 72 seconds per question.
2. TestReach platform unfamiliarity — RCPCH switched from the previous provider to TestReach in 2025. The platform has its own quirks (question flagging, navigation, calculator access). Use the RCPCH practice run before exam day.
3. Recognition on darker skin — meningococcal rash, jaundice, eczema and erythematous conditions present differently. RCPCH images now include patients with varied skin tones; revise specifically for this.
4. Immunisation schedule recent changes — RSV maternal vaccine introduced 2024, RSV infant nirsevimab/clesrovimab, MenB schedule, HPV reduced to 1 dose. Older revision sources lag.
5. Paediatric weight-based dosing — BNFc differs from adult BNF, calculations under time pressure (e.g. fluids 100-50-20 rule, paracetamol/ibuprofen by weight).
6. Safeguarding edge cases — when to break confidentiality (Fraser/Gillick), fabricated/induced illness recognition, sexual abuse presentations. Routinely tested.
7. Newborn examination — recognising developmental dysplasia of the hip (Ortolani/Barlow), cardiac murmurs differentiating innocent from significant (4 Ss + still + soft), red reflex.
8. Statistics in paediatric trials — sensitivity/specificity of screening tools (Guthrie, NIPE), NNT for vaccine effectiveness, study design.

A pragmatic phased approach used by recent ST1–ST3 paediatric passers, often paired with TAS preparation.

1. Weeks 1–4

   Foundation pass across all 12 blueprint topics. 30 questions/day with the iatroX adaptive engine. Review current authoritative paediatric and immunisation guidance alongside weak topics. Use a common-conditions atlas for skin and ENT presentations.

2. Weeks 5–8

   Targeted weak-area drilling using spaced repetition. Daily paediatric drug calculation practice (BNFc). Safeguarding scenarios. RCPCH practice questions on the official portal.

3. Weeks 9–10

   One or two timed 100-SBA mock exams under exam conditions per week. Review every incorrect answer in detail and re-attempt 24 hours later. Practise the TestReach platform if you have access.

4. Weeks 11–12

   Bookmark review only. Light reading on safeguarding frameworks, immunisation updates and acute drug doses. Confirm RCPCH booking and admission documentation. Sleep, hydrate, do not learn new material.

Dedicated MRCPCH FOP 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.

MRCPCH consists of three theory papers — Foundation of Practice (FOP), Theory and Science (TAS) and Applied Knowledge in Practice (AKP) — plus a clinical OSCE (MRCPCH Clinical). The three theory exams can be sat in any order, but all three must be passed before sitting the Clinical. FOP is typically the entry-level theory paper, sat in ST1 or early ST2.

Three diets per year. 2026/01: 18 February. 2026/02: 24 June. 2026/03: 14 October. FOP and TAS are sat on the same day — FOP in the morning, TAS in the afternoon.

A single paper of 100 best-of-five SBAs over 2 hours, delivered via TestReach (since 2025). From the 2024.3 diet, the paper length was shortened from the previous format. Question style is best-of-five SBA only — multiple true/false has been removed.

Pass marks are set per diet using the Angoff standard-setting method. From the 2025.2 diet onwards, the third-judgement step (post-candidate-performance review) was removed, simplifying the process. There is no fixed percentage — the pass mark accounts for paper difficulty.

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.

Online remote invigilation is available, subject to eligibility (no test centre in country of residence, approved reasonable adjustment etc.). Most candidates sit at a Pearson VUE-style test centre. Application windows are slightly shorter for online than for test centre (5 days vs 7 days).

Full MRCPCH FOP 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.