Theory exam structure and syllabi

Information about the structure and syllabi of the theory examinations of the MRCPCH (membership examination) and the DCH (Diploma in Child Health). 

On this page:

About Foundation of Practice (FOP)

The aim of FOP is to assess the candidate's knowledge, understanding and clinical decision making abilities, and ensure they have reached the standard of someone entering their core specialist training. This exam used to be known as the MRCPCH Part 1A. It lasts 2.5 hours. This is also part of the DCH.

The questions are typically a combination of the following (see more detail below):

  • best of five - 61 questions
  • extended matching - 14 questions

Note multiple true/false questions are no longer used in FOP.

About Theory and Science (TAS)

The aim of TAS is to test the basic scientific, physiological and pharmacological principles upon which clinical practice is based, and to test the principles of evidence-based practice. The TAS used to be known as the MRCPCH Part 1B. The exam lasts 2.5 hours.

The questions are typically a combination of the following (see more detail below):

  • best of five - 61 questions
  • extended matching - 14 questions

Note multiple true/false questions are no longer used in TAS.

The official resource tool for this examination, Clinical Cases for MRCPCH Theory and Science, is available for purchase.

About Applied Knowledge in Practice (AKP)

The aim of AKP is to assess the candidate’s knowledge, understanding and clinical decision making abilities, who have reached the standard of someone entering their core specialist training. The AKP used to be known as MRCPCH Part 2. There are two exams of 2.5 hours each, which take place on the same day.

The questions are typically a combination of the following (see more detail below):

  • best of list/ Single best answer
  • extended matching
  • n from many.

Candidates' marks will be combined from the two AKP papers for an overall mark. Each paper will carry approximately the same amount of marks.

Theory examination syllabus

Theory examination syllabus (PDF, 322 KB, 46 pages) - this is intended to act as a guide for learners undertaking the theory examinations, FOP, TAS and AKP

Question types for FOP and TAS

Questions cover one aspect of the topic. Example questions

  • 'Choose the most likely diagnosis from the following'
  • 'Choose the best treatment for each of these children'
  • 'Choose the organism which matches most closely each of the following case scenarios'.

Best of five

These are used to test judgment and experience. A simple statement or short clinical scenario leads into five options. All could be possible but only one is completely correct, or more correct than the others.

They should only cover one aspect of the topic. So stems might be:

  • 'What is the most likely diagnosis?'
  • 'Which investigation is most likely to lead to a diagnosis?'
  • 'What is the best next step?'
  • 'What is the best advice to give to parents?'
  • 'What is the most likely pathogenesis of this condition?'
  • 'What is the most common cause of this?'

Extended matching

These are used in much the same way as 'best of five' questions. In this case, a list of 10 possible answers is offered with three statements or clinical scenarios. The candidate chooses the best option from the introductory list. Again, all could be possible but only one is completely correct or more correct than the others.

Extended matching questions are often accompanied by laboratory results that are similar but with differences.

Question types for AKP

Each question of the AKP carries its own weighting. You will see how many marks each question is worth in the test. The maximum score per question will be based on the number of correct responses required. Incorrect responses will gain a score of zero.

Extended matching

Explained above

Best of list / Single best answer

There is one best answer from a given list. Although all the answer options given may be reasonable, one will be the best answer. Marks will only be awarded for choosing the correct answer.

N from many

Similar to a Single best answer except here two or three answers are required from a longer list.

Sometimes you would like to ask for more than one answer to a scenario since there may be two equally important investigations that should be done, or three abnormalities on an x-ray. N from many questions allow for this by asking for 2 or (maximum) 3 answers from a longer list of possible options.

Photographic material

These questions are based upon photographic material. The images are prepared from clinical and retinal photographs, radiographs, illustrations of investigation results and occasionally from pathological material. Candidates are asked to identify abnormalities, or provide a diagnosis, to recommend investigation or treatment or a combination of these.

Data interpretation

These questions will consist of laboratory data or graphical data, for example electrocardiograms introduced by a short statement of the clinical setting. Candidates are asked for specific points of interpretation.

Please note that drugs will almost invariably be referred to by their UK approved names rather than their trade names. Biochemical and other measurements will be expressed in Sl units (normal ranges or reference ranges will only be provided where these are likely to be in doubt).

Case histories

Each question will be a case history with results of physical examination and investigations. They are designed to test ability in diagnosis and in the planning of investigations and management.

These questions also include photographic material.

Sample exams

To help you prepare, you can take up to four sample papers, or specimen papers, online.