About
The standard for all MRCPCH Theory exams is set using an absolute criterion-referenced approach rather than a norm-referenced approach; as such, there is no number or percentage of candidates predetermined to pass or fail.
Hypothetically, using a criterion-referenced approach means all candidates could pass the exam or fail the exam. As a result of the standard-setting process, the pass mark and pass rate may vary for each diet; however, the difficulty is considered when setting the pass mark so as to maintain a consistent standard.
The specific type of standard setting used in the MRCPCH is a Modified Angoff Method. For each exam diet a panel of Angoff judges who are subject matter experts grade the difficulty of the exam, by item, which results in a cut-score or pass mark.
Prior to grading the exam, judges are reminded of the 'typical candidate' (see below) for each exam, on whom the difficulty of the exam is based, and are asked to conceptualise the notion of the 'borderline candidate'. The borderline candidate is a fictitious trainee who has a 50% chance of passing the exam. Once this has been established, the judges are asked to independently grade each item of the exam and rate out of 100 borderline candidates the percentage of how many will answer the question correctly. Once completed these ratings are compiled and prepared for a panel discussion.
The judges will then come together as a panel to examine the ratings for each item in sequence and discuss each item’s rating. Judges will discuss disparity in ratings and different viewpoints. Once these have been considered, if they wish, judges will have an opportunity to re-rate items based on the discussions, taking into account:
- the judgements of the entire panel
- the definition of the borderline candidate
- the comments of the panel.
These judgements are the last ratings provided, which when averaged become the final criterion-referenced score for an item. The mean of all these final scores is calculated and the nearest achievable mark becomes the pass mark for the exam.
For each MRCPCH Theory exam, a Result Review Meeting (RRM) is held, where any anomalous items are identified through statistical analysis and candidate feedback and discussed for suitability. If it is decided that the items were unsuitable for use in the exam, they will be removed and will not contribute to the overall pass mark.
Typical candidates
- Typical candidates for the MRCPCH Foundation of Practice (FOP) examination
The aim of the MRCPCH Foundation of Practice examination is to ensure that doctors who will come into contact with children have acquired a knowledge base that will provide a secure footing for clinical practice. Some of these doctors will go on to pursue careers as paediatricians but others may work in primary care settings or work in other hospital settings.
In setting the expected pass mark for the FOP, the Angoff panel are asked to consider the typical candidate as having the clinical knowledge base that would be expected of a competent medical graduate with 4 to 6 months' experience of paediatrics and child health.
Most candidates would be expected to put at least 150-200 hours of preparation time into this exam.
- Typical candidates for the MRCPCH Theory and Science (TAS) examination
The aim of the MRCPCH Theory and Science examination is to ensure that doctors who intend to become paediatricians can demonstrate an understanding of the theoretical and scientific principles that would underpin their practice upon completion of training.
Whilst this is a broad subject area, the typical candidate for the MRCPCH TAS will be a medical graduate who has completed Foundation programme training and in addition has 6 to 12 months of experience in paediatrics and child health.
Most candidates would be expected to put at least 200 hours of preparation time into this exam, but the precise amount of time required will depend upon their existing knowledge base.
- Typical candidates for the MRCPCH Applied Knowledge in Practice (AKP) examination
The aim of the MRCPCH Applied Knowledge in Practice examination is to assess the candidate's knowledge, understanding and clinical decision-making abilities and to ensure that they have reached the standard of someone entering their core specialist training.
A typical MRCPCH AKP candidate would be expected to know how to successfully manage children with a range of disease that would be encountered within 12 to 18 months of paediatric practice.
They would usually have devoted at least 200 hours of additional personal study to this exam.