RCPCHStart - guidance for trainees

RCPCHStart means Specialty Trainee Assessment of Readiness for Tenure. It guides trainees as they prepare for completion of training and practice as a new consultant paediatrician.

Find out how to check your eligibility, apply and pay, and how it fits in with your educational supervision.
Last modified
4 April 2019

What is RCPCHStart?

RCPCHStart is a three-hour assessment with consultant paediatricians. It assesses your abilities in relation to clinical decision making as a new consultant. And, it helps you address any gaps that you may have in your training.

It has a circuit of 12 stations, which test different skills. The stations include scenario based discussions on acute disease, chronic problems, behaviour difficulties and neonatal care. Other scenarios include safeguarding, ward handover and ethics. There are also stations on critical appraisal and teaching.

You can read more about the circuit, watch our videos and download example scenarios on our how it works page.

Who needs to, or should, take RCPCHStart?

You must take RCPCHStart if you are Paediatric training expecting to attain a CCT (certificate of completion of training) or CESR Combined Programme, ie will complete a UK Paediatric Training programme leading to entry on the Specialist Register.

You can also take part if you are a doctor in a non-approved training post, such as a Specialty Doctor, Trust Doctor, Associate Specialist, Staff Grade or Locum Approved for Service post.

If you are not sure whether to take it, please email us on training.services@rcpch.ac.uk.

When do you take it, and when does it take place?

We normally host RCPCHStart twice a year, in the spring and autumn. The next dates are 30 September / 1 October and 2019 and 1 / 2 April 2020. We are aware that the autumn session falls during Jewish New Year; if this will cause a problem for you, please contact us on training.services@rcpch.ac.uk.

You can take RCPCHStart after you have become an ST6. But, we recommend you do it in your ST7 year. This allows at least six months to complete any follow up actions.

What happens if I am in sub-specialty ('GRID') training?

If you plan to complete training in an approved subspecialty GRID training programe, you must have RCPCHStart in that sub-specialty. We advise that you apply after you have been accepted for a subspecialty GRID post and are working in that post. You should be confident that you are ready to be assessed in your subspecialty before you apply.

You will need to include your subspecialty on your application so we can place you on the relevant circuit.

You may have to take the assessment at a specific session (Spring or Autumn) - see below for dates. If possible, apply for the session where we plan to host your subspecialty. If not, apply for the first available session and outline your circumstances (completion date being brought forward. etc), and we will send your name and request onto the CSAC.

Sub-specialty Session
AIID (Allergy, Immunology, Infectious disease) 30 Sep - 1 Oct 2019 /  1 - 2 Apr 2020
CCH 30 Sep - 1 Oct 2019 /  1 - 2 Apr 2020
Child Mental Health 30 Sep - 1 Oct 2019 /  1 - 2 Apr 2020
Endocrinology 30 Sep - 1 Oct 2019 /  1 - 2 Apr 2020
Emergency Medicine 30 Sep - 1 Oct 2019 /  autumn 2020
Metabolic Medicine 30 Sep - 1 Oct 2019 /  autumn 2020
Nephrology 1 - 2 Apr 2020
Neurology 30 Sep - 1 Oct 2019 /  1 - 2 Apr 2020
Neurodisability 30 Sep - 1 Oct 2019 /  autumn 2020
Neonatal Medicine 30 Sep - 1 Oct 2019 /  1 - 2 Apr 2020
Oncology 30 Sep - 1 Oct 2019 /  1 - 2 Apr 2020
PICM 30 Sep - 1 Oct 2019 /  1 - 2 Apr 2020
Palliative Medicine 1 - 2 Apr 2020
PGHAN 1 - 2 Apr 2020
Respiratory 30 Sep - 1 Oct 2019 /  autumn 2020
Rheumatology 30 Sep - 1 Oct 2019 /  autumn 2020

How much does it cost?

The RCPCHStart fee policy is changing. We will publish more details when the next application window opens.

You will need to pay for RCPCHStart after you have been granted a place and we accept credit cards and debit cards.

We are happy to issue receipts for the assessment fee - please email your request to us at training.services@rcpch.ac.uk

We do not pay for travel or accommodation costs.

Where does it take place?

RCPCHStart usually takes place at the Royal College of General Practitioners Assessment Centre in Euston, London. This is a specialised venue for this type of assessment.

We are exploring locations outside London from 2020.

How do you apply?

You can apply online during an application period - you'll need to log in, go to Account and find the RCPCHStart panel. 

We will allocate places after the application period - please allow one to two working weeks after it closes.

Prioritising applications

We recommend you apply for RCPCHStart early in the application period. We prioritise as follows:

  1. Applicants in run-through training, particularly those in ST8 posts
  2. Applicants with completion of training dates closest to the assessment - you can let us know in your application if your completion date is likely to change
  3. Date application received

An expectation to complete your CCT early is insufficient evidence of a change and we will require confirmation from your Educational Supervisor before we accept an earlier date.

If you think you may gain your CCT early, or you have any other information that you think would be useful for us to know, please include this in your application, or contact the RCPCH Training Services team.


You can withdraw up to one week before the assessment date. You must inform us in writing to training.services@rcpch.ac.uk and we may ask you to provide supporting documentation.

If you are unable to attend the assessment due to unforeseen circumstances, please inform us in writing no later than the day of the assessment.

Refund policy

Time of cancellation before RCPCHStart


Up to 14 working days

Full minus 10% admin fee (if place can be taken by another trainee a 100% refund can be offered)

Within 14 working days before

50% refund regardless of whether another trainee can take the place

No refund will be given for non-attendance on the day regardless of reason.

How do I prepare?

You aren’t required to do any ‘revision’ – the scenarios should be examples of your ‘day-to-day’ work.

You will probably find it helpful to familiarise yourself and keep up to date with NICE guidance and GMC guidance on confidentiality, consent, capacity, duty of candour, colleague in difficulty, answering complaints and safeguarding. You may consider going through your drug charts with a pharmacist.

What do I need to know on the day?

You are welcome to bring food and drink. The circuit is over three hours without a break. There are water points to top up your bottle and an on-site café for before and after the assessment.

We provide paper though, you might want to bring a highlighter for the critical appraisal scenario. A spare pen is a good idea too.

There is no dress code. Do dress as you would when going to work. There's no need for a suit and tie, or dress - but if that’s more comfortable for you, then that’s fine, too!

How do assessors judge my performance?

RCPCHStart has anchor statements which allow assessors to make judgments on trainees at each station.

This covers six domains, though not all stations cover all domains. These are: decision making and prioritising, knowledge, management of complexity, professional approach, safety and risk management, and communication.

A global rating is also made as an assessment of performance overall in the scenario.

Within each domain, the trainee is assessed at three levels - well above expected standard, performed at expected standard, and further development required.

You can download the benchmarking standards below.

The assessors complete an assessor feedback form at each station, also available to download below.

How do I get feedback?

We will send your feedback report about six weeks after the assessment. It will appear in your RCPCH ePortfolio, and you can search for it in your timeline.

Your report will include your global rating, your overall score, your performance against the competency domains and the cohort mean and written feedback for each station. It is similar to the ePaedMSF report.

There is no pass/fail mark. However, trainees can underperform and the feedback will include recommendations to address any development areas.

What do I do with the feedback?

You should discuss your feedback with your educational supervisor within four weeks of getting it. Your supervisor can help you interpret the feedback into a development plan.

You and your supervisor can use the Guide for RCPCHStart assessment feedback and targeted development for educational supervisors, available to download below.

If you are not in training, you will be asked to nominate a supervisor who can assist in the feedback process.

What happens if there are concerns?

The responsibility to remediate concerns will lie with your local education provider. The College works closely with all paediatric schools, College Tutors and educational supervisors to ensure a robust system is implemented in assisting those in training to address issues.

Trainees are not expected to undertake the assessment again unless it is agreed between them and their supervisor/ paediatric school as part of their feedback.

How does this relate to ARCPs (Annual Review of Competence Progression)?

RCPCHStart is not designed to gate‐keep progression through training and should not be the sole determinant of ARCP outcome. Rather it is another formative piece of evidence a trainee has in their portfolio on capabilities acquired through training that are relevant to completing training.

Any requests to take RCPCHStart again must be discussed by the RCPCHStart Executive on a case-by-case basis.

You can find out more in the RCPCHStart and ARCPs statement, as well as the Guide for educational supervisors, available to download below.


If you have any queries, please contact training.services@rcpch.ac.uk