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
31 March 2020

What is RCPCHStart?

It's a three-hour assessment with consultant paediatricians which assesses your abilities relating to clinical decision-making as a new consultant. It helps you address any gaps that you may have in your training.

RCPCHStart 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 scenarios 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 trainee 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. Note: This is subject to availability and capacity, with trainees taking preference.

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

When do I take it?

We normally host RCPCHStart twice a year, in the spring and autumn. The next dates are:

  • 1 and 2 April 2020 - RCGP, London - Cancelled - trainees have been contacted and offered the next available assessment sitting
  • 8 and 9 October 2020 - Manchester and we are locating an extra venue for these dates - TBC

You can apply to take RCPCHStart after you have started ST6. However, we recommend you take the assessment when you are most suited (usually ST7, for some it might be ST8) as long as you allow at least six months to address any developments required. Do not expect to be guaranteed a place in ST6 or early ST7 even if you have applied previously - we determine places based on CCT date detailed in the latest ARCP outcome we have access to.

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

If you plan to complete training in an approved sub-specialty GRID training programme, 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 sub-specialty on your application so we can place you on the relevant circuit.

You might 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 sub-specialty. 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.

Note: The 1-2 April 2020 session has been cancelled; we have contacted trainees to offer the next available assessment sitting

Sub-specialty Session
AIID (Allergy, Immunology, Infectious disease) 1 - 2 Apr 2020 / 8 - 9 Oct 2020
CCH 1 - 2 Apr 2020 / 8 - 9 Oct 2020
Child Mental Health 1 - 2 Apr 2020 / 8 - 9 Oct 2020
Endocrinology 1 - 2 Apr 2020 / 8 - 9 Oct 2020
Emergency Medicine 8 - 9 Oct 2020
Metabolic Medicine 1- 2 April 2020 / Spring 2021
Nephrology 1 - 2 Apr 2020 / Spring 2021
Neurology 1 - 2 Apr 2020 / 8 - 9 Oct 2020
Neurodisability 8 - 9 Oct 2020
Neonatal Medicine 1 - 2 Apr 2020 / 8 - 9 Oct 2020
Oncology 1 - 2 Apr 2020 / 8 - 9 Oct 2020
PICM 1 - 2 Apr 2020 / 8 - 9 Oct 2020
Palliative Medicine 1 - 2 Apr 2020 / Spring 2021
PGHAN 1 - 2 Apr 2020 / Spring 2021
Respiratory 8 - 9 Oct 2020
Rheumatology 8 - 9 Oct 2020

How much does it cost?

New fees will come into effect from October 2020 (unless transferring over from the April 2020 rescheduled START assessment) and are:

  • Run-through trainees that enrolled with the RCPCH for training before 1 August 2019 pay between £268 and £559
  • Run-through trainees that enrolled with the RCPCH for training on or after 1 August 2019 (indicatively taking the START assessment in 2024) pay £850
  • Non run-through trainees - £850
  • For a fuller explanation on how the fees are determined, please see our training guide

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.

The 8-9 October 2020 session will take place in Manchester.

How do I apply?

Note on CCT date Before you apply, check your latest ARCP (Annual Review of Competence Progression) has the correct CCT date, as we use this to prioritise placements for RCPCHStart. If the CCT date is not correct, you will need to get confirmation of your correct CCT date from your Training Programme Director or Head of School, and ask them to complete the Record of Completion of Training Date on your ePortfolio. 

You can apply online when applications open for the appropriate session:

Assessment Application window Status
April 2020 (London) From first Monday Oct to last Friday Nov 2019 Closed; assessment date cancelled
October 2020 (Manchester) TBC Not yet open
Spring 2021 (TBC) From first Monday Oct to last Friday Nov 2020 Not yet open
Autumn 2021 (TBC) From first Monday Apr to last Friday May 2021 Not yet open

You'll need to log in, go to Account and find the RCPCHStart panel. Then, follow the on-screen instructions.

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 CCT dates closest to the assessment determined by training time left rather than chronoloically - see 'Note on CCT date' above
  3. Date application received

The number of times of you have applied will not be relevant if your CCT date does not warrant a place on the assessment. An expectation to complete your CCT early is insufficient evidence of a change and we will require confirmation from your Training Programme Director and CSAC, if GRID training, before we accept an earlier date. You are now able to submit a Record of Completion of Training Date on your ePortfolio to show us the most accurate CCT date possible.

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, you must include this in your application. Make sure you use the comments box on the application form and send support for an earlier CCT date from Programme Director or CSAC to training.services@rcpch.ac.uk.

If we don't receive the necessary information and email support before the application window closes, we may not be able to consider you for shortlisting or offer you a place. Please note, there is no guarantee of a place in the assessment even if you do have supporting emails as others may take priority.

The final decision on place allocation rests with the RCPCH office so we need all relevant information to make an informed decision.

Withdrawing and refunds

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