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
13 September 2018

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 before you apply for your CCT (certificate of completion of training) or equivalent if you:

  • entered Level 3 training (ST6) on or after 1 August 2011
  • entered Level 3 training earlier but were on shared parental leave/OOPE (out of programme education)/OOPR (out of programme research)/career break and only started work in your ST6 post on or after 1 August 2011.

You are recommended to take RCPCHStart, but it is not mandatory, if you are:

  • SpR (Specialty Registrar) 3-5 transferring to the run-through curriculum.

You can also take part if you:

  • 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 start@rcpch.ac.uk.

When do you take it?

We host RCPCHStart twice a year, in the spring and autumn.

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 CCT in a sub-specialty ('grid'), you must have RCPCHStart in that sub-specialty. We advise that you apply after you have been accepted for a sub-specialty or community child health post and are working in that post. You should be confident that you are ready to be assessed in your sub-specialty before you apply.

You will need to include your sub-specialty 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 sub-specialty. If not, apply for the first available session and outline your circumstances (CCT date being brought forward. etc), and we will send your name and request forward to the CSAC.

Sub-specialty Session
AIID (Allergy, Immunology, Infectious disease) October 2018/March 2019
CCH October 2018/March 2019
Child Mental Health October 2018/March 2019
Endocinology October 2018/March 2019
Emergency Medicine October 2018/September 2019
Metabolic Medicine October 2018/September 2019
Nephrology March 2019
Neurology October 2018/March 2019
Neurodisability October 2018/September 2019
Neonatal Medicine October 2018/March 2019
Oncology October 2018/March 2019
PICM October 2018/March 2019
Palliative Medicine March 2019
PGHAN March 2019
Respiratory October 2018/March 2019
Rheumatology October 2018/September 2019

How much does it cost?

You need to pay for RCPCHStart when you apply online, and we accept credit cards and debit cards. 

The cost is £250 for run-through trainees, and £850 for non run-through trainees. We are happy to issue receipts for the assessment fee - please email your request to us at start@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. Applications are not currently open.

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 CCT dates closest to the assessment - you can let us know in your application if your CCT 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 RCPCHStart team.


You can withdraw up to one week before the assessment date. You must inform us in writing to start@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. 

Refunds are discretionary. We normally refund the full fee minus an administration charge of £40 to the debit card or credit card you paid with. We cannot process refund request more than one month after the assessment date.

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. But, 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 judgements 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 station.

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 competences acquired through training, and which are appropriate at CCT.

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 start@rcpch.ac.uk.