RCPCH START - how it works (structure and specimen papers)

START means Specialty Trainee Assessment of Readiness for Tenure, and it guides trainees as they prepare for completion of training and practice as a new consultant. The assessment is designed to assess generic skills. Here is how it works and what to expect on the day. Example scenarios are available to download at the bottom of the page.
Status
Last modified
16 December 2025

Structure and specimen questions

We have a circuit with stations testing different skills. These include:

  • Can you hand over to a colleague?
  • Can you take a ward round?
  • Can you safely prescribe?
  • Can you make decisions in a clinical situation where the diagnosis is not clear?
  • Can you lead the team on the ward?
  • Do you understand safeguarding children and the ethics that underpins our practice?
  • Can you read a paper and take away the clinically important messages?

Circuit and scenarios

The START Assessment is held online and has 10 stations. Each station is eight minutes long.

The 10 stations are:

  • Scenario based discussion - 3 stations
  • Ward round and handover
  • Safeguarding children
  • Critical review of literature
  • Safe prescribing
  • Ethics, consent, law
  • Conflict and risk management
  • Teaching

You can download example scenarios below. These relate to the specimen trainee feedback report, also below.

Format

  • The sequence in which you take the stations in the circuit varies.
  • Each station is eight minutes long.
  • There are four-minute breaks between each station, in which you will read the next scenario.
  • There will be a 20 minute break during the assessment.

Feedback sheet

At the end of each station the assessor will make an overall judgement of your performance, with these categories:

  • Above competence
  • Meets competence
  • Development needed to achieve competence
  • Significant concerns

Remember, we are not assessing to find outstanding trainees. We are looking for those trainees who meet the standard required: trainees who can perform at the level of a newly-appointed consultant.

 

Benchmarking

The ‘anchor statements’ for each station enable the assessors to make judgements on trainees, and the trainees to understand the expected standards. You can download these benchmarking standards below.

 

Contact information

If you have any questions, please contact us at START@rcpch.ac.uk