RCPCHStart (Specialty Trainee Assessment of Readiness for Tenure) is primarily an assessment of Clinical Decision Making and of Level 3 competencies not assessed elsewhere. 



The next RCPCHStart assessment will be held at the RCGP in Euston, London, on 11-12 April 2018.

The next dates are 29-30 October 2018. The application round for this will open June 2018.

If you belong to a Grid Subspecialty, please note that you may have to take the assessment at a specific session (Spring or Autumn) - see below for dates. If at all possible, you should aim to apply for the preferred session, but if that’s not possible, then 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.

Subspecialty Session
Nephrology April 2018
AIID April/October 2018
Child Mental Health April/October 2018 
Oncology April/October 2018 
PICM April 2018 
Endocrinology April/October 2018 
Neurology April/October 2018 
Neurodisability October 2018
Palliative Medicine April 2018
PGHAN April/October 2018 
Respiratory April/October 2018 
Rheumatology October 2018 
Emergency Medicine October 2018 
Neonatal Medicine April/October 2018
CCH April/October 2018 
Metabolic Medicine October 2018

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Application information

The application period for the April 2018 assessment has now closed.

You must complete online applications for the assessment. Please note that priority is given to Run Through applicants, particularly those already in ST8 posts. We also reserve the right to limit the amount of subspecialties represented at any given assessment.

We will prioritise applications with CCT dates closest to the assessment - please inform us at time of application if the CCT date given in the application is likely to change. It is advisable to apply for the assessment in a timely manner, as we may need to prioritise applications by date received after our initial placement by CCT.

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.
  • You can sign in, go to Account at the top of the site, and to START
  • RCPCHStart online application guidance(PDF, 8 pages, 554KB) - for guidance on completion of the online form
  • RCPCHStart Trainee Guidance April 2018 (PDF, 3 pages, 429KB) - for guidance on the application, assessment and feedback release
  • If you think you might gain your CCT early, or you have any other information that you think would be useful for us to know, please let the RCPCHStart Team know when you apply for the assessment.


  • RCPCHStart costs £250 on application for run-through trainees, and £850 for non run-through trainees.
  • Our withdrawal and refund policy requires that the necessary supporting documentation is supplied with the written notification of withdrawal. The full fee paid minus an administration charge of £40 will be refunded by means of the way it was paid. (Refunds are discretionary.) We will not be able to process any refunds received more than one month after the assessment date.


  • All trainees who have entered Level 3 training on or after 1 August 2011 are required to undertake the RCPCHStart Assessment before applying for their CCT. If you entered Level 3 training earlier but were on maternity leave / OOPE / OOPR / career break and only started work in your ST6 post on or after 1 August 2011, you also need to undertake the RCPCHStart Assessment. Any SpR 3-5 transferring to the run-through curriculum is strongly recommended to take RCPCHStart, although it is not mandatory, as it is an important part of preparation in becoming a consultant.
  • All trainees wishing to CCT in a sub-specialty must have a RCPCHStart assessment in that sub-specialty. We advise that you apply once you have been accepted for a GRID 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 applying.

RCPCHStart and educational supervision

  • Please be aware that feedback should be discussed with your educational supervisor within four weeks of the feedback being released to formulate a plan to address any areas identified for development. Your supervisor should use the RCPCHStart Targeted Feedback October 2016 (PDF, 347KB, 5 pages) to help them do this. Trainees should also read this document.
  • Scores and feedback are not reviewed as they are part of a formative assessment. You need to discuss your feedback with your educational supervisor who will be able to help you interpret the suggestions in the feedback into a development plan.

If your supervisor has any reflections on this they can contact us by email at start@rcpch.ac.uk 

RCPCHStart and ARCP (Annual Review of Competence Progression) 

  • Scores and feedback are not reviewed as they are part of a formative assessment. You need to discuss your feedback with your educational supervisor who will be able to help you interpret the suggestions in the feedback into a development plaRCPCHStart Board Statement (September 2013) (PDF, 110KB, 2 pages) - please read for information about RCPCHStart and ARCP.
  • Note that any requests to take RCPCHStart again must be discussed by the RCPCHStart Executive on a case-by-case basis.

Guidance and further resources


Please contact start@rcpch.ac.uk if you have any further queries.

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