About the exam
MRCPCH Theory Exam structure
An independent guide to the three current, non-sequential MRCPCH theory examinations: Foundation of Practice, Theory and Science, and Applied Knowledge in Practice.
Issuer and path
MRCPCH Theory Examinations Study Guide is administered through Royal College of Paediatrics and Child Health. Check official resources before booking, retesting, or relying on a stale requirement.
Foundation of Practice (FOP)
100 scored + 0 pretest
Knowledge, understanding and clinical decision making for doctors seeking to provide clinical care for children, focused on commonly encountered conditions.
Theory and Science (TAS)
100 scored + 0 pretest
Basic scientific, physiological and pharmacological principles of clinical and evidence-based paediatric practice.
Applied Knowledge in Practice (AKP)
120 scored + 0 pretest
Clinical decision making and management at the standard expected of a candidate entering core specialist training, supported by paediatric experience.
Before applying for a theory diet
Confirm PMQ acceptance, exam choice, current attempt and currency position, application window, TestReach location or remote eligibility, reasonable-adjustment evidence and the timings in your admission document.
Official Outline Coverage Map
Coverage is mapped to official outline item counts so content depth can be checked without hard-coding a single exam.
| Topic | Official outline items | Your questions | Your flashcards | Confidence |
|---|---|---|---|---|
| FOP: Adolescent Health and Medicine (5%-30% range band) | 0 | 5 | 5 | Strong |
| FOP: Behavioural Medicine and Psychiatry (5%-30% range band) | 0 | 5 | 5 | Strong |
| FOP: Cardiology (5%-30% range band) | 0 | 4 | 5 | Strong |
| FOP: Dermatology (10%-50% range band) | 0 | 9 | 5 | Strong |
| FOP: Diabetes Mellitus (10%-50% range band) | 0 | 9 | 5 | Strong |
| FOP: Emergency Medicine (10%-50% range band) | 0 | 9 | 5 | Strong |
| FOP: Endocrinology and Growth (10%-50% range band) | 0 | 9 | 5 | Strong |
| FOP: Ethics and Law (5%-30% range band) | 0 | 4 | 5 | Strong |
| FOP: Gastroenterology and Hepatology (20%-80% range band) | 0 | 13 | 5 | Priority |
| FOP: Genetics and Dysmorphology (5%-30% range band) | 0 | 4 | 5 | Strong |
| FOP: Haematology and Oncology (10%-50% range band) | 0 | 9 | 5 | Strong |
| FOP: Infection, Immunology and Allergy (20%-80% range band) | 0 | 13 | 5 | Priority |
| FOP: Metabolism and Metabolic Medicine (5%-30% range band) | 0 | 4 | 5 | Strong |
| FOP: Musculoskeletal (10%-50% range band) | 0 | 9 | 5 | Strong |
| FOP: Neonatology (10%-50% range band) | 0 | 9 | 5 | Strong |
| FOP: Nephro-urology (10%-50% range band) | 0 | 9 | 5 | Strong |
| FOP: Neurodevelopment and Neurodisability (10%-50% range band) | 0 | 9 | 5 | Strong |
| FOP: Neurology (5%-30% range band) | 0 | 4 | 5 | Strong |
| FOP: Nutrition (10%-50% range band) | 0 | 9 | 5 | Strong |
| FOP: Ophthalmology (5%-30% range band) | 0 | 4 | 5 | Strong |
| FOP: Palliative Care and Pain Management (5%-30% range band) | 0 | 4 | 5 | Strong |
| FOP: Patient Safety and Clinical Governance (5%-30% range band) | 0 | 4 | 5 | Strong |
| FOP: Pharmacology (10%-50% range band) | 0 | 9 | 5 | Strong |
| FOP: Respiratory Medicine with ENT (20%-80% range band) | 0 | 13 | 5 | Priority |
| FOP: Safeguarding (5%-30% range band) | 0 | 4 | 5 | Strong |
| FOP: Science of Practice (5%-30% range band) | 0 | 4 | 5 | Strong |
| TAS: Adolescent Health and Medicine (5%-30% range band) | 0 | 5 | 5 | Strong |
| TAS: Behavioural Medicine and Psychiatry (5%-30% range band) | 0 | 5 | 5 | Strong |
| TAS: Cardiology (10%-50% range band) | 0 | 9 | 5 | Strong |
| TAS: Dermatology (5%-30% range band) | 0 | 5 | 5 | Strong |
| TAS: Diabetes Mellitus (5%-30% range band) | 0 | 4 | 5 | Strong |
| TAS: Emergency Medicine (5%-30% range band) | 0 | 4 | 5 | Strong |
| TAS: Endocrinology and Growth (10%-50% range band) | 0 | 9 | 5 | Strong |
| TAS: Ethics and Law (5%-30% range band) | 0 | 4 | 5 | Strong |
| TAS: Gastroenterology and Hepatology (20%-80% range band) | 0 | 13 | 5 | Priority |
| TAS: Genetics and Dysmorphology (10%-50% range band) | 0 | 9 | 5 | Strong |
| TAS: Haematology and Oncology (10%-50% range band) | 0 | 9 | 5 | Strong |
| TAS: Infection, Immunology and Allergy (20%-80% range band) | 0 | 13 | 5 | Priority |
| TAS: Metabolism and Metabolic Medicine (10%-50% range band) | 0 | 9 | 5 | Strong |
| TAS: Musculoskeletal (5%-30% range band) | 0 | 4 | 5 | Strong |
| TAS: Neonatology (20%-80% range band) | 0 | 13 | 5 | Priority |
| TAS: Nephro-urology (10%-50% range band) | 0 | 9 | 5 | Strong |
| TAS: Neurodevelopment and Neurodisability (5%-30% range band) | 0 | 4 | 5 | Strong |
| TAS: Neurology (10%-50% range band) | 0 | 9 | 5 | Strong |
| TAS: Nutrition (5%-30% range band) | 0 | 4 | 5 | Strong |
| TAS: Ophthalmology (5%-30% range band) | 0 | 4 | 5 | Strong |
| TAS: Palliative Care and Pain Management (5%-30% range band) | 0 | 4 | 5 | Strong |
| TAS: Patient Safety and Clinical Governance (5%-30% range band) | 0 | 4 | 5 | Strong |
| TAS: Pharmacology (10%-50% range band) | 0 | 9 | 5 | Strong |
| TAS: Respiratory Medicine with ENT (20%-80% range band) | 0 | 13 | 5 | Priority |
| TAS: Safeguarding (5%-30% range band) | 0 | 4 | 5 | Strong |
| TAS: Science of Practice (10%-50% range band) | 0 | 9 | 5 | Strong |
| AKP: Adolescent Health and Medicine (8%-17% range band) | 0 | 5 | 5 | Strong |
| AKP: Behavioural Medicine and Psychiatry (8%-17% range band) | 0 | 5 | 5 | Strong |
| AKP: Cardiology (25%-33% range band) | 0 | 11 | 5 | Strong |
| AKP: Dermatology (8%-17% range band) | 0 | 5 | 5 | Strong |
| AKP: Diabetes Mellitus (25%-33% range band) | 0 | 11 | 5 | Strong |
| AKP: Emergency Medicine (25%-33% range band) | 0 | 10 | 5 | Strong |
| AKP: Endocrinology and Growth (25%-33% range band) | 0 | 10 | 5 | Strong |
| AKP: Ethics and Law (8%-17% range band) | 0 | 5 | 5 | Strong |
| AKP: Gastroenterology and Hepatology (25%-33% range band) | 0 | 10 | 5 | Strong |
| AKP: Genetics and Dysmorphology (8%-17% range band) | 0 | 5 | 5 | Strong |
| AKP: Haematology and Oncology (25%-33% range band) | 0 | 10 | 5 | Strong |
| AKP: Infection, Immunology and Allergy (38%-50% range band) | 0 | 16 | 5 | Priority |
| AKP: Metabolism and Metabolic Medicine (25%-33% range band) | 0 | 10 | 5 | Strong |
| AKP: Musculoskeletal (8%-17% range band) | 0 | 5 | 5 | Strong |
| AKP: Neonatology (38%-50% range band) | 0 | 16 | 5 | Priority |
| AKP: Nephro-urology (25%-33% range band) | 0 | 10 | 5 | Strong |
| AKP: Neurodevelopment and Neurodisability (25%-33% range band) | 0 | 10 | 5 | Strong |
| AKP: Neurology (25%-33% range band) | 0 | 10 | 5 | Strong |
| AKP: Nutrition (8%-17% range band) | 0 | 5 | 5 | Strong |
| AKP: Ophthalmology (8%-17% range band) | 0 | 5 | 5 | Strong |
| AKP: Palliative Care and Pain Management (8%-17% range band) | 0 | 5 | 5 | Strong |
| AKP: Patient Safety and Clinical Governance (8%-17% range band) | 0 | 5 | 5 | Strong |
| AKP: Pharmacology (25%-33% range band) | 0 | 10 | 5 | Strong |
| AKP: Respiratory Medicine with ENT (38%-50% range band) | 0 | 16 | 5 | Priority |
| AKP: Safeguarding (25%-33% range band) | 0 | 10 | 5 | Strong |
| AKP: Science of Practice (8%-17% range band) | 0 | 5 | 5 | Strong |
How to use this guide
How to prepare across FOP, TAS and AKP
Learn each paediatric specialty through three different lenses: common clinical foundations, underlying science, and applied clinical decision making.
1. Identify the examination lens
Ask whether the item requires common-practice recognition, an underlying scientific explanation or an applied management decision.
2. Anchor age and acuity
Use developmental stage, weight, physiology and immediate risk before applying a diagnosis or intervention.
3. Extract decisive evidence
Combine the stem with examination findings, images, laboratory data, ECGs and treatment response.
4. Match depth to FOP, TAS or AKP
Choose safe initial care for FOP, the best mechanism for TAS, or the best current decision for AKP.
5. Select one best answer
Compare plausible options against the exact lead-in, answer every item and move on because wrong answers carry no penalty.
FOP official syllabus
Foundation of Practice: 26 specialty mappings
Knowledge, understanding and clinical decision making for doctors seeking to provide clinical care for children, focused on commonly encountered conditions. The exact 2026 range band is retained on every specialty.
FOP Syllabus
Knowledge, understanding and clinical decision making for doctors seeking to provide clinical care for children, focused on commonly encountered conditions.
Choose a topic to open below
TAS official syllabus
Theory and Science: 26 specialty mappings
Basic scientific, physiological and pharmacological principles of clinical and evidence-based paediatric practice. The exact 2026 range band is retained on every specialty.
TAS Syllabus
Basic scientific, physiological and pharmacological principles of clinical and evidence-based paediatric practice.
Choose a topic to open below
AKP official syllabus
Applied Knowledge in Practice: 26 specialty mappings
Clinical decision making and management at the standard expected of a candidate entering core specialist training, supported by paediatric experience. The exact 2026 range band is retained on every specialty.
AKP Syllabus
Clinical decision making and management at the standard expected of a candidate entering core specialist training, supported by paediatric experience.
Choose a topic to open below
FOP: Adolescent Health and Medicine
Development, transition, risk-taking, mental and sexual health, confidentiality and chronic-condition care in young people. Recognise common paediatric presentations, make an age-appropriate assessment and select safe initial investigation or treatment.
Key rules
Rule 1
Recognise common adolescent health needs, risk behaviours and transition issues.
Exam cue: Identify age, acuity and the common presentation before selecting the safest first-line answer.
Rule 2
Relate puberty and continuing neurodevelopment to cognition, behaviour, sexual health and treatment.
Exam cue: Recognise common adolescent health needs, risk behaviours and transition issues.
Rule 3
Assess risk, confidentiality, capacity and complex transition or sexual-health decisions.
Exam cue: Address self-harm, exploitation, safeguarding and confidentiality limits directly.
Common traps
Do not overcomplicate a common presentation with a rare diagnosis before checking age-specific red flags and first-line care.
Prevention: Do not choose a plausible fact that answers a different exam lens or a different time point.
Do not transfer adult norms, doses or decision thresholds to a child without checking age, development and weight.
Prevention: Do not calculate until weight, units, concentration, maximum dose and monitoring are explicit.
Do not infer a fixed Adolescent Health and Medicine item count from the published 5%-30% range band.
Prevention: Do not choose a plausible fact that answers a different exam lens or a different time point.
Memory anchors
FOP lens
Recognise common paediatric presentations, make an age-appropriate assessment and select safe initial investigation or treatment.
Adolescent Health and Medicine: foundation
Recognise common adolescent health needs, risk behaviours and transition issues.
Adolescent Health and Medicine: science
Relate puberty and continuing neurodevelopment to cognition, behaviour, sexual health and treatment.
Adolescent Health and Medicine: applied practice
Assess risk, confidentiality, capacity and complex transition or sexual-health decisions.
Adolescent Health and Medicine: safety check
Address self-harm, exploitation, safeguarding and confidentiality limits directly.
Next best moves
Quick check-up
Use a short quiz to confirm the rule pattern is actually sticking.
Check-up Questions
A 15-year-old asks to discuss contraception without her parent present. She understands the options and consequences. What is the best first response?
A 14-year-old with type 1 diabetes repeatedly misses insulin at school because of embarrassment. What is the most helpful next step?
Answer all questions to submit.
Next step personalized recommendations
Open another topic next
Official resources
Verify the details with the official sources
Use these links for eligibility, scheduling, handbook rules, and issuer updates. Our guide helps you study; official sources tell you what the testing partner currently requires.
RCPCH: Theory examinations
Current theory hub covering the three examinations, TestReach delivery, preparation, dates and regulations.
RCPCH: Theory structure and syllabi
Current FOP, TAS and AKP purposes, item counts, timings, SBA format, image guidance and syllabus download.
MRCPCH Theory Examination Syllabi v3
February 2026 official syllabus containing all 26 specialty columns and the updated FOP, TAS and AKP blueprint range tables.
RCPCH: Before applying for theory exams
Current non-sequential exam order, eligibility, delivery options, fees and preparation information.
RCPCH: How you sit the exam
Current TestReach computer delivery, test-centre and remote-invigilation rules and exam timings.
RCPCH: 2024 theory format changes
Official change to 100 SBA FOP, 100 SBA TAS and 120 SBA AKP, removing EMQ and N-of-many formats.
RCPCH: MRCPCH and DCH regulations
Current eligibility, currency, attempts, Clinical progression, Modified Angoff and examination rules.
RCPCH: Theory standard setting
Official criterion-referenced Modified Angoff explanation and diet-specific pass-mark boundary.
RCPCH: 2025 Angoff process amendment
Official removal of the third post-performance Angoff judgement from the April 2025 diet.
RCPCH: Theory sample papers
Official specimen links with the warning that older FOP and TAS examples include question formats no longer used.
RCPCH: Upcoming theory dates
Live diets, examination dates, locations and application windows, which should be checked before booking.
FAQ
Common MRCPCH Theory questions
Is this an official RCPCH resource?
No. This is an independent study guide. The current RCPCH syllabus, regulations, admission document, TestReach instructions and direct candidate communications remain authoritative.
What does the mrcpch-theory slug include?
It includes the complete theory stage: Foundation of Practice, Theory and Science, and Applied Knowledge in Practice. These are three separate examinations rather than three papers contributing to one combined score.
Must FOP, TAS and AKP be taken in order?
No. RCPCH describes them as non-sequential and candidates may take them in any order. All three must be passed before applying for MRCPCH Clinical.
What is the current FOP format?
Foundation of Practice contains 100 five-option Single Best Answer questions and lasts 120 minutes. It assesses knowledge, understanding and clinical decision making for commonly encountered child-health conditions.
What is the current TAS format?
Theory and Science contains 100 five-option Single Best Answer questions and lasts 120 minutes. Its focus is the scientific, physiological, pharmacological and evidence-based basis of paediatric practice.
What is the current AKP format?
Applied Knowledge in Practice contains 120 five-option Single Best Answer questions split into two same-day parts. Each part contains 60 questions and lasts 150 minutes.
Can FOP and TAS be taken on the same day?
Yes. Candidates may apply for both on the same day; RCPCH states that FOP is held in the morning and TAS in the afternoon, with a break between them.
Are extended matching questions still used?
No. From the September 2024 diet, all three examinations use best-of-five SBA questions. Some older FOP and TAS specimen papers still show extended matching questions, and RCPCH explicitly warns that those formats are no longer used.
What does a best-of-five SBA test?
A stem leads to five plausible options. More than one option may contain a correct element, but only one is the best answer for the precise clinical or scientific question. Marks are awarded only for the selected best answer.
What is the difference between FOP, TAS and AKP?
FOP emphasises common paediatric presentations and foundational clinical decisions. TAS asks for mechanisms, physiology, pharmacology and evidence. AKP requires synthesis of history, examination, images and data to make higher-complexity clinical management decisions.
How many syllabus specialties are there?
The current version 3 syllabus contains 26 specialty areas. Each is mapped separately to FOP, TAS and AKP, giving 78 exam-by-specialty outline rows in this guide.
Are the published percentage ranges fixed weights?
No. The current syllabus groups specialties into three percentage-range bands for each examination but does not publish a fixed item count for an individual specialty or an additive percentage distribution. This guide preserves each exact band and does not convert it into an unsupported official count.
Why did the syllabus version change in 2026?
RCPCH issued version 3 in February 2026 and records that the ranges on the FOP, TAS and AKP blueprint pages were updated. The wider specialty syllabus remains organised as three exam-specific columns aligned to Progress+.
Can image and data questions appear?
Yes. RCPCH describes clinical and retinal photographs, radiographs, investigation images, laboratory or graphical data and ECGs. AKP may test short histories, clinical images, X-rays, data, ECG data and evidence-based medicine.
How are the theory examinations marked?
Every question is worth one mark, marks are awarded only for the correct best answer, and negative marking is not used. FOP, TAS and AKP are passed independently rather than through an aggregate theory score.
How is each pass mark set?
RCPCH uses criterion-referenced Modified Angoff standard setting. Subject-matter judges estimate the expected performance of a minimally competent candidate item by item, so the pass mark and pass rate may vary by diet. From the April 2025 diet, the post-performance third judgement was removed, leaving two Angoff judgements.
Who is eligible for the theory examinations?
RCPCH requires a valid primary medical qualification from a registered institution that renders the holder eligible for UK GMC registration, or an overseas qualification recognised by the GMC. Current registration and booking evidence should be checked before applying.
Is FOP only part of MRCPCH?
No. FOP is also the theory component of the Diploma of Child Health. DCH candidates take FOP and DCH Clinical, while MRCPCH candidates must pass FOP, TAS, AKP and MRCPCH Clinical.
How long do theory passes remain current for Clinical?
The current regulations require MRCPCH Clinical to be passed within seven years of completing all three theory examinations. If the period expires, the rules describe re-sitting AKP to restart the registration period, subject to individual circumstances and approved exceptions.
How many attempts are permitted?
Current regulations ordinarily allow six attempts at each of FOP, TAS, AKP and MRCPCH Clinical. The attempt rule was extended to candidates outside UK paediatric training and international candidates from September 2024, with a further-attempt route based on additional educational experience.
Are the 601 practice questions official?
No. They are original independent practice items. The bank labels every item as FOP, TAS or AKP and covers all 78 exam-by-specialty mappings, but it is not a combined full mock: the official examinations contain 100 FOP, 100 TAS and 120 AKP questions and are passed separately.