Exam guide
The MRCPCH Foundation of Practice and Theory and Science, explained
Two theory papers, both 100 single best answer, one clinical (FOP) and one scientific (TAS). Set by the Royal College of Paediatrics and Child Health.
Last checked 15 August 2026. Confirm current fees, dates and the live syllabus on the RCPCH's own site before booking.
How the exam is structured
MRCPCH is sat as 2 separate stages, each its own sitting — not one combined exam.
Foundation of Practice (FOP)
| Papers | Foundation of Practice (FOP) |
|---|---|
| Questions | 100 across 1 paper |
| Time | 120 minutes total (120 min for Foundation of Practice (FOP)) |
| Question types | 100 SBA |
Theory and Science (TAS)
| Papers | Theory and Science (TAS) |
|---|---|
| Questions | 100 across 1 paper |
| Time | 120 minutes total (120 min for Theory and Science (TAS)) |
| Question types | 100 SBA |
| Options per SBA/MCQ | 5 (A–E) |
|---|---|
| Sittings per year | 3 |
| Set by | Royal College of Paediatrics and Child Health |
Where the marks are
Most candidates revise every domain evenly by accident, which spends most of their time on a fraction of the paper. A SpecialityMCQ session is built to the weights below, then tilted toward whichever domain is currently costing you marks.
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Gastroenterology & Hepatology
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Infection, Immunology & Allergy
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Respiratory Medicine with ENT
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Neonatology
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Endocrinology & Growth
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Haematology & Oncology
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Nephro-urology
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Neurology
The RCPCH's published blueprint (Theory Examination Syllabi v3) assigns each subspecialty to one of three official emphasis tiers, not a single percentage — that domain-to-tier assignment is official. The specific percentage shown is SpecialityMCQ's even-split derivation within the college's published tier range, averaged across FOP and TAS.
A sample question
Written in-house to the MRCPCH style and answered against a named, current source — not claimed to be from a past paper. It plays exactly as it would in the app.
An 8-month-old infant is brought to the paediatric assessment unit with a two-day history of fever, now 39.2°C. On examination he is pale and lethargic, with a capillary refill time of 4 seconds and a weak, high-pitched cry. Which of these findings places him in the 'red' (high-risk) category of the NICE traffic light system for febrile children under 5?
- Source
- Fever in under 5s: assessment and initial management (NICE, 2019) — Traffic light system for identifying risk of serious illness
- Checked
- Read against this source on 12 Aug 2026. If the guidance changes, the question comes back for another read before it is shown again.
Where this answer comes from
TAKEAWAY
A capillary refill time of 3 seconds or more sits in the 'red' circulation-and-hydration column of the NICE traffic light system, alongside reduced skin turgor — it is one of the features that, on its own, marks a child as high risk and prompts urgent face-to-face assessment.
Why B is right
A capillary refill time of 3 seconds or more is listed under the 'red' circulation and hydration column of the NICE traffic light table.
Duration of fever is not itself a traffic light criterion at this length. NICE instead flags fever with no obvious source persisting 5 days or more as a prompt for further assessment, which is a different threshold and a different reason.
Height of fever alone is only a formal traffic light criterion within a specific age band: 39°C or higher is 'amber' for infants aged 3-6 months. This infant is 8 months old, so temperature alone does not map to an amber or red criterion here — the capillary refill time is what places him in the red category.
A cry that responds normally to reassurance is a reassuring ('green') feature. It is a weak, high-pitched, or continuous cry that is amber or red, depending on severity.
Normal colour of skin, lips and tongue is a green (low-risk) feature, the opposite of what places a child in the red category.
You just answered one. Five a day are free.
Start freeA real question, written in-house to this exam's style, shown exactly as it would play in the app.
Where SpecialityMCQ fits
SpecialityMCQ's MRCPCH bank grows toward the weights above, written as single best answer items set in UK NHS practice. Sessions balance every domain, then tilt toward whichever is currently costing you marks. Anything you miss returns on a spacing curve until it sticks, and every answer names the source it rests on and the date that source was last read.
New questions a day are free, with no card required, and the review deck is free for good.
Questions about the MRCPCH exam
What is the MRCPCH Foundation of Practice and Theory and Science?
MRCPCH Foundation of Practice and Theory and Science is set by the Royal College of Paediatrics and Child Health. Two theory papers, both 100 single best answer, one clinical (FOP) and one scientific (TAS).
How is the MRCPCH exam structured across its stages?
MRCPCH is sat as 2 separate stages, not one combined exam: Foundation of Practice (FOP): 100 questions across 1 paper (120 minutes); Theory and Science (TAS): 100 questions across 1 paper (120 minutes). Each with 5 options per single-best-answer item.
What does the MRCPCH blueprint cover?
The chart on this page shows the highest-weighted domains. The RCPCH's published blueprint (Theory Examination Syllabi v3) assigns each subspecialty to one of three official emphasis tiers, not a single percentage — that domain-to-tier assignment is official. The specific percentage shown is SpecialityMCQ's even-split derivation within the college's published tier range, averaged across FOP and TAS.
How many times a year can I sit MRCPCH?
3 sittings a year, per the RCPCH's own published exam calendar. Confirm current dates and fees on the college's own site before booking.
Is SpecialityMCQ affiliated with the RCPCH?
No. SpecialityMCQ is an independent revision tool and is not affiliated with, endorsed by, or accredited by the Royal College of Paediatrics and Child Health.
Sitting a different exam? SpecialityMCQ also covers MRCS Part A , MRCOG Part 1 and Part 2 , MRCPsych Paper A and Paper B and MRCEM Primary and MRCEM SBA , each with its own guide.
SpecialityMCQ is an independent revision tool. It is not affiliated with, endorsed by, or accredited by the Royal College of Paediatrics and Child Health, or any other exam authority. This page summarises the college's own published exam information for candidates and is not a substitute for it. Always confirm current syllabus, fees and dates on the college's own site before applying.