How to prepare for the MRCPCH
MRCPCH Clinical is a 10-station circuit (four short clinical stations with real children, plus development, history, two communication and two video stations), with a different examiner at each station marking set domains. Prepare by examining as many children as you can, focused on the task you are given, practising describing developmental assessments out loud, and rehearsing history and communication scenarios against the RCPCH's anchor statements, which set out what 'Meets Standard' looks like.
Step by step
- 1
Apply when your sponsor agrees you are ready
You need all three theory exams first, and the RCPCH strongly recommends two and a half years of training since graduation and at least 12 months in posts caring for emergency paediatric patients in the five years before the exam. Your sponsor must confirm you are ready, and you must pass within seven years of your final theory exam.
- 2
Learn the anchor statements
The RCPCH recommends studying the anchor statements, which set out the criteria examiners are trained to mark against in each station, and the level expected for 'Meets Standard'. Examiners are not looking for outstanding candidates, only for the clinical standard expected of a newly appointed ST4.
- 3
Examine children, doing exactly the task set
In each short clinical station the examiner gives the task; you have six minutes for it, then three minutes of discussion, and some children have no abnormal signs. If asked for one part, such as palpating the abdomen, do just that. The RCPCH's candidate guide describes preparing through regular bedside review, in-house peer practice and sitting in specialist clinics.
- 4
Practise describing developmental assessments
The development station has no child: you take a history for nine minutes without asking directly about the area to be assessed, then describe your assessment while the examiner gives cues. The RCPCH encourages practising the verbal delivery of developmental assessments in a structured, systematic way and pausing after each element so the examiner can give its cue.
- 5
Rehearse the history station to 13 minutes
The history station gives you 13 minutes with a parent or adolescent, with no examination, then a discussion of the problems and your management plan. Practise with a timer from referral letters like the RCPCH's sample, and finish with a clear problem list and plan.
- 6
Keep communication stations on task
Scenarios follow six patterns: information giving, breaking bad news, consent, critical incident, ethics and education, face to face, by telephone or by video. Practise choosing the most relevant information, explaining without jargon, responding to the emotional context and, as the RCPCH advises, summarising the main points before the end.
- 7
Practise describing signs from video
In each video station you watch a clip for up to three minutes, as often as you like, then discuss the signs, likely diagnosis and management. The RCPCH notes that replaying the clip leaves less time for discussion, so practise naming what you see from one or two viewings.
Official resources
- MRCPCH Clinical exam (face-to-face) guidance hub
The RCPCH's hub for every official preparation document, the marksheets and a development mock-station video.
- MRCPCH Clinical Examination Candidate Guide
The circuit, marking, conduct rules and sample history, communication and video scenarios.
- Station descriptions and flow charts
The timed flow of each station type and what each is designed to test.
- Clinical examination technique (clinical stations and development)
The level of examination technique expected of a good candidate, system by system.
- Anchor statements by station type
What 'Meets Standard', 'Borderline' and 'Below Standard' look like for each domain in each station.
- Describing developmental assessments and understanding cues
How cues work in the development station and how to describe an assessment so you receive them.
- MRCPCH Clinical exam: how to apply
Eligibility, recommended experience, sponsors, dates, fees and how places are allocated.
Common mistakes examiners report
- Doing a full routine when a specific task is set. The RCPCH's example: if asked to palpate the abdomen, do not begin by examining the hands. source
- Reporting signs that are not there, or examining without asking permission. The anchor statements place both 'describes non-existent signs/invents signs' and 'No attempt to seek permission' at Below Standard. source
- Leaving out or rushing parts of a developmental assessment. If you omit an element the examiner will not give its cue, and if you mention it only in passing they may ask for detail first. source
- Asking irrelevant questions or piling on information in communication stations. The RCPCH says the station is not a test of how much you convey and you should avoid both. source
Practise with MedMock
MedMock simulates the four spoken long stations of MRCPCH Clinical: History, Development and both Communication stations, with an AI parent role-player and the real timings, and you can have each station you finish marked, as in the worked example of a communication station. The four short clinical stations and the two video stations are not simulated, so examining children with a senior watching remains essential.
Questions candidates ask
Is there a limit on attempts?
UK trainees who have already sat the exam six or more times must contact the RCPCH Clinical Examinations team before applying again, and everyone must pass within seven years of passing their final theory exam.
What happens if I score very low?
A score of 52 or below is a deferment mark: you must not apply for the next diet. The RCPCH strongly advises re-attempting only when you feel ready and discussing your feedback with your educational supervisor or sponsor first.
Can I take notes during the exam?
Yes. Note-taking is allowed, but you must leave all notes with the host at the end of your circuit.
Do I need a preparation course?
No course is required. The RCPCH endorses no clinical exam courses other than its own, and recommends not booking any course until you have been told you have a place.
How long should I prepare?
The RCPCH does not set a preparation period; it recommends the training and emergency paediatric experience described above before you apply. It helps to book once you can run each station type to time with a senior marking you against the anchor statements.
Sources
- MRCPCH Clinical Examination Candidate Guide (RCPCH, PDF)
- MRCPCH Clinical exam (face-to-face) - guidance hub (RCPCH)
- MRCPCH Clinical examination candidate guidance (RCPCH)
- MRCPCH Clinical exam - how to apply (RCPCH)
- MRCPCH Clinical Exam: Clinical Examination Technique (Clinical Stations & Development), revised 9 December 2025 (RCPCH, PDF)
- MRCPCH Clinical: Station Descriptions & Flow Charts (RCPCH, PDF)
- MRCPCH Clinical: Describing developmental assessments and cues (RCPCH, PDF)
- MRCPCH Clinical: Anchor statements by station type (RCPCH, PDF)
- Exam results for MRCPCH and DCH (RCPCH)
- Examinations - resources to support your revision (RCPCH)
Checked on 27 September 2026.
Exams and their regulations change. MedMock is not affiliated with any examining body; always check the current guidance on the official site before you book.