MRCPCH Foundation of Practice and Theory and Science: what each paper tests

FOP and TAS are separate sittings, each its own paper of 100 single best answer questions in 120 minutes, five options, with no extended matching in either. They are not taken back to back as one event; a candidate sits them at different points in training.

The names describe what each paper is testing for. Foundation of Practice is built around clinical scenarios — recognising and managing the child in front of you. Theory and Science sits behind that: the physiology, pharmacology and pathological process that explains why the clinical picture looks the way it does.

FOP leans clinical: presentations, examination findings and immediate management across general paediatrics and its subspecialties. TAS leans scientific: the underlying physiology, pharmacology and mechanisms of disease behind those same subspecialties.

Both papers draw on the same set of subspecialty topics — gastroenterology and hepatology, infection and immunology, respiratory medicine, neonatology, endocrinology, haematology and oncology, nephro-urology, neurology among them — examined from a clinical angle in FOP and a scientific angle in TAS.

The RCPCH's published Theory Examination Syllabi assigns each subspecialty to one of three official emphasis tiers, not to a single percentage figure. That tier assignment — which subspecialties sit in the higher-emphasis tier and which sit lower — is the college's own published structure.

A percentage figure for each subspecialty is useful for planning revision time, but the RCPCH itself does not publish one. Any specific percentage you see, including on this site, is a derivation — an even split within the college's published tier range, averaged across FOP and TAS — not a number the college has stated. Treat it as a reasonable planning estimate, not a college figure.

• Work from the tiers, not an invented precision. Give more time to subspecialties in the college's higher-emphasis tier, and keep the lower tier ticking over rather than skipping it.
• Practise FOP and TAS separately in the angle each one tests — clinical management for FOP, the science behind it for TAS — even where the same topic appears in both.
• Track which subspecialties are currently costing you marks and tilt sessions toward them, rather than spreading time evenly across every topic regardless of where you are weak.
• Bring misses back on a spacing schedule so a wrong answer is met again before it is forgotten, rather than moving on and never returning to it.

The SpecialityMCQs MRCPCH revision follows the RCPCH's own tier structure rather than an invented percentage, tilts each session toward whichever subspecialty is currently weakest, and brings misses back on a spacing schedule. FOP and TAS are practised as the separate papers they are, with every answer naming the reference or guideline it rests on.