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MRCPCH Foundation of Practice (FOP) — Information & Free Practice

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About MRCPCH Foundation of Practice (FOP)

MRCPCH Foundation of Practice (FOP) · GB

Key exam facts

Provider
Royal College of Paediatrics and Child Health (RCPCH) sets and administers the FOP theory examination; test centres/online invigilation are delivery methods.
Format
Computer-based examination with 100 single best answer (SBA), best-of-five questions; taken at a test centre or, subject to eligibility, by remote invigilation.
Exam questions
Total questions: 100.
Time limit
2 hours of examination time; approved reasonable adjustments may allow extra time (e.g. 25% gives 2 hours 30 minutes). Arrival/login takes place before the examination.
Passing score
Criterion-referenced pass mark set using Modified Angoff methodology against an absolute standard; no single permanent percentage cut-off is given. Each correct answer earns one mark; no negative marking.
Exam fee
FOP single examination: £365 GBP for UK-based sitting and £455 GBP internationally, in both 2026 and 2027. Test-centre and online-invigilation fees are the same. FOP+TAS combined is a separate fee and is not this single-exam price.

Topics covered

The authority publishes percentage ranges for each content area. The practice percentages below use the midpoint of each range, normalized to 100%; they are not exact percentages published by the authority. Practice question counts may differ slightly because of rounding.

  • FOP blueprint group: 5–30% — Official range: 5–30% (Practice allocation: 17.95%)

    • Adolescent Health/Medicine
    • Know how the health needs of adolescents are different from other age groups and know about good practice in transition to adult services
    • Know about risk- taking behaviours including non-adherence, deliberate self-harm and substance misuse and understand how these present and are managed within Health and Social Services
    • Know about the clinical presentation of young people with eating disorders
    • Know about contraceptive and sexual health issues including sexually transmitted infections and teenage pregnancy and how to provide appropriate advice
    • Behavioural Medicine/Psychiatry
    • Know the determinants of child and adolescent mental health
    • Know about the effects of physical diseases on behaviour and vice versa including somatisation disorders
    • Understand how common emotional and behavioural problems may evolve
    • Know about the role of Child and Adolescent Mental, Health Services (CAMHS)
    • Understand the principles of managing common emotional and behavioural problems such as temper tantrums, breath- holding attacks, sleep problems, feeding problems, the crying baby, oppositional behaviour, enuresis and encopresis, excessive water drinking, school refusal, bullying and chronic fatigue syndrome and know when to refer
    • Know about the signs and symptoms of Attention Deficit Hyperactivity Disorder (ADHD) and appropriate referral pathways
    • Know the features of depression in children and adolescents and when to refer to specialist services
    • Cardiology
    • Know the clinical features of common congenital heart conditions and understand the principles of management
    • Know the common causes of cyanosis and how to assess these
    • Know the causes of murmurs palpitations, syncope and chest pain, understand the principles of management and know when to refer
    • Know the causes and clinical features of heart failure, understand the principles of management and know when to refer
    • Know the value of oxygen saturation measurement in the assessment of possible congenital heart diseases
    • Know the causes and clinical features of hypertension and how to measure and interpret blood pressure in different age groups
    • Know the recommendations regarding endocarditis prophylaxis in children with heart diseases
    • Ethics and Law
    • Understand the principles of child advocacy i.e. that all decisions are to be made in the best interest of the child and issues relating to consent and confidentiality
    • Genetics and Dysmorphology
    • Understand patterns of disease inheritance and able to construct a family tree and interpret patterns of inheritance
    • Know about the features of common chromosome disorders e.g. Down, Turner and Fragile X syndromes
    • Know the basis of genetic screening and diagnosis, the common conditions for which they are used and the ethical dilemmas they pose
    • Know about environmental factors which may affect pre-natal development, e.g. maternal health, alcohol and drugs
    • Metabolism and Metabolic Medicine (including fluid management and acid base balance)
    • Know about fluid, acid-base and electrolyte disturbances and their management
    • Know the common clinical presentations of metabolic disease
    • Know about metabolic bone disease and its management
    • Know about the screening procedures for inherited metabolic conditions
    • Neurology
    • Know the causes of headache and to be able to treat or refer as necessary
    • Know the likely causes and management of meningitis/encephalitis and altered consciousness
    • Know the causes of hydrocephalus, macrocephaly and microcephaly and when to refer
    • Know the causes and presentation of seizure disorders, their differential diagnosis, the principles of management and when to refer
    • Ophthalmology
    • Know the presenting features of visual impairment and the principles of management
    • Know the causes and management of eye infections and inflammatory disorders
    • Know the common causes of an absent red reflex, to able to refer appropriately and be aware of management options
    • Know the common causes of ptosis and proptosis and the principles of management
    • Know the causes and presentations of strabismus and the principles of management
    • Palliative Care and Pain Management
    • Know about end of life care and bereavement counselling and understand the opportunities for respite care, including the role of children’s hospices
    • Understand the principles of pain management and be aware of the treatment options available to children of all ages
    • Patient Safety and Clinical Governance
    • Know the role of patient safety and clinical governance in safe healthcare delivery
    • To be able to describe the impact of human factors on delivering safe clinical care
    • Know how to exchange information in a timely manner to establish a shared understanding among appropriate members of the team
    • Know what to do to minimise risk of transmission of infection
    • Understand the factors that drive pandemic/ epidemic infections and appreciate how this is used in clinical practice to prevent them
    • Understand the ethical implications of patient testing in the event of a needle stick injury
    • Safeguarding
    • Know the presentations of physical, emotional and sexual abuse, neglect and fabricated and induced illness
    • Know what steps should be taken when child abuse is suspected
    • Science of Practice
    • Demonstrate appropriate use of clinical guidelines in practice

  • FOP blueprint group: 10–50% — Official range: 10–50% (Practice allocation: 30.77%)

    • Dermatology
    • Know the causes and management of skin infections and cellulitis
    • Know the side effects and different potencies of topical steroids
    • Know the common causes of fever and rash – e.g. exanthemata, Kawasaki
    • To be able to assess simple birth marks such as strawberry naevi and Mongolian blue spots and refer when appropriate
    • Know the causes features and management of rashes- HSP, erythema nodosum and multiforme and the association between skin rashes and common systemic diseases and when to refer
    • To be able to diagnose, investigate and manage common skin rashes e.g. eczema, acne, impetigo, staphylococcal scalded skin syndrome, dermatitis, cradle cap, and nappy rash
    • Understand the emotional impact of severe dermatological problems
    • Diabetes Mellitus
    • To be able to recognise the features of a child or young person presenting with diabetes including diabetic ketoacidosis and know the principles of management
    • Understand the management of diabetes in primary care including blood sugar monitoring and insulin regimens
    • Know the causes, complications and treatment of hypoglycaemia in the diabetic child
    • Endocrinology and Growth
    • Know the presentation of disorders of the adrenal, thyroid and parathyroid glands and understand the principles of management
    • Know the presentation of disorders of the pituitary gland and understand the principles of management
    • Understand the patterns of normal growth and development including puberty and its normal variations
    • Understand the principles and practice of growth measurement, including plotting and interpretation of growth charts
    • Know the causes of abnormal growth including short stature and slow or accelerated growth. Know about appropriate assessment, investigation and treatment
    • Emergency Medicine (including accidents and poisoning)
    • Know the common causes of cardiac arrest, the prognostic factors that influence the outcome and how to provide basic life support and advise others
    • Know how to control acute blood loss until help arrives
    • To be able to recognise and provide initial management for life- threatening airway, breathing or circulatory compromise
    • Know about immediate care for children with burns and scalds, recognising that they may be a presentation of non- accidental injury
    • Know the causes and features of anaphylaxis and its management
    • Know how to recognise acute seizures and initiate emergency treatment
    • Know how to recognise and initiate treatment for children presenting with neurological emergencies
    • Be aware of common causes of accidents in children and adolescents including safeguarding implications and understand prevention strategies
    • Know how to differentiate between life or limb threatening injuries and injuries that can be managed less urgently
    • Know the principles of managing limb threatening injuries
    • Know of appropriate use of radiological investigations in trauma
    • Know when to suspect and how to safely initiate management in head and spinal injury
    • Know the common causes of poisoning in children and adolescents including safeguarding implications
    • Haematology and Oncology
    • Know the causes and presentations of anaemia and their initial investigation and management
    • Know and understand safe transfusion practice
    • Know the causes of bleeding, purpura and bruising and recognise features in the presentation which suggest serious underlying pathology
    • Know how to interpret haematological investigations including full blood count, blood film and coagulation studies
    • Know the clinical manifestations of acute leukaemia, lymphoma, and solid tumours
    • Know how to assess a child with lymphadenopathy or other masses and when to refer
    • Know about the risks and benefits of ionising radiation
    • Understand the role of different health care professionals in shared care for oncological conditions
    • Musculoskeletal
    • Know the normal variations of limb development e.g. bow legs and knock knees, in-toeing, flat feet
    • Know about the assessment, causes and initial management of joint and limb pain, joint laxity and swelling
    • Be aware of the presentation of muscular disease including the dystrophies
    • Know the differential diagnosis of pain on walking and limp and initial management
    • Know the causes of back pain and initial management
    • Know the causes of acute and chronic arthritis including those with systemic manifestations (e.g. Henoch- Schönlein purpura) and understand the principles of management
    • Know how to recognise the various causes of scoliosis and how they present
    • Know how to recognise developmental dysplasia of the hip, appropriate referral pathways and usual management
    • Neonatology
    • Know and understand the effects of antenatal and perinatal events
    • Know about antenatal diagnosis of neural tube defects
    • Know the problems associated with prematurity and the long-term sequelae including the impact on the family and community
    • To be able to recognise and initiate the management of common disorders in the newborn including sepsis
    • Understand the principles of new born feeding and growth recognising the importance of breast feeding and being able to advise on lactation difficulties and contraindications
    • Be aware of the occurrence and clinical features of maternal to fetal transmission of infection
    • Know about the support networks for families and babies including those from socially disadvantaged families
    • Know the range of newborn screening tests used in the UK including haematological and metabolic conditions, cystic fibrosis and the universal newborn hearing screening programme
    • Know about common minor congenital abnormalities and their initial management
    • Understand the causes and features of neonatal jaundice knowing when to refer for further investigation and able to recognise early presentation of neonatal hepatitis and biliary atresia
    • Know the presentations of neonatal seizures and recognise abnormal neurological features e.g. the floppy baby
    • Know the principles and methods of neonatal resuscitation
    • Know how to recognise, assess and initially manage respiratory disorders in the neonatal period
    • To be able to recognise and assess birth injury with appropriate referral
    • Know about the identification, initial management and appropriate referral pathways for neonatal surgical problems including NEC
    • Nephro-urology
    • Understand the principles of management of disorders of urogenital tract disorders and know when to seek surgical referral
    • Know the manifestations of acute and chronic renal diseases
    • Know the manifestations and management of urinary tract infections in different age groups
    • Know the causes of haematuria and proteinuria (including nephrotic syndrome and acute nephritis) and recognise features in the presentation which suggest serious or significant pathology
    • Know the principles of managing enuresis
    • Know the causes and assessment of polyuria and polydipsia and when to refer
    • Neurodevelopment and Neurodisability
    • Understand normal development including common variants
    • Know the causes of disability, disordered development and learning difficulties
    • Know the causes of speech and language delay or disorder and principles of management including autism spectrum disorder
    • Understand the definition and effects of neurodisability on children and families
    • Nutrition
    • Know the constituents of a healthy diet at all ages including breast and formula feeding in infancy
    • Understand the principles of infant feeding
    • Know the causes of malnutrition and understand the epidemiology and public health consequences of obesity
    • To be able to recognise obesity, understand the consequences of obesity on health and well-being in the short and long term and advise young people and their families on effective strategies to manage this and use BMI measurements and charts
    • Know the clinical presentation, and management of vitamin deficiencies
    • Pharmacology
    • Know how to find out information necessary for safe prescribing through use of paediatric formularies and pharmacy liaison
    • Know how to prescribe safely and be aware of adverse effects and interactions of drugs
    • Know about the need to explain to parents the unlicensed and off-label prescription of drugs

  • FOP blueprint group: 20–80% — Official range: 20–80% (Practice allocation: 51.28%)

    • Gastroenterology and Hepatology (including surgical abdominal conditions)
    • Know the causes of acute abdominal pain, and recognise when to refer, including urgency of referral
    • Know the presentations, causes and management of chronic and recurrent abdominal pain including when to refer
    • Know the causes of vomiting/regurgitation at different ages and to be able to assess, manage and refer appropriately
    • Know the causes of acute diarrhoeal illness, how to assess and manage and when to refer
    • Know the common causes of chronic diarrhoea and its initial investigation and management
    • Know the common causes of food allergies and intolerances, their initial management and when to appropriately refer
    • Know how to diagnose and manage constipation
    • Know the causes of jaundice and when to refer
    • Know the common causes of upper and lower gastrointestinal bleeding, initial management and appropriate referral
    • To be able to recognise and understand the management of common surgical conditions including hernias, and pyloric stenosis
    • Know the varied presentations of coeliac disease and its investigation and management
    • Know the presentation of disorders of the exocrine pancreas
    • Infection, Immunology and Allergy
    • Know about common infections of children in the UK and important worldwide infections, e.g. TB, HIV, hepatitis B, malaria, polio
    • Know the UK national guidelines on notification of communicable diseases
    • Know and understand the basic principles of infection control, how outbreaks of infection including nosocomial infection occur, and how they should be investigated
    • To be able to assess and manage a febrile child and have knowledge of current evidence based guidelines
    • Understand the principles and the rationale of immunisation programmes including the national immunisation programme for children in the UK
    • Know and understand the indications, contraindications, complications and controversies of routine childhood immunisations and able to advise parents about immunisations
    • Know the common allergies and advise on management
    • Know when antimicrobials are indicated
    • Understand the normal patterns and frequency of infections in childhood
    • Respiratory Medicine with ENT
    • Recognise the presenting features of hearing impairment and the principles of assessment and management
    • Know the causes and management of conditions affecting the nose including epistaxis and allergic rhinitis
    • Know the causes and management of respiratory infection, earache, ear discharge, otitis media and glue ear
    • Know about obstructive sleep apnoea and the principles of management
    • Know how to assess and manage children with acute asthma and wheeze and plan long term management
    • Know the causes of stridor and the principles of management
    • Know the presentations of cystic fibrosis and the principles of treatment
    • Understand the causes of chronic cough and appropriate investigations
    • Know the role of health promotion programmes in preventing respiratory morbidity e.g. smoking cessation, sudden infant death and able to advise parents on avoiding risks
    • Understand the long-term complications of medications used for asthma

How to prepare

Work through the topics, read the explanation after each answer, and revisit the areas where you miss questions. Use the official outline and reference materials below to guide your study.

These independent practice questions are not actual exam items and do not guarantee a passing result.

Frequently asked questions

What is the exam format?

Computer-based examination with 100 single best answer (SBA), best-of-five questions; taken at a test centre or, subject to eligibility, by remote invigilation.

How many questions are on the exam?

Total questions: 100.

How long is the exam?

2 hours of examination time; approved reasonable adjustments may allow extra time (e.g. 25% gives 2 hours 30 minutes). Arrival/login takes place before the examination.

What is the passing score?

Criterion-referenced pass mark set using Modified Angoff methodology against an absolute standard; no single permanent percentage cut-off is given. Each correct answer earns one mark; no negative marking.

How much does the exam cost?

FOP single examination: £365 GBP for UK-based sitting and £455 GBP internationally, in both 2026 and 2027. Test-centre and online-invigilation fees are the same. FOP+TAS combined is a separate fee and is not this single-exam price.

Official sources and references

Confirm current exam arrangements with the exam provider.