MRCPCH Clinical Format: Stations, Timing, and Communication Tasks

The current MRCPCH Clinical format is a 10-station face-to-face circuit: four short clinical stations, one development station, one history station, two communication stations and two video stations. Eight stations last 9 minutes, while the history and development stations are 22 minutes each, with 4 minutes between stations for reading or movement; the whole circuit takes about 160 minutes. As of July 3, 2026, this is still the live format candidates sit, although RCPCH is piloting a future redesign for 2027 or later.

Why this format matters

This exam rewards synthesis, not just performance of steps. RCPCH explicitly distinguishes it from an undergraduate OSCE: you need to examine well, identify and interpret signs, and then turn that into a safe management plan. Marks are awarded across domains rather than simple tick boxes, so candidates often drop marks when they do one part well but fail to explain what it means.

Across the circuit, 41 domains are marked, each scored 0, 1 or 2, giving a maximum of 82. RCPCH currently publishes a minimum pass mark of 62 out of 82 for the face-to-face format. That is why station-shaped, timed practice beats vague revision every time.

MRCPCH Clinical format at a glance

Station type	Number	Station time	Reading time before entry	What you have to do
Short clinical	4	9 min	No candidate sheet; task given verbally	Focused physical examination, identify signs, interpret findings, discuss management
Development	1	22 min	4 min	Take a focused developmental history, describe the assessment, interpret cues, discuss diagnosis and management
History	1	22 min	4 min	Take a focused history, then discuss problems, differential diagnosis and management
Communication	2	9 min	4 min	Speak with a role-player and handle explanation, concerns and next steps
Video	2	9 min	4 min	Watch a clip, identify signs, reason through the case and discuss management

This is the working shape of the circuit described in the current RCPCH candidate guide and station flow charts.

Short clinical stations are the exception: you do not get a candidate information sheet, and the examiner gives the task verbally when you enter. For stations 5 to 10, you use the 4-minute interval to read the stem; in development, you also review universal cues such as photos, audio or video. Note-taking is allowed in the face-to-face exam, but your notes must be left behind at the end of the circuit.

Each station has its own examiner. RCPCH runs 12 candidates on a circuit, with the history and development stations duplicated to make the flow work, and candidates are usually asked to arrive 1 hour before their morning or afternoon circuit starts.

What happens in each station type

Short clinical stations

These are the stations most like classic bedside paediatrics. You enter, receive a system-focused task from the examiner, examine the child, summarise the key signs, interpret them, and then discuss diagnosis, complications, investigations and management. Examiners may move you on if you spend too long examining, because they still need enough evidence to mark the reasoning and management domains.

Think focused, smooth and child-friendly. A candidate who looks organised, gentle and used to examining children will usually sound more convincing when they come to interpretation.

Development station

This is currently scenario-based rather than patient-based. You read the stem and cues, take a focused developmental history from a role-player for 9 minutes, summarise briefly, then spend 9 minutes describing how you would carry out the relevant developmental assessment while the examiner gives dependent cues; the last 3 minutes are for diagnosis, differential diagnosis and management.

The trap is to give a shopping list of toys and milestones. What examiners want is a structured description linked to the likely problem: what you would assess, what you would look for, what the cues mean, and how that changes your plan.

History station

This is a double station with 13 minutes for focused history-taking and 9 minutes for discussion with the examiner. You are being assessed on prioritised information gathering, then on whether you can turn that history into a sensible differential and management plan.

In practice, this means you should not try to do a full clerking. If the stem is a 4-year-old with abdominal pain and vomiting, you need red flags, acuity, hydration, surgical risk, relevant background and parental concerns early.

Communication stations

There are two communication stations, both 9 minutes long, each with a role-player. The role-player may be a parent, adolescent, health professional or member of the public, and the task may be face to face, by telephone or as a video consultation. RCPCH describes six broad scenario types: information giving, breaking bad news, consent, critical incident, ethics and education. In these stations, the examiner observes the interaction but does not cross-question you during the station.

This matters. You are not trying to impress the examiner with volume. You are trying to help the person in front of you understand the problem, feel heard, and leave with a clear plan.

Video stations

You read a short stem, then once the station starts you get 3 minutes to watch the clip as many times as you like. After that, you cannot replay it. The next 3 minutes focus on identifying and interpreting signs, and the final 3 minutes focus on management; the examiner may prompt you with a hypothetical diagnosis so you can discuss safe next steps.

Do not narrate every frame. Call the key signs early, commit to the likely syndrome or emergency, and then move to first actions.

Communication tasks: what to say under pressure

Most candidates slip here for one of two reasons: they give a lecture, or they become so empathic that they stop leading the consultation. A simple structure works well across most communication tasks in this exam, including information giving, consent, ethical conflict and critical incident scenarios.

Use this framework:

Open well: introduce yourself, confirm who you are speaking to, and set the agenda.
Find their starting point: ask what they understand, what they have been told, or what worries them most.
Explain the key message: give two or three high-yield points in plain English.
Check and respond: pause, invite questions, notice emotion, and address concerns directly.
Close safely: summarise, agree next steps, and safety-net where appropriate.

A common station might involve a parent distressed after an error, or an adolescent discussing a long-term condition such as asthma. In both, examiners listen for clear explanations, active listening, appropriate empathy, and a shared plan. If you are unsure of a rare detail, say what you would do safely now and who you would involve, rather than bluffing.

Timing strategy for the MRCPCH Clinical format

Use station-specific mental clocks, not a vague sense of urgency. The official flow charts are clear enough that you can rehearse each station to the minute.

Short clinical: think 6 + 3 — about 6 minutes to examine, 3 minutes to summarise, interpret and manage.
Development: think 9 + 1 + 9 + 3 — history, summary, describe assessment with cues, then reasoning and management.
History: think 13 + 9 — gather the history, then analyse and plan.
Communication: one clean 9-minute consultation. Do not spend 7 minutes gathering background you do not need.
Video: think 3 + 3 + 3 — watch, interpret, manage.

During reading time, write down only three things: the task, the likely priorities, and your closing summary. Anything more tends to slow you down. If you finish a station early, stop cleanly; the candidate guide makes clear that you remain in the room until the end rather than filling the silence with increasingly speculative answers.

Common mistakes

These are the patterns that repeatedly cost candidates marks:

doing a tidy examination but failing to name or interpret the abnormal signs
taking a full clerking in the history station instead of a focused history
treating the development station like a recital of milestones rather than a structured assessment
using jargon in communication stations and never checking understanding
forgetting to address the parent or young person's actual concern
watching the video clip passively instead of deciding what signs you are looking for
letting one bad station contaminate the next one

Practice workflow

Build practice around the real circuit. You will improve faster from repeated timed reps than from another evening of passive reading. The official guidance hub also provides station flow charts, marksheets and anchor statements, which are worth using in your debrief.

A practical weekly loop looks like this:

two 9-minute short clinical stations at the bedside with a timer
one 22-minute history or development station with strict bell times
two communication scenarios using a colleague as parent, adolescent or junior doctor
one video station with a hard 3-minute viewing cap
a 10-minute debrief against domains: what to cut, what to say earlier, and what safety step you missed

If you use AI for rehearsal, use it mainly for history and communication stems. For short clinical stations, keep coming back to real children, real examination technique and real sign interpretation.

Summary

The current MRCPCH Clinical Examination is a 10-station face-to-face circuit: 4 short clinical, 1 development, 1 history, 2 communication and 2 video stations.
Eight stations last 9 minutes; history and development are 22-minute double stations.
Communication stations test clarity, empathy, accurate information and agreed next steps, not how much you can talk.
In short clinical and video stations, marks depend on naming signs, interpreting them and moving to safe management.
If you are sitting in 2027 or later, recheck RCPCH before planning revision, because a redesigned clinical exam is being piloted.

MRCPCH Clinical Format: Stations, Timing, and Communication Tasks

Why this format matters

MRCPCH Clinical format at a glance

What happens in each station type

Short clinical stations

Development station

History station

Communication stations

Video stations

Communication tasks: what to say under pressure

Timing strategy for the MRCPCH Clinical format

Common mistakes

Practice workflow

Summary

References

Practice Pediatrics with a live AI examiner

Why this format matters

MRCPCH Clinical format at a glance

What happens in each station type

Short clinical stations

Development station

History station

Communication stations

Video stations

Communication tasks: what to say under pressure

Timing strategy for the MRCPCH Clinical format

Common mistakes

Practice workflow

Summary

References

Related guides

Practice Pediatrics with a live AI examiner