Your MRCPCH Clinical exam week checklist in the final seven days should be brutally simple: rehearse the real station timings, tighten the phrases you use to open and close each station, and remove every avoidable exam-day problem. The current face-to-face exam is a 10-station circuit with four short clinical stations, one development station, one history station, two communication stations and two video stations, so last-week practice needs to look like that circuit rather than a random run of paediatric cases.
Why the last week matters
This exam is not marked like a typical undergraduate OSCE with a long yes/no task list. RCPCH marks you across domains such as information gathering or giving, physical examination, identification of signs, clinical reasoning, management planning and communication, so a polished technique without a sensible conclusion will still lose marks.
Timing also drives performance. Short clinical, communication and video stations run for 9 minutes, while history and development stations run for 22 minutes; the other scenario-based stations come with reading time, but short clinical stations do not. In the final week, you get more value from repeating those timings than from reading another textbook chapter.
As of July 2026, RCPCH is still running the current face-to-face format, but it is also piloting a revised future exam. So prepare for the live format in front of you, and re-check the guidance hub and your admission paperwork for your own diet.
Your MRCPCH Clinical exam week checklist
Seven days to go
Build one full mock circuit around the official structure. That means four short clinical stations, one development station, one history station, two communication stations and two video stations, with the right timings and short resets between stations. If you cannot run a full circuit, run half a circuit twice.
Use the week to narrow, not widen, your preparation.
- Re-read the official station descriptions, flow charts and anchor statements so you know exactly what a meets-standard performance looks like.
- Write a one-line opening and one-line closing for each station type. Under pressure, rehearsed structure is calming.
- Make a short list of your recurring errors: missing red flags, talking too fast, failing to summarise, weak management plans, or forgetting to address parental concerns.
- Book one serious mock with someone who will interrupt you, stop you on time, and force you to commit to a diagnosis and next step.
A good final week target is repetition of the same behaviours: focused history, clear summary, explicit interpretation, safe next steps.
Three to four days to go
Now switch from broad revision to daily timed reps. A realistic session is two short clinical stations, one long station, one communication station and one video station, followed by a short debrief.
For each rep, ask your partner to score only three things:
- Did you sound organised from the first 30 seconds?
- Did you name the important signs or concerns clearly?
- Did you finish with a safe, prioritised plan?
That is closer to examiner thinking than vague feedback such as sounded okay.
The day before
Protect the basics. Most last-minute problems are logistical, not clinical.
- Check your final placement or admission document, route, parking, and expected arrival time.
- Pack photo ID and your final placement letter.
- Pack your stethoscope. RCPCH also advises bringing surgical masks for the short clinical stations.
- Choose clothes you would wear for a normal clinical working day.
- Stop heavy study early enough to sleep properly.
The morning of the exam
Arrive early enough to be boring. RCPCH says candidates should arrive one hour before the circuit starts unless the admission document gives a different time, and late arrival after the circuit has begun means you will not be allowed to sit. You will register, show ID, complete the relevant parts of your mark sheets in pencil, and receive a personalised route map.
Use note-taking sparingly. RCPCH allows note-taking in the face-to-face clinical exam, but you cannot take personal items onto the circuit apart from approved essentials, and any notes must be left behind for secure disposal. Jot prompts, not essays.
Station-by-station polish for the final week
Short clinical stations
These are four patient-based stations. There is no candidate information sheet, the examiner tells you the system and task, and you then need to examine efficiently, summarise the key signs, interpret them, offer a sensible differential and outline management.
A simple closing framework works well:
- Key signs
- Most likely diagnosis
- Important differential
- Severity or stability
- Immediate investigations and first management steps
- Escalation if the child is unwell
For example, if you examine a child with a cardiovascular problem, do not end with a vague line about doing some bloods and discussing with seniors. A stronger finish is: the key findings are X and Y, this is most consistent with Z, my main differential is A, I would assess stability, review observations and relevant bedside tests, and escalate early if there are red flags.
Development station
The current development station is scenario-based rather than patient-based. After reading time, you take a focused developmental history, briefly summarise it, then describe step by step how you would perform the developmental assessment and interpret the likely pattern of difficulty.
Your verbal structure should sound deliberate:
- Opening concern and parent agenda
- Pregnancy, birth and neonatal background if relevant
- Gross motor, fine motor, speech and language, social and adaptive skills
- Hearing, vision, behaviour and regression red flags
- Functional impact on the child and family
- How you would observe the child before approaching
- What you would test in each domain, and why
- Your synthesis: isolated delay, global delay, neurodisability pattern, autism concern, or another explanation
If the stem is a 2-year-old with language delay, say what you would look for before you start: eye contact, shared attention, play, gesture, response to name, social reciprocity. Examiners want to hear your clinical reasoning, not a shopping list of milestones.
History station
The history station gives you more time, but candidates still waste it. In the live format you have reading time, then a focused history phase, followed by discussion with the examiner about problems, likely diagnosis and management.
A reliable structure is:
- Open and define the main problem
- Clarify chronology
- Pull out severity and red flags early
- Take only background history that changes risk or management
- Summarise in one or two sentences
- State your leading diagnosis and differential
- Give a prioritised plan
For a 4-year-old with abdominal pain and vomiting, you do not need a museum tour of paediatric history. You need the timeline, hydration, bilious vomiting, stool pattern, fever, urinary symptoms, pain migration, surgical red flags, and the child’s current clinical state. Then say what you think and what you would do next.
Communication and video stations
There are two communication stations and two video stations, each lasting 9 minutes. Communication stations reward accurate explanation, rapport, listening, handling concerns and agreeing next steps; in the video station, you can watch the clip as many times as you want during the first 3 minutes in the room before discussion moves on to signs, diagnosis and management.
For communication, use this shape:
- Introduce yourself and your role
- Check what the parent already knows
- Set a shared agenda
- Explain in short chunks without jargon
- Pause to check understanding
- Ask directly about worries or expectations
- Agree the next step and safety-net clearly
For video, force yourself to speak in order. Start with what you see, then what it means, then what you would do. If the clip shows an infant with abnormal movements or respiratory distress, name the observable features before you jump to the diagnosis. That alone makes you sound more senior.
Common mistakes in the final week
- Doing passive revision instead of timed station practice
- Treating every history like a clerking rather than a focused exam history
- Finishing a short clinical station without stating the key signs out loud
- Giving a differential without saying which diagnosis is most likely
- Offering generic management with no prioritisation or escalation
- Using too much jargon in communication stations
- Forgetting to address parental concerns and next steps
- Writing too much during reading time
- Letting one bad station infect the next one
Practice workflow
RCPCH’s own guidance points candidates back to regular bedside review, peer practice and clinic exposure, especially for communication-heavy specialties such as cardiology or neurology. In the last week, keep the workflow simple and repeatable.
- Pick one station type.
- Run it to time.
- Debrief immediately against a small number of domains.
- Repeat the same station straight away, aiming to fix only one or two errors.
- Log the error in a notebook or spreadsheet.
- Re-test that error the next day.
If you use AI for practice, use it as a prompt generator and timing tool, not as your final authority on clinical accuracy. The safest pattern is AI or peer rehearsal first, then a quick check against trusted paediatric guidance or your supervisor if you are unsure.
One high-yield habit is the two-minute redo. After every mock, repeat just your opening 30 seconds and your closing 90 seconds. Those are the parts candidates most often improve quickly.
Summary
- Your MRCPCH Clinical exam week checklist should focus on timing, structure and logistics, not last-minute content hoarding.
- Rehearse the live circuit: four short clinical, one development, one history, two communication and two video stations.
- In every station, say the important findings, what they mean, and what you would do next.
- Pack early, arrive early, and remove avoidable stressors from exam morning.
- Keep your last mocks short, timed, and brutally specific.
References
- https://www.rcpch.ac.uk/resources/mrcpch-clinical-exam-face-face-guidance-hub
- https://www.rcpch.ac.uk/sites/default/files/2025-12/mrcpch-clinical-f2f-candidate-guide.pdf
- https://www.rcpch.ac.uk/sites/default/files/2025-12/mrcpch-clinical-f2f-station-descriptions-and-flowcharts.pdf
- https://www.rcpch.ac.uk/resources/mrcpch-clinical-exam-exam-day-after
- https://www.rcpch.ac.uk/resources/mrcpch-clinical-exam-how-apply
- https://www.rcpch.ac.uk/education-careers/examinations/your-exam-results-mrcpch-dch
- https://www.rcpch.ac.uk/education-careers/training-assessment/assessment-review-information-updates