What is the MRCPCH AKP exam?

The MRCPCH Applied Knowledge in Practice (AKP) exam is a written assessment that evaluates a candidate’s understanding, knowledge, and clinical decision-making abilities in paediatrics at the level expected of a newly appointed Specialty Trainee 4 (ST4) doctor. The AKP is the third part of the Member of the Royal College of Paediatrics and Child Health (MRCPCH) qualification and is essential for progression toward clinical training in paediatrics.

The AKP exam involves a series of Single Best Answer (SBA) questions that assess knowledge synthesis, clinical reasoning, and the application of paediatric knowledge in practical clinical settings. It is comprised of two exams, each 2.5 hours long, and contains 60 questions, for a total of 120 questions.

To qualify for the MRCPCH clinical examination, candidates must pass all three MRCPCH theory exams (FOP, TAS, and AKP) and meet the eligibility requirements as per the RCPCH guidelines. This exam builds upon foundational clinical knowledge and incorporates both theoretical and applied understanding​.

Applying to sit the MRCPCH AKP exam in person

According to the RCPCH website, to apply to sit the AKP exam, you must first be registered for an exam account, which you will need to do at least 10 days before the exam application window opens. In order to be eligible to apply for and sit the AKP exam, you must hold a primary medical qualification, recognised by the General Medical Council of the United Kingdom.

How to apply to sit the MRCPCH AKP exam in person

1. Log in to your RCPCH online account.
2. On My Account, go to the Exams panel, and click on the link to apply. This opens the exam booking system.
3. First, you'll see your exam dashboard. This displays your qualification progress - which exams you need to sit, and whether you have sat and passed each. It also displays the exams you can apply for, i.e. when the application period is open for your next exam(s).
4. Click on Bookings > Available bookings to see the exam options you are eligible for and select the exam.
5. Select the method of delivery (test centre or online delivery) and then the location in which you wish to sit your exam. Not all candidates are eligible for online delivery - see the online invigilation eligibility criteria on our How You Sit Your Exam page.

Next MRCPCH AKP exam dates

AKP 2025.1

Exam date: Wednesday 22 January 2025

Applications open: From Monday 4 November 2024 (09:30 UK time)

Applications close: Monday 11 November 2024 (all at 16:00 UK time)

AKP 2025.2

Exam date: Wednesday 21 May 2025

Applications open: From Monday 10 March 2025 (09:30 UK time)

Applications close: Monday 17 March (all at 16:00 UK time)

AKP 2025.3

Exam date: Wednesday 17 September 2025

Applications open: From Monday 7 July 2025 (09:30 UK time)

Applications close: Monday 14 July 2025 (all at 16:00 UK time)

Applying to sit the MRCPCH AKP exam via online invigilation

The RCPCH states that to apply for online invigilation, you will need to provide evidence that you meet one of the following criteria:

• No test centre in the country of residence during the time of the exam
• Residence more than 200 miles from a test centre
• Approved reasonable adjustment as sitting the exam at a test centre would be detrimental to your health.

Preparing for MRCPCH AKP

When to start MRCPCH AKP revision

There are no set guidelines on how long you should spend preparing to take the MRCPCH AKP exam - it depends entirely on your learning preferences. Some people who have taken the exam in the past recommend 4-6 weeks for your studying, whilst others suggest 2-3 months - it all depends on your working pattern and how you absorb information.

MRCPCH AKP syllabus breakdown

The MRCPCH AKP exam consists of two 2.5-hour papers, each containing a mix of SBA questions designed to test your knowledge, understanding, and clinical decision-making abilities.

Below you’ll find a general overview of the AKP syllabus with common associated topics, although it is worth noting that the exact topics covered in the exam may vary slightly.

• Adolescent Health & Medicine: Puberty, STIs, contraception
• Behavioural Medicine & Psychiatry: ADHD, ASD, mood disorders
• Cardiology: Congenital heart defects, arrhythmias
• Dermatology: Eczema, psoriasis, common skin infections
• Diabetes Mellitus: DKA management, insulin therapy
• Emergency Medicine: Sepsis, trauma, resuscitation
• Endocrinology & Growth: Thyroid disorders, short stature
• Ethics & Law: Consent, safeguarding, confidentiality
• Gastroenterology & Hepatology: IBD, coeliac disease, liver failure
• Genetics & Dysmorphology: Down syndrome, inheritance patterns
• Haematology & Oncology: Leukaemia, anaemia, sickle cell disease
• Infection, Immunity & Allergy: Sepsis, anaphylaxis, immunodeficiencies
• Metabolism & Metabolic Medicine: Inborn errors of metabolism, acid-base balance
• Musculoskeletal Medicine: Juvenile idiopathic arthritis, fractures
• Neonatology: Prematurity, neonatal sepsis
• Nephro-urology: UTIs, nephrotic syndrome, AKI
• Neurodevelopment & Neurodisability: Cerebral palsy, developmental delay
• Neurology: Seizures, meningitis, neurodegenerative diseases
• Nutrition: Malnutrition, feeding difficulties
• Ophthalmology: Strabismus, retinopathy of prematurity, infections
• Palliative Care & Pain Management: End-of-life care, symptom relief
• Patient Safety & Clinical Governance: Medication errors, risk management, infection control
• Pharmacology: Drug interactions, common paediatric medications
• Respiratory Medicine & ENT: Asthma, bronchiolitis, tonsillitis
• Safeguarding: Non-accidental injury, neglect
• Science of Practice: Study design, evidence-based medicine
  
  

The best revision resources for MRCPCH AKP

Free MRCPCH AKP Revision Resources

Pastest AKP Instant Insights

A highly useful free tool is the Pastest AKP Instant Insights blog post which features interviews and discussions with exam candidates to get their rundown of the latest insights they can provide. This includes common topics that appeared on the latest run of exams, suggested areas of focus, and tips for sitting the exam itself.

MRCPCH Theory Examination Syllabi

This is the official MRCPCH Theory examination guidelines for all examinations, including AKP as well as FOP and TAS. In this document, you’ll find everything you need to know about all three of the written exams for MRCPCH, as well as what you need to know about each topic in the exam.

Planning and productivity resources

Exam Countdown Lite: This one is pretty self-explanatory, but this is a handy app that allows you to keep track of any exam dates you have coming up.

Forest: How often do you find yourself being distracted by your phone? Forest is a handy app for productivity that keeps you on track. When activated, the Forest app plants a tree, and that tree grows if you stay on the app. Once the virtual tree if fully grown, a real tree will be planted by someone from Forest!

Notion: Almost like a digital notebook, Notion allows you to create pages, databases and to-do lists to stay organised in your life and work. Your virtual workspace can be completely customised to suit your needs depending on what you’re working on; it’s super flexible to adapt to however you work best.

Google Calendar: Chances are you may already have this one. Google Calendar is a digital calendar app where links can be embedded, your schedule colour-coded and things swapped around at the touch of a screen.

Reclaim.AI: This time management app pairs with Google Calendar, it adds everything into your schedule, whilst taking into account the tasks that are already in it. For example, if you realise you haven’t factored in an exam that’s coming up in four weeks. You can give Reclaim a due date and a time allocation of how many hours you need per week to get this task done and Reclaim will integrate your new task into your schedule without disrupting your previous arrangements.

Best textbooks for MRCPCH AKP

There are a number of core textbooks that are highly useful when it comes to revising for the AKP exam:

Nelson Textbook of Pediatrics: A classic, highly regarded and comprehensive text that covers all aspects of paediatric medicine.

Oxford Textbook of Paediatrics: Another excellent choice to supplement your AKP revision, offering a detailed and up-to-date overview of paediatric medicine.

Paediatric Life Support (PLS): An essential book for gaining a key understanding of paediatric emergencies and resuscitation.

For books that go a little deeper and focus on more specific areas:

MRCPCH AKP: A Guide to the Applied Knowledge in Practice Exam: This book is specifically tailored to the AKP exam, providing practice questions, tips, and explanations.

Oxford Handbook of Paediatrics: A portable and concise reference for quick look-ups.

Paediatric Formulary: A valuable resource for drug information and dosing - a handy one to have both for the AKP exam and when on the ward.

Online MRCPCH AKP resources

Pastest AKP Resources: Pastest is home to the largest MRCPCH AKP question bank out there - 1,600 as of 2024! - giving you plenty of practice when it comes to getting to grips with the examination! There are also past papers that you can work through to give you a feel of how things might go on exam day. Our collection of videos and podcasts also gives you the chance to hone in on areas that you might find difficult.

You can get access to the full Pastest resource by selecting when you want to take the exam - and prices vary from there. Not sure yet? You can sign up to a free trial of Pastest AKP before you decide!

Do's and Don’ts for MRCPCH Revision

Do's

Identify personal weaknesses: Establishing your weak points and dedicating more time to them from the very start, rather than only spending time on favoured topics, will build your self-confidence in those weaker areas and take away the pressure of revising the topics at the last minute. Pastest has an amazing tracking dashboard that allows you to see your weaknesses. Furthermore, if you feel a question has flagged a gap in your knowledge, utilise the “more questions like this” feature to quickly test yourself before hopping back into your session!

Maintain motivation: Setting some short- and long-term goals during the preparation period, and establishing a rewards system, can help you remain on track with your revision.

Effectively use resources: Solid revision should use a wide variety of different types of resources that best suit your learning style; whether it is textbooks, webinars, practice questions, or others.

Dedicate revision time accordingly: The clinical domain comprises 80% of the exam questions, and an appropriate amount of time should be spent on studying for this section. However, ensure you do not overlook critical appraisal and administration.

Don’ts

Always work alone: Working in a group of other GP trainees preparing for the exam is a great way to revise some components. You can learn from each other’s mistakes and help and support each other.

Underestimate the time needed for revision: At least 3 months are needed to revise, but if your home life or your placement is particularly busy, you should attempt to dedicate more time. Trainees commonly start revising 4-6 months before the exam.

The day of the MRCPCH AKP (Exam Centre)

What do I need to take with me on the day of the MRCPCH AKP?

On the day of the exam, candidates will need two forms of ID: primary ID which must be photographic, and secondary ID must display at least the candidate’s name and signature. The name on the IDs should be identical to that on the application. If this is not the case, supporting documents showing a link between the different names must be brought. Candidates must arrive on time. All personal belongings will be left in a locker outside the test room.

Candidates will be required to sign a non-disclosure agreement before the start of the test. The exam is computerised, and all candidates will complete a short tutorial to get used to the computer system before the exam begins. No additional time will be given if candidates decide to leave the room for water or to use the bathroom.

What can I take into the MRCPCH AKP exam?

Pearson Vue has its own examination centre rules which can be found here. In brief, the rules include:

You cannot take:

• Bags
• Coats
• Calculators
• Books
• Notes
• Mobile phones
• Electronic equipment including laptops, tablets and pagers.
• Watches
• Wallets or purses
• Food and drink

Personal items must be left in a locker and your mobile phone switched off.

The day of the MRCPCH AKP (Online)

When sitting the exam online, you will be monitored remotely by an online invigilator. The online invigilation team uses trained human invigilators combined with AI proctor software. The footage will also be recorded and reviewed later by the RCPCH. Online exams must take place in a suitable private space, such as your home, to maintain exam conditions.

International candidates in most countries without test centres will be able to use online invigilation. This is subject to eligibility requirements, local laws, network connectivity, and other technical requirements. The software is currently not able to support candidates in UAE to sit the exam online (due to local legal restrictions). Many candidates have had connectivity problems attempting to sit the exam online in Egypt, Iran, Myanmar, Syria, and Sudan. If you do wish to sit online, we would recommend seeking a venue where there is more likely to be backup generators and strong internet connectivity.

Frequently asked questions about MRCPCH AKP

How long is the MRCPCH AKP exam?

The MRCPCH AKP exam consists of two 2.5-hour papers taken on the same day.

When can I take the MRCPCH AKP?

To qualify for the AKP exam, the Royal College of Paediatrics and Child Health (RCPCH) states:

• Candidate must hold a valid primary medical qualification (PMQ) from a registered institution.
• “Primary medical qualification” shall mean a qualification rendering the holder eligible for registration with the General Medical Council of the United Kingdom, or in the case of overseas bodies, being recognised by the General Medical Council of the United Kingdom.

What are Pearson Vue Exam Centres like for MRCPCH AKP?

Pearson Vue has nearly 6,000 test centres across the globe in over 180 countries. You’ll need to choose a test centre location that is convenient for you to travel to, and that has availability for the dates you want to take the exam. Keep in mind that test centre availability can be limited, as you will see candidates sitting a wide range of other exams - from driving theory tests to risk management qualifications.

When selecting a test centre, make sure to take note of the opening times and any special instructions or rules for that location. Some test centres may have specific requirements for what you can bring into the testing room, or how you should behave during the exam.

However, it can be noted Pearson VUE has some allowances for comfort aids, which can be found here.

When do I get my MRCPCH AKP results?

According to RCPCH, your results will be available in your online account 6 to 7 weeks after you sit your exam. They will also email you your results, with more detailed feedback, a week later.

Is the MRCPCH exam hard?

The difficulty levels of the MRCPCH exam papers - including FOP/TAS and AKP - are set to guarantee that all candidates have reached the required standard of someone entering specialist training. These exams are generally considered to be challenging, however it is possible to pass with the right knowledge and a focused and dedicated mindset.

How many times are you allowed to sit the MRCPCH AKP?

According to RCPCH, each examination candidate will be allowed up to 6 attempts at each part of MRCPCH.

If a candidate has failed an examination on six occasions, that candidate must provide the RCPCH with evidence of additional educational experience before further attempts at that examination will be allowed.

Candidates who do not attend an examination will have that examination counted as an attempt. Candidates must inform the College in writing and provide evidence to support non-attendance within thirty days of the examination date, to ensure that their non-attendance is not counted as an attempt.

Hopefully, this in-depth guide has told you everything you need to know about the MRCPCH AKP exams. With the right resources and tools at your disposal and plenty of time to prepare, we are sure you’ll be able to pass and proceed to the next stage of your medical career!