Covid-19 exams update


Since 2020.3 RCPCH have offered the options of sitting an exam at a centre with social distancing measures in place or remote exams which can be undertaken at home or a private space with online invigilation.

The format and timings of the exams are exactly the same as previously. Please refer to the rest of the booklet for help and guidance on this.

Sitting the exam at an exam centre during Covid-19

  • Face coverings are mandatory up to the point of the exam starting. You may choose to take it off to complete the exam or keep it on depending on your personal preference. You will need to put the face covering back on if you require a toilet break and for leaving the exam centre.
  • If you have any flu-like symptoms including sore throats and the recognised symptoms of Covid-19 within the past 14 days you will not be permitted to enter.
  • Similarly if you have been diagnosed with Covid or in close personal contact with someone who was diagnosed you will not be able to enter.
  • If you have returned from travel to a highly infected area in the last 14 days. Please note this is constantly being updated for list of countries and you should check the RCPCH website for the exact list/if able postpone any travel.

When you arrive at the exam centre

  • Your face covering must be worn whilst in the waiting area and maintain social distancing of >2m from others in the waiting area or during queuing process.
  • You will need to remove your face covering for a brief period to confirm your identity on check in.
  • If you decide to wear gloves these must be transparent.
  • Only bring essential items.
  • Please review your local test centre guidance when emailed to you.

At the exam centre

  • Hand sanitising stations will be available
  • Where possible one way systems will be in place
  • There will be no access to public water fountains and vending machines so bring a drink/snacks if required
  • Between uses all keyboards, computer mice and desk areas will be sanitised prior to your arrival.
  • You must bring your own pen or pencil

As social distancing measures will be in place you may not get a place in an exam centre as these will be allocated on a first come, first serve basis.

Sitting the exams at home or other private space with online invigilation

First thing to note is if sitting the exam in work it must be a private office where interruptions are not going to happen, you must ensure IT support is available and do the systems check on the devices you will be using. RCPCH do not recommend sitting the exam at work.

You will need

  • A desktop or laptop computer
    • To sit the exam and record live audio and video
    • The computer must have an inbuilt microphone and not headphones or a headset unless arranged prior to the exam in line with reasonable adjustments
    • A webcam
    • Latest version of google Chrome
    • Dual screens are not permitted
    • Windows 8 or higher or MAC OSX/the latest
    • Ensure your laptop is plugged in to charge
  • A mobile device such as a smartphone or tablet
    • Additional monitoring for online invigilation
    • The ProctorExam app (instructions provided by RCPCH)
    • Android 4.1 or higher or iOS (Apple) 8.0 or higher
    • Use your wifi NOT your data
    • Has to be plugged in for the exam to charge

Before the exam

Two weeks before the exam date you will be emailed a link to do a systems check and set up. This is a test run to ensure everything is working as well as showing where you will sit the exam. If anything needs upgrading you will need to request a further system check by emailing so do not leave it to the last minute!

If you do not do the systems check you will not be allowed to sit the exam

The day of the exam

  • You will need your photo ID and admission document
  • Make sure your webcam works or you will not be allowed to proceed
  • Bathroom breaks will be limited to one 5 minute break in each paper.
  • If you have medical needs which means you may need this rule adjusted this must be declared on your application form
  • You cannot have paper during the exam
  • Water must be in a see-through bottle or glass If able set up the webcam so the door to the room is behind you to avoid any confusion if someone enters the room.
  • You can wear comfortable clothing
  • Remember you are being recorded both with audio and video!

FAQs for Covid changes to written exams

I am due to sit the exam at a test centre but have developed symptoms and/or tested positive for Covid and/or need to self-isolate, what should I do?

Inform the Royal College ASAP via the examinations team. You may need to cancel or transfer the exam to another time.

What happens if a local lockdown happens in my region or where the exam is due to take place?

Depending on when the lockdown happens two options are likely to happen;

  • If the lockdown happens well in advance of the date to confirm online invigilation numbers the College will aim to offer candidates the change to switch to online invigilation instead
  • If it occurs shortly before the examination the College will liaise with candidates to discuss transfers or cancellations
I am sitting my exam at work due to no other suitable facility. What can I do to ensure it goes smoothly?

Discuss with your IT services ASAP as well as your clinical or educational supervisor to see how this can be facilitated. Ensure that there are signs on doors and walls so people know not to interrupt. Don’t take your bleep!

My internet can be temperamental, is this taken into account in terms of time lost?

If you lose internet connection the timer stops. You will need to re-enter your details when your internet connection is restored and the time will restart.

Good luck!

Please check RCPCH for the most up to date guidance for exam changes with Covid-19

MRCPCH COVID Adapted Clinical Examination – advice and guidance

The RCPCH has worked tirelessly to ensure that our paediatric training has not been compromised by the COVID-19 pandemic. It was their priority that paediatricians were able to develop, progress and be assessed in their training to the same high standard that was previously delivered.

Their hard work has resulted in the formation of the MRCPCH COVID adapted clinical examination, a virtual examination hosted on an online platform called Practique. To minimise disparity between the face to face and virtual exam, several adaptations have been made to optimise the examination format on a virtual platform. The college are clear in their message that if you have prepared and are capable of passing the face to face examination, there is no reason that you should not be successful in the COVID adapted examination.

The exam is standard set to ensure fairness to all candidates and the examiners are experienced and trained in the new format. Allowances will not be made to candidates for the exam being of a virtual format but there is support available if a technical issue were to occur. Ultimately this exam has been designed and tested through many pilot attempts by experienced examination officers and medical professionals to ensure the progression of competent and confident paediatricians in a COVID safe way.

What are the main differences?

The first difference is that there are no children or parents involved in the examination. As strange as this might seem, having performed as a candidate in the pilot examination this was not a big problem. The use of video clips and photographs worked well to show what type of clinical situation the station was about and talking through the history and examination with the examiner was similar to practicing for the exam with colleagues, describing exactly what you are looking for and why, just without actually performing the examination

The other main difference is that you do not get to illicit signs through your examination but rather rely on cues from the examiner. I found this a little awkward during the first station but you quickly get the hang of it and I think if you practice in this manner it will not be a challenge on the day.
The format of the exam has been altered slightly changing from 10 stations to 9.

  • 2 short clinical stations
  • 1 extended clinical station*
  • 1 development station
  • 1 history station
  • 2 communication stations
  • 2 video stations

*more details below

There will be role players in the communication station, the history station, the development station and the extended clinical station but in the other stations it is just you conversing with the examiner. The role players make excellent parent substitutes as they are well rehearsed and I felt my interaction with them was very believable.

How is the exam delivered?

The examination is run using the Practique system which has also used for the START assessment and GRID interviews this year. It is a platform that enables you to move through a series of virtual rooms in which you face a different station and meet with a different examiner and an invigilator. The software is very intuitive and simple to navigate. You are able to see a document containing information about the patient in the station or watch a short video clip to provide you with a clinical sign before entering your station with the examiner, invigilator and maybe a role player. The invigilators are not examiners but are the time keepers of the whole examination. They interrupt to advise on timings during your station and ensure that everyone starts and finishes at the same time.

They are able to communicate with other invigilators to ensure that if there is a technical problem with a candidate that is resolved before everyone can move on. When you have finished a station and the invigilator tells you to, you click next to move to the next virtual room and perform your next scenario.

Despite the slightly strange feeling of being in a virtual room with complete strangers, it was actually a very calm experience and worked very well. I was amazed at how quickly you became immersed in the scenario despite sitting in the comfort of your own home!

New stations and delivery of original stations on a virtual platform

The extended clinical station is a new station in the adapted examination. It is 23 minutes in length with 4 minutes of reading and preparation time.
In this time you should;

  • Take a focused history from an actor usually acting as a part and present back to the examiner
  • Explain how you would carry out your examination of the child and what clinical signs may be relevant
  • Discuss investigations and management
    • This is important as it shows your ability to think about the next steps in a child’s care as you would as a registrar and consultant

There is a lot to cover and the examiner will try and guide you through to ensure that you get to all parts of the question. They want you to score marks in all domains and so will do their best to move you forwards if you are spending too much time on one particular answer.

The development station is the station that I think is the most different. Whilst you have the advantage of not having to contend with a stroppy toddler, you have the disadvantage of maybe losing your flow as the child is not directly in front of you. However, the College has made a photograph of all the equipment you require for a full developmental assessment, which you are allowed to leave up during your station. This acts as a really helpful reminder of all the aspects of development you need to cover. The photograph and list of equipment is available on the RCPCH MRCPCH COVID adapted examination website.


Cues are what the college has labelled the information given to you during the examination. The college has divided the cues up into universal and dependent cues. The universal cues are those given to everyone as a standard. They are things that would be noticed by any candidate as they entered the station ie a large sternotomy scar, an inhaler at the bedside, an abnormal gait. This information is delivered in the text or video clip shown before the station starts.

A dependent cue is information given to you by the examiner in response to something that you have said, for example ‘I am looking at the nails for peripheral stigmata of disease such as clubbing’, the examiner would say, ‘you can see clubbing of the finger nails’. Had you not examined the nails then the examiner would not have given you this information. They are allowed to prompt you so if you had said that you would look at the nails but did not say what for, they may ask you to detail what you are looking for. This highlights how important it is to describe in detail how you would perform an examination and what you are looking for. After each part of the examination, pause, to enable the examiner an opportunity to feed back the signs elicited.

Whilst this virtual method of examination may make you thankful that you do not have to manage a child who is not being compliant, the college have said that they can make the virtual child challenging so be prepared to describe your strategies for calming and distracting an upset child!


There should be few differences in the preparation required for either the face to face or the virtual examination. The main thing is just to ensure that you practice examination with a colleague, talking through your technique and allowing pauses for cues. If you practice this it will mean you are more prepared on the day.

In terms of knowledge, there should be no difference in the preparation you need to do for the virtual examination. The stations are essentially the same but just delivered in a slightly different way.

You don’t have to plan your travel or buy an expensive suit, you can perform the exam in your kitchen and the examiners can only see your face and shoulders! I’m not advocating jogging bottoms but you might get away with a comfy pair of slippers!

Final points

  • Make sure you do the examination at home, not at work on an NHS computer as firewalls can interfere with the virtual platform.
  • Ensure you are in a well-lit room with a plain backdrop so that your examiner is not distracted by your artwork or cat!
  • Make sure you are not going to be disturbed for the duration of the examination by family, roommates or pets.
  • Your desk should be clear from books, paper and pens. You are not allowed to take notes at all during the examination. There should be no prompts stuck to your computer or your walls behind your screen and all other windows on your desktop should be closed.
  • Read the instructions fully before entering a station and look in detail at any video clip or photograph you are given. Many of the videos by the College’s own admission are very dated! Nonetheless, they do show a clinical sign clearly!
  • Make sure that you do the checks on the device you are going to use in the examination, in the location you are going to do it. The emails that come through explaining what to do are a little overwhelming but they are easy to follow.
  • Chime is a programme that checks the microphone and camera of your device as well as your internet connection to ensure that it is adequate to run the software.
  • Use Google Chrome on your device as this is optimised for Practique.

Doing these checks early can help alleviate any anxieties you have. For the GRID interviews they created a dummy account so that you could run through the Practique programme beforehand.

The Future

Whilst there are advantages to performing the exam virtually remember that this isn’t an easy option. If you pass your membership on this attempt, recognition of your achievement is no less valid than if you had done the examination face to face. The RCPCH has worked extensively to ensure that the expectations of candidates in both examinations are comparable.

However, they have decided that if a candidate fails, this attempt will not be counted in their total number of attempts possible to pass the exam. This virtual examination will not be forever, once the risks of COVID have passed the examination will return to a face to face setting. Our careers are based around the care of sick children and their families and their involvement in our training is paramount in developing competent and skilled paediatricians for the future.

Good luck!

Please check RCPCH for the most up to date guidance for exam changes with Covid-19

Adapted from:


Version 1.5 2020
Authored by | Dr Amy Huxtable, Dr Sophie Slater, Dr Heather White

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