Syllabus Final Version Boards Mar 2016 For Candidates - 5

Theory Examination Syllabus
Published by:
Royal College of Paediatrics and Child Health
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The Royal College of Paediatrics and Child Health (RCPCH) is a registered charity in England and Wales (1057744)
and in Scotland (SC038299)
Foreword
This syllabus is intended to act as a guide for learners undertaking the theory examinations, which
for most individuals are a prerequisite for membership of the Royal College of Paediatrics and
Child Health (MRCPCH). The theory examinations are now entirely computer-based and consist of
three parts. These are not sequential and candidates can choose to sit the examinations in any
order. Acquisition of these examinations is essential for competency progression for UK trainees
and we expect those in training programmes to have completed all their theory examinations by
the end of the second year of training (ST2).
Our experience is that some doctors take parts of the theory examination before entry to the
paediatric training programme and the foundation of practice and theory and science
examinations do not necessarily require the trainee to have significant clinical experience. The
three parts of the examination are:
The Foundation of Practice Examination (FOP). This is intended to test the

knowledge of doctors seeking to provide clinical care for children. It
covers a wide range of commoner conditions that are frequently
encountered and it also continues as the theoretical component of the DCH.
The Theory and Science of Practice Examination (TAS). The emphasis of the
examination is to test the basic scientific, physiological and pharmacological
principles upon which clinical practice is based.
The Applied Knowledge of Practice Examination (AKP) aims to test clinical

decision making and management. Candidates benefit from clinical experience in
paediatrics to undertake this examination.
This syllabus aims to clarify for learners and teachers the core knowledge requirements for
paediatricians attempting the theory examinations. It should be read in combination with the
existing Curriculum for Paediatric Training in General Paediatrics.
We have reviewed, shortened and harmonised the existing syllabi and we hope this version
will be more user friendly, allowing trainees to link their learning with their training.
Contents
Theory Examination blueprints 4
Adolescent Health/Medicine 5
Behavioural Medicine/Psychiatry 6-7
Cardiology 8-9
Dermatology. 10-11
Diabetes Mellitus.. 12
Emergency Medicine 13-14

(including accidents and poisoning)
Endocrinology and Growth15-16
Ethics and Law 17
Gastroenterology and Hepatology 18-20

(including surgical abdominal conditions)
Genetics and Dysmorphology 21
Haematology and Oncology 22-23
Infection, Immunology and Allergy .24-25
Metabolism and Metabolic Medicine 26

(including fluid management and acid base balance)
Musculoskeletal.. 27-28
Neonatology..29-30
Nephro-urology. 31-32
Neurodevelopment and Neurodisability. 33
Neurology. 34
Nutrition. 35
Ophthalmology.. 36
Palliative Care and Pain Management 37
Patient Safety and Clinical Governance.. 38
Pharmacology. 39
Respiratory Medicine with ENT 40-41
Safeguarding. 42
Science of Practice 43
Examination blueprint for Foundation of Practice (FOP) 44
Examination blueprint for Theory and Science of Practice (TAS). 45
Examination blueprint for Applied Knowledge in Practice (AKP).. 46

Royal College of Paediatrics and Child Health Theory Examination Syllabus
Theory Examination blueprints

RCPCH strives to ensure that all examinations are valid and reliable, through consistency in the
way that examinations are created and with a detailed standard setting process once the
examination has been sat. The blueprints in this document support this, allowing specific mapping
of questions to the syllabus, and ensuring adequate selection across the entire syllabus, with
consistency of subject content, depth and difficulty over time.
These blueprints have been used to construct the RCPCH theory examinations from summer 2016
onwards as part of our ongoing quality improvement work. It is hoped they will be of value for
trainees as they prepare to sit the Foundation of Practice (FOP), Theory and Science of Practice
(TAS) and Applied Knowledge in Practice (AKP) examinations.
Theory Examination blueprints 4

Adolescent Health/Medicine
Foundation of Practice Theory and Science Applied Knowledge in

(FOP) (TAS) Practice (AKP)
Know how the health needs of Know how to manage
adolescents are different from transition of adolescents with
other age groups and about chronic health needs to adult
good practice in transition to services
adult services
Know about risk-taking Understand how ongoing Know how to assess and
behaviours including non- dynamic brain development diagnose risk taking
adherence, deliberate self- affects cognition, risk taking behaviours including non-
harm and substance misuse and decision making in adherence, self-harm, alcohol
and understand how these adolescence and substance misuse and
present and are managed make appropriate referral to
within Health and Social specialist services
Services
Know about the clinical Know how to assess, diagnose

presentation of young people and manage eating disorders
with eating disorders and know the risks and
complications of treatment
Know about contraceptive and Understand the Be able to assess, diagnose

sexual health issues including pathophysiology of sexually and manage problems relating
sexually transmitted infections transmitted diseases and their to sexual health including
and teenage pregnancy and treatment contraception, sexually
how to provide appropriate transmitted disease and
advice teenage pregnancy
Adolescent Health/Medicine 5
Behavioural Medicine/Psychiatry

Know the determinants of
child and adolescent mental
health
Know about the effects of Know about the effects of

physical diseases on behaviour physical diseases on behaviour
and vice versa including and vice versa including
somatisation disorders somatisation disorders as they
occur in secondary care and
when to refer to specialist
services
Understand how common

emotional and behaviour
problems may evolve
Know about the role of Child Understand the role of Child

and Adolescent Mental, Health and Adolescent Mental Health
Services (CAMHS) Services (CAMHS) and know
how to refer appropriately
Understand the principles of Understand the scientific basis Be able to assess, diagnose
managing common emotional of the management of and manage common
and behaviour problems such emotional and behavioural emotional and behaviour
as temper tantrums, breath- problems problems such as sleep
holding attacks, sleep problems, feeding problems,
problems, feeding problems, disruptive behaviour, eating
the crying baby, oppositional disorders, chronic fatigue
behaviour, enuresis and syndrome, as they present in
encopresis, excessive water secondary care, and
drinking, school refusal, understand when to refer to
bullying and chronic fatigue specialist services
syndrome and know when to
refer
Know about the signs and Know the scientific basis of the Know the signs and symptoms
symptoms of Attention Deficit treatment for Attention Deficit of Attention Deficit
Hyperactivity Disorder Hyperactivity Disorder (ADHD) Hyperactivity Disorder
(ADHD) and appropriate (ADHD) and the principles of
referral pathways diagnosis and management
Know the features of Be able to assess and

depression in children and diagnose important mental
adolescents and when to refer health problems in children
to specialist services and adolescents including
depression, psychosis and
early onset schizophrenia and
understand when to refer to
specialist services
Behavioural Medicine/Psychiatry 6

Know and understand the
presentation of conduct
disorders/antisocial behaviour
Be able to identify anxiety

disorders, phobias, panic
attacks, and obsessive
compulsive disorders and
know when to refer to
specialist services
Be aware of the pharmacology

of the main medications used
in child and adolescent mental
health
Behavioural Medicine/Psychiatry 7
Cardiology

Know the anatomy and
embryology of the normal
heart and vascular system
Know the clinical features of Understand the development Know the various
common congenital heart of the heart and know the presentations of congenital
conditions and understand the abnormalities that are heart problems at all ages and
principles of management associated with common be able to assess, diagnose
congenital heart diseases and manage and make
appropriate referrals
Know the genetic and

environmental factors in the
aetiology of heart disease
Know the normal fetal

circulation and transitional
changes after birth
Know the common causes of Understand the physiological

cyanosis and how to assess basis of myocardial function
these
Understand how the anatomy

of the heart relates to changes
in physical signs including what
underlies the heart sounds and
murmurs
Know the causes of murmurs Understand the Be able to assess, diagnose

palpitations, syncope and pathophysiology of cardiac and manage murmurs, chest
chest pain, understand the conditions including cyanosis, pain, palpitations, cardiac
principles of management and heart failure, shock, syncope, arrhythmias and syncope
know when to refer myocarditis and unexpected
cardiac death
Know the causes and clinical Be able to assess diagnose

features of heart failure, and manage heart failure,
understand the principles of myocarditis and pericardial
management and know when disease
to refer
Know the value of oxygen Be able to interpret Understand investigation of

saturation measurement in the appropriate investigations in a cardiac diseases e.g. ECG,
assessment of possible child with suspected cardiac ECHO, catheterisation and
congenital heart disease pathologies including their appropriate selection in
hypertension diagnosis and management
Understand how the electrical

activity of the heart translates
to the ECG
Cardiology 8

Know the causes and clinical Understand how blood Be able to assess, diagnose
features of hypertension and pressure is generated, and manage hypertension
how to measure and interpret measured and interpreted in (pulmonary and systemic) and
blood pressure in different age health and disease and the make appropriate referrals
groups pathophysiological
mechanisms resulting in
hypertension
Know the cardiac

complications of other system
disorders
Understand the pharmacology Know the indications and

of drugs used to treat common common side-effects of drugs
cardiac conditions including used to treat common cardiac
duct dependant cyanosis, heart conditions including duct
failure and arrhythmias dependent cyanosis, heart
failure and arrhythmias
Know the recommendations Understand the scientific basis Be able to assess, diagnose
regarding endocarditis of infective endocarditis and manage infective
prophylaxis in children with endocarditis
heart diseases
Cardiology 9
Dermatology

Understand the anatomy of the
skin
Know how abnormalities in Be able to assess and

skin anatomy and physiology diagnose ectodermal dysplasia
relate to appearance, and epidermolysis
dysfunction and disease
Understand how injuries to the

skin including burns affect
function
Know the causes and Understand the role of Be able to assess, diagnose
management of skin infections infective agents in skin disease and manage skin infections in
and cellulitis children
Know the side effects and Understand the pharmacology

different potencies of topical of agents used to treat
steroids common skin diseases
Be able to assess and

diagnose systemic disorders
that involve the skin and know
when to refer
Know the common causes of

fever and rash e.g.
exanthemata, Kawasaki
Be able to assess simple birth Be able to assess, diagnose

marks such as strawberry and manage birth marks,
naevi and Mongolian blue naevi, neurocutaneous lesions
spots and refer when and make appropriate
Know the causes features and Be able to assess, diagnose

management of rashes- HSP, and manage drug eruptions,
erythema nodosum and urticaria and dermatitis
multiforme and the association
between skin rashes and
common systemic diseases
and when to refer
Be able to diagnose, Understand the aetiology,

investigate and manage presentation and management
common skin rashes e.g. of eczema
eczema, acne, impetigo,
staphylococcal scalded skin
syndrome, dermatitis, cradle
cap, and nappy rash
Dermatology 10

Understand the emotional
impact of severe
dermatological problems
Dermatology 11
Diabetes Mellitus

Be able to recognise the Understand the aetiology and Be able to assess, diagnose
features of a child or young pathophysiological basis of and manage diabetes and its
person presenting with diabetes mellitus types 1 and 2 complications including
diabetes including diabetic and MODY and the scientific diabetic ketoacidosis
ketoacidosis and know the basis of the investigation of
principles of management suspected diabetes
Understand the physiological

actions of hormones on
glucose homeostasis
Understand the anatomy

embryology and function of
the endocrine pancreas
Understand the management Understand the

of diabetes in primary care pathophysiological basis of
including blood sugar diabetic emergencies
monitoring and insulin including diabetic ketoacidosis,
regimens hypoglycaemia,
hyperglycaemia
Understand the
pharmacological basis of
treatment of diabetes
Know the causes, Be able to diagnose and

complications and treatment manage hypoglycaemia in the
of hypoglycaemia in the diabetic child
diabetic child
Diabetes Mellitus 12
Emergency Medicine
(including accidents and poisoning)

Know the common causes of Understand the science and Be able to assess, diagnose
cardiac arrest, the prognostic rationale underpinning basic and manage shock and
factors that influence the and advanced life support cardiac arrest and be able to
outcome and how to provide teach basic life support to a
basic life support and advise parent
others
Know how to control acute Understand the Be able to manage life

blood loss until help arrives pathophysiological processes threatening haemorrhage and
of the various types of shock, understand the principles
including haemorrhagic, behind different management
hypovolaemic, neurogenic and considerations, such as
septic shock permissive hypotension,
surgical referral, dilution of
coagulation factors, early use
of platelets and blood
products
Be able to recognise and

provide initial management for
life-threatening airway,
breathing or circulatory
compromise
Know about immediate care Understand the scientific basis Be able to assess and provide
for children with burns and for the recognition and initial management for
scalds, recognising that they management of the seriously ill children presenting with burns
may be a presentation of non- or injured child including burns and scalds
accidental injury and scalds
Know the causes and features Understand the Be able to assess, diagnose
of anaphylaxis and its pathophysiology and the and manage children
management science, behind the presenting with anaphylaxis
management of anaphylaxis including acute life
threatening upper airways
obstruction
Know how to recognise acute Be able to assess, diagnose

seizures and initiate and provide initial
emergency treatment management for children
presenting with acute seizures
Know how to recognise and Understand the anatomical and Be able to assess, diagnose
initiate treatment for children pathophysiological changes and provide initial
presenting with neurological that lead to the signs and management for children
emergencies symptoms of neurological presenting with acute
injury neurological emergencies e.g.
coma and stroke
Emergency Medicine 13

Be aware of common causes Understand the , epidemiology, Be able to manage childhood
of accidents in children and physiological and metabolic accidents including trauma
adolescents including mechanisms, consequences of and drowning and be able to
safeguarding implications and accidents including trauma, advise parents on how to
understand prevention drowning, inhalation. avoid accidents
strategies Understand the science
underpinning accident
prevention
Know how to differentiate Understand the Be able to differentiate

between life or limb pathophysiology of bone between life or limb
threatening injuries and healing threatening injuries and
injuries that can be managed injuries that can be managed
less urgently less urgently
Know the principles of e able to initiate appropriate

managing limb threatening management of limb
injuries threatening injuries and know
when to urgently refer.
Know of appropriate use of Understand the risks of Be able to interpret basic

radiological investigations in radiological investigation and trauma X-rays
trauma how to mitigate these,
including investigations that do
not use imaging.
Know when to suspect and Understand the Be able to manage head and
how to safely initiate pathophysiology of severe spine trauma according to
management in head and head and spinal injury and APLS/ATLS guidelines
spinal injury neurogenic shock
Know the common causes of Understand the mode of Be able to identify causes of
poisoning in children and action, physiological and poisoning and their
adolescents including metabolic mechanisms and presentation, know how to
safeguarding implications consequences of substances initiate appropriate
taken without medical advice management and be able to
for recreational use or self- anticipate potential
poisoning complications
Emergency Medicine 14
Endocrinology and Growth

Understand the anatomy
embryology and function of
the important endocrine
organs e.g. brain, thyroid,
parathyroid, adrenals and
gonads
Know the presentation of Understand the Be able to assess, diagnose

disorders of the adrenal, pathophysiological basis of and manage disorders of the
thyroid and parathyroid glands disorders of the hypothalamus, adrenal, thyroid and
and understand the principles pituitary, thyroid, parathyroid parathyroid glands
of management and adrenal glands
Know the presentation of Know the causes and

disorders of the pituitary gland management of pituitary and
and understand the principles hypothalamic disorders
of management
Understand the
pathophysiological basis of
endocrine emergencies
including adrenal crisis and
hypoglycaemia
Understand the physiological

actions and regulation of
endocrine hormones
Understand the scientific basis Be able to identify endocrine

of the investigation of complications of other
endocrine diseases diseases and refer
appropriately
Understand the patterns of Understand the physiological

normal growth and basis of growth and puberty
development including
puberty and its normal Know the genetic and
variations environmental factors that
influence growth and puberty
Understand the principles and Understand the scientific and

practice of growth statistical basis of growth
measurement, including measurement and charting
plotting and interpretation of
growth charts
Endocrinology and Growth 15


Know the causes of abnormal Know the causes of problems
growth including short stature relating to growth and
and slow or accelerated puberty. Be able to assess,
growth. Know about diagnose and manage,
appropriate assessment, referring when appropriate
investigation and treatment
Endocrinology and Growth 16

Ethics and Law

Understand the principles of Know the legal rights of Be able to apply legal rights of
child advocacy i.e. that all children and young people in children and young people
decisions are to be made in the UK within the current UK legal
the best interest of the child framework
and issues relating to consent
and confidentiality
Ethics and Law 17

Gastroenterology and Hepatology

(including surgical abdominal conditions)

Know the causes of acute Be able to assess, diagnose
abdominal pain, and recognise and manage acute abdominal
when to refer, including pain and make appropriate
urgency of referral referrals
Know the presentations, Be able to assess, diagnose

causes and management of and manage chronic and
chronic and recurrent recurrent abdominal pain
abdominal pain including when
to refer
Know the causes of Understand the Be able to assess, diagnose

vomiting/regurgitation at pathophysiology of and manage
different ages and be able to vomiting/regurgitation vomiting/regurgitation
assess, manage and refer
appropriately
Know the causes of acute Understand the pathological Be able to assess, diagnose
diarrhoeal illness, how to mechanisms of infective agents and manage acute diarrhoeal
assess and manage and when in the gut and liver illness
to refer
Know the common causes of Understand the Be able to assess, diagnose

chronic diarrhoea and its initial pathophysiology of diarrhoea and manage chronic diarrhoea
investigation and management and its complications
Know the common causes of Understand the Be able to assess, diagnose

food allergies and intolerances, pathophysiology of food and manage food allergies and
their initial management and allergies and intolerances intolerances and understand
when to appropriately refer. the role of the dietician
Know how to diagnose and Understand the Be able to assess, diagnose

manage constipation pathophysiology of and manage constipation and
constipation encopresis and their
complications
Know the causes of jaundice Understand the Be able to assess, diagnose

and when to refer. pathophysiology of liver and manage liver diseases and
disorders including jaundice disorders and make
Know the common causes of Be able to assess, diagnose

upper and lower and manage bleeding from the
gastrointestinal bleeding, gastrointestinal tract and
initial management and make appropriate referrals
appropriate referral
Gastroenterology and Hepatology 18


Know the anatomy and Be able assess, diagnose and
embryology of the provide initial management of
gastrointestinal tract and how congenital malformations of
variation relates to specific the gastrointestinal tract and
disorders e.g. malrotation, liver
atresias, Hirschprung disease
Be able to recognise and Be able to assess and

understand the management diagnose surgical disorders of
of common surgical conditions the gastrointestinal tract
including hernias, and pyloric
stenosis
Know the varied presentations Know the basic histopathology Be able to assess, diagnose
of coeliac disease and its and cellular dysfunction of and manage conditions
investigation and management important disorders causing resulting in malabsorption
malabsorption including including coeliac disease
coeliac disease
Know the presentation of Understand the physiological Be able to assess, diagnose

disorders of the exocrine basis of normal gut, liver and and manage diseases and
pancreas exocrine pancreatic function disorders of the pancreas.
including motility, digestion,
absorption and secretion
Be able to assess, diagnose

and manage chronic
inflammatory and autoimmune
diseases of the gastrointestinal
tract and know when to refer
Be able to assess, diagnose

and initiate management of
the conditions that cause
hepatitis and hepatic cirrhosis,
and make appropriate
referrals
Understand the anatomical and

physiological and hormonal
changes in gut and liver that
occur throughout childhood
Understand the role of the gut

in homeostasis and its
dysfunction

aetiology of gut and liver
disease


Understand the
pharmacological basis of
treatment of gastrointestinal
and hepatic disorders

Genetics and Dysmorphology

Understand patterns of Understand the scientific basis Be able to explain and provide
disease inheritance and be of genetic disorders and advice regarding patterns of
able to construct a family tree inheritance inheritance
and interpret patterns of
inheritance
Know about the features of Understand the chromosomal Be able to diagnose and
common chromosome and molecular basis of genetic manage common genetic and
disorders e.g. Down ,Turner disorders and the principles of dysmorphological conditions
and Fragile X syndromes testing and make appropriate
referrals
Know the basis of genetic Understand the scientific basis Be able to advise regarding
screening and diagnosis, the of genetic screening and pre and postnatal screening
common conditions for which diagnosis and demonstrate
they are used and the ethical understanding of subsequent
dilemmas they pose referral and management
Know about environmental Know the environmental Understand the effects of

factors which may affect pre- factors which may affect environmental factors which
natal development, e.g. prenatal development may affect development of the
maternal health, alcohol and fetus e.g. maternal health,
drugs drugs and alcohol
Genetics and Dysmorphology 21

Haematology and Oncology

Know the causes and Understand the physiology and Be able to assess, diagnose
presentations of anaemia and pathophysiology of and manage children with
their initial investigation and haematopoiesis that occur anaemia including bone
management throughout childhood marrow failure and know when
to refer
Know and understand safe Understand the scientific basis Understand the risks, benefits
transfusion practice of blood transfusion including and precautions involved in
the role of major and minor blood transfusion
blood antigens
Know the causes of bleeding, Understand the Be able to assess, diagnose

purpura and bruising and pathophysiology of and manage coagulation
recognise features in the coagulation disorders and disorders, hypercoagulable
presentation which suggest hypercoagulable states states, purpura and bruising
serious underlying pathology
Know how to interpret Be able to interpret commonly Be able to assess, diagnose

haematological investigations reported haematological and manage neutropenia
including full blood count, investigations
blood film and coagulation
studies
Know the clinical Know the genetic and Be able to assess, diagnose
manifestations of acute environmental factors in the and make appropriate referral
leukaemia, lymphoma, and aetiology of haematological of leukaemias and
solid tumours disorders and malignancies lymphoproliferative disorders.
and understand the molecular Be able to assess, diagnose
basis of cell growth and and make appropriate referral
regulation of solid tumours
Know how to assess a child Know the anatomy of the

with lymphadenopathy or reticuloendothelial system
other masses and when to
refer
Know about the risks and Understand the tissue effects Be able to assess, diagnose
benefits of ionising radiation of ionising radiation and make appropriate referral
of side-effects of treatment for
malignancy e.g. chemotherapy
and radiotherapy and
understand the risks and
benefits of the use of ionising
radiation in investigation and
treatment
Haematology and Oncology 22


Understand the disease
associations of specific
syndromes with propensity to
malignancy e.g.
hemihypertrophy, Fanconi
anaemia
Understand the role of Understand the different roles

different health care of individuals and services
professionals in shared care involved in providing shared
for oncological conditions. care for oncological conditions
Understand the pharmacology Understand the practical

of drugs used in the treatment application and potential
of haematological and complications associated with
oncological disorders including bone marrow transplantation
monoclonal antibodies and immunosuppressive
therapy
Haematology and Oncology 23

Infection, Immunology and Allergy

Know about common Know the epidemiology, Be able to assess, diagnose
infections of children in the UK pathology and natural history and manage infections
and important worldwide of common infections of acquired in the UK and
infections, e.g. TB, HIV, childhood including normal overseas including TB ,HIV and
hepatitis B, malaria, polio patterns of frequency know when to refer
Know the UK national Be able to follow the UK

guidelines on notification of national guidelines on
communicable diseases notification of communicable
diseases
Know and understand the Understand microbiological Know the principles of

basic principles of infection characteristics, including infection control including the
control, how outbreaks of antibiotic resistance, virulence control of nosocomial
infection including nosocomial and other mechanisms which infection and be able to
infection occur, and how they lead to the spread of infection implement them in clinical
should be investigated in communities and practice
populations
Be able to assess and manage Understand the

a febrile child and have pathophysiology of fever and
knowledge of current evidence sepsis and the scientific
based guidelines rationale for treatment
Understand the principles and Understand the scientific basis

the rationale of immunisation of immunisation
programmes including the
national immunisation
programme for children in the
UK
Know and understand the Be able to advise primary care

indications, contraindications, professionals on immunisation
complications and in children with important
controversies of routine medical conditions or in
childhood immunisations and unusual circumstances and
be able to advise parents when complications occur
about immunisations
Know the common allergies Understand the scientific basis Be able to assess, diagnose
and advise on management. of allergy and anaphylaxis and and manage allergies
the rationale for treatments
Understand host defence Know the causes and common

mechanisms and their pattern presentations of vulnerability
of development to infection including
primary/secondary
immunodeficiency and when
to refer
Infection, Immunology and Allergy 24


Know the epidemiology, Be able to assess, diagnose
genetic and environmental and manage auto-immune
triggers and natural history of disorders with appropriate
atopic, allergic and referral
autoimmune diseases
Know when antimicrobials are Understand the pharmacology Understand appropriate and
indicated and rational use of judicious use of antimicrobials
antimicrobials including the including treatment,
problem of resistance prophylaxis and drug
development resistance
Understand the normal Know the classification and

patterns and frequency of essential features of infectious
infections in childhood agents
Infection, Immunology and Allergy 25

Metabolism and Metabolic Medicine

(including fluid management and acid base balance)

Understand the biochemistry Know the biochemical features
and metabolism of fat, protein of metabolic diseases and be
and carbohydrate including able to undertake and
urea cycle, Krebs cycle, fatty interpret relevant metabolic
acid cycle investigations

aetiology of metabolic
disorders
Know about fluid, acid-base Understand the Be able to assess, diagnose

and electrolyte disturbances pathophysiology of metabolic and manage fluid and
and their management disorders e.g. electrolyte and electrolyte disturbances and
acid base disturbance, disorders of acid-base balance
hyperammonaemia,
hypoglycaemia
Know the common clinical Understand the scientific basis Have a good understanding of
presentations of metabolic of investigations that are used the clinical presentation and
disease in the diagnosis of metabolic prognosis of metabolic
disorders diseases and be able to
assess, diagnose and initiate
management and refer
appropriately
Know about metabolic bone Understand the physiology and Be able to assess, diagnose
disease and its management pathophysiology of bone and manage metabolic bone
metabolism disease, including rickets
Know about the screening Understand the scientific Know the screening
procedures for inherited principles underlying screening procedures for inherited
metabolic conditions. for metabolic disease metabolic conditions and
understand the implications of
positive tests
Understand the principles of

dietary, vitamin and
pharmacological treatment of
metabolic diseases
Metabolism and Metabolic Medicine 26

Musculoskeletal

Know the normal variations of Know and understand the
limb development e.g. bow anatomy of the
legs and knock knees, in- musculoskeletal system
toeing, flat feet
Know about the assessment, Know the histology and

causes and initial management understand the physiology and
of joint and limb pain, joint pathophysiology of muscles
laxity and swelling and joints in health and disease
and understand how structure
relates to function
Know the science underlying Be able to assess, diagnose

investigations used in the and manage musculoskeletal
diagnosis of musculoskeletal disorders including those with
disorders systemic manifestations, acute
and chronic arthritis and know
when to refer
Be aware of the presentation Know the genetic and Be able to assess, diagnose
of muscular disease including environmental factors in the and manage muscular
the dystrophies aetiology of musculoskeletal dystrophies, neuropathies,
disorders myopathies and myalgia with
appropriate specialist advice
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 Understand the Be able to assess, diagnose
chronic arthritis including pathophysiology underlying and manage vasculitic
those with systemic disease associations of disorders with appropriate
manifestations (e.g. Henoch- rheumatological conditions referral
Schnlein purpura) and with other conditions including
understand the principles of eye disease, and metabolic
management disorders
Know how to recognise the Be able to assess, diagnose

various causes of scoliosis and and manage specific bone
how they present disorders such as scoliosis,
developmental dysplasia of
the hip, Perthes disease and
make appropriate referral
Musculoskeletal 27

Know how to recognise
developmental dysplasia of
the hip, appropriate referral
pathways and usual
management
Understand the pharmacology

of agents, including
monoclonal antibodies, used in
the treatment of
musculoskeletal disease
Musculoskeletal 28
Neonatology

Know and understand the Understand the normal Be able to advise parents and
effects of antenatal and physiological processes colleagues about the
perinatal events occurring during the perinatal prognosis and likely
period complications of a high risk
pregnancy, including those
involving alcohol or drug
abuse
Know about antenatal Be able to assess, diagnose
diagnosis of neural tube and manage congenital
defects neurological malformations
Know the problems associated Understand the scientific basis Know the long-term outcome
with prematurity and the long- of common diseases and of the high risk neonate
term sequelae including the conditions affecting the new including chronic lung disease
impact on the family and born including the and retinopathy of
community consequences of prematurity prematurity
Be able to recognise and

initiate the management of
common disorders in the
newborn including sepsis
Understand the principles of Understand the physiology Be able to manage neonatal
new born feeding and growth underlying fluid and electrolyte feeding and nutrition, fluid and
recognising the importance of management and nutrition in electrolyte disorders including
breast feeding and being able the neonate hypoglycaemia
to advise on lactation
difficulties and
contraindications
Be aware of the occurrence Understand the science of Be able to assess, diagnose
and clinical features of acquired and congenital and manage and minimise the
maternal to fetal transmission infections in the newborn risk of congenital and acquired
of infection period neonatal infections including
HIV
Know about the support

networks for families and
babies including those from
socially disadvantaged families
Know the range of newborn Understand the statistical Know the current newborn
screening tests used in the UK principles and science of the screening practices and be
including haematological and practice of newborn screening able to manage abnormal
metabolic conditions, cystic results
fibrosis and the universal
newborn hearing screening
programme
Know about common minor Understand the embryology of Be able to assess, diagnose
congenital abnormalities and the human fetus from and manage congenital
their initial management conception to birth and how anomalies presenting in the
errors in this process can lead neonatal period and make
to diseases or congenital appropriate referral
anomalies
Neonatology 29

Understand the causes and Understand the physiology of Be able to initiate and
features of neonatal jaundice jaundice in the neonatal period interpret diagnostic tests and
knowing when to refer for and principles of treatment plan initial management of the
further investigation and be conditions that cause neonatal
able to recognise early jaundice
presentation of neonatal
hepatitis and biliary atresia
Know the presentations of Understand the causes and Be able to assess, diagnose
neonatal seizures and mechanism of brain injury in and manage neurological
recognise abnormal term and preterm infants and disorders and make
neurological features e.g. the its relationship to short and appropriate referral
floppy baby long term neurodevelopmental
sequelae
Know the principles and Understand the physiological Be able to assess and manage
methods of neonatal basis of neonatal resuscitation neonatal resuscitation and its
resuscitation complications
mechanical ventilation
including the interpretation of
blood gases
Know how to recognise, assess Understand the Be able to assess, diagnose
and initially manage pathophysiology of respiratory and manage neonatal
respiratory disorders in the disease of the newborn and its respiratory disorders with
neonatal period complications appropriate referral
Be able to recognise and Be able to assess, diagnose
assess birth injury with and manage birth injury with
appropriate referral appropriate referral
Know about the identification, Be able to assess, diagnose
initial management and and manage neonatal surgical
appropriate referral pathways problems and make
for neonatal surgical problems appropriate referral including
including NEC NEC
Neonatology 30
Nephro-urology

Understand the principles of Know the anatomy and Be able to assess, diagnose
management of disorders of embryology of the urogenital and manage congenital
the urogenital tract and know system anomalies of the urogenital
when to seek surgical referral system

aetiology of renal and bladder
disorders
Know the manifestations of Understand the physiology of Be able to assess, diagnose

acute and chronic renal the normal kidney and bladder and manage nephro-urological
diseases and the pathophysiological disorders, including those with
and histopathological changes systemic manifestations and
that occur in renal disorders make appropriate referral
Know the manifestations and Be able to assess, diagnose

management of urinary tract and manage urinary tract
infections in different age infection with appropriate
groups referral
Know the causes of Be able to assess, diagnose

haematuria and proteinuria and manage nephritic and
(including nephrotic syndrome nephrotic syndromes with
and acute nephritis) and appropriate referral
recognise features in the
presentation which suggest
serious or significant
pathology
Know the principles of Be able to assess, diagnose

managing enuresis and manage enuresis
Know the causes and

assessment of polyuria and
polydipsia and when to refer
Understand the scientific basis Be able to select imaging

of imaging and physiological investigations of the
investigations used in renal urogenital system and
disorders interpret the results
Understand the physiological Be able to assess, diagnose

basis of renal dialysis and and manage acute and chronic
hemofiltration renal failure
Nephro-urology 31

of agents commonly used in
renal disorders
Nephro-urology 32
Neurodevelopment and Neurodisability

Understand normal Know the anatomy and
development including understand the physiology of
common variants the central and peripheral
nervous systems
Know the causes of disability, Understand the scientific basis Be able to assess, diagnose
disordered development and of normal and disordered and manage developmental
learning difficulties neurodevelopment in disorders, learning difficulties
childhood including theories of and causes of disability
pathophysiology recognising including cerebral palsy and
the known genetic and abnormal movement disorders
environmental factors
Know the causes of speech Understand the features of

and language delay or speech and language
disorder and principles of disorders including autism
management including autism spectrum disorder, and know
spectrum disorder when to refer
Understand the definition and Understand the scientific basis Be able to assess a child with
effects of neurodisability on of non-pharmacological and neurodisability and understand
children and families pharmacological treatments for the principles of management
the management of
neurodisability
Neurodevelopment and Neurodisability 33

Neurology

aetiology of neurological
disorders
Understand the scientific Know the indications for and

principles of limitations of
neurophysiological studies e.g. neurophysiological studies e.g.
EEG, EMG, BAER, otoacoustic EEG, EMG, BAER, otoacoustic
emissions emissions and be able to
recognise common abnormal
EEG patterns
Know the causes of headache Understand the physiological Know the investigation and
and be able to treat or refer and pathophysiological management of headache
as necessary changes that occur in including unusual causes such
neurological disorders as raised intracranial pressure
including migraine, raised
intracranial pressure, idiopathic
intracranial hypertension,
epilepsy
Know the likely causes and Understand the causes of Be able to assess, diagnose
management of abnormalities seen in the CSF and manage acute infections
meningitis/encephalitis and used in the diagnosis of of the nervous system
altered consciousness neurological conditions
including infections
Know the causes of Understand the causes of Be able to assess, diagnose

hydrocephalus, macrocephaly abnormalities seen in the and understand the principles
and microcephaly and when to production and resorption of of management for children
refer CSF with microcephaly,
macrocephaly and
hydrocephalus
Be able to recognise
abnormalities seen on
neuroimaging
Know the causes and Understand the scientific basis Be able to assess, diagnose
presentation of seizure of pharmacological and non- and manage seizure disorders
disorders, their differential pharmacological treatments and conditions which may
diagnosis, the principles of for the management of mimic them
management and when to neurological disorders e.g.
refer AEDs or ketogenic diet
Neurology 34
Nutrition

body composition in children
and its basic assessment e.g.
weight, BMI
Know the constituents of a Understand the scientific basis

healthy diet at all ages of nutrition
including breast and formula
feeding in infancy
Understand the principles of Know the constitution of infant

infant feeding feeds commonly used in health
and disease
Know the principles of

nutritional management in
childhood disease e.g.
neonates, intensive care, cystic
fibrosis
Know the causes of Know the nutritional Be able to assess, diagnose

malnutrition and understand consequences of being and manage malnutrition,
the epidemiology and public underweight and overweight obesity and their
health consequences of on other body systems e.g. complications
obesity cardiac and on long term
health
Be able to recognise obesity, Know the epidemiology of

understand the consequences obesity and malnutrition in
of obesity on health and well- global child health
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, Know the scientific basis of Be able to assess, diagnose
and management of vitamin dietary supplementation and manage specific vitamin
deficiencies including with calories, and mineral and micronutrient
vitamins, minerals deficiencies
Nutrition 35
Ophthalmology

Know the presenting features Know the anatomy and Be able to assess, diagnose
of visual impairment and the embryology of the eye and and manage visual impairment
principles of management understand how structure of
the eye relates to function
Know the causes and Know the genetic and Be able to assess, diagnose
management of eye infections environmental factors in the and manage ophthalmological
and inflammatory disorders aetiology of eye disorders conditions including glaucoma
and papilloedema and know
when to refer
Know the common causes of Understand the normal Know the presentation,
an absent red reflex, be able to development of vision and the diagnosis and management of
refer appropriately and be pathophysiology of visual eye tumours and cataract
aware of management options impairment
Know the common causes of Be able to assess and

ptosis and proptosis and the diagnose ptosis and proptosis
principles of management and know when to refer
Know the causes and Know the physiology of the Be able to assess and
presentations of strabismus eye and its movement e.g. diagnose causes of abnormal
and the principles of pupillary reflexes, anisocoria, movement of the eyes
management strabismus, refractive errors, including nystagmus and
nystagmus strabismus

of agents commonly used in
eye disease including
antimicrobials and mydriatics
Ophthalmology 36
Palliative Care and Pain Management

Know about end of life care Understand the science and Understand the ethics of
and bereavement counselling rationale underpinning palliative care in life limiting
and understand the termination of resuscitation conditions and in the
opportunities for respite care, and withdrawal of care withdrawal or withholding of
including the role of childrens including the criteria for care
hospices diagnosis of brain stem death
Understand the principles of Understand the principles of Understand and be able to

pain management and be pharmacological and non- apply pharmacological and
aware of the treatment pharmacological interventions non-pharmacological
options available to children of in symptom control for interventions in children
all ages children
Palliative Care and Pain Management 37

Patient Safety and Clinical Governance

Know the role of patient safety Understand the concepts of Be able to apply patient safety
and clinical governance in safe patient safety and clinical thinking
healthcare delivery governance
Be able to describe the impact Know about the human factors Understand how human
of human factors on delivering and physiological stressors factors can be minimised in
safe clinical care (e.g. fatigue, hunger) that practice
contribute to adverse events
Know how to exchange Know how effective Be able to lead a safe and
information in a timely manner communication has been effective handover to
to establish a shared shown to reduce clinical risk communicate key patient
understanding among concerns and enable
appropriate members of the prioritising of sick patients,
team allocation of resources
Know the main routes of Know what to do to minimise

transmission of hospital risk of transmission of infection
acquired infections and their
prevention
Understand the factors that Know the current infection

drive pandemic/epidemic control strategies for
infections and appreciate how epidemic/pandemic infections
this is used in clinical practice
to prevent them
Understand the ethical Know about risk stratification

implications of patient testing and how to use this in relation
in the event of a needle stick to prophylactic antiretrovirals
injury
Patient Safety and Clinical Governance 38

Pharmacology

Know how to find out Understand the mode of Be able to initiate safe
information necessary for safe action, physiological and prescribing and drug
prescribing through use of metabolic mechanisms of prophylaxis
paediatric formularies and therapeutic agents including
pharmacy liaison intravenous fluids
Know how to prescribe safely Understand the mechanisms of Know and understand the
and be aware of adverse undesired effects of adverse effects and
effects and interactions of therapeutic agents interactions of drugs
drugs
Know about the need to Be able to explain to parents

explain to parents the the unlicensed and off-label
unlicensed and off-label prescription of drugs
prescription of drugs
Understand the
pharmacokinetic principles of
dosing and prescribing in
children
Pharmacology 39
Respiratory Medicine with ENT

Recognise the presenting Know and understand the Be able to assess, diagnose
features of hearing impairment anatomy and embryology of and manage hearing
and the principles of the respiratory tract and the impairment
assessment and management ear
Know the causes and Know the genetic and Be able to assess, diagnose
management of conditions environmental factors in the and manage conditions
affecting the nose including aetiology of respiratory affecting the ears, nose and
epistaxis and allergic rhinitis diseases and disorders of the throat including epistaxis and
ears, nose and throat know when to refer
Know the causes and Understand the physiology and Be able to assess, diagnose
management of respiratory pathophysiology of the and manage lower respiratory
infection, earache, ear respiratory system in health tract infection in children
discharge, otitis media and and disease
glue ear
Know about obstructive sleep Understand the physiological Be able to assess and
apnoea and the principles of changes that occur in the diagnose sleep disordered
management respiratory system during breathing and understand the
sleep principles of management
Know how to assess and Be able to assess, diagnose

manage children with acute and manage wheezing
asthma and wheeze and plan illnesses
long term management
Know the causes of stridor and Be able to assess, diagnose

the principles of management and manage stridor
Know the presentations of Know and understand the Understand the diagnosis and
cystic fibrosis and the pathophysiology of cystic management of cystic fibrosis
principles of treatment fibrosis and principles of and common complications of
treatment the disease
Understand the causes of Be able to assess and manage

chronic cough and appropriate chronic cough including
investigations arranging and interpreting
investigation when
appropriate
Understand the physiological Be able to select and interpret

changes that occur in appropriate respiratory
respiratory disease and how investigations e.g. blood
this is reflected in respiratory gases, lung function tests,
function tests bronchoprovocation testing,
and oximetry recordings
Respiratory Medicine with ENT 40


Know the role of health Understand the risks Be able to assess, diagnose
promotion programmes in associated with smoking and and manage acute life
preventing respiratory passive smoking exposur threatening events including
morbidity e.g. smoking the management of sudden
cessation, sudden infant death unexpected death in infancy
and be able to advise parents
on avoiding risks
Understand the physiology of Know and understand the
mechanical ventilation indications for long term
ventilation and respiratory
support and be able to assess
and manage acute
deterioration
Understand the long term Understand the pharmacology

complications of medications of agents commonly used in
used for asthma respiratory disease and the
scientific basis of non-
pharmacological interventions
e.g. physiotherapy
Respiratory Medicine with ENT 41

Safeguarding

Know the presentations of Know the evidence base for Know the different
physical, emotional and sexual sound decision making in child presentations of non-
abuse, neglect and fabricated protection accidental injury: physical,
and induced illness emotional, sexual, neglect and
fabricated and induced illness
and how to differentiate these
from accidental injury,
diseases and variations of
normality
Know the epidemiology of

physical abuse, sexual abuse
neglect and fabricated and
induced illness
Know what steps should be Know the scientific basis of Be able to assess and manage
taken when child abuse is investigations recommended in physical and emotional abuse
suspected the investigation of suspected and fabricated and induced
non-accidental injury illness
Know the scientific limitations Know the emotional and

of imaging and investigations behavioural consequences of
in the diagnosis of non- child abuse and neglect on the
accidental injury child and young person
Safeguarding 42
Science of Practice

Understand research
methodologies
Demonstrate appropriate use Understand the principles of Be able to apply evidence

of clinical guidelines in statistical testing, evidence based medicine to clinical
practice based medicine, its limitations practice
and applications in practice
Be able to recognise
appropriate statistical testing
and to choose the correct test
in context
Know the principles of clinical

and research governance
Know the principles of Be able to interpret a research

screening in research and paper or systematic review
clinical practice appropriately
Science of Practice 43
Examination blueprint for Foundation of

Practice (FOP)
BO5 questions - 61 and EMQ questions - 14
Percentage of questions to be included [25%min-38% max] Percentage of questions to be included [44%min-53% max]
Adolescent Health/Medicine Dermatology
Behavioural Medicine/Psychiatry Diabetes Mellitus

Cardiology Endocrinology and Growth
Ethics and Law Emergency Medicine (including accidents and poisoning)
Genetics and Dysmorphology Haematology and Oncology
Metabolism and Metabolic Medicine (including fluid
management and acid base balance) Musculoskeletal
Neurology Neonatology
Ophthalmology Nephro-urology
Palliative Care Neurodevelopment and Neurodisability
Patient Safety and Clinical Governance Nutrition
Safeguarding Pharmacology
Science of Practice
Percentage of questions to be included [18%min-22% max]
Gastroenterology and Hepatology (including surgical

abdominal conditions)
Examination blueprint for Foundation of Practice (FOP)

44
Examination blueprint for Theory and

Science of Practice (TAS)
BO5 questions - 61 and EMQ questions - 14
Adolescent Health/Medicine Cardiology
Behavioural Medicine/Psychiatry Endocrinology and Growth

Dermatology Genetics and Dysmorphology
Diabetes Mellitus Haematology and Oncology
Emergency Medicine (including accidents and poisoning) management and acid base balance)
Ethics and Law Nephro-urology
Musculoskeletal Neurology
Neurodevelopment and Neurodisability Pharmacology
Nutrition Science of Practice
Ophthalmology
Palliative Care
Patient Safety and Clinical Governance
Safeguarding

abdominal conditions)
Neonatology
Examination blueprint for Theory and Science of Practice (TAS)

45
Examination blueprint for Applied

Knowledge in Practice (AKP)
120 questions which can be tested on short history, clinical with images, x-ray, data, data with
ECG, evidence based medicine and extended matching questions.
Adolescent Health/Medicine Cardiology
Behavioural Medicine/Psychiatry Diabetes Mellitus

Dermatology Endocrinology and Growth
Ethics and Law Emergency Medicine (including accidents and poisoning)
Genetics and Dysmorphology abdominal conditions)
Musculoskeletal Haematology and Oncology
Nutrition management and acid base balance)
Ophthalmology Nephro-urology
Palliative Care Neurodevelopment and Neurodisability
Patient Safety and Clinical Governance Neurology
Science of Practice Pharmacology
Safeguarding
Neonatology
Examination blueprint for Applied Knowledge in Practice (AKP)

46

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Theory Examination Syllabus

The Foundation of Practice Examination (FOP). This is intended to test the

The Applied Knowledge of Practice Examination (AKP) aims to test clinical

Behavioural Medicine/Psychiatry 6-7

Emergency Medicine 13-14

Endocrinology and Growth15-16

Ethics and Law 17

Gastroenterology and Hepatology 18-20

Genetics and Dysmorphology 21

Haematology and Oncology 22-23

Infection, Immunology and Allergy .24-25

Metabolism and Metabolic Medicine 26

Neurodevelopment and Neurodisability. 33

Palliative Care and Pain Management 37

Patient Safety and Clinical Governance.. 38

Respiratory Medicine with ENT 40-41

Examination blueprint for Foundation of Practice (FOP) 44

Examination blueprint for Theory and Science of Practice (TAS). 45

Examination blueprint for Applied Knowledge in Practice (AKP).. 46

Theory Examination blueprints

Theory Examination blueprints 4

Foundation of Practice Theory and Science Applied Knowledge in

Know about the clinical Know how to assess, diagnose

Know about contraceptive and Understand the Be able to assess, diagnose

Foundation of Practice Theory and Science Applied Knowledge in

Know about the effects of Know about the effects of

Understand how common

Know about the role of Child Understand the role of Child

Know the features of Be able to assess and

Foundation of Practice Theory and Science Applied Knowledge in

Be able to identify anxiety

Be aware of the pharmacology

Foundation of Practice Theory and Science Applied Knowledge in

Know the genetic and

Know the normal fetal

Know the common causes of Understand the physiological

Understand how the anatomy

Know the causes of murmurs Understand the Be able to assess, diagnose

Know the causes and clinical Be able to assess diagnose

Know the value of oxygen Be able to interpret Understand investigation of

Understand how the electrical

Foundation of Practice Theory and Science Applied Knowledge in

Know the cardiac

Understand the pharmacology Know the indications and

Foundation of Practice Theory and Science Applied Knowledge in

Know how abnormalities in Be able to assess and

Understand how injuries to the

Know the side effects and Understand the pharmacology

Be able to assess and

Know the common causes of

Be able to assess simple birth Be able to assess, diagnose

Know the causes features and Be able to assess, diagnose

Be able to diagnose, Understand the aetiology,

Foundation of Practice Theory and Science Applied Knowledge in

Foundation of Practice Theory and Science Applied Knowledge in

Understand the physiological

Understand the anatomy

Understand the management Understand the

Know the causes, Be able to diagnose and

Foundation of Practice Theory and Science Applied Knowledge in

Know how to control acute Understand the Be able to manage life

Be able to recognise and

Know how to recognise acute Be able to assess, diagnose