MRCPCH reasonable adjustments: how to apply for theory exams

Request an MRCPCH theory-exam reasonable adjustment when you book the FOP, TAS or AKP sitting. Select the Reasonable Adjustment option and upload supporting evidence that explains the condition, how it affects sitting the exam and the specific adjustment recommended. RCPCH says evidence is required for every exam application. If the need arises after booking, contact the RCPCH Help Centre promptly. Before exam day, confirm that every approved arrangement appears correctly on your admission document.

Reasonable-adjustment applications are easier to manage when they are treated as an examination-logistics project rather than a last-minute addition. The essential sequence is: understand the actual conditions of the sitting, prepare evidence that connects your needs to those conditions, make the request at booking, respond to any questions and verify the final arrangement in writing.

This guide covers Foundation of Practice (FOP), Theory and Science (TAS) and Applied Knowledge in Practice (AKP). It explains the current RCPCH administrative process as checked on 26 September 2026. It does not provide medical or legal advice, decide whether a particular adjustment should be approved or replace instructions issued to an individual candidate.

The current RCPCH process at a glance

RCPCH's theory-exam application page says that reasonable-adjustment requests must be made at the time of booking. The current education and training policy also says that supporting evidence must be provided for every exam application.

The core workflow is:

1. read the current conditions for the delivery method you intend to use;
2. prepare supporting evidence before the application window opens;
3. select the Reasonable Adjustment option in the booking form;
4. upload the evidence with that application;
5. monitor messages and answer requests for clarification;
6. read the decision rather than assuming that the requested arrangement was approved; and
7. check the admission document before the examination.

RCPCH says requests received later than seven weeks before the exam cannot be guaranteed. For a theory exam, however, the practical rule is earlier and clearer: request the adjustment when booking. Do not interpret the seven-week limit as a reason to submit a theory application without the request or evidence and plan to add them later.

For an MRCPCH theory exam, "early" means evidence ready before booking, the request made inside the booking form and the approved arrangement checked again before exam day.

What supporting evidence needs to do

The current RCPCH policy says that evidence for an examination request should be a letter or medical report from a qualified professional. It should:

• confirm the condition;
• explain how it affects the candidate's ability to sit the examination; and
• include specific recommendations for adjustments.

That structure matters. A document that only names a condition may not explain the functional effect under examination conditions. A request that only names an adjustment may not show why it is relevant. The evidence should connect the two without asking the candidate to write a diagnosis or clinical assessment themselves.

A useful administrative check is to ask whether a reviewer can identify four elements:

Element	Question the evidence should answer
Basis	What condition or impairment is being documented?
Examination impact	How could it affect sitting this examination?
Recommendation	What specific adjustment is recommended?
Source	Is the evidence provided by an appropriately qualified professional?

This table is an editorial checklist, not an alternative RCPCH form. Follow any more specific evidence requirements in the live policy and booking system.

RCPCH also asks candidates to consider adjustments used in previous examinations or in the workplace. Those details can help describe the request, but they do not replace current supporting evidence or guarantee the same outcome.

Evidence is required for every exam application

Do not assume that evidence submitted for an earlier FOP, TAS or AKP sitting is automatically attached to the next application. RCPCH currently states that supporting evidence must be provided for every exam application.

This is particularly important when:

• FOP and TAS are booked as separate examination components;
• an adjustment was approved for a previous diet;
• the recommended arrangement has changed;
• the delivery method is different; or
• the candidate is progressing from a theory exam to a clinical exam, which has a different application process.

Keep an accessible copy of the evidence, the submitted request, correspondence and the final decision. That record is for accurate resubmission and checking; it is not a substitute for uploading what the current application asks for.

Prepare before the application window opens

The booking window is the submission point, not the ideal starting point for collecting evidence. RCPCH advises candidates who need a new exam account to register at least ten days before the application window. Candidates who may request an adjustment should also allow time to obtain appropriate evidence and read the rules before booking begins.

Use this pre-booking checklist:

• confirm the exact component and intended diet;
• check the current application dates and local opening time;
• make sure the RCPCH exam account is active;
• read the test-centre and remote-invigilation conditions;
• identify which feature of the examination environment creates the need;
• obtain the supporting letter or report;
• check that the document is readable and clearly relates to you;
• confirm that it describes examination impact and specific recommendations; and
• save the current RCPCH policy links with the application record.

Do not send personal evidence to PaedVault or place it in a revision note. Use only the official RCPCH application or contact route specified for the request.

Make the request in the booking system

RCPCH's current theory-exam application guidance gives two direct steps:

1. select the Reasonable Adjustment box on the application form; and
2. upload the supporting evidence, including the exact details of the requested adjustment.

Read the whole form before submitting it. Delivery method, location and adjustment are connected operational decisions, but they are not interchangeable. Selecting online delivery does not itself create an adjustment request, and requesting an adjustment does not automatically confirm online delivery.

After submission:

• retain the confirmation email;
• keep a copy or accurate record of what was requested and uploaded;
• monitor the email address connected to the RCPCH account;
• reply promptly if the examinations team asks for clarification; and
• do not treat silence, a previous approval or a requested option as confirmation.

The decision is individual. Examples in the policy show what may be possible, not what every candidate will receive.

If the need arises after booking

Sometimes relevant circumstances are identified or change after the application is submitted. RCPCH directs candidates who need to submit a request after applying, or who have questions, to the RCPCH Help Centre.

Act promptly. The current policy says requests must be received no later than seven weeks before the examination and that requests after that point cannot be guaranteed. The detailed examination policy also warns that a late request may mean the candidate needs to defer if the arrangement cannot be put in place.

Do not try to solve a late request by negotiating informally with an invigilator on the day. The examination venue or remote invigilator needs the approved arrangement in advance. Use the official Help Centre route and follow the response given for that sitting.

Reasonable adjustment and online delivery are separate decisions

Most MRCPCH theory candidates sit in a test centre. RCPCH currently restricts online invigilation to candidates who meet published eligibility criteria and provide evidence at booking. One criterion is an approved reasonable adjustment where sitting at a test centre would be detrimental to health.

This does not mean that every reasonable-adjustment request leads to online delivery. RCPCH says online requests and reasonable adjustments are assessed individually against the evidence. A candidate should therefore distinguish:

• the functional adjustment being requested;
• the proposed delivery method;
• the evidence supporting each relevant requirement; and
• the final option actually approved.

The MRCPCH online-or-test-centre guide explains the wider eligibility and operational differences. Always prefer the current RCPCH page when a live rule differs from an older article or personal account.

Breaks in remotely invigilated theory exams

The default remote-invigilation rule is restrictive. RCPCH currently says candidates are expected to remain at the workstation and cannot take a toilet break unless an exceptional arrangement was agreed in advance.

If an accessibility reason may require a toilet break during an online examination, RCPCH says evidence must be submitted at the point of application through the reasonable-adjustment request. Current regulations state that candidates with prearranged breaks or approved extra time are permitted one five-minute break per paper.

The decisive documents are the current regulations, the individual decision and the admission document. Do not infer permission from another candidate's arrangement. Leaving the workstation without a prearranged adjustment can have serious examination consequences under the current rules.

Examples are possibilities, not promises

RCPCH lists examples such as extra time, coloured overlays, font adjustments, access to medication, food or drink, and an examination being taken online. Its detailed policy includes other possible environmental or access arrangements.

Use the examples to help describe a function, not to select an entitlement from a menu. A clear request states:

• the examination condition that creates difficulty;
• the specific support being requested;
• how the proposed support addresses that difficulty; and
• what the supporting professional recommends.

RCPCH decides what is reasonable and operationally possible after considering the evidence. PaedVault cannot predict or approve that decision.

Check the decision and admission document

An approved arrangement is only useful if the candidate and delivery team are working from the same details. When the decision and admission document arrive, compare them with the request.

Check:

Item	What to verify
Candidate and component	Correct name, FOP/TAS/AKP component and sitting
Delivery method	Correct test centre or approved online delivery
Adjustment	Every approved adjustment is stated accurately
Timing	Extra time or agreed breaks are represented correctly
Location or equipment	Any approved environmental arrangement is included
Instructions	Arrival, login and contact instructions are understood

If an expected approved arrangement is missing or unclear, contact the RCPCH examinations team through the official route before exam day. Do not edit the document or rely on a personal note.

Add this check to the practical preparation described in the final 72-hours guide. The point is verification, not repeated reassurance: one systematic comparison, followed by timely escalation of a real discrepancy.

A practical application timeline

The dates differ by diet, so use the current RCPCH calendar rather than counting backwards from an old sitting.

Before the booking window

Read the current exam conditions, activate the account, obtain evidence and decide which delivery method you intend to request. Keep the evidence ready in a format accepted by the booking system.

During booking

Choose the correct examination and delivery option. Select the Reasonable Adjustment box, describe the request accurately, upload the evidence and review the completed form before payment or submission.

Immediately after booking

Read the confirmation. Record what was submitted and monitor messages. If you discover an omission, use the Help Centre promptly rather than waiting for the admission document.

When RCPCH communicates the decision

Read the actual approved arrangement. If clarification is needed, use the contact route provided. A requested adjustment and an approved adjustment are not the same record.

When the admission document arrives

Check the component, delivery method, timings and each approved arrangement. Resolve a discrepancy before the sitting.

Before exam day

Re-read the current instructions and rehearse the approved process only. The MRCPCH exam-nerves performance plan can help turn confirmed logistics into a familiar routine without changing the arrangement itself.

Common application mistakes

Waiting for booking to start collecting evidence

The application window may be short. A professional report that needs clarification cannot always be obtained and corrected immediately.

Naming a diagnosis without explaining examination impact

RCPCH asks for evidence that connects the condition to the ability to sit the examination and includes specific recommendations.

Assuming a previous approval carries forward

Current policy requires supporting evidence for every exam application.

Treating online delivery as the adjustment

Online eligibility, the underlying adjustment and the evidence all need to be considered separately. The requested delivery method is not approved merely because it was selected.

Treating policy examples as guaranteed outcomes

Published examples indicate possible arrangements. RCPCH assesses the individual request and evidence.

Failing to check the admission document

An early application does not remove the need for a final written check. Confirm that the approved arrangement is represented correctly.

Depending on an informal exam-day solution

Invigilators follow authorised instructions. Requests and discrepancies should be resolved through RCPCH before the examination.

How this fits with revision planning

An adjustment request is important, but it should not consume the entire preparation plan. Separate administrative actions from learning actions:

Administrative track	Revision track
Obtain and submit evidence	Continue planned retrieval and review
Monitor the decision	Sample syllabus coverage
Check the admission document	Practise pacing under the confirmed arrangement
Resolve discrepancies	Keep the normal error-correction loop running

Once the arrangement is confirmed, practise with its real timing and break structure rather than a guessed version. The MRCPCH time-management guide explains how to build pacing checkpoints, while the booking-readiness guide helps keep administrative readiness separate from academic readiness.

Final answer

Prepare an MRCPCH theory-exam reasonable-adjustment request before the booking window, submit it in the booking form with supporting evidence and verify the decision in the admission document. Evidence should link the condition, its effect on sitting the examination and the specific adjustment recommended. Submit evidence for every application, contact the RCPCH Help Centre promptly if circumstances arise after booking, and never assume that a previous arrangement, online delivery or a requested option has been approved for the current sitting.

Frequently asked questions

Can I request extra time for an MRCPCH theory exam?

Yes. RCPCH lists extra time as a possible reasonable adjustment for FOP, TAS and AKP, but approval is individual. Request it at booking through the Reasonable Adjustment section and provide supporting evidence that explains the examination impact and includes a specific recommendation. Do not assume that extra time granted for an earlier exam automatically applies to the next sitting.

Do I need to submit evidence for every MRCPCH exam application?

Yes. RCPCH's current policy states that supporting evidence must be provided for every exam application. Keep copies for your records, but upload the evidence requested for each new application rather than relying on a previous FOP, TAS, AKP or clinical-exam submission.

Can I request an MRCPCH reasonable adjustment after booking?

Contact the RCPCH Help Centre as soon as possible if the need arises or was omitted after booking. RCPCH says requests received later than seven weeks before the exam cannot be guaranteed, and late implementation may not be possible. For theory exams, the normal process remains to request the adjustment and upload evidence at the time of booking.

Does a reasonable adjustment guarantee an online MRCPCH theory exam?

No. Online invigilation has separate eligibility requirements, and RCPCH assesses reasonable-adjustment and online-delivery evidence individually. An approved adjustment may support online delivery in some circumstances, but selecting online delivery or requesting an adjustment does not by itself confirm that mode. Follow the final decision and admission document.

How do I check that my MRCPCH adjustment has been approved?

Read the decision sent by RCPCH and check that the approved arrangement is accurately shown on the admission document, including delivery method, extra time, agreed breaks or other operational details. If anything is missing or unclear, contact the examinations team through the official route before exam day rather than relying on an informal note or invigilator discretion.

Sources

1. RCPCH - Reasonable adjustments policy for education and training activities
2. RCPCH - Theory exams: how to apply on the online booking system
3. RCPCH - Regulations and rules for MRCPCH and DCH examinations
4. RCPCH - Theory exams: how you sit your exam
5. RCPCH Help Centre - How can I get a reasonable adjustment for an education or training activity with RCPCH?
6. RCPCH - Appendix C: Reasonable adjustment policy for RCPCH examinations