100+ Free RCPSC Pediatrics Practice Questions
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Key Facts: RCPSC Pediatrics Exam
2 MCQ papers
Written component is Paper 1 and Paper 2, each ~100 single-best-answer questions
RCPSC - Format of the Examination in Pediatrics
3 hours per paper
Each written MCQ paper is 3 hours, for 6 hours of written testing
RCPSC - Format of the Examination in Pediatrics
70%
Pass score required for each component, written and applied
RCPSC - Format of the Examination in Pediatrics
8 stations
Applied component is a structured oral of 8 stations of 16 minutes each
RCPSC - Format of the Examination in Pediatrics
C$5,130
2026 comprehensive objective exam fee covering written and applied components
RCPSC - Assessment and exam fees 2026
5-10%
Marks weighting for Infectious Diseases, Neonatal-Perinatal and Acute Care domains
RCPSC - Pediatrics written exam blueprint
Decoupled
Passing the written but not the applied does not require retaking the written
RCPSC - Format of the Examination in Pediatrics
100
Free original single-best-answer practice questions here
OpenExamPrep
The Royal College Certification Examination in Pediatrics is Canada's national certifying exam for specialist Pediatricians, administered by the Royal College of Physicians and Surgeons of Canada. The written component has two single-best-answer MCQ papers (~100 questions each, 3 hours per paper), and the applied component is a structured oral of 8 stations of 16 minutes; the written must be passed before the applied. The pass score is 70% for each component. 2026 registration is C$5,130 for the comprehensive objective exam (or C$2,565 per component), with a separate assessment fee. This 100-question bank provides original single-best-answer practice across the official blueprint, built on Canadian Paediatric Society and AAP guidelines.
Sample RCPSC Pediatrics Practice Questions
Try these sample questions to test your RCPSC Pediatrics exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.
1A term newborn is born through thick meconium-stained fluid and is apneic and floppy at birth. After warming, drying, stimulating and positioning the airway, the heart rate is 40 bpm despite 30 seconds of effective positive-pressure ventilation with chest rise. What is the next step?
2A 3-day-old breastfed term infant has a total serum bilirubin that plots above the phototherapy threshold for age in hours on the nomogram. The infant is feeding well, is well hydrated, and the direct (conjugated) fraction is normal. What is the most appropriate management?
3A term infant of a mother with poorly controlled gestational diabetes is jittery at 2 hours of age. A point-of-care glucose is 1.5 mmol/L (27 mg/dL) and the infant feeds poorly. What is the most appropriate initial management?
4A preterm infant born at 28 weeks develops worsening respiratory distress, abdominal distension, bloody stools and bilious aspirates on day 8 of life. Abdominal radiograph shows pneumatosis intestinalis. What is the most likely diagnosis?
5A term newborn fails the routine pulse oximetry screen with a saturation of 88% in the right hand and 85% in the foot. The infant is mildly tachypneic but pink with feeding. A hyperoxia test shows little rise in PaO2. What is the most appropriate next investigation?
6A 6-week-old presents with poor feeding, sweating during feeds, tachypnea and hepatomegaly. Examination reveals a harsh holosystolic murmur at the left lower sternal border. What is the most likely diagnosis?
7A 2-year-old with tetralogy of Fallot becomes acutely cyanotic, irritable and tachypneic while crying. He squats spontaneously and the murmur softens. What is the most appropriate initial maneuver?
8A previously well 4-year-old presents with fever for 6 days, bilateral non-exudative conjunctivitis, a strawberry tongue, cracked lips, a polymorphous rash, and unilateral cervical lymphadenopathy. Which therapy most reduces the risk of coronary artery aneurysms?
9A 10-month-old presents in winter with 3 days of cough, coryza, low-grade fever, then increasing work of breathing with wheeze, crackles and mild hypoxemia. He is feeding adequately. What is the most appropriate management?
10A 2-year-old presents with a sudden barky cough, inspiratory stridor at rest and mild chest wall retractions after a few days of coryza. He is alert and well hydrated with no drooling. What is the most appropriate first-line treatment?
About the RCPSC Pediatrics Exam
The Royal College Certification Examination in Pediatrics is the national certifying exam for specialist Pediatricians in Canada, administered by the Royal College of Physicians and Surgeons of Canada. It assesses readiness to enter unsupervised specialist practice and consists of a written component (two MCQ papers of about 100 single-best-answer questions each, 3 hours per paper) followed by an applied structured-oral component (8 stations of 16 minutes). The pass score is 70% for each component. Most questions assess the Medical Expert role, with some assessing intrinsic CanMEDS roles, and content follows a blueprint covering all major pediatric domains. The exam follows Canadian and American standards of care, drawing on Nelson Textbook of Pediatrics, Canadian Paediatric Society statements and American Academy of Pediatrics guidance.
Assessment
Two-component exam. Written: Paper 1 (~100 single-best-answer MCQs) and Paper 2 (~100 single-best-answer MCQs). Applied: structured oral with 8 stations of 16 minutes each. The written must be passed before the applied.
Time Limit
Written: 3 hours for Paper 1 and 3 hours for Paper 2 (6 hours MCQ total). Applied: about 2 hours (8 stations x 16 minutes).
Passing Score
70% for each component, set by a standard-setting panel. Paper 1 and Paper 2 scores are combined into one overall written score; candidates pass the written component overall rather than each paper.
Exam Fee
2026 exam registration (CAD): comprehensive objective exam C$5,130 (written and applied together) or C$2,565 each component separately, plus a separate assessment-of-eligibility fee (e.g. C$850 for Canadian residency specialty training). All fees in Canadian dollars. (Royal College of Physicians and Surgeons of Canada (RCPSC))
RCPSC Pediatrics Exam Content Outline
Infectious Diseases, Neonatal-Perinatal and Acute Care
Blueprint: Infectious Diseases 5-10%, Neonatal-Perinatal Medicine 5-10%, Acute Care (critical care/emergency) 5-10%. Covers neonatal resuscitation and sepsis, jaundice, immunization (Canadian schedule), common and serious infections, fluid resuscitation, shock, status epilepticus and pediatric emergencies.
Cardiovascular, Respiratory, GI, Renal, Endocrine, Heme/Onc and Neurology
Major organ-system domains each weighted 0-10%: congenital and acquired heart disease, asthma and respiratory illness, gastroenterology/hepatology, nephrology and genitourinary disorders, endocrinology and metabolism, hematology and oncology, and the neuromuscular system. Emphasizes diagnosis, investigation and management.
Development, Genetics, Adolescent, Allergy, Dermatology and social pediatrics
Development and Behaviour (0-10%) plus domains weighted 0-5%: genetics/metabolics, adolescent health, allergy/clinical immunology, nutrition, dermatology, mental health, child maltreatment, ophthalmology, ENT, MSK/rheumatology, clinical pharmacology, surgery and intrinsic CanMEDS roles.
How to Pass the RCPSC Pediatrics Exam
What You Need to Know
- Passing score: 70% for each component, set by a standard-setting panel. Paper 1 and Paper 2 scores are combined into one overall written score; candidates pass the written component overall rather than each paper.
- Assessment: Two-component exam. Written: Paper 1 (~100 single-best-answer MCQs) and Paper 2 (~100 single-best-answer MCQs). Applied: structured oral with 8 stations of 16 minutes each. The written must be passed before the applied.
- Time limit: Written: 3 hours for Paper 1 and 3 hours for Paper 2 (6 hours MCQ total). Applied: about 2 hours (8 stations x 16 minutes).
- Exam fee: 2026 exam registration (CAD): comprehensive objective exam C$5,130 (written and applied together) or C$2,565 each component separately, plus a separate assessment-of-eligibility fee (e.g. C$850 for Canadian residency specialty training). All fees in Canadian dollars.
Keys to Passing
- Complete 500+ practice questions
- Score 80%+ consistently before scheduling
- Focus on highest-weighted sections
- Use our AI tutor for tough concepts
RCPSC Pediatrics Study Tips from Top Performers
Frequently Asked Questions
How many questions are on the Royal College Pediatrics written exam?
The written component has two papers of multiple-choice questions: Paper 1 has about 100 single-best-answer MCQs and Paper 2 has about 100, for roughly 200 MCQs in total. Each paper is 3 hours.
What is the passing score for the Royal College Pediatrics exam?
The pass score is 70% for each component (written and applied), determined through a standard-setting process. Paper 1 and Paper 2 are combined into one overall written score, so you pass the written component overall rather than each paper individually.
Is the exam written-only or does it have an oral component?
It has two components. The written MCQ component comes first, and only candidates who pass it are invited to the applied component, a structured oral examination of 8 stations of 16 minutes each (about 2 hours).
How much does the Royal College Pediatrics exam cost?
For 2026, the comprehensive objective exam (written and applied) costs C$5,130, or C$2,565 per component if registered separately. A separate assessment-of-eligibility fee also applies, for example C$850 for Canadian residency specialty training. All fees are in Canadian dollars.
What guidelines does the exam follow?
The exam follows Canadian and American standards of care, drawing on Canadian Paediatric Society (CPS) position statements, American Academy of Pediatrics (AAP) statements, Choosing Wisely Canada, and textbooks such as Nelson Textbook of Pediatrics and Rudolph's Pediatrics.
Are these official Royal College practice questions?
No. These are original OpenExamPrep questions modelled on the official blueprint and single-best-answer format. The Royal College provides its own sample MCQs and competencies document separately on royalcollege.ca.