Dr Alex Edgerley, Dr Will Creasy, Dr Seb Gray, Dr Sophie Croft

So you’re thinking of applying for the best specialty in medicine. Great! We can’t wait to work with you. So, here’s some advice to help you over the little hurdle of the application process.

Disclaimers

1. Reading this article isn’t an alternative to properly preparing for the application process. Anyone serious about applying for a ST1 post should carefully thumb their way through the official RCPCH Applicant Guidance on the RCPCH website.
2. This article was originally written based on the 2018/2019 application process but has been updated in 2022 and again in 2025. We aim to be as accurate as possible but for the most detailed information please see the RCPCH website.

Application Numbers & Competition Ratios

According to RCPCH stats, there were 2,780 ST1 applicants for a total of 476 posts for the 2025-26 application year. This gives a competition ratio of 1 : 5.63, a rate that has gradually increased over the past few years (in 2018-19 the ratio was 1 : 1.3, 2022-23 1 : 2.35). The exact reasoning behind this surge in applications is unclear, however since COVID-19 the college moved to virtual interviews negating the need for travel making applications for UK and international graduates easier logistically. It is important to note that many applicants will apply to more than one specialty, and some decide against specialty training all together after applying.

Regions

Like the Foundation Program application, the country is split into regions which each have about 15-45 training posts with the exception of London – which has a whopping 105 jobs. Unlike the Foundation Program application, you can specify regions as “not wanted”. This means you can avoid being allocated somewhere you don’t want to go. But, the flip side of only ranking your favourite regions means that if you do not manage to score highly enough in the interview, you will not be offered a job at all.

After the offers are released, applicants have the option to ‘upgrade’. This means that if other applicants do not accept an offer that you have ranked highly, your offer may be ‘upgraded’ to this higher option. You are also able to re-rank your jobs after the initial offers are released in time for the ‘upgrading’, as the RCPCH are aware that sometimes plans will change between the initial ranking and when the offers are released.

Application Window and Important Dates

The application window opens on Thursday 23^rd of October and closes on the 20^th of November. So, if you’re planning to start training after FY2 you need to have your application ready by the end of your first F2 rotation. 

 Timeline

• End of October – applications open
• End of November – applications close
• Start of Feburary to Beginning of March – interview window
• End of March – offers released

Requirements for Recruitment

Please take a moment before applying to check you are eligible for training. We run through some of the requirements later in this document but for full details use refer to the Health Education England Paediatric Entry Criteria ST1. They are straightforward if you are a UK graduate coming straight from foundation training but worth looking over no matter your previous experience.

Application on Oriel

All applications are made through the Oriel system, a fairly old-school programme with a continuous GMT clock ticking away at the top of the page. The deadline (16:00pm on Thursday 20th November 2025) is based off of this clock with no room for negotiation so make sure you get it all completed in plenty of time. One second past the deadline your entire application will be lost with no way to retrieve it or appeal.

Please note that new this year (for 2026 recruitment), Round 1 applicants will be limited to a maximum of 5 applications across all specialties.

Part 1 – Oriel Application Form

Part 1 asks for basic personal contact information, employment history and proof of eligibility to work in the UK. You do not need to have worked in paediatrics during F1-F2 in order to apply. There is a maximum threshold of 24 months whole time equivalent experience in Paediatrics for applying into ST1. For those of you who have more than 2 years of paediatrics under your belts, there are options to apply in at ST3 and above. Please be wary of this if you are planning on taking multiple years out before applying into training.

Applicants who do not have valid right to work documents will need to apply for Tier 2/Skilled Worker sponsorship. From 1 July 2021, EU/EEA citizens have needed to either provide confirmation that they have obtained EU settlement or pre-settled status, have another valid right to work visa (e.g. dependent visa) or will need to apply for Skilled Worker sponsorship.

Part 2 – Oriel Application Form

This section should be quick and straight forward for most first-time applicants. If you have previously been enrolled in another training programme or need to upload a special circumstances form (typically if you are a carer or have disability/medical needs yourself), this is the place to do it.

Part 3 – Supporting Information (Oriel Application Form)

This is the section of the application that covers experiences, qualifications and the white box questions used for shortlisting. Your responses will be evaluated by two Consultant Paediatricians with the combined score being your total.

The areas of assessment that must be covered are as follows:

1.         Transferable clinical capabilities (Out of 8)

2.         Personal achievements and reflection (Out of 8)

3.         Quality Improvement Project (QIP)/Audit relevant to application level and experience of applicant (Out of 5)

4.         Academic achievements relevant to application level and experience of applicant (Out of 3 +1)

5.         Teaching relevant to application level and experience of applicant (Out of 5)

Total score for application form: 30 (per assessor)

You can find the full scoring frame-work on the RCPCH website, which you should read thoroughly, here – Paediatrics – Level 1 for ST1 and ST2 entry | Medical Education Hub (hee.nhs.uk)

This part of the application is essential and inevitably most time-consuming so try to start early. Use the frame-work to help with your answers, they have specified exactly what they want to read here; quality and relevance is much more important than quantity!

Once finished, it is submitted online via the Oriel system. Get people to read it, and read it again! It helps to ask several people at different levels of experience – maybe a registrar, a consultant and a colleague at your level. They will all pick up on different things.

If the longlisting criteria has been met and you score high enough on your shortlisting questions you will be asked to book in for an interview!

Preferencing

At the time of initial application, applicants will not need to indicate their region programme preferences.

Applicants who are successfully shortlisted will be able to rank their preferences via Oriel from Tuesday 10th February 2026 to Monday 17th March 2025.

It is a good idea to do a bit of research at this point into the different regions and which trusts they contain. The exposure to various subspecialties will differ and geographically some regions can be VERY big. This is especially important for applicants who rely on public transport to get about.

Commonly Asked Questions

Q: Would you recommend doing the first parts of the MRCPCH exams for my application?

A: Hmmm, not really…

You might have noticed that there’s no mention of the word ‘exam’ on the Shortlisting Framework or the Person Specification. This means NO direct points are available for exam certificates (for ST1). Revising for the exams will take up considerable amounts of your free time, which you could be using to rack up points in the various categories mentioned above. That being said, if your CV is already sparkling and you enjoy exams (ha ha), go for it. There are lots of people who opt to take the exams early for various different reasons but whether you do or don’t, it won’t impact on getting a Paediatric ST1 place.

Q: Does it matter that I don’t have a paediatric job for F1 or F2?

A: Emphatically NO, it doesn’t matter at all.

The RCPCH is totally aware that the FPAS Application process doesn’t always reflect how good a paediatrician you are going to be, thus it doesn’t discriminate against people who do not have paeds jobs in FY1 or FY2. The RCPCH is more focused on your commitment to the speciality, and wants to see you doing tasters and attending paediatric themed study days or being involved in paediatric audits etc. Most foundation year training posts will likely contain either GP or ED, and with enough planning and polite emailing it should be relatively easy to arrange a taster week using study leave. Regardless, there are PLENTY of opportunities to gain experience in looking after children and being inspired by other fantastic paediatric doctors. which you can reflect on in your interview.

Interview Process

The interview is undoubtedly the trickiest section of the application, however with a little bit of consideration you can prepare yourself pretty well for the big day.

The Online Interview booking window is from Wednesday 21st January 2026 to Friday 23rd January 2026. Slots will be available on a first come, first served basis. The interviews themselves will run from Tuesday 3^rd February to Friday 13^th March using the Qpercom platform.

The interview will be a two station multi scenario format with each station lasting 20 minutes. Two clinicians will run the interview in each station and will score the applicant independently. The entire interview will be 50 minutes in length.

YOU ARE ALLOWED TO PREPARE PAPER NOTES BEFORE! This is key! Many of the questions will be fairly predictable so practice your answers and write down a few points for you to glance at. Do not use electronic devices, especially your laptop actually running the interview, and do not write out anticipated answers in full. The phrasing of the question will likely be different to what you have prepared and that will come across.

Also feel free to jot down points during the exam (again on paper). It’s recommended by the college and be especially useful in the scenarios where brief histories are provided. 

Applicants will be assessed, on the following domains in relation to their clinical experiences to date and their understanding of issues relevant to working in the NHS:

1.         Communication (40 marks total)

2.         Career Motivation (40 marks total)

3.         Reflective Practice (40 marks total)

4.         Paediatric Clinical Reasoning (40 marks total)

The whole point of the interview is to show the panel why you think you would make a good paediatrician and highlight the things about you as an individual that will make you a great trainee.

The interview is nationally ranked – your answers will be independently scored against a mark scheme. As a result, the interview panels are given set questions to ask, and have less flexibility in their questioning. The panel are unlikely to ask you to expand on your given answers, nor ask many other follow up questions, so if you answer your questions succinctly, don’t be concerned if your station finishes early! This also means that the interview can be well prepared for, as the RCPCH guidelines highlight exactly to expect. They’re not trying to catch you out, so if you prepare well there shouldn’t be any surprises!

And a final bit of advice for this interview, particularly in the career motivation and reflective practice sections, is to be honest! It is better to speak patiently about why YOU want to do paediatrics instead of reciting a formulaic answer half remembered from an interview textbook. The panel will likely recognise if you’re saying what you think they want you to say, rather than how you actually feel. If one of the main reasons you want to do paediatrics is because you love talking about Paw Patrol and debating which dinosaur is the best with children to make them feel at ease, then let the interview know this.

Make sure you inform your rota coordinator about the interview as soon as you know the date!

1)   Communication Station – 10 minutes, 40 marks

Do you remember your paeds OSCE at med school with warmth and fondness? If so, then this is certainly the station for you! You will be given a scenario to read 5 minutes before the start of the interview and then have a 10 minute consultation with an actor, masquerading as a teenage patient or parent/carer. This will involve an explanation of a clinical condition, or reasons for an intervention or transfer.

Although the scenarios are paediatric themed, they are purposely designed NOT to disadvantage those who have not had a paediatric training post.

They will undoubtedly have some qualm or question, so listen carefully and try to offer solutions as sensitively as possible. Use the core skills of communication you’ve developed during foundation training and medical student days.

• Ask the patient/parent what is wrong – the information sheet will not necessarily tell you all the issues.
• Try and get the patient/parent to do as much talking as possible in the first part of the conversation. Remember the golden minute!
• Do not act above your station and DO NOT ‘blag’ it – if you don’t know an answer to a question then say you will ask your senior and come back later (i.e. how long am I going to be in hospital for?).
• Always search for hidden concerns– once you have established a rapport with the patient/parent they may have be willing to unveil further worries that they were uncomfortable to mention at the Sensitively explore whether there is anything else you can help with.
• Summarise where possible – If appropriate make a clear, simple plan with the patient. Check that they can retain and understand it at the end of the conversation.

2)   Career motivation – 10 minutes, 40 marks

This section should be used to highlight the salient points of your “Supporting information” white space application. You will be required to demonstrate the following:

• “Demonstrate commitment to a career in paediatrics.”
• “Demonstrate understanding of the specialty.”
• “Demonstrate how their personal attributes and career so far will help to make them a good Paediatrician.”

The panel will not have access to your “Supporting Information” application (which has already been marked by this point), and so you should use the most important things you wrote about in the white spaces to demonstrate the three points above.

It is important that you can talk about the things you are proudest of on your CV and how it will consequently make you a good paediatrician. For example, talking about your experiences of taster day will allow you to discuss all of the above points. Not only will carrying out the taster demonstrate a commitment to paediatrics, it will also give you an opportunity to demonstrate understanding of the specialty, Furthermore, talking about a consultant you met during this taster will give you a platform to discuss all the personal attributes that make a good paediatrician and have you ALSO share these same traits. Anything discussed in this section should be linked back to why the interviewer should pick you to join paediatrics.

Try not to overload the panel with a list of your achievements. It is much more important to give quality answers that show understanding and ability to reflect. It may, therefore, be helpful to pick a handful of things to talk about and then reflect on, rather than getting to the interview and stumbling over listing everything (which we’ve all done in some interview or another!).

Finally, be prepared to answer the ‘big questions’ in this section – i.e. “Why do you want to be a paediatrician?” or “What are the characteristics of a good paediatrician?”

3)   Reflective Practice – 10 minutes total, 40 marks

The guidance for this section is very clear and highlights two specific questions that will be asked:

• “Please could you briefly describe a significant clinical event you were involved in or observed and discuss your learning from it?”
• “How do you use similar reflective practice in your daily work?”

In this section it is important to not spend too long explaining the exact minutiae of the scenario in length and instead focus your time on your learning points and how it has changed your practice. Practice concisely summarising the scenario instead of using the entire ten minutes reciting the patient’s blood results and never talking about what the learning points of the case were.

This is a station that can be well prepared for, so have a good think about something that has happened during your clinical career that may have changed your practice for the future. Remember, this does not necessarily have to be a clinical change to your practice; it could be organisational, how to manage work-place relationships or even self-care/wellbeing related.

In summary, use an event at work, explain what your involvement was, and how the learning points from this experience will make you a good paediatric trainee. Don’t be afraid to talk about a negative experience here. A challenging situation usually provides lots of learning points and you can then show awareness of the developmental goals you need to achieve in order to be an excellent paediatrician.

Given this is a reflective practice station, do not leave without saying the following phrases:

• “I discussed this with my clinical/education supervisor…”
• “I made entry in me e-portfolio”
• “I reflected on this…”

4)   Paediatric Clinical Thinking – 10 minutes, 40 marks

 You will be given a short clinical scenario to evaluate and talk through, similar to the case based discussions you’ve done throughout your foundation training. Expect a paediatric themed case designed with the intention of not disadvantaging those without prior paeds experience.

The clinical scenarios will include a brief history, and possibly the child’s observations with some basic clinical findings. You will be asked to explain what you would do in this scenario. Expect conditions with an urgent/ emergency aspect such as: sepsis, asthma, head injury, suspected cancer etc.

These scenarios can be practiced easily with a senior or colleague, so practice, practice and practice some more! Please remember that you are attending an interview for an ST1 job –  not a consultant post – so you are expected to perform to the level of a competent new ST1.  You need to demonstrate that you can think clearly, spot an unwell child, escalate this to a senior and start a basic management plan until they arrive.

Other advice:

• Talk through the scenario logically – ABCDE, history, examination, tests, plan.
• State the obvious! “This child is sick” or “Those observations are abnormal”. You can’t be given marks if you don’t say what you’re thinking
• If the child is sick (which is almost inevitable) mention that you would ask for help from your registrar / consultant or put out a 2222 in a peri-arrest situation.
• Be aware of what department you are in and what type of hospital it is – do you have seniors within earshot or will you need to bleep them? Are you in a fancy tertiary centre or a small district general which will not have access to specialist services such as neurosurgery? Will the child need a retrieval team to transfer them to a PICU? Being aware of ‘next steps’ is important here.
• One of the most important things in this station is to know your limitations. Don’t guess the answer/management, don’t suggest you would do anything beyond your clinical ability. Always state you would check guidelines and call for senior help if you are unsure! There is no longer a paediatric prescribing task in the ST1 interviews. HORAAAAYYY!

Bonus Content

Progress +

Paediatric training has recently had a re-vamp, and the new changes are all part of something called ‘Progress +’. The main things to note are that training is now to be 7 years, split into two levels (ST1-ST4 and ST5-ST7), and is largely competency based. You can find more information about these training programme changes on the RCPCH website, which will be important to understand before you apply.

Progress+ and me – information for trainees by ST level | RCPCH

Fast-tracking Applications

As paediatric training is largely competency based, you are also now able to apply for ‘fast-tracking’ when joining the programme. Simply, this means if you have more than 12 months experience in paediatrics (excluding foundation years) you can apply to be considered to go through paediatric training at a faster rate. You are still required to do your ST1 year, but beyond this you may be able to skip parts of your training, provided you have all of your competencies.

Fast-tracking and missing any years out of your training is a big decision to make, so read the applicant guidance carefully and think about having a chat with a senior at work to decide whether it is the right decision for you.

Summary

The paediatric application takes a substantial amount of time and mental effort, however most candidates would agree that it’s a reasonable and fair process. The competition ratios are increasing but manageable, the application is focused on your positive traits rather than areas of development and you can expect the interview panel to be friendly and encouraging (paediatricians are lovely). If you have any questions, buy a paediatric trainee a coffee at work and ask them for their experiences in the application.

Good luck, and we look forward to you joining the team!

Final Thoughts

1. Read the Applicant Guidance. Read it cover to cover. Everything included is there for a reason.
2. Prepare for the interview, and use the guidelines. They are not trying to trick you! So if they say they are going to ask specific questions, believe them!
3. In your supporting information and interview, demonstrate why you would be a brilliant paediatrician and that you have the right core values to flourish as a paeds trainee. Have a think about a great reg or consultant that you work with or have met on a taster. What are their best attributes? What makes them particularly impressive?

Dr Alex Edgerley ST5; Dr Will Creasy, Paediatric ST1; Dr Seb Gray, Consultant Paediatrician; Dr Sophie Croft, Paediatric ST1