FCPS Part 2 Paediatrics Exam 2027: Format, Eligibility & Fee
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FCPS Part 2 Paediatrics Quick Summary
FCPS Part II in Paediatrics is the final exit exam of the College of Physicians and Surgeons Pakistan (CPSP). It has two computer-based theory papers of 100 single best answer MCQs each, then a TOACS and clinical cases held only in Pakistan. The fee is Rs 15,050, and the next theory dates are 16 February and 17 August 2027. You need four years of completed training, the IMM, an approved synopsis and a published article.
Passing FCPS Part II in Paediatrics gives you the FCPS fellowship and the specialist title in Pakistan. This guide covers who can apply, the research rule that now catches many candidates out, how the theory and clinical parts are marked, what to study and how to plan the last few months, with sample questions from our QBank.
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Who can sit FCPS Part 2 Paediatrics
FCPS Part II in Paediatrics is open to trainees who have completed four years of supervised training in Paediatrics at a CPSP accredited unit. Before you apply you need:
- FCPS Part I passed in the relevant subject group, or a CPSP exemption.
- The Intermediate Module (IMM) passed.
- All four years of training and every required rotation completed. CPSP does not relax this for the major subjects.
- A training completion certificate from your supervisor, and your e-logbook entries up to date.
- An approved synopsis and a published article (see the next section).
Training done partly abroad must be in a unit CPSP accredits for that period. If you are not sure whether a rotation counts, ask the CPSP Department of Postgraduate Medical Education before the closing date, not after.
Research and the published article rule
Research is now a hard requirement, not something you can finish later. Under CPSP notifications issued in July and September 2025:
- Your synopsis must be approved by the CPSP Research Evaluation Unit (REU).
- You must complete the Research Methodology, Biostatistics and Academic Writing (RMB&AW) workshop before writing the synopsis.
- You need one original article based on that synopsis, with you as first author, published in an indexed journal with an impact factor or in an HEC W or X category journal.
- The article must be uploaded to your CPSP e-portal at least three months before the exam.
Journal review and publication can take six months or more, so start the synopsis early in your third year.
How to apply, step by step
CPSP publishes the exam notice with closing dates on its website. Read the eligibility section for your subject.
Make sure training records, e-logbook, IMM result, workshops and the published article are all on your CPSP e-portal account.
Apply through the e-portal and choose your theory centre in Pakistan, or one of the CPSP centres abroad that holds Part II theory.
Pay Rs 15,050 before the closing date to avoid the late fee.
Your exact date, shift and centre appear on the admit card in your e-portal account.
Theory papers
| Paper | Questions | Time |
|---|---|---|
| Paper I | 100 single best answer MCQs | 2.5 hours |
| Paper II | 100 single best answer MCQs | 2.5 hours |
Both papers are computer-based and are taken on the same day in two shifts. Questions are clinical scenarios at the level of a consultant in training: expect management decisions, interpretation of investigations and complications rather than plain recall. Only candidates who pass the theory are called for the clinical exam.
TOACS and clinical exam
Paediatrics follows the same pattern as the other major subjects: candidates who pass the theory sit a TOACS first, and those who clear it go on to long and short cases with paired examiners, where history taking from parents, examination of the child and growth and development assessment are tested. CPSP sets the number of stations and the marks for each part in its exam guideline, so check the current version on the CPSP website before you prepare.
The TOACS carry forward rules below apply to Paediatrics in the same way as to the other major subjects.
TOACS results are announced on the same day. A score of 55% or more lets you take the cases in that exam only; 60% or more carries forward to the next exam, so you can skip the TOACS while your theory pass is still valid.
What to study for FCPS Part 2 Paediatrics
CPSP does not publish a weighting for each topic. The bars below are our guide to how much time each area deserves, based on how the theory papers usually look:
A 16-week study plan
Most candidates prepare during the final months of training, so plan for about two hours on working days and more at weekends:
| Weeks | Focus | Daily target |
|---|---|---|
| 1 to 4 | Read the core text for the highest weighted areas and make short notes | 40 MCQs plus reading |
| 5 to 8 | Remaining areas, with recent guidelines for common conditions | 50 MCQs |
| 9 to 12 | Timed blocks of 100 questions, review every wrong answer | 100 MCQs on alternate days |
| 13 to 14 | Two full mock papers and weak area revision | Mock papers |
| 15 to 16 | Clinical practice: present long cases to a senior, rehearse TOACS stations | Two cases a day |
Recommended books for FCPS Part 2 Paediatrics
Read one core text well and use the others for reference, alongside a question bank.
| Book | Why it helps |
|---|---|
| Nelson Textbook of Pediatrics | The reference text for the theory papers. |
| Illustrated Textbook of Paediatrics (Lissauer) | Readable core text for revision. |
| Basis of Pediatrics (Pervez Akbar Khan) | Widely used in Pakistan, with local disease patterns. |
| Hutchison's Clinical Methods or a paediatric clinical methods book | History and examination for the long and short cases. |
| Advanced Paediatric Life Support manual | Emergency algorithms that appear in TOACS stations. |
Sample FCPS Part 2 Paediatrics MCQs
These five questions come from the free trial of our FCPS Part 2 Paediatrics QBank, covering neonatal and general paediatrics. Tap a question to see the answer and explanation.
A 3.2-kg term newborn is intubated after failed mask ventilation. After 30 seconds of ventilation through the endotracheal tube with good bilateral chest rise in 40% oxygen, his heart rate is 50/min. What is the most appropriate next step?A. Give adrenaline through the endotracheal tubeB. Give 10 mL/kg 0.9% saline through an umbilical venous catheterC. Increase oxygen to 100% and start chest compressions at a 3:1 ratioD. Start chest compressions at a 15:2 ratio and continue 40% oxygenE. Give 2 mL/kg 10% dextrose through an umbilical venous catheter
Answer: C. Increase oxygen to 100% and start chest compressions at a 3:1 ratio
Explanation: Chest compressions start when the heart rate stays below 60/min after at least 30 seconds of ventilation that inflates the lungs, ideally through an endotracheal tube or laryngeal mask. When compressions start, increase oxygen to 100% and wean it once the heart rate recovers. Use the two-thumb technique on the lower third of the sternum, compressing about one-third of the chest depth, in a 3:1 ratio (90 compressions and 30 breaths per minute, about 120 events).
A 15-month-old girl was treated for Kawasaki disease with IV immunoglobulin 2 g/kg 3 months ago. Her echo at 6 weeks was normal and aspirin has been stopped. She is now due for her measles-mumps-rubella (MMR) and varicella vaccines. What is the most appropriate advice?A. Give MMR and varicella vaccines todayB. Defer MMR and varicella vaccines until 11 months after IVIGC. Give MMR today but never give varicella vaccineD. Avoid all live vaccines for lifeE. Defer the vaccines until 6 weeks after IVIG
Answer: B. Defer MMR and varicella vaccines until 11 months after IVIG
Explanation: IVIG contains antibodies against measles, mumps, rubella and varicella. At 2 g/kg, these passive antibodies can neutralise live attenuated vaccine virus and prevent seroconversion. The AHA and the AAP Red Book advise deferring measles- and varicella-containing vaccines for 11 months after high-dose IVIG for KD.
A 2-year-old boy has had two simple febrile seizures, 5 months apart, each lasting about 2 minutes. His development is normal and he has no family history of epilepsy. His parents are very anxious and ask what medicine can stop further seizures. What is the most appropriate advice?A. Regular paracetamol and ibuprofen at the start of every feverB. Daily sodium valproate until age 5 yearsC. Oral diazepam at the start of every feverD. No preventive medicine; give education and seizure first-aid trainingE. Daily phenobarbitone until age 5 years
Answer: D. No preventive medicine; give education and seizure first-aid training
Explanation: The AAP 2008 guideline and NICE advise no continuous or intermittent anticonvulsant prophylaxis for simple febrile seizures, even when recurrent. Febrile seizures are benign: they do not cause brain damage, lower IQ or epilepsy. Drugs that reduce recurrence have harms that outweigh the benefits: valproate carries a risk of hepatotoxicity (especially under 2 years) and pancreatitis; phenobarbital causes behavioural and cognitive effects; intermittent diazepam causes sedation that can mask CNS infection.
A 5-year-old girl weighing 18 kg is admitted with gastroenteritis. Her creatinine 3 months ago was 35 µmol/L. Today it is 80 µmol/L. Over the last 14 hours her urine output has averaged 6 mL/h. The laboratory flags the creatinine as within the reference range for the analyser. What is her KDIGO acute kidney injury stage?A. No AKI, because creatinine is within the reference rangeB. Stage 1C. Stage 2D. Stage 3E. Stage 1, by the urine output criterion only
Answer: C. Stage 2
Explanation: KDIGO staging uses the rise from baseline, not the laboratory reference range, which is often based on adults. Her creatinine has risen from 35 to 80 µmol/L, which is 2.3 times baseline (stage 2 = 2.0 to 2.9 times). Her urine output is 6 mL/h / 18 kg = 0.33 mL/kg/h for 14 hours, which also meets stage 2 (<0.5 mL/kg/h for ≥12 hours).
A 7-year-old girl has had fever and increasing pain in her right lower leg for 4 days and now refuses to walk. There is point tenderness and warmth over the distal tibial metaphysis, with no joint effusion. CRP is 70 mg/L. Plain X-ray of the tibia is normal. Blood cultures have been taken. Which imaging test is most appropriate to confirm the diagnosis?A. Repeat plain X-ray in 10 to 14 daysB. CT of the tibiaC. MRI of the tibiaD. Ultrasound of the soft tissuesE. Doppler ultrasound of the leg veins
Answer: C. MRI of the tibia
Explanation: Fever, refusal to walk and point tenderness over a metaphysis suggest acute haematogenous osteomyelitis. Plain X-rays are usually normal for the first 10 to 14 days, because bone must lose 30 to 50% of its mineral before lytic change shows; early X-ray mainly excludes fracture or tumour. MRI is the imaging test of choice: it shows marrow oedema within days, and also detects subperiosteal or soft-tissue abscesses, joint involvement and physeal spread, which guide surgery.
Want to try more FCPS Part 2 Paediatrics questions?
Start with 30 free questions from the same QBank, each with a full explanation, then unlock the full bank when you are ready.
Fee and 2027 dates
| Item | Details |
|---|---|
| Exam fee | Rs 15,000 plus Rs 50 handling charges (Rs 15,050) |
| Late fee | Charged after the normal closing date; see the CPSP notice |
| Withdrawal | 75% of the fee is refunded if you withdraw by the deadline |
| Theory dates 2027 | 16 February and 17 August 2027 |
| Theory centres in Pakistan | Karachi, Hyderabad, Larkana, Quetta, Multan, Lahore, Faisalabad, Islamabad, Peshawar and Abbottabad |
| Theory centres abroad | Riyadh, Kathmandu and Birmingham (Solihull) |
| Clinical exam | Pakistan only; venue announced after the theory result |
Fees and dates are those CPSP has announced for the current cycle. Always confirm them in the latest notice before paying.
Results and attempts
After you pass the theory, you can appear in three of the next four consecutive clinical exams, counting any you miss, and the first clinical attempt is mandatory. If you do not pass within these chances, you need to pass the theory again.
Once you pass, CPSP awards the FCPS fellowship. Many fellows go on to work in the Gulf, where each country has its own licensing exam; see our guides to the DHA Dubai exam, the QCHP Qatar exam and the Saudi licensing exam.
Frequently asked questions
How many MCQs are in the FCPS Part 2 Paediatrics exam?
The theory has two computer-based papers, each with 100 single best answer MCQs, so 200 questions in total. Each paper lasts two and a half hours.
What is the fee for FCPS Part 2 Paediatrics?
Rs 15,000 plus Rs 50 handling charges, so Rs 15,050. A late fee applies after the closing date.
When is the next FCPS Part 2 exam?
For Medicine, Surgery, Paediatrics, Obstetrics and Gynaecology and Ophthalmology, the 2027 theory exams are on 16 February and 17 August 2027.
Is a published article required for FCPS Part 2?
Yes. CPSP requires one original article based on your approved synopsis, with you as first author, in an indexed journal with an impact factor or an HEC W or X category journal. It must be on the e-portal at least three months before the exam.
How many attempts do I get at the clinical exam?
After you pass the theory, you can sit three of the next four consecutive clinical exams, counting any you miss, and you must take the first one.
What happens if I pass the TOACS but fail the cases?
A TOACS score of 60% or more carries forward, so you can go straight to the long and short cases next time while your theory pass is valid. A score of 55% to 59% lets you sit the cases only in the current exam.
Which book is best for FCPS Part 2 Paediatrics?
Nelson is the reference text, with Lissauer or Pervez Akbar Khan for revision, a paediatric clinical methods book for the cases and an APLS manual for emergencies.
Further reading
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