In early 2020, rising COVID-19 rates in Hong Kong, Malaysia and Singapore meant undertaking risk assessments and cancellations, and evaluating the potential impact to scheduled exam events (theory and clinical) within these countries. As the pandemic worsened, our Exams and Assessment Board had to start making the difficult decisions to cancel exams both in the UK and overseas.
Following a huge amount of work undertaken by College staff and clinicians, we managed to get adapted versions of our exams up and running by September 2020. But how did we manage it quickly and fairly, and what happens next?
Theory exams
The main adaption was the introduction of remote proctoring, in which an individual can take their exam in a location of their preference as long as they can meet the technical specifications and have a reliable internet connection. This meant we were able to offer our exams in test centres or via remote proctoring in the UK and overseas, with the main emphasis being on safety, reliability and individual preference. 
In remote proctoring, invigilation takes place with our delivery partner (as per our normal procedures). The team at the College conducts post-exam audit of& any issues that have been flagged.
We also worked with our delivery partner to provide a smaller number of seats in test centres for those candidates who were not able to take the exam at home. Crucial to this has been the implementation of social distancing rules based on local regulations, as well as providing clear guidance in case anyone develops symptoms, gets ‘pinged’ to self-isolate or tests positive at the last minute.
By combining both in-person and online delivery we have been able to meet demand including the backlog that had built up.
[For updated information, see Theory examinations]
Diploma of Child Health Clinical exam
DCH Clinical has been adapted; we've made changes to some stations or to the way they are delivered. We successfully ran two weeks of DCH Clinical between October 2020 and April 2021 on the online platform.
We've seen demand for this exam increase, and including candidates from countries where the DCH was not previously offered. We appreciate how a remote DCH provides more access options for candidates who may previously have found it difficult to travel to a limited number of centres in the UK and overseas. We'll continue to review whether the DCH can continue to be delivered online. A massive thanks to the DCH team which has a small core group of dedicated volunteers and just the one administrator to keep all the plates spinning.
[For updated information, see DCH Clinical candidate guide]
MRCPCH (membership) Clinical exam
This has, without doubt, been the most challenging exam to deliver.  Once we had determined we had to shift to an online delivery method, it quickly became apparent that we could not include children and parents in the exam. We decided that all stations would have to be scenario based, which meant enlisting the help of a many senior examiners to produce volumes of scenarios for clinical and development stations.
In addition, we had to adapt our circuit to work with our online delivery platform. This added to the complexity of delivering the exam and so we provided extra guidance and training to all participants, including webinars and dedicated web pages for both online and face-to-face delivery.
We had to create virtually a new clinical exam, assessing most of the areas covered by the previous exam, while ensuring that the experience remains fair, secure and accessible to all candidates. The COVID Adapted Clinical exam is not ideal in many ways, but we are dedicated to continuing with this modified approach until we can return to our normal methods of exam delivery.
Due to these immense challenges and being able to only run the exam for a limited number of candidates per diet, we have not been able to meet the demand for MRCPCH Clinical, And, due to the success of delivering the theory exams remotely, the number of candidates waiting to take the clinical exam will grow.
[For updated information, see MRCPCH Clinical guidance hub]
Next steps
Before COVID-19, we had been working hard to increase capacity both overseas and in the UK, and we are frustrated that all of our planning to further increase capacity was undone by the pandemic. If you are one of those individuals who is still waiting for your clinical exam, we are sorry and do appreciate your patience and understanding.
I want to take this opportunity to thank exam candidates for their continued efforts despite the challenges (especially when an entire circuit in the MRCPCH Clinical is held up as someone’s WiFi give up at the crucial point!). Thanks also to all those doctors who are still waiting to sit their clinical exams and have been patient with us during these challenging times.
Dr Vasanta Nanduri is the RCPCH Officer for Examinations.