Format of the Examination in Child and Adolescent Psychiatry - 2025

The purpose of the examination is to assess the candidate’s clinical competence and readiness to enter clinical practice. The exam is developed and reviewed by the Child and Adolescent Psychiatry examination board, which is made up of Royal College Fellows who are recognized content experts. In addition, the exam is reviewed by a quality reviewer(s), a linguistic reviewer(s) for translation accuracy, and a Royal College editor(s). 

The content of the examination is based on a blueprint that reflects the Competencies in Child and Adolescent Psychiatry and the depth of knowledge required for the examination to ensure that the examination reflects relevant clinical practice in Child and Adolescent Psychiatry. All candidates are strongly encouraged to read the examination blueprint table (in the “Content of the Written Examination” section below) and the Competencies thoroughly. 

The Royal College Examination in Child and Adolescent Psychiatry is a written-only examination. The pass score is 70%.

Questions are reviewed if they were overly difficult, failed to distinguish between low and high scoring candidates, or for which new evidence emerged between the time of question writing and exam administration. As a result of this review process, some questions may be excluded from the final exam score for all candidates. The exam scores are then reviewed by a panel of subject matter experts in a standard setting process and adjusted if appropriate, to ensure that 70% constitutes a proper standard for candidates entering unsupervised practice. 

The format of the examination is provided in the table below:

The written examination assesses knowledge and application of knowledge necessary to safely function unsupervised as a competent specialist in Child and Adolescent Psychiatry. Most questions will concentrate on the Medical Expert role, but some can also assess the other intrinsic CanMEDS roles (Communicator, Professional, Health Advocate, Leader, Collaborator and Scholar).

The content of the examination is based on a blueprint that reflects the Competencies in Child and Adolescent Psychiatry. The content is balanced to ensure an appropriate representation of the relevant domains. Typical areas of knowledge assessment and a range of percent marks on the examination are included in the table below.

*The ranges are approximate and may vary slightly

The subjects covered in this examination will include: basic sciences; normal development; psychopathology including but not limited to phenomenology; assessment, investigation and diagnosis; management/therapeutics including but not limited to psychosocial and biological treatments; and may include special populations (e.g. gender, sexual orientation, location, immigration status, cultural and racial diversity, legal status). It may also include assessment of the understanding of preventive measures, leadership role, capacity, service delivery, collaboration in an interdisciplinary team, advocacy, critical appraisal, ethical and biopsychosocial aspects of child and adolescent mental health and psychiatric care.

Each short-answer question is created with a list of model answer(s). This list is used to guide the markers as to the value of the responses when scoring the question. Partial marks may be allocated for some responses. Members of the Examination Board score short-answer questions, and discuss with their colleagues as needed to ensure any correct response outside of the anticipated model answer(s) is given appropriate marks. If a candidate provides more responses than requested, only the first responses corresponding to the number of answers required will be considered in marking (e.g., if a question asks for 3 answers and a candidate provides 5, only the first 3 answers listed will be marked). Marks are only awarded for correct answers; no marks are deducted for incorrect responses. Be as concise and precise as possible.

SAMPLE SAQ QUESTIONS

To access examination dates, view Deadlines, dates and locations.

To access information on exams, how exams are developed, exam format, pass rates, and tips on how to study for the exam, view Prepare for exams.

To access information on what to expect on exam day: FAQs, identification requirements, conflicts of interest, candidate conduct, and more, view Exam day.

To access information on results dates, how to access your results, data verification, and more, view Results.

All candidates should be aware that regional differences in terminology may not be reflected in the exam. The terminology used in the exam has been vetted by the Royal College’s team of language professionals in close collaboration with a linguistic reviewer, who is a physician. It reflects standard terminology appropriate for your specialty.

Royal College exams routinely include abbreviation and acronym definitions. However, abbreviations and acronyms that are common knowledge to clinicians are not spelled out (e.g. MRI, CT, ECG, IV, BMI, HIV, CBC, etc.). The same practice applies for clinical trial names, with exceptions for when candidates are being asked to define or explain the trials themselves.

Below is a table that includes explanations of specific terms used in exam questions.

For sources with multiple editions, please refer to the most recent edition. If a textbook or guideline has been published in the last 12 months, answers will also be accepted from the previous edition of the textbook.

The Royal College exams follow the Canadian and/or American “standard of care” for clinical practice, and clinical practice guidelines published in Canada and the United States. In the absence of Canadian or American guidelines and when relevant, candidates may reference guidelines from other international organizations.

Study materials include, but are not limited to:

• Kaplan & Sadock’s Comprehensive Textbook of Psychiatry
• Dulcan’s Textbook of Child and Adolescent Psychiatry
• Lewis’s Child and Adolescent Psychiatry: A Comprehensive Textbook
• Rutter’s Child and Adolescent Psychiatry

• Journal of the Canadian Academy of Child and Adolescent Psychiatry
• Journal of the American Academy of Child and Adolescent Psychiatry
• Child and Adolescent Psychiatry and Mental Health

• CADDRA “Canadian ADHD Practice Guidelines” (2020)
• AACAP “Clinical Practice Guidelines for the Assessment and Treatment of Children and Adolescents with Anxiety Disorders” (2020)
• AACAP “Practice Parameter for the Assessment and Treatment of Psychiatric Disorders in Children and Adolescents with Intellectual Disability (Intellectual Developmental Disorder)” (2020)

• DSM-5
• Familiarity with current evidence based scientific literature in Child and Adolescent Psychiatry, including landmark studies

To ensure fairness to all candidates, all of the information that can be shared about the format of the examination is available in this document. If you require clarification on the content of this document, please contact credentials@royalcollege.ca.