Thank you for participating in the session today.

It was the first session of discussing the clinical extended station of the examination.

We got an update on the timeline of the station. Four minutes to read the information and watch the universal cues for the candidate, 10 minutes with the role player taking the history in which you would be given a warning at six minutes, remaining time with the examiner six minutes summarising and examine discussing the examination and then three minutes of management discussion.

Our session today was of a three month old baby who had been brought to accident and emergency for cough and poor feeding. Universal queues were of a chest x-ray, skull X-ray and CT of the brain. Dr P & Dr Y role played the mother very well.

Universal cues were not adequately interpreted and signs were not picked up. This lead to the confusion in the history.

We later discussed the cues, signs and how the history can be improved and focused. Examination of an infant with suspected injuries was explained by Dr Aloke.
Learning points are:

  • Watch the cues VERY carefully to pick up signs. Very unlikely to give Normal cue.
  • Use the 4 minutes to wisely – it is a long enough time – but it flies.
  • Adjust your questions to address the cue findings.
  • Systematic approach to history and examination.
  • Have a ‘plan’ of how to interpret CXRs and common scans.
  • In Extended clinical station – ‘Any’ condition / pathology can be presented
  • Follow the cues – they are key guide to history
  • Gentle handling / examination of baby. Say it.
  • Time management is important. Get to the point – quickly.
  • “I want to know…” vs “I am trying to understand ..”.
  • General ‘keep’ of child and weight are very important signs to note.

If there is anything else I have missed or to add a comment

MRCPCH Clinicals Online working together to reach your

Anil Garg