Dear All
Thank you for participating in the session today.

The RRR discussed:

• 6/12 old with neuroblastoma – diagnosis
• Hearing loss in 7 year old noted by parents
• Respiratory distress & Respiratory Distress Syndrome

The Clinical station was of a 4 year old with parental concerns about his walking and falling.Universal cues were: Difficulty in getting up, Calf hypertrophy. The diagnosis was relatively easy but there was difficulty in completing the exam in mandated 6 minutes.
Learning points:

• Do NOT say I will build rapport with the child – as you will be asked – HOW?
• This will throw off track. Say what you will actually say.
• Expose fully – do not pull up trousers or shirt.
• If refused – then accept and improvise – what might you see if clothes not there
• General physical examination
• Universal cues need to be ‘described’ in examination
• Time management – practice to finish the exam in 5 minutes
• Learn to use unfamiliar words you will use in the exam
• It is a Focussed exam – you cannot do it like an undergraduate.
• Practice, Practice, Practice

Please visit www.mrcpchonline.org to add your comments or points I may have missed.
Anil Garg