Dear All

Thank you for participating in the session today.

In Rapid Random Reviews we discussed:

• Haemolytic Uraemic Syndrome
• Cow’s Milk Protein Allergy
• Acute Liver Failure – causes

Communication scenario was about a 2 day old baby with rising bilirubin requiring an exchange transfusion. task was to explain to parents and seek consent for Exchange transfusion. Dr S took the hotseat with Dr R in the Examiner mode. Dr S made a good attempt at communicating with the parent but got bogged down with parent / role player refusing to move forward when given a vague jargonistic answer to how their child was. Dr Shishir provided valuable advice on tackling a Communication station. 

AG provided some background physiological information and correct use of ‘language’ to transmit with minimal confusion and avoiding lengthy ‘fillers’ we commonly tend to use at the beginning of our journey.

The Learning points are:

• Read scenario carefully
• Read the Task carefully TWICE.
• Plan for First 2 minutes – Shishir’s Rule
• Respond to Role player’s queries and agenda
• Acknowledge RP’s Queries and Learn to Park – do not get distracted.
• Use simple language – avoid jargon 
• 30 sec rule – do not speak for more than 30 secs!
• Do not give non committal answers.

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

Anil Garg

Dear All

Thank you for participating in the session today – a double session at the start of our current course for February 2026 exam.

AG gave general introduction and over view of the MRCPCH Clinical exam and how it is changing. It is still not back to it’s original form i.e. children are not present at all stations where they were previously – noticeably the Development Station. This station essentially remains ‘Virtual’ with candidate having to verbalize their assessment of ‘cirtual’ child to the examiner. This can be a benefit in certain circumstances. 

Important to practice to timelines of the exam and work through toa ‘focused’ exam versus a full examination at clinical stations.

Discussed Communication – most important skill in my opinion with marks to be gathered all across the exam and not only the 2 dedicated stations. Essential to keep Role player’s agenda in mind.

30 second Rule – speak in 30 sec bytes and 2 mins Shishir’s Rule of planning only for that time while practicing the Communication station.

We will take on Rapid Randoms Reviews, Hot seat and Examiner hats from next week.

Learning points are:

• Mark allocation for various stations
• 30 second and 2 min Rules
• Be prepared to adapt your approach with circumstances
• Pause – use it as an important tool
• Ring’s true to my previous attempt

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

Anil Garg

Preparatory / Revision course starting 19 Dec 2025.

Respected sir,

I passed my exam with a score of 75 marks. I can’t thank you in words for how much your classes and mentorship have guided me through this exam. I owe this result to you. Thank you so much sir.

Dr LR – India. 25th November 2025

Sir I have passed the Clinicals.

Dr PH Kolkata -25 November 2025

[25/11/2025, 09:53:08] SK:-Kolkata

Good morning sir
I am very happy to say that i have passed the clinical exams
Your guidance was very helpful to me
Thank you so much
[25/11/2025, 10:09:04] Anil: Congratulations Shruti. You make us proud. Very glad and wish you a brilliant career.

Dear All

Thank you for attending the final session of our current course preparing for the exam in few days.

In Q&As we discussed common concerns candidates have and how to mitigate the risk and avoid losing marks. When to say ‘I do not know – will check and get back to you” and when to ‘ throw the question back at the Role player for their response”. 

To draw a diagram to explain your point or better to describe it so you are in constant connect with the Role player. 

We wish Best of Luck to all our members and all others who are sitting the exam.

Look forwad to hearing from you after your exam.

It has been a pleasure working with you all. 

We will meet again in January 2026.

Anil Garg & Shishir & Other team members

Dear All

Thank you for participating in the session today.

In RRR we discussed:

• NAI – warning signs to note 
• GOR – complications
• Neonatal jaundice – persistent

The Mini Mock exam was of a Neurology station. 2 year old with parents concerns of his walking. Scar lower skull – upper cervical spine. Biggish head. Dr P took the hot seat with Dr S & Dr I the examinaer hat. A good attempt was made but final effeort needed a lot to be practiced and to be worked upon.

The Learning points are:

• Read and learn systemtic examination for various systems
• Practice repeatedly so as not to have a ‘blank out’ in the. exam.
• Always expose the relevant parts – inspect front & back
• Be prepared for a young child to be ‘distressed and not cooperate’.
• Examiner is watching – be GENTLE – do not force your examination
• STEP BACK – let the child calm down.
• Continue to observe – mention what you would you elicit by your exam
• Presenting: do NOT follow a ‘top to bottom approach’ -tiem will run out
• Start with obvious – your diagnosis and supporting signs

Please visit www.mrcpchonline.org to add your comments or points I may ahve missed.

MRCPCH A to Z ~ OnlineFOP TAS AKP CLINICALS – working together to reach your goalwww.mrcpchonline.org



Anil Garg

Dear All

Thank you for participating in the session.

In Rapid Random Review We discussed:

• Asthma – triggers
• Atopic associated conditions
• Drugs in Asthma

The mini Mock was a Respiratory station – 15 year old admitted with increasing shortness of breath for 2 weeks. Universal clues: pink with nasal prong Oxygen, gross clubbing. Dr I took the hotseat with Dr P & Dr S in Examiner hat mode. Dr concluded the exam in 8 minutes and covered most of the points. Examiners commented on some lack of structure – missing general examination and then returning to it. We discussed the differential of this case as: Interstitla lung disease, Suppurative lung disease.

Learning points are:

• Practice Practice Practice.
• More structured examination technique
• Count respiratory rate in General examination inspection
• Start examination with Hands – least likely to upset
• Write A4 sheet for other examinations.

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

Anil Garg

Dear All

Thank you for participating in the session.

In Rapid Random Review we discussed:

• Croup
• Acute abdominal Pain
• Galactosemia

AG discussed discussed murmurs. There are a common point of confusion and can cause serious problems in the exam. 

Common conditions seen in the exam are: VSD, PDA, Pulm stenosis, Aortic stenosis, Aortic regurgitation, ASD. They all produce a systolic murmur except Aortic Regurgitation that is diastolic and PDA – continuous. The key to differentiating them is 1: location and 2: Intensity.

We discussed the various murmurs and how to identfy and present the findings. 

The Learning points are:

• Systematic approach
• Good to hear and learn of various murmurs in One place
• Attend cardiac clinic to gain experience
• Move sthescope very quickly between two sites to identify ‘louder’
• Close eyes when listening – you will hear better.

Please visit www.mrcpchonline.org to add your comments or points I may ahve missed.

Anil Garg

Dear All

Thank you for particpating in the session.

In Rapid Random Review we discussed:

• Maternal drugs affecting foetus
• Ambiguous genitalia
• Limp in a 6 year old

Mini Mock CVS was of 6 years old child reviewed inoptpaitents. H/o cardiac surgery with central and lateral sternotomy and a continuos murmur in upper left sternal region. Dr P had the Hot seat with Dt I & Dr P with examiner hats. Dr P made a good attempt in ‘examining’ the case and followed his template. Most points were covered. There was confusion as to identification of the murmur. Discussion was reasonable. Dr P and Dr I picked up the shortfalls. It was noted that on this attempt the time taken was 9 minutes, inspite of some technical glitches – much improved from previous session. 

Learning points are:

• Structured smooth examination 
• Learn to identify more murmurs
• Systolic, Diastolic and Continuous – location with thrill will provide rest
• Do NOT fit your findings into a preconcieved Diagnosis
• Present what you find and be confident of your findings.
• We will discuss and Learn murmurs at next session

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

Anil Garg