Dear All

Thank you for participating in the session today.

In RRR we discussed:

• Fragile X
• Haemolytic Uraemic Syndrome
• Vomiting in an infant

The Communication scenario was a new born baby noted to be dusky at 4 hours of age. Registrar’s – (candidate’s) clinical assessment is the likely diagnosis is Transposition of Great Arteries (TGA). Task is to explain to mother and get consent for urgent treatment and transfer toa surgical unit. Dr A was a very good role player as the mother. Dr P and Dr P wore the examiner hat and Dr D was in the hotseat. The attempt was good and most points were covered in the attempt. There were a few questions that came up:

• Should we discuss with Consultant before or after speaking with RP?
• How to avoid medical jargon?
• Why it happened i.e. the malformation / defect?

The Learning points are:

• Read the stem VERY carefully and note all the information provided.
• Keep your explanations simple.
• You can escalate your ‘complexity’ depending on response.
• Do not for 30 sec rule – hence keep them brief
• Get a chaperone – ward sister is generally very good
• Do not bring in details that do not add to communication
• Too many details only create confusion.
• You should speak to RP first and then inform Consultant in this scenario
• Sometimes Medical jargon cannot be avoided else discussion can reduce to ‘Baby talk’.
• With use of Medical terms – ALWAYS explain what the term means.
• We do not know why it happened. Sometimes nature ‘goes wrong’. Development of a human baby from a single cell is an extremely complex process that we do not understand. It is NOBODY’s fault.Do
•  NOT give wrong information.
• Always be a positive and reassuring doctor – NOT Doom & Gloom

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

Anil Garg

Dear All

Thank you participating in the session today.

In RRR we discussed:

• Epilepsy – types grouped into
• Bronchiolitis
• Status Epilepticus – management

The Communication scenario was of an 11 month infant admitted with neck stiffness likely due to meningitis. Task was to explain to parent diagnosis and to obtain consent for investigations, including Lumbar puncture and treatment. Dr A was the Role player and was very convincing. Dr P took the hotseat and was doing well when she had to leave to manage an actual child admitted with convulsions. Dr P took over and completed the task well. Dr D and Dr J had Examiner’s hat and provided structured feedback and marks.

The learning points are:

• Read the task VERY CAREFULLY.
• Every word is there contributing to the overall picture.
• Paraphrase the information provided and come to task quickly
• Give Role player to set their agenda
• Do NOT follow YOUR agenda. Be careful.
• It is not ONLY about completing the task.
• 30 seconds rule for speaking.
• Dialogue vs Monologue.
• Use pause to break your ‘speaking’.
• It needs practice so work hard with colleagues

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.

In RRR we discussed:

• Infective Hepatitis
• Respiratory Distress Syndrome – Newborn
• Floppy newborn

The Clinical station was Communication scenario was of a 6 yr old referred for parental concerns regarding decreased activity and excessive TV watching. Dr P was a very able Role Player in Mother’s role. Dr A took the hot seat and Dr A & Dr J had the examiner hat. The attempt was good. We need to remember our limitations and that we work with other professionals who are more able than us in specific fields hence we should use them Dietician, physiotherapist etc.

The Learning points are:

• Read information carefully as there is a lot of information given.
• Watch your body language – EYE contact is a MUST.
• Sound confident.
• Opening statement after introductions: paraphrase info given.
• Concentrate on cues given.
• Do NOT slide into History Mode from Communication mode.
• Do Summarise at 6 minutes
• Involve Role Player in the discussion – DIALOGUE
• Do not get into monologue.
• It is about SHARING information – not telling everything you know.

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

Anil Garg

Dear all

Thank you for joining the session today.

AG gave a presentation on the Clinical exam as from 2023 with details available on the RCPCH website.

The New Exam is really the ‘OLD’ exam now that children are also going to come back to the Clinical stations.

However the Development Station will still be without children hence continue to practice Vocalization of the assessment process.

Video station, Communication & History and Management stations do not change from the Covid times.

We will upload the presentation.

Anil Garg

Dear All

DIWALI GREETING to ALL for aHAPPY AND PROSPEROUS YEAR.

We are holding an open session on 25 November 2022 at 6:00 – 7:00 pm on the clinical EXamination from January 2023.

Do join if you are able to.

Anil Garg is inviting you to a scheduled Zoom meeting.

Topic: Anil Garg’s Personal Meeting Room

Join Zoom Meeting
https://us02web.zoom.us/j/2191937091?pwd=TXdjQ2ZWRFdzMW5QOVJoOE5yWTFoQT09

Meeting ID: 219 193 7091
Passcode: SummerE

Dear Dr Garg, 

Thank you for your email.

I passed the MRCPCH Clinical Exam! Thanks so much for your teaching, I found your videos and discussion sessions very useful for my studies. 

Best regards,

T L. Hing Kong. 22 October 2022

Dear All

Thank you for participating in the session today. Yesterday and today were we heard from our doctors who took the exam in India and Nepal recently. As a First All 10 of the 10 who took sat the exam are successful. It is the first time when all have passed. This makes us really proud and we would like to congratulate them on their hard work and success.

In Rapid Random Review we discussed:

• Myocarditis
• Precocious Puberty
• Acute diarrhoea

The Communication scenario was of a discussion in Antenatal clinic with a women who has a positive drug screen taken 3 weeks ago. Dr D was the Role Player, Dr A and Dr P had the examiner hat and Dr R took the hot seat. Dr R had a very good attempt at a relatively difficult scenario. Introduction was good. Others contributed in the follow up discussion.

The Learning points are:

• Read the Information provided VERY CAREFULLY
• Identify key points
• Understand the Task carefully.
• Be calm – even when Role Player shows aggression
• Speak in 30 sec bits – AVOID monologues
• Communication is about Dialogue
• Speak Less – Hear more.
• Let Role Player Direct you. Do NOT follow your agenda.
• Brief summary at 6 minutes
• http://www.frimleyhealthandcare.org – gives guidelines on Drug misuse

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

Anil Garg

Lovely Diwali present to all due to your hard work.

Thank u Dr Anil Garg sir for all your guidance and blessings . I passed the clinical exam . Thanks all friends for support..🙏 Dr D Oman 19 Oct 2022

Sir I passed.
I will always be thankful for your guidance.
Each and every class was so useful and the way you teach ,I could remember your words in the actual exam..
Also scored 80 🙂. DR PV – New Delhi. 19 Oct 2022

Hi sir

This is Dr Prahada from India sir
I cleared my mrcpch clinical sir

Thank you for the guidance and support all through the years sir . You were very supportive . Dr P Chennai, India 19 Oct 2022

I am really grateful Dr Anil Sir🙏🙏
I too passed my exam in first go. When I joined the group I had no idea how I will pass but with ur guidance I cleared my exam🙏🙏 Dr KR Ghaziabad, India. 19 Oct 2022

Thank you everyone 😊
And special thanks to Dr Sumit,Dr Misbah and Dr Shishir also. Dr PV

Dear Anil Sir
I too cleared clinical.Thankyou so much for all the guidance and support .When i joined your classes just 2 months before exam i was totally clue less.Every thing discussed in the class was really helpful.Also thank Dr Sumit and Dr Shisher for their tips and guidance. Dr NJ Kerala, India

Sir,
I’ve cleared MRCPCH CLINICAL with good marks.

I owe you a lot of thanks and gratitude.
From your methodical teaching, encouraging words, invaluable inputs and interactive sessions I had learnt a lot.

Pranams, Sir.

Wish you a best of health and happiness ,

Regards,

Tamal ( Dr Tamal Laha from KOLKATA ). Dr TL India. 19 Oct 2022

Respected Sir,
I hope my email finds you in good health.
I hope you remember me. I was taking your online classes for the clinicals earlier on. Unfortunately this time I couldn’t take any.Good thing that i took notes from your classes and never lost them. I cleared my clinicals from Nepal.I am very thankful for your motivation and guidance.
Thanking You
Dikshya. Dr DP. Nepal. 19 Oct 2022

Exam result



You replied on Wed 19/10/2022 13:38

You replied on Wed 19/10/2022 13:38

anish joseph <ajrindia2003@yahoo.com>

Dear.   Sir.       I have cleared mrcpch clinical.i got 71. I thank you with all my heart your guidance and motivation. Its been a long journey..but your frequent encouragement helped me achieve this.       With regards. Anish

Sent from Yahoo Mail on Android. Dr AJ Kanyakumai, India

Dear All

Thank you for participating in the session today.

In RRR we discussed:

• Hypertension in a 8 year old
• Diabetic Ketoacidosis – assessement
• Acute hemiplegia

The Video station had a baby clinical signs (universal cues) looking generally well, jaundice and some hiccups (red herring). Dr P took the hotseat while Dr D had the examiner hat. Universal cues were picked up but emphasis was also paid to other not so important cues. Dependent Cues with History & Examination could be more targeted. Let’s assume the diagnosis is Rhesus disease causing jaundice. Management does not mean jumping to ‘Treatment’ intervention like phototherapy or Exchange transfusion. Assessment – investigation to gauge severity of disease process should come first.

The Learning points are:

• Common things are common – (think of top 3 you have seen)
• Read and get comfortable with all ‘Hypers…’, ‘Hypos….’
• Look up and remember guidelines all ‘Status ….’ at a minimum
• BSPeds – gives collection of current guidelines
• Categorise cause ‘system wise’…
• In Neonates – always check Birth weight & Current Weight.
• Feeding is very important – breast or bottle
• Practice, Practice, Practice.

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

Anil Garg

Dear All

Thank you joining the session today.

In RRR we discussed:

• Munchausen by proxy
• Chronic Fatigue Syndrome
• Hearing loss in 6 yr old

The Video station had a 6 yrs old with generalized rash, flaccid blisters, eye and oral cavity involvement. Dr R & Dr D had the examiner hat while Dr A was in the hotseat. Clinical cues were all picked and differential was thought of. Specific history and examination points could be better elicited. Know important complications. Management is important – learn important initial 3-4 points. There will not be time for very detailed discussions.

Learning points are:

• Practice to formulate clear questions
• Be brief and to the point.
• Do not waste valuable time in explaining your rationale.
• Each word in the stem is chosen very carefully and has relevance.
• Examination: specific ‘test’ for: crepitation, bulging fontanelle, Nikolski’s sign etc
• Read VERY carefully.
• Develop a Differential diagnosis – ask related questions.
• Generalized rash – drug history: antibiotics, anticonvulsants.

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

Anil Garg