Dear All

Thank you for participating in the session today.

International Child Health Group is subgroup RCPCH of paediatricians with interest in collaborating with peers internationally. Currently we are working on and rolling out mentorship scheme. My request to you all will be to check the site and join the Group.

https://ichg-global-health-mentorship-scheme.mn.co/

ICHG Global Child Health Network Created by the International Child Health Group (ICHG) – a subspecialty interest group of the Royal College of Paediatrics and Child Health (RCPCH). It is a group for paediatricians and health professionals with an interest in improving global child health. The ICHG Global Health Mentorship Scheme is a new mentorship scheme for all students and professionals with an interest and a passion for Global Child Health. Mentors are paired with Mentees all around the world aiming to share career advice, opportunities and knowledge with a focus on Global Child Health.ichg-global-health-mentorship-scheme.mn.co

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Our meeting was a little short due to Mentorship seminar.

In our RRR we discussed:

• Bow legs. Possible causes. Rickets: cause of rickets

Communication scenario was of a 14 year old girl, a Jehovah’s witness needing urgent transfusion to avoid permanent damage or death. Mother is refusing to give consent. Dr J was a superb role player and Dr V was in the hot seat. Very well attempted.

Learning points are:

• Confirm how RP will like to be addressed – DO NOT assume
• Do not make it a monologue
• Check what RP knows before going into details yourself
• Gillick competence – read and know
• Avoid jargon – ‘modalities’ of treatment’.
• Safe Guarding is an important and necessary management option
• Discuss Safe guarding and DO NOT be afraid to say it is Legal requirement
• Take personalities out of the discussion

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

Anil Garg

MRCPCH Clinicals Onlineworking together to reach your goalwww.mrcpchonline.org

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MRCPCH 2022/2 May 2022 Exam format
Dear potential candidates,
I know many are concerned as still unsure of the format of the upcoming exam in May 2022.

This is to inform that we are aiming to have patients in the Short Clinicals +/- Development stations pending approval from the RCPCH Exam Board. I have been in discussion over the last few weeks and we are still awaiting their decision.

I will inform as soon as I receive the final verdict.

Meanwhile, you will need to continue preparing for both formats till further notice.

However, this does not affect half the stations – namely History, Communication and Videos which remain the same.

Regards,
Dr Tang Swee Ping,
Lead Examiner MRCPCH Malaysia
5/3/22

Dear All

Thank you for joining the session today.

In RRR we discussed:

• Dyspnoea – how to assess. most severe difficulty in speaking
• Child Development Team (MDT) – members and roles
• Seizure & Epilepsy. What?

In the Communication Station – the scenario was of a 2.5 yr old admitted multiple bruises of different ages. Non Accidental Injury is suspected. Grandfather, who does not know, has come to collect the child. Explain your suspicion and management plan. Dr I was in the Role player mode and Dr A took the hot seat. A very good attempt, knew all the relevant points however presentation needs to be worked on.

Learning Points are:

• Do Not forget Rules of ‘Engagement’.
• Introductions – ask what the Role Player will like to be called as.
• Let them speak to mention their concerns or expectations.
• Mention your task
• Rapport building
• Explore social history – who all take care of child
• Do NOT make it a lecture. Remember 30 second rule.
• Role player is Less stressful but gives insight into what to explore
• Hot seat is a MUST – you will have 9 of them in the exam
• Practice makes Perfect – help you stay in control

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:

• MRSA colonisation of neonate – otherwise healthy. Management.
• Eczema Herpeticum
• Autosomal Recessive Inheritance

In the Clinical Station we discussed Communication. AG discussed a PowerPoint presentation covering – The Tasks, How to attempt, Do’s and Don’ts, How to set the scene and how to do well. Shishir’s 2 minute rule and AG’s 30 seconds bites.

The Learning points are:

• Architect for a communication station
• Introductions
• Avoid jargon
• Use age appropriate language. Start as with 10 year old.
• Check understanding.
• Summarize at 6 minutes.
• Remian relaxed.

We have suggestions on scenarios we should like to discuss over next few weeks.

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. We had 6:00 – 7:00 pm session only. The afternoon session we did have as our fellows from Malayasia, Hongkong have had their exams and are now waiting for the results.

The RRR were:

• Stages of play
• GMFCS scale
• Investigations in Moderate / Severe global developmental delay

The Development station scenario was of parental concern regarding a 3.5 year old. Task was to assess developmental age. Dr A had agreed to be the role player / examiner giving the cues. Dr Ab was in the hot seat. There is a lot to learn in verbalising the developmental exam.

The Learning points are:

• Structure the exam carefully
• Technique needs to be fluent
• Start with General observation of the ‘room.
• Choose toys and present with One tool at a time.
• Mention clearly you are REMOVING the tool before offering next
• Change tools if child reluctant to interact. Come back again if time permits.
• Use mother to ‘ask child’ to complete a particular task.

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

Anil Garg

Dear All

Thank you for participating in the session today.

In RRR we discussed:

• Syndrome diagnosis (Trisomy 21) & Genetic counselling
• Nightmare & Night Terrors: if NO IDEA – throw back on Role player.
• Rickets – causes

The Video Station was of a video clip of 2 year old generally looking well with facial swelling, puffy eyes. Dr I took the hotseat and picked up the clinical signs but the history could have been more specific. It is important to get he differential diagnosis at the start – do not go into the video station with ONLY one diagnosis.

Learning points:

• Read the lead in statement very carefully
• After watching the cues develop a differential diagnosis
• Do NOT end up with ONLY ONE diagnosis.
• The differential will guide you to the History questions and Examination points
• Management of Investigations – give with expected results – NOt just a list
• Visualize what you would do on the ward
• Always involve your Consultant and Tertiary unit where appropriate

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

Anil Garg

Dear All

Thank you for participating in the session today.

In RRR we discussed:

• Urine specimen collection in suspected UTI
• Vit K deficiency in newborn
• Short stature

In the Video station we had clip of a 6 month old with transverse abdominal scar and pale stools. Dr I took the hot seat and made a good attempt at history points to ask, examination and differential. We explored the history further.

Learning points are:

• Common conditions first
• Structured questioning
• Specific questions – do not ask general broad based questions
• Straight forward – go for the obvious
• Do not waste opportunity on asking questions about signs already obvious
• Use appropriate terms – neonate means upto 4 weeks
• Surgery in at 6 weeks will be answered ‘not in neonatal period’.

Vist www.mrcpchonline.org to add your comments or any points I may have missed.

Anil Garg

Thank you for participating in the session today.

In RRR we discussed:

• Hypospadias
• Failure to thrive – 11 month old
• SVT – Supra Ventricular Tachycardia

In the Clinical station we had a 14 year old young person who has come for routine visit. Task was to examine the Respiratory system. Dr A took the hotseat. It was a little tricky as universal cues were not all fully correctly identified. Collectively most of the cues were identified. The discussion was an overall group discussion.

Learning points were:

• Watch the universal cues carefully
• you may need to ‘step back’ and look over the cues broadly
• Formulate a differential diagnosis with cues
• History – social is import – who all help in childcare?
• Single parent should not automatically infer – Child neglect.
• Keep things simple in discussion and do not Over complicate matters

Visit www.mrcpchonline.org to add your comment or any points I may have missed.

Anil Garg

Dear All

Thank you for your participation in today’s session.

In RRR we discussed:

• DKA – priorities in management
• PDA – newborn

DDH – diagnosis and management

The History station was of a 10 year old being reviewed with mother for worsening symptoms for 3 months. Dr M took the hotseat and made a good attempt at history and discussion.

Learning points:

• Asthma is a very common and need to know it VERY well.
• History needs to be systematic and cover family, social history
• Medication history is important
• Remember Communication is IMPORTANT here also
• Do not forget your communication skills.

Visit www.mrcpchonline.org to add your comments and any points I may have missed.

Anil Garg

Dear All

Thank you for participating in the session today.

In RRR we discussed:

• Exomphalos
• Cyanosis
• Child abuse – categories

The History wash role played by Dr A of a 15 year old young person with diabetes mellitus – poor controlled and with weight loss. Dr O was in the hot seat. The history was covered very well and almost all points were covered and checked. Presentation was precise and Management discussion was good.

Learning points:

• Structure to history taking is a MUST.
• Usually something has happened in previous 3-6 months in a Chronic illness
• Keep the task in mind
• Make a differential of possible causes and explore appropriately
• Probe into compliance if evidence of non-compliance provided
• Do not pass it over with a cursory question
• Read Non acute management of diabetic complications

We will be covering another History scenario on Thursday.

Visit www.mrcpchonline.org to add a comment or points I may have missed.

Anil Garg