Dear All
Thank you for participating in the session today.
In RRR we discussed:1: Munchausen by proxy. Presentation and management2:Asthma management
We did not do the third instead we had a PowerPoint presentation on the clinical station by AG. Universal cues, Dependent cues, how to obtain the dependent cues.
Clinical case was of a 15 year old with progressive SOB for the past few weeks + clubbing.Dr E and Dr A were in the hotseat and made good attempt at going through the examination process.

The learning points are:

• Time management is MOST important
• Practice to complete the systemic exam in 5 minutes
• Smooth systematic examination
• General + Inspection, Palpation, Percussion, Auscultation
• Wait with pause to get Dependent cues.
• Summary: Do not repeat what examiner has just told you.
• 4-5 sentences, your differential diagnosis and observations to support
• Management in Broad categories first.

Visit 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:

• Hearing loss in children
• Warts
• Short stature

Think of common causes first before moving onto rare aetiologies.
The Communication scenario was to discuss Dorgan donation from parent of a 14 year old admitted following a rod traffic accident. A difficult scenario but in the hotseat were Dr. A and Dr S with Role play by Dr S & Dr A. Excellent role play and excellent attempt at the station.
Learning points were:

• Read the task VERY CAREFULLY
• Use silence as pauses – have very great effect
• Situational awareness
• Explore previous knowledge before adding your information
• Answer RP’s direct questions – do not ignore
• Summarize.

Visit www.mrcpchonline.org to add your comments or add any points I have missed.
Anil Garg

Thank you for your participation in the session today.
In the RRR we discussed:

• Complications of diabetes
• UTI – guidelines
• Collection of Urine sample in paediatric age group

In Communication scenario task was to explain suspected diagnosis Teacher Collins to parents. Dr I & Dr I were in the hotseat and Dr M & Dr A were very good role players. The attempts were good but there are a lot of learning points:

• Abnormal child vs child with different features
• Offer to see the child together and highlight ‘different features’ mentioned.
• Do not follow your agenda – GIVE role player a chance to express their concerns
• Genetic tests: TCS: TCS1, TCS2 AD & TCS3 AR. Check.
• Diagnosis does not need MDT. Management does.
• Check UTI guidelines.

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

Thank you for participating in the session today.
In RRR we discussed:

• 18 month old with difficulty in going to sleep
• DDH / CDH
• Limp in 6 year old

The Communication scenario was of an 11 month old with suspected meningitis. Mother is not giving permission for a Lumbar puncture. Dr A & Dr D were in the hotseat while Dr A & Dr J were very competent role players.

The task was difficult and the learning points are:

• To be accurate with anatomical description
• Meningitis is not infection of the brain.
• Treatment of meningitis is Antibiotics and NOT Lumber Puncture.
• LP is important to confirm diagnosis and decide on best treatment option
• Viral meningitis will not need antibiotics.
• Address RP’s CONCERNS or they will NOT move forward
• If you are going round in loops – STEP out.
• Seniors will come as soon as they have finished a ‘clinic’ or looking after another child

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

Thank you for participating in the session today.

RRR – We discussed:

• Hypothyroidism. Check if thyroxine crosses the placenta
• Anorexia nervosa – refeeding syndrome
• Down’s syndrome – inheritance genetics

We had a PP presentation on basics of Communication station, What to expect, how you re marked and suggested way through the station.Dr S & Dr E were in the hotseat and made very good attempt at the scenario of a drug error and explaining to parent.
Learning points:

• Build rapport
• Angry role player – let them have their say – do not interrupt
• Accuracy of information is very important
• Be situationally aware of the setting
• You may not wish to discuss sensitive information in from of children.

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

Thank you for participating in the session today. We met new members – welcome to them all.
In the RRR we discussed:

• Birth injuries: Categories broad categories before getting into individuals
• Infective Endocarditis: Predisposition & Duke’s criterion
• ITP: Management – check your local guideline.

In the Clinical station the scenario was of a 7 years old, operated at 1 year of age. Features of Trisomy 21, median sternotomy scar, Superior axis with biventricular hypertrophy on ECG and an audio cue. Dr A, Dr R and Dr C were in the hot seat and did a fair job – with certain things to improve.
Learning points:

• Time managment – try to finish the exam in 5 minutes
• It is a focused exam – remember you CANNOT cover EVERYTHING.
• Note the universal cue. If syndromic – try to check by confirming dependent cues
• Do NOT make up findings to box into your presumed diagnosis
• General physical exam is MUST – DO NOT forget GROWTH.
• Revise ECGS – basics
• Revise murmurs: What, where and what they imply
• THRILL means murmur is LOUDEST there.

Visit www.mrcpchonline.org to add your comments or anything I may have missed.
Anil Garg

Thank you for your participation.

We had a very informative and interesting session. Besides our regular topics of RRR & Clinical station.
Dr Fatima, Dr Shishir, Dr Misbah and Dr Hiren joined us to give their experience of the exam and tips that helped them.

• Put yourself in the hot seat – best leaning experience
• Practice regularly with a small group of like minded peers
• Video record yourself – you will be amazed at what you see
• Exam – theory is important but there is not time in the clinical
• Know your basics very well.
• SUMMARIZE – learn to do in 4-5 sentences.
• Breaking ice – be situationally aware.
• Discussion open in Broad categories initially

In RRR we discussed:

• Parvovirus B19
• Diabetes – aims of management and what may cause problems
• Brest milk jaundice – what is it?

Video was on a small baby with rash and golden crust.
Visit www.mrcpchonline.org to add your comments or points I have missed.
Anil Garg

Dear Sir, 28 October 2021

Greetings!!

Thank you very much for your focused and calibrated teaching sessions, it helped me a lot. Many thanks  to all faculties Dr Siba sir, Dr Urmila madam, Dr Alok sir and my study partner which made navigation through and successful to the goal. I am very thank full  for all good wishes of learners group members and colleagues.

There are always pearls of wisdom which we learn from every teachig session in Sir” s class but  some of it really useful for life it self  like  sir always says dont be  doctor of doom and gloom,  there is always bright  side of any dark event /incidence etc…

I would say it is both which are important learning and un learning  sound strange but  yes learning of important points which are needed for  exam as well as unlearning of wrong pattern or faulty approach are equally important which make pass through  successfully from  quality control (EXAM!!!).

I wish all good luck for all professional learners for up coming exams.

Best Regards

Thank you for your participation is today’s session.

In RRR we discussed:

• 3 year old referred by GP with Hb 60gm/L
• 3 year old with swollen wrist and ankle
• 3 year old exposed to room fire presenting with Stridor

We did not have role player hence covered a Video Station.
Video scenario showed a 14 year old with dermatomal rash in trunk and Hickmann line. Most missed the Hickmann line which was essential to differential diagnosis and management.

Learning points:

• Learn of common iv access methods in children in UK.
• Swelling – painful or painless will guide to correct diagnosis
• If diagnosis clear – causes will be discussed so think about them.
• Complications of Herpes zoster in Immunocompromised children. Eye!
• Summarize succinctly.

Visit www.mrcpchonline.org To add your comments or points I have missed.
Anil Garg

Thank you for participation in our session today. We started our Autumn session today.

In RRR we discussed:

• Chronic Renal Failure
• Limp in a 7 year old. Painful / painless essential to know.

We then practised a scenario of Angry parent of a 5 week old baby admitted with diagnosis of pyloric stenosis. Dr S and Dr R were in the hotseat and others participated with excellent feedback.
Learning points are:

• Acknowledge task early on – with in first minute
• Avoid jargon +
• There is always an agenda of the Role player
• Time management
• Have a flexible plan – be ready to adapt to Role player agenda
• 30 second byte for information giving
• Plan for first 2 minutes of the scenario only
• ELSE you are on YOUR agenda Not Role Player

Visit www.mrcpchonline.org to add your comments or anything I may have missed.
Anil Garg