Dear All

Thank you for participating in the session.

In RRR we discussed:

• Itching
• Polyuria
• Volume of Feed – neonate

History Mini Mock was replaced with a Communication scenraio due to technical difficulties. The scenario was chosen by Dr S – who also was the RP. 6 week old baby is in ICU, ventilated with bilateral subdural haematomas. Task was to expalin baby’s condition and diagnosis to mother. Dr P took the hotseat and made a good attempt at the task. However the views and assessement of Examiner Dr P and Dr I were that the task was not ‘really’ tackled appropriately, mother was not convinced of the replies she received, was mechanical and did not address non accidental injury as cause of baby’s condition. Dr AG swapped roles and was in the Hotseat with Dr S wearing the RP hat. AG addressed mother’s concerns after rapport building and brought in NAI as possible cause of baby’s current condition. AG also gave a differential of possible causes of bleed – haematological disorder, accident and the need to investigate further ags per national guidelines. AG avoided ‘Who had done it’ – parking it as will be investigated by Social service and possible police – for now to concentrate on baby’s progress and safety. The examiner’s were satisfied with the interaction.

Learning points are:

• Use 3 mins while waiting to have a Differential diagnosis
• Practice timing
• Do not spend too much time on one point only
• Acknowledge Role Players concerns and answer as appropriate
• Do not forget your TASK
• Do not blame them for child’s condition
• Check who else at home as other sibs will need place of safety
• Who all involved in child’s care?
• Social service try to keep the family together by providing support
• Remain a positive doctor
• Reamin clam
• Do not be intimdated by Role player

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

Anil Garg