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FC PAED(SA) EXAMINATIONS GUIDELINES FOR CANDIDATES

This document is intended to provide candidates with some background about the FC Paed(SA) examinations and to provide you with some advice and information to help you pass the exams. 1.0 BACKGROUND For both FC Paed(SA) Part I and Part II the examiners selected by the College are asked to provide the convenor with a range of questions (different types and different topics). The convenor provides examiners with the blueprint showing what topics were covered in previous exams and in what proportions. This guides them in terms of choice of topic and allows the convenor to blueprint the current examination paper: [1] always covering a proportion of core topics and [2] ensuring a spread of topics over within and between examination. The papers are reviewed by an Examination Review Committee which may advise the convenor about balance in the papers, as well as considering relevance, validity, style and comprehensibility. Once questions are selected, examiners are asked to submit marking memoranda against which they will be expected to mark the papers. Here is example of a blueprint for one of the written examinations, showing the proportion of marks allocated per subject (the total here for two written papers is 8.0):
Accidents, Poisoning, Emergencies Adolescent health (incl. Allergic and other immunologic Behaviour disorders and child Bone and joint disorders Development, language, hearing and Endocrine and metabolic disease ENT Gastrointestinal disorders Genetics Growth Haematology and oncology Heart disease HIV Infections and immunity Liver Neonatology Neurology Nutrition and infant feeding Pharmacology Renal and genito-urinary tract Respiratory diseases Skin diseases Surgical disorders Care of the 'normal' child Child abuse/rape Child morbidity and mortality Children with special needs Clinical skills and procedures Ethical dilemmas in paediatric care Health programmes and services Health promotion and prevention Immunisation Legislation/consent/rights Pain, palliative care and death Social support (grants, adoption, etc) Statistics, epidemiology, EBM, audit 85-Oct 0.33 86-Mar 0.5 0.5 0.5 0.5 0.38 1 1 0.25 0.25 86-Sep 87-Mar 0.5 87-Sep 88-Mar 0.25 0.25 88-Sep 0.25 0.25 1 0.25 89-Mar

1 0.25 0.5 0.33 1.25 0.2 1 0.2 0.6 0.8 0.65 0.7 0.7 1 0.4 0.25 0.5 0.25 1 0.38 0.88 1.25 0.5 0.5 0.5 0.5 0.25 0.5 0.75 0.25 0.25 0.5 0.5 0.25 0.5

0.25 0.25 0.5 0.25 0.5

0.25 0.25 0.25 0.25 0.2 0.9 0.25 0.5 0.25 0.5 0.25 0.4

1.5 0.75 0.3 0.25 0.25 0.75

1.8 1.05 0.75 0.3 0.35 0.5 0.25

0.5 0.5 0.5

0.25 0.25 0.5 0.5 0.25 0.25 0.25 0.25 0.5 0.25 0.25 0.5 0.25 0.13 0.25 0.25 0.25 0.25 0.5 0.5 0.25 0.25 0.25 1 0.5 0.3 0.15 0.6

0.33 0.5 0.9 0.5 0.3 0.8 0.25 0.5

0.25 0.5

0.75 0.1 0.25

0.3

0.6 0.25 0.15 0.25 0.4

-22.0 STUDYING Pay attention to the whole syllabus. Blueprinting ensures a spread of questions in your examination and over time. Expect questions on epidemiology and statistics, ethics and community paediatrics. Make a point of reviewing the principel peer-reviewed journals over the last 6 months examiners are likely to ask you about topical subjects. 3.0 3.1 ANSWERING QUESTIONS IN THE PAPERS MCQs There are three types: 3.1.1 SECTION 1: Multiple true-false questions (X-type question Orange): INDICATE WHETHER EACH STATEMENT IS TRUE OR FALSE 3.1.2 You will receive one mark for each correct answer and a negative mark for each incorrect answer (ie a negative marking system will be used). For example, if you answer three statements correctly and two wrongly, you will receive a mark of 3-2=1. If you are uncertain if a particular statement is true or false, leave it blank, and you will receive a mark of zero for that statement. For example, if you answer three statements correctly, and leave two statements blank, you will receive a mark of 3. The maximum mark per question is 5, and the minimum mark is 0.

SECTION 2: Best of five options (A type questions Red): SELECT THE SINGLE BEST OPTION You will receive three marks for a correct answer and a zero mark for an incorrect answer

3.1.3

PART 3: Extended matching (R type question - Brown): SELECT THE SINGLE BEST OPTION from the list of options, for each scenario Each option may be used once, more than once, or not at all. You will receive two marks for a correct answer and a zero mark for an incorrect answer SHORT NOTES AND THEME / SCENARIO-BASED QUESTIONS Read the question carefully so that you understand whats being asked of you. Answer the question. If the examiner wants an approach to investigating chronic lung disease you wont get any marks for discussing the management. Concentrate on being clear and concise. Allocate time carefully considering not only the marks apportioned to that question but the content you are expected to cover in the answer. Try and answer every question ... even a few salient facts can give you 3/10 for part of a question allowing you to pass the whole question. Try to remember what you learnt at the bedside as well as in textbooks.

4.0

THE OSCE Again be clear and concise ... try to answer in point form. Theres usually a relationship between the number of marks allocated and the response required, and the examiners are asked to be explicit. If you are asked for SIX complications of cerebral palsy and provide eight answers you will only be marked on the FIRST six responses .... make sure those are the correct ones.

5.0.../

-35.0 PERFORMING IN THE CLINICAL EXAMINATION Practice, Practice, Practice! Your department should be providing regular clinical evaluations in the form of mock cases from the time that you start as a registrar. As you approach the Part II examination in earnest (last 2-3 months) we recommend two tutors doing one case each per week with you. 5.1 Examination: Always read the history that you are given theres usually pertinent information supplied (if your clinical summary does not explain this history you may have missed something). Anthropometry: You must be familiar with WHO charts and Z scores. Accurate analysis is crucial! And it kick-starts your presentation so you want to start well. Dont assume you know it all practice talking your way through the anthropometry with every case you see. Always measure the BP. I would have liked a BP is a bad habit and it will let you down when the child is actually hypertensive. Please know the important normal values! There is a simple formula: the systolic BP should not exceed 100 + Age x 3. Be precise in conveying clinical findings; you need to be familiar with and use criteria eg if you are calling early clubbing you should be able to demonstrate 2/3 clinical criteria. Use your approaches to guide you: eg in a cardiac case you must ask yourself [1] is the child in failure? [2] does the child have infective endocarditis? [3] does the child have rheumatic fever? Always look for and comment on relevant negatives, Dont forget to assess development in every child. A comment on technique. Structure your approach to the FC Paed(SA) case, so that you have a generic framework to hold on to if you get a curveball. Do you write while you examine or after? How do you allocate time? Always set aside at least 5-10 minutes to THINK, to SYNTHESISE and to CHECK clinical findings that you may have forgotten or missed! Once youve decided an on approach, stick to it. 5.2 Presentation: Practice on every ward round, every phone consult and every handover. While not wanting to be too brief, please dont describe at length normal findings in unaffected systems. Rather focus on relevant negatives. Aim to be confident and engaging. Style is not a substitute for substance but it helps! 5.3 Summation and Synthesis: This is where you show off your clinical reasoning which is the key to a good specialist opinion. [1] Identify ALL the important clinical problem(s) [2] Generate a relevant differential diagnosis, using positive and negative findings to weigh up the different possibilities, and remembering to account for ALL your negative and positive findings ... always talk about THIS patient with THIS set of signs [3] Suggest which investigations might help to make a diagnosis, as well as those which might point to severity or demonstrate complications. You should be able to motivate why you want each one. [4] Sketch out a management plan that deals with the immediate problems, as well as the long term issues [5] Dont forget multidisciplinary involvement but avoid jargon... if you are going to cite the Occupational Therapist make sure that you know what he or she will do for THIS case. 5.4 The Dialogue with the Examiners: Remember, the examiners are trying to help you pass. Listen to them! If they ask you to go back there is a reason. If you dont understand why ask for clarity rather than getting into an argument. 5.5 Investigations: Know your ECGs and CXRs. Be comfortable with analysing the whole range of laboratory results. Practice discussing them for an audience at every opportunity! 5.6.../

-45.6 How Are You Assessed? We use anchor statements to guide the evaluation process. They are reproduced below for your information. 5.7 A Final Word: Remember the big picture ... There is nothing they can give me to which I cant present an approach ... and try to avoid thinking in terms of Whats the answer? but rather trying to decide What is wrong with this child? and What is my plan? 6.0 ANCHOR STATEMENTS EXAMAMINATION FOR THE FC PAED(SA) PART II CLINICAL

JOHANNESBURG JUNE 2012