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Guide to the MRCPCH Examinations

This Guide was written by
Dr Claire Head
Dr Rebecca Moon
Dr Rosada Sacranie
Dr Sebastian Grey
for Paediatric Trainees in the Wessex Deanery
t has been ada!ted for use in South "or#shire by
Dr Rum Thomas
$uly %&'%
Re(ision date) $uly %&'*
Contents
(Ctrl+Click to jump to page)
General advice.................................................................................................................... 4
Structure............................................................................................................................. 5
Question types.................................................................................................................... 5
Multiple coice !uestions.................................................................................................... 5
"est o# #ive.......................................................................................................................... $
%&tended matcing !uestions............................................................................................. $
'e#erence "ooks................................................................................................................ $
(nline and !uestion )ooks.................................................................................................. *
+art , -ritten......................................................................................................................... *
General advice.................................................................................................................... *
.e %&am........................................................................................................................... /
Question structure............................................................................................................... /
"est o# list .......................................................................................................................... /
0s in part 12 pick te )est ans3er ...................................................................................... /
%&tended matcing !uestions ............................................................................................/
0 list o# options is given at te )eginning o# eac !uestion. 4n response to eac statement
you must coose te most appropriate ans3er.................................................................../
5 #rom many ...................................................................................................................... /
6ou are re!uired to coose a num)er o# options #rom a longer list2 suc as treatment
options................................................................................................................................ /
Question #ormat.................................................................................................................. /
7ong case istories............................................................................................................. /
8ata interpretation.............................................................................................................. /
+otograpic material......................................................................................................... 9
General te&t)ooks............................................................................................................. 1:
Question )ooks................................................................................................................. 1:
-e)sites........................................................................................................................... 11
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Clinical e&amination.............................................................................................................. 1,
0pproac.......................................................................................................................... 1,
Getting started.................................................................................................................. 1,
Clinical .eacing............................................................................................................... 1,
%&ample o# clinical circuit.................................................................................................. 1,
Clinical stations................................................................................................................. 1=
Clinical specials................................................................................................................ 14
>se#ul )ooks #or clinical revision....................................................................................... 1$
Clinical 'evision Courses................................................................................................. 1*
-at to do i# you #ail......................................................................................................... 1/
?.o study te penomena o# disease 3itout )ooks is to sail an uncarted sea2 3ile to
study )ooks 3itout patients is not to go to sea at all.@ ....................................................19
A Sir -illiam (sler2 Bater o# Modern Medicine (1/49C1919)............................................19
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The MRCPCH exams
.e M'C+CD e&amination is a game 3it its o3n rules and peculiarities. 0ltoug aving a
good kno3ledge o# paediatrics is important2 success is a)out )eing a)le to understand te
!uestion and ten identi#y te correct ans3er (3ic un#ortunately may not )e 3at you
ave o)served in clinical practice).
.is guide 3ill give you suggestions on o3 to prepare #or all te parts o# te M'C+CD
e&amination. .e 8eanery 3ill soon introduce a system o# ?e&am )uddies@ C you 3ill )e
paired up 3it a trainee 3o as passed te e&ams recently A tey 3ill )e a)le to give you
use#ul tips and tecni!ues. .e S.%++ days 3ill )e revised to include some e&am #ocused
teacing.
Part '
General ad(ice
.oug te 5elson .e&t)ook o# +ediatrics may )e a #ascinating read2 you may su##er #rom
in#ormation overload C and ten not #ocus on te parts tat are relevant to passing te
e&aminationE +assing te e&am is )ased on pattern recognitionF te same areas are covered
repeatedly.
8o as many !uestions as possi)le to elp you recogniGe te !uestions and te gaps in your
kno3ledge C ten read around tat particular su)ject. .est your kno3ledge )y doing more
!uestions C use a variety o# )ooks and 3e)sites as tere is limited )ene#it #rom revising te
ans3ers to !uestions you already kno3.
.e !uestions disproportionately cover certain areas 3ile ignoring oters. 0s a
conse!uence te cornerstone to passing te e&am is aving done lots o# similar (and
occasionally identical) !uestions )e#ore. Make sure tat you cover certain important topicsH
• 4mportant potentially #atal conditionsH e.g. meningococcal meningitis;sepsis2 ductC
dependent cardiac de#ects2 nonCaccidental injury
• Common syndromes A .risomy ,12 .urnerIs syndrome
• 8evelopment and gro3t2 #altering gro3t
• 4mmunisations C look at 8epartment o# Dealt 3e)site #or up to date scedule.
• "asic sciences and statistics A sorryE 4t is usually easy to ans3er correctly as te
!uestions tend to )e easier tan tose #or oter ?more interesting@ clinical topics.
%&amination and revision tecni!ue and kno3ing your o3n strengts and 3eaknesses
related to revision and 3ritten e&aminations are e!ually important as kno3ing te su)ject.
.ink o# o3 you ave revised #or past e&ams and 3at 3orked 3ell #or you. 4t is more
important to cover all areas o# te curriculum !uite 3ell tan kno3 lots a)out your particular
areas o# interest. 0 revision timeta)le may )e use#ul #or some people in tis respect2 )ut
3eter or not you use one make sure you allot ade!uate time to all areas o# te curriculum.
>se te resources availa)le to you. .e 'C+CD as in#ormation on teir 3e)site a)out te
sylla)i #or te e&aminationsF some o# tis as )een included in tis guide. .ey also ave
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practice papers and ans3ers #ound atH ttpH;;333.rcpc.ac.uk;trainingCe&aminationsC
pro#essionalCdevelopment;e&aminations;mrcpcCpartC1Cupdates;structureCspecimen
Structure
.ere are t3o papers2 1a and 1). 6ou may apply to take only 1a or )ot parts on te same
day. %ac paper is , J ours in lengt.
+art 1 a (designated as ?Boundation o# +ractice #rom ,:1=) is relevant to tose 3orking in
non ospitalC)ased paediatrics and is te 3ritten component o# te 8CD e&amination. 4t
includes !uestions tat ave a general practice;community paediatrics slant2 e.g. prescri)ing
te contraceptive pill #or teenagers2 presentations tat are seen in general practice and te
community.
+art 1) (#rom ,:1= .eory and Science o# +ractice) tests kno3ledge on te science o#
medicine A anatomy2 pysiology2 patopysiology2 parmacological principles and more
comple& pro)lem solving !uestions not tested in 1a.
.e papers are divided into te #ollo3ing !uestion typesH
• 1, %&tended matcing !uestions (%MQ) 3ort 9 marks eac (= per item)
• 15 Multiple trueC#alse !uestions 3ort 5 marks eac (1 per item)
• 4/ "est o# #ive !uestions 3ort 4 marks eac
+uestion ty!es
Multi!le choice ,uestions
.e e&aminers are aiming to ?test 3eter a candidate as true kno3ledge o# a #act or tinks
tat someting similar ()ut 3rong) sounds vaguely #amiliar.@
.ese are not negatively marked so you sould aim to ans3er all o# tem.

.ey carry te least marks as a total o# te tree !uestion types C do not spend too long on
te ans3ers.
.ere are certain ?rules@ 3en ans3ering tese !uestions. .is does not replace revision
and kno3ing te su)ject 3ell2 )ut may elp you to avoid common tricks and ans3er
!uestions 3ere you are not sure o# te ans3er.
• 'ead te !uestion care#ully2 donIt miss out key 3ords. 4# you are ans3ering a
!uestion and you miss out te 3ord ?e&cept@ in te prase ?all o# te statements are
correct e&cept@ you 3ill put do3n te 3rong ans3er.
• .rust your instinct C your initial ans3er is likely to )e correct.
• Do3ever do leave time to ceck your ans3ers at te end and make sure tat you
ave not read te !uestion 3rong te #irst time.
• .ey usually test su)jects 3ere tere is little am)iguity C a de#inite yes;no ans3er.
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• Do3ever2 as a rule ans3ers 3it al3ays or never are usually #alse as rarely in
medicine does someting al3ays appen or never appen.
• "e3are dou)le negatives2 not uncommon and not in#re!uently )ot mean o#ten.
• "e3are te meaning o# 3ords used in !uestions2 #or e&ample typically means
usually.
• 0ns3ers containing num)ers can )e tricky. .ose containing very precise #igures #or
e&ample 59K are unlikely to )e true. 0sk yoursel# 3at te num)er means in te
conte&t o# te !uestion. Bor e&ample i# te !uestion states *5K o# in#ants 3alk )y
teir #irst )irtday2 ask yoursel# do te majority o# in#ants 3alk )y teir #irst )irtdayL
• 4n !uestions 3ere one o# te ans3ers is ?all o# te a)ove@ i# you kno3 tat at least ,
o# te stem ans3ers are correct ten it is likely tat tey are all correct2 and all o# te
a)ove is te correct ans3er.
-est of fi(e
.ese carry te most marks o# te total in part 1 3ritten.
.ese !uestions are designed to test judgment and e&perience. .ey start 3it a statement2
and are #ollo3ed )y #ive ans3ers. Some o# te ans3ers 3ill )e correct2 )ut only one 3ill )e
te most appropriate ans3er to te statement. .is makes tem te most di##icult !uestion to
ans3er as it can )e ard to pick te rigt option o# te #ive possi)le ones o##ered. Sould
only cover one aspect o# a topic2 so possi)le !uestions may )eH
• M-at is te most likely diagnosisLM
• M-ic investigation is most likely to lead to a diagnosisLM
• M-at is te )est ne&t stepLM
• M-at is te )est advice to give to parentsLM
• M-at is te most likely patogenesis o# tis conditionLM
• M-at is te most common cause o# tisLM
0s te )est o# 5 carry te most marks and are more di##icult to ans3er2 you sould make
sure tat you complete as many o# tis !uestion type as possi)le.
Extended matchin. ,uestions
.ese are similar to )est o# #ive !uestions. 0 statement is given2 and ten te candidate ten
as to pick te ans3er #rom te attaced list. %&amplesH
• Coose te most likely diagnosis #rom te #ollo3ing.
• Coose te )est treatment #or eac o# tese cildren.
• Coose te organism 3ic matces most closely eac o# te #ollo3ing case
scenarios.
.e Student "MN as a good article on e&amine tecni!ue 3en ans3ering MCQs. .e
article can )e #ound atH ttpH;;careers.)mj.com;careers;advice;)mj.==:.*5:=.s,,/.&ml
Reference -oo#s
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Get only one or t3o good te&t)ooks tat 3ork #or you. -it any )ook try )e#ore you )uyF
most o# tese are availa)le in your ospital li)rary. The books marked * are available in
the Illingworth Library at Sheffield Children’s Hospital.
/issauer and Claydon) llustrated Guide to Paediatrics 01%&'%2
• 7ots o# pictures 3it use#ul summary )o&es and ta)les
• 0 little oversimpli#ied
-eattie) Essential Re(ision notes in Paediatrics for MRCPCH
• Oery good re#erence te&t)ook )ut not )edtime readingE
Easterbroo#) -asic Medical Science for MRCP !art ' 01%&&32
• .e )est )ook #or )asic science
• +articularly good respiratory and cardiology capters.
Sheridan) 4rom -irth to 4i(e "ears 01%&&52
• "est )ook #or early cild development
/e(ene) MRCPCH Mastercourse 6olumes ' 7% 01%&&82
• %ndorsed )y te 'C+CD
• 8oes not cover te complete content o# te e&am.
• Mi&ture o# standard te&t and case istories
• P,:: includes a C8 o# e&aminations and pictures and access to a 3e)site
• -e)site not very user #riendly and as limited content C try )e#ore you )uy
9nline and ,uestion boo#s
• +as.est o##er a num)er good )ooks. +astestonline.co.uk also as a 3e)site o# over
15:: e&am !uestions 3ic is good valua)le #or money and easy to use.
• 333.one&amination.com as a )ank o# over =::: !uestions. .ese are muc easier
tan te e&am so aim #or an average mark Q *:K (te e&am pass mark is $:C$=K).
• +ractice papers on 'C+CD 3e)site.
Sidwell and Thomson) +-ase Paediatrics * MC+s for the Part - MRCPCH 01%&&52
Hal!ert -asic Child Health Practice Pa!ers 01%&&82
• 0ll tree types o# !uestions
• Sort e&planatory notes 3it te ans3ers
-eattie and Cham!ion) MRCPCH ') Essential +uestions in Paediatrics 01%&&:2
• 0ll tree types o# !uestions 3it e&planatory notes 3it te ans3ers
• Split into capters )y su)ject to aid revision planning
Part % Written
General ad(ice
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• .e e&am ?is a test o# clinical kno3ledge and decision making@
• .e !uestions are more predicta)le.
• Bocus on areas tat are not seen routinely in clinical practice C meta)olic2 renal2
gro3t and endocrine.
• 8o as many !uestions as possi)le2 and ten read a)out te topics.
The Exam
.ere are t3o papers eac , J ours in lengt2 )ot are taken on te same day. %ac
!uestion carries its o3n 3eigting. .e ma&imum score per !uestion 3ill )e split )y te
num)er o# correct responses re!uired. .ere is no negative marking.
+uestion structure
-est of list
0s in part 12 pick te )est ans3er
Extended matchin. ,uestions
0 list o# options is given at te )eginning o# eac !uestion. 4n response to eac statement
you must coose te most appropriate ans3er.
; from many
6ou are re!uired to coose a num)er o# options #rom a longer list2 suc as treatment
options.
+uestion format
/on. case histories
.ese are o#ten more tan a page long2 3it or 3itout )lood test results. 4tIs important to
igligt key points as you read troug and reCread te case or you 3ill miss te important
points.
• .ese include common as 3ell as very uncommon topics.
• %liminate ans3ers tat you kno3 it de#initely is not and you 3ill pro)a)ly )e le#t 3it ,
or = ans3ers2 te task is ten to pick out te key in#ormation tat separates te
conditions A tink a)out tis 3en revising2 look at conditions 3ic present similarly
and o3 tey di##er (rases2 joint s3ellings).
• Questions 3ill ask you to suggest te diagnosis2 most appropriate investigation or
management or a com)ination o# tese.
Data inter!retation
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6ou 3ill )e asked to interpret investigations in te conte&t o# a clinical setting. 5ormal ranges
or re#erence ranges 3ill only )e provided 3ere tese are likely to )e in dou)t.
• Daematology and )iocemistry results
• "lood gases
• %lectrocardiograms
o >sually o)vious diagnoses A e.g.F complete eart )lock2 -+-2 SO.2 sinus
tacycardia.
o 'ead +aediatric %lectrocardiograp "MN ,::,F ,=4H1=/,C5
• Spirometry
• %lectroencepalograms
o Gaon, Paediatric exams, A survival guide gives an e&cellent description o#
a)normal ?diagnostic@ %%Gs. %&amplesH ypssarrytmia2 = DG spike and
3ave< encepalitis and temporal lo)e epilepsy
• 0udiograms A sensorineural versus conductive earing loss
• Cardiac cateter data A easy to interpret 3it a scematic diagram
• Statistics;Critical appraisal;Study design
• 4nterpretation o# p values2 con#idence intervals
• Most appropriate study design to ans3er !uestions
Photo.ra!hic material
6ou 3ill )e asked to identi#y a)normalities2 provide a diagnosis2 investigations or treatment
or a com)ination o# tese.
• .e images are usually o)vious and #airly common diagnoses
• Good !uestions to do 3en you are too tired to #ocus on anyting else
• Google image syndromes2 rases and dysmorpic syndromes
• Medical imagingH &Crays2 C. scans2 M'4s and nuclear imaging
• 5eonatal radiologyH
o Cest
 Oascular cateter and endotraceal tu)e placement
 0ir leaks
 Cystic lesionsH diapragmatic ernia2 cystic adenomatoid
mal#ormation2 congenital lo)ar empysema
 8i##use opaci#icationH yaline mem)rane disease2 transient
tacypneoa o# te ne3)orn2 congenital pneumonia2 meconium
aspiration syndrome
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 .racealCoesopageal #istula2 oesopageal atresia
o 0)domen
 Meconium ileus2 necrotiGing enterocolitis2 intestinal atresia
o Cranial ultrasound A lesion is usually o)vious
General textboo#s
Paul Gaon) Paediatric Exams = Sur(i(al Guide 0%&&>2< 01%&&&2
• -ell 3ritten2 includes nearly everyting you need to kno3 #or te e&am
• -ell laid out and easy to read
• 7ots o# e&amples o# data interpretation (cardiac cateter data2 lung #unction and
audiograms)
• 5o pictures toug.
Ste!hen Stobel) The Great 9rmond Street Colour Handboo# of Paediatrics and
Child Health 01%&&82
• %&cellent potograpic material 3it descriptions
• Contains more in#ormation on sligtly more unusual diagnoses
Gardiner) 9xford S!ecialty Trainin.) Trainin. in Paediatrics 01%&&:2
• Good introduction to reading #or te e&ams
Ewer) Core Clinical Cases Paediatics 01%&''2
• Clinical pro)lem solving approac
• -ill also elp in your clinical practice
+uestion boo#s
Make sure read !uestion )ooks tat #ocus onH
• 8ata interpretation
• 'adiological imaging
• +otograps o# clinical signs C C syndromes2 rases etc.
• Grey cases (See )elo3 num)er =)
.e +as.est revision )ooks are generally very good. +ass +aediatrics and Curcill
7ivingstone also does a good range o# !uestion )ooks.
;ic# -arnes and $ulian 4orton) +uestions for the MRCPCH Part % Written
Examination 01%&&>2
• Bocuses on grey case !uestions
• Callenging !uestions2 ans3ers include complete )ut concise e&planations.
• %&cellent ta)le and diagnostic algoritm on meta)olic pro)lems (p =92 4:)
?ate Crease) MRCPCH Part % +uestions and answers for the new format exam
01%&&52
• Good range o# !uestion styles and topics covered and easy to use
• 5o pen and paper re!uired C ans3ers given on te )ack o# te !uestion2
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• Questions seem easier tan te actual e&am and grey cases are not as detailed
$ Robertson) %3& +uestions for the MRCPCH Part % 01%&&@2
Raine '&& Cases in Paediatrics 01%&&:2
• Separate capters on signs and data interpretation in di##erent systems
• Good #or practice once you ave an idea o# o3 to start doing data !uestions
• Good )ooks to use in conjunction 3it Gaon 3en revising ?systems@
;a.i -ara#at) Get Throu.h MRCPCH Part %) Data nter!retation +uestions 01%&&52
• Das good e&amples o# all te di##erent types o# !uestions
Christo!her Schel(an) Paediatric radiolo.y for MRCPCH and 4RCR 01%&'&2
• %&cellent #or radiology revision
• -ell laid out2 good !uality pictures and e&planations
;a.i -ara#at) Get Throu.h MRCPCH Part %) '%3 +uestions on Clinical
Photo.ra!hs 0%&&32
• Contains good !uality potograps
• Content can )e more o)scure tan in te actual e&am
Crai. and -rownlee) MRCP 0Paediatric2 Paediatric Picture Tests 01'::82
Winrow) '&& Paediatric Picture Tests 01'::32
• ?(ld@ )ut easy to read (especially 3en you are tired and;or #ed up)
Websites
• 333.one&amination.com A rater limited !uestion )ank2 3ic are generally not te
standard or #ormat o# te part , e&amination.
• 333.pastestonline.co.uk A a greater num)er o# !uestions tan oter online !uestion
)anks )ut very #e3 ave potograps or data to interpret e&cept #or )lood results.
Cases are signi#icantly sorter tan tose seen in te e&am. Good #or kno3ledge
consolidation.
• %&am papers on 'C+CD 3e)site
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Clinical examination
=!!roach
• .e e&aminers are asking temselves is tis person ready to )e on te middleCgrade
rotaL
• 6ou need a minimum total mark o# 1:: (out o# 1,:) re#lecting an average o# ten
?passes@ over te ten stations
• "eing #riendly and nice to te cild 3ill get you most o# te marks. 'emem)er to
introduce yoursel# to te cild and te parents and c lean your ands )et3een te
stations.
Gettin. started
• 4t is normal to )e petri#ied just tinking a)out te e&am2 tis 3ill su)side 3it practice.
6ou 3ill ten start to #eel ready #or te e&am in te #e3 3eeks )e#ore2 and )ecome
a)solutely petri#ied again just )e#oreE
• Get organised C arrange a study group so you can support and #eed)ack on eac
oter.
• +ractice2 practice2 practice. Start around $C/ 3eeks )e#ore te e&am2 longer tan
tis and you 3ill )urn out too !uickly.
• 'ead all te in#ormation on te 'C+CD 3e)site to #amiliarise yoursel# 3it o3 te
e&am 3orks. .ere is also lots o# in#ormation including guidelines on 3at is
e&pected 3en e&amining di##erent systems and o3 te marking is per#ormedH
o ttpH;;333.rcpc.ac.uk;trainingCe&aminationsCpro#essionalC
development;e&aminations;mrcpcCclinicalCupdates;structure;struct
o ttpH;;333.rcpc.ac.uk;sites;de#ault;#iles;asset<li)rary;%&ams;M'C+CD
K,:Clinical;M'C+CDK,:ClinicalK,:%&amK,:.ecni!ue.pd#
Clinical Teachin.
• .e +ost Graduate Medical %ducation Centre at Se##ield CildrenIs Dospital 3ill
organise a time ta)le. Contact +GM%Rse##ield.ac.uk or 8r Sanjay Suri2 .+8 #or
S.1C=.
• .e S.%++ days 3ill also include some e&amination #ocused teacing #rom 0utumn
,:1,.
• 0lso arrange clinical teacing individually 3it consultants 3itin your o3n
departments.
Exam!le of clinical circuit
• .e e&am #ollo3s an (SC% style #ormat. .e stations test te #ollo3ingH
o +ysical e&amination skills
o 'ecognition o# clinical signs and symptoms
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o Cild development
o Communication skills
o Distory taking
o 0)ility to make a diagnosis and plan management
Clinical stations
• 6our clinical e&aminations o# all te systems must all )e so 3ell practiced tat tey
are automatic )y te time you take te e&am. .is 3ay you can #ocus on picking up
te clinical signs2 rater tan per#orming te e&amination.
• +ick up as many clues )e#ore you touc te cild. 0ny clues around te cild or )ed2
scars2 level o# nutrition etc.
• 'emem)er to 3as your ands and introduce yoursel#.
• .ere are a #e3 cronic conditions and clinical syndromes 3it lots o# signs tat lend
temselves 3ell to te clinical e&am2 e.g. 5B12 CB2 post op cardiac surgery e.g.
Ballots2 Mar#ans2 glycogen storage diseases2 .risomy ,12 .urnerIs syndrome2
0ngelman syndrome. Sno3 tem 3ell.
• Sno3 o3 you 3ill approac any eventuality tat may arise. Bor e&ample doing a
cardiac e&amination on a )ouncy , year old or a lo3er lim) e&amination in a cild
3o is in a 3eelcair.
• 8o not panic i# te cild cries or re#uses e&amination. "e nice2 try distraction )ut do
not upset te cild #urter. .e e&aminers recogniGe tis is a pro)lem 3it cildren.
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Comment on 3at you can and state 3at else you 3ould ideally do and tat in real
li#e you 3ould return later i# possi)le to complete te e&amination.
• 8ecide 3eter you 3ill present your #indings as you go or at te end.
• +ractice presenting your #indings slickly in #ront o# consultants 3o 3ill give you
constructive #eed)ack. .is 3ill )uild your con#idence. SummariGe your clinical
#indings at te end and state your diagnosis.
• 'emem)er tat apart #rom cardiology and development2 te clinical stations do not
ave to )e te named e&amination )ut can )e ?oter@2 as suc2 e&aminations suc as
tyroid2 aematology2 eyes2 can occur any3ere. Some cildren may also )e used
out o# teir traditional conte&t e.g. CB as a)domen i# a)dominal scar #rom meconium
ileus.
Clinical s!ecials
Musculos#eletal and other station
• Can )e a di##icult station as you may )e asked to do a limited musculoskeletal e&am
3ic many people are not #amiliar 3it.
• 4t is important to listen care#ully to 3at te e&aminer is asking you2 and #ocus your
e&amination )ased on tis.
• Noints sould )e e&amined using a look2 #eel and move approac.
• 0 modi#ied pG07S sould )e used 3en e&amining te lo3er lim)2 upper lim) and
neck. Do3ever te station is not simply a re!uest to per#orm pG07S.
• Make sure you also ave a sceme #or a good eye e&am #or te oter station.
• 0rtritis researc >S as more in#ormation on te pG07S e&amination2 and you can
re!uest a #ree 8O8 o# tis e&amination #rom teir 3e)site.
De(elo!ment
• -it a little practice tis )ecomes an easy station. 0 good 3ay is to spend an
a#ternoon in cildrenIs outpatients playing ?guess te age@ using simple play. 6ou
3ill tere#ore see a mi&ture o# normally and a)normally developing cildren.
• 6ou may ave a normally developing cild as cildren o# local doctors are used i#
insu##icient patients.
• Bor speec and language do not #orget earing A try clapping or making loud noise
)eind cild #or gross assessment.
• Bor #ine motor2 do not #orget to make a )rie# statement on vision;use o# glasses.
• 6ou can make comments to te e&aminer as you proceed suc as ?tis skill 3ould )e
e&pected o# an && year old@. .is may stop you #orgetting 3ere you are at 3it te
e&amination.
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• Make it #un A te cild 3ill interact 3it you )etter as tey are likely to )e )ored o#
)uilding to3ers and dra3ing circles i# you are te 1,
t
person to e&amine temE
Communication
• .ey are e&pecting te candidate to communicate in areas tat an S.4 migt
encounter.
• .e main #ocus is communication2 )ut tey also mark you on your kno3ledge )ase
a)out te topic. Do3ever tere are tecni!ues to get around tis2 #or e&ample i# you
are asked to teac a medical student on a topic tat in te panic o# te moment you
kno3 very little a)out2 lines suc as ?4 need to ceck up on some in#ormation2 sall
3e meet tomorro3 to discuss again@2 or i# asked a !uestion )y a parent ten ?4 3ill
ceck and get )ack to you@. Donesty is )etter tan saying someting tat is clearly
#actually incorrect2 and demonstrates te approac tat you 3ould ope#ully take in
real li#eE
• 'ead te !uestion )e#ore you start and ten reCread it again. .ere 3ill )e certain
points tat you need to cover in te allotted time to get te #ull marks. %ven i# you are
amaGing at communication2 you 3ill not get #ull marks i# you ave not covered all
areas.
• %&plaining su)jects to a medical student is !uite popular no3 e.g. pro)lems
associated 3it e&treme prematurity.
• (ter topics commonly areH
o %&plaining a diagnosis
o 'eason #or admission
o Cange in treatment
o Con#lict resolution
o "reaking )ad ne3s
o Counseling in treatened preterm la)our
• 0ll communication scenarios sould #ollo3 a )asic structure o#H
1. 4ntroduction
,. -at te oter person kno3s already and 3at tey 3ant to kno3
=. %&planation o# 3at tey 3ant to kno3
4. Clari#ication o# understanding and opportunity to ask !uestions
5. -at you are going to do no3 and 3at you e&pect te oter person to do
$. (##er to meet again to e&plain #urter and provide 3ritten in#ormation i#
relevant
• >se sort sentences and simple 3ords.
• "e unam)iguous.
• 8ra3ing diagrams can )e a use#ul 3ay o# e&plaining tings.
• .elepone conversations are no3 )eing used in 3ic te oter person may )e in
anoter room. .is does make some aspects more di##icult as you cannot see )ody
language2 )ut similarly you 3ill not )e marked on your )ody languageE
6ideo station
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• -ildcard station2 it is di##icult to prepare #or tis.
• 8esigned to cover topics tat cannot )e covered else3ere.
Bavorites areH
o Gaits
o %mergencies A acute astma2 )ronciolitis2 dia)etic ketoacidosis
o Cest and cardiac signs etc using a recording stetoscope to so3 te signs
o 7umps )umps and rases
o 5onCaccidental injury
o Mental ealt presentations
• 'ead te !uestion and remem)er to 3atc te video A te computer program gives
you a elp#ul 3arning to remind you to 3atc itE 'emem)er to put te eadpones on
(surprisingly some people do #orgetE).
• 6ou can 3atc te videos as many times as you 3ant.
• 6ou cannot go )ack and cange an ans3er once you ave su)mitted it )ut you can
come )ack to a !uestion you ave not ans3ered.
History ta#in. and mana.ement
• (utpatient style. Dal# te time spent taking a istory and al# discussing te management
3it te e&aminer.
• +ractice approac to common outpatient scenarios and teir management.
o 0stma
o 8ia)etes
o Constipation
o %nuresis
Aseful boo#s for clinical re(ision
S$ -edwani) MRCPCH Clinical) Short Cases< History Ta#in. and Communication S#ills for
Paediatric Membershi! 01%&''2
• Good descriptions o# clinical #indings in common conditions
• %&cellent capter on o3 to approac a variety o# communication scenarios
Rebecca Casans) Communication Scenarios for the MRCPCH and DCH Clinical Exams
01%&&52
• 7ots o# communication scenarios 3it advice on 3at sould )e included
• %&cellent #or practicing in a small group
Wayne Harris) Examination Paediatrics 01%&''2
• -ritten #or te 0ustralian paediatric e&ams2 e&cellent #or te M'C+CD as 3ell
• 8etailed approac to te e&amination o# di##erent systems and interpretation o# clinical
#indings
Mary Sheridan) 4rom -irth to 4i(e "ears 01%&&52
• ?.e classic cild development te&t.@
Ste!henson) Clinical Paediatrics for Post.raduate Examinations 01%&&%2
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1$
• +re dates te recent canges to te sylla)us )ut as a good e&planation o# te clinical
signs and o3 to per#orm clinical e&aminations
Damian Roland) Circuits for the MRCPCH 01%&&8
• %&cellent e&planation o# o3 te e&amination 3orks
• Clear guidance on 3at is e&pected at te stations
Stanley Ben.eya) The MRCPCH Clinical Exam Made Sim!le 0with D6D2 01%&''2
• 8O8 igligts common mistakes made )y candidates
Clinical Re(ision Courses
• Clinical revision courses are e&pensive2 )ut some people #ind tem use#ul. Many people do
manage to pass M'C+CD clinical 3itout attending clinical revision courses.
• .ey do provide te opportunity to see lots o# di##erent clinical conditions in a sort space o#
time2 and may provide some e&posure to conditions you ave not seen.
• Can elp to )uild con#idence (particularly 3en you see oter peopleIs e&amination
tecni!uesE)
• .e 4mperial College M'C+CD clinical course includes a #ull day dedicated to cardiology
3ic can )e use#ul i# you ave not done a cardiology jo). 0lso covers communication2
clinical e&aminations and video stations. .is course is o3ever e&pensive and is o#ten #ully
)ooked several monts )e#ore te e&am so )ook early i# you 3ant to attend.
(ttpH;;3331.imperial.ac.uk;medicine;researc;researctemes;reprodscience;paediatrics;mrc
pccourse;)
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What to do if you fail
.ere are people 3o #ind tey are good at passing e&ams and ten tere are some 3o
struggle 3it tem. .e section is #or tose o# you tat struggle or are struggling 3it e&ams.
Birstly you are not alone. Secondly do not despairF you 3ill pass i# you are determined and #ocused in
your preparation. .e pass mark #or part 1 and , varies2 )ut is usually )et3een $,C$5K. .o pass te
clinical you must get 1::;1,:.
.e college 3ill send you a )reakdo3n o# your marks #or parts 1 and , in eac su)ject. 6ou 3ill also
get a median and mean mark to compare your )reakdo3n to. Bor te clinical e&am you 3ill get a
)reakdo3n o# eac station2 3it additional comments #rom te e&aminer. .ry to identi#y te areas tat
you struggled 3it and #ormulate an action plan to tackle tem ne&t time. 4t may also elp to talk it
troug 3it someone at 3ork or someone 3o as struggled 3it te e&am.
8r Cli## "evan (cli##.)evanRsc.ns.uk) at Se##ield CildrenIs Dospital is particularly good at
providing oneCtoCone coacing #or candidates 3o ave struggled 3it teir e&ams.
.e main reasons tat usually cause candidates to #ail areH
• ;ot re(isin. for lon. enou.h
%veryone is di##erent2 / 3eeks revision #or te #irst , parts2 and $C/ 3eeks #or te
clinical is usually ade!uate. 6ou 3ill need to plan to revise #or longer tan in te past
as #inding te time )et3een 3orking si#ts is muc arder tan revising at medical
scool. 6ou sould take te 3eek o## )e#ore te e&am to consolidate and #ocus
3olly on te e&am. 6ou sould also take a stretc o# time o## 1 mont )e#ore to get
on top o# your study and plan your preparation.
• ;ot enou.h focus
0 #e3 lucky people can get )y and pass 3ile still aving a social li#e and enjoying
teir time o## 3ork. .ey are in te minority. Most people cannot ave a social li#e
3ilst doing tese e&ams. (n your days o## you need to )e treating your day as a
normal 3orking day and spending te day studying C 9am to 5pm. 6ou are pro)a)ly
not studying enoug i# you ave time to go out 3it #riends every nigt or at
3eekends. 4t sounds simple and sel# e&planatory )ut many people tink tey can
study and ave a li#e C you canIt2 and tat includes trying to study in Star)ucksE ">.
you do get it )ack 3en you pass C and you can enjoy it guilt #reeE
• Poor re(ision techni,ueC
.is is more relevant to te 3ritten e&ams. 4t is di##icult to revise and retain all te su)ject
areas tat you could )e tested on. 8oing as many !uestions as possi)le and ten2 reading
around tat area 3ill elp your retentive memory. .e same su)jects come up again and
again. Bind easy 3ays to retain )oring su)jects suc as dra3ing out #lo3 diagrams2 using
mnemonics to remem)er lists2 etc.
• Poor exam techni,ueC
4# you tink tat tis may )e te case try and sit do3n 3it someone and go troug some
!uestions 3it tem2 discussing te ans3ers as you go. .e +as.est courses are e&pensive2
)ut it may )e 3ort going on a course2 as tey go troug large num)ers o# !uestions and
discuss te ans3ers as a group.
• ;ot enou.h confidence
6ou need to S5(- you can pass tese e&ams. Saying T4 tink 4Im going to #ailI can
)e sel# #ul#illing and not use#ul to your con#idence. 6ou ave to go into tis e&am 3it
te kno3ledge tat you can do tis.
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• Ha(in. the wron. attitude
4# you #ind yoursel# saying Ti# 4 #ail ten itIs ok C 4 can sit it ne&t timeI ten you are more
likely to #ail. 4n tis case your attitude to studying and sitting te e&am is 3rong. 6ou
need to )e studying to pass.
• Personal ssues
.ry looking at te reasons you migt )e #ailing. 4# you are planning a 3edding2 aving
a )a)y2 )reaking up 3it a )oy#riend or girl#riend2 moving ouse or #igting illness it is
3ort considering putting o## te e&am until you can #ocus on it. 4t is ok to take a
)reak #rom sitting te e&ams to sort out your li#e and your attitude to te e&am.
0n appeals process does e&ist2 i# you #eel tat you ave grounds. .e details are availa)le on te
college 3e)site.
.ere are many resources availa)le #rom te 8eanery i# you are struggling 3it te e&ams. 4# you are
3orried a)out #ailing you are more likely to pass i# you ask #or elp earlier. Many candidates struggle
3it at least one o# te tree parts o# te e&am2 so donIt #eel you are alone. .alk to your clinical
supervisor2 educational supervisor or someone on your team i# you #eel you 3ould like some elp.
Binally2 remem)er to apply logic and reasoning in your reading and clinical practice A you 3ill )e a
)etter paediatrician i# you understand te pysiologic )asis o# disease. .is 3ill elp you to interpret
clinical signs and manage clinical pro)lems more e##ectively. .en you 3ill enjoy reading to improve
your practice2 rater tan just ?cramming #or te e&am@.
DTo study the !henomena of disease without boo#s is to sail an uncharted sea< while
to study boo#s without !atients is not to .o to sea at allCE
F Sir William 9sler< 4ather of Modern Medicine 0'5>:G':':2
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