. .

,
Checklist for F_ocused. '1istory taking
.
( As p~r system
. .
involved)
. ' ' ~

( 15 min station)
. <~
... .
. Student name: .oate:.,
' ·. .
· : .· .·
~erieral department: · . . .,. -~n.cti·9 f.roun~r ·~lh year :·.
·... ••. •
Introductory statem~·n t {writt~n at the station or stated by exa·miner to ~andidate) ·
Mark Task ID ID ID ID ID ID ID ID ID ID

1 Mark - Welcome patient and parent,

introduces self, explains role & gains consent

1 Mark Personal History

1 Mark Complaint

Pres_ent History

5 Mark Analysis of complaint(2 mark)

. .. Symptoms of affected system (1mark)

Common symptoms of other systems (1mark)

.. Medical Care: Investigations, {reatment(1mark)

1 Mark Perinatal History

Antenatal

Natal

Neonatal
1 Mark Developmental I ..
History
.. : . I •
Mental .
I•

Motor
 ..
.. ..
Nutri tiona l Histo ry .. .. ....... ., .
:
1 Mark .. · ·.
: :
..•,·:
: .. . • " ·' ..
Type of feeding .. .· .. .. ... ..
.. .. ·.
:_., ..: . .. .. •.... ·.·. .. ·- . . ..
- ·'
. Weani~g · . ..
..;·:, .
... ..,
....
,.
- ..· •.
., .. .
..
:

, .. ..
, . ,. ,.
Supplem_~..nts: ..
. : .. .... ·-: ·
... '
. .. ; .. ..
. ... ,
... ccina,tfon His.! ory
'
..
C

.
....
.'
·. ..
. .-
· ,•
-·..'
..
..
0 .5 .!Vlark Va_ .. .,
; ,.

0.5 Mark Past Histo ry ·

Significant illness
Significant Events

1 Mark Fami ly Histo ry

Consanguinity
Similar Condition

2 Mark Global assess ment :

s-
-Than ks patien t and offers help to redres
.
- positiv e finding s
- Summ arizes appro priate ly with only the ..
. ..
-State s the provis ional diagno sis
mann er
- Perfo rms in a confid ent, fluent , profes sional

Total Mark (15 mark s)

N.B Marks for Comm unica tion , perso nal,

Comp l~int and prese nt histo ry are fixed.
Howe ver as per the rest items in histor y
..
it could be Indivi dualiz ed as per differ ent Case Diagn osis
y in CNS cases and so on.
Eg more marks on perina tal and devel opme ntal histor
, , ••
,,
... . ' •:

.. .
,;