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Paediatrics is an 8-week placement of 6 weeks in the hospital and 2 weeks at the GP.

How you will spend your time


Your exact daily routine will depend on your regional hospital. I had quite a good time at Ipswich, with a good mix of different clinics, ward time and reading. We had to organise ourselves which clinics to go to, but with a bit of effort, one could manage to get a nice overview of Paediatrics during the 6 weeks (oncology, cardiology, respiratory, general, genetics, developmental, neonatal, GP referrals, etc.). There was also a lot of teaching, not necessarily as a separate event for the medical students, but for the entire paediatric team. Nevertheless, they were really useful sessions worth attending.

Your exposure to paediatrics at the GP depends on how happy he/she is to schedule sessions with children especially and how well they know the course. If you just tag along to normal practice business, you may not see many paediatric cases at all, especially if the placement is in the summer when little people tend have a break from colds etc. Our practice was not the best in terms of paediatric exposure, but we had a useful afternoon in a community centre at the health visitor’s clinic. These are drop-in sessions where new mothers come to weigh their babies and can ask questions etc. As the moms are usually not in a rush and often also bring their older children, it was quite a good opportunity to get lots of practice doing developmental assessments.

How to fit in pathology


Unless you are required to attend wards all day every day, this placement is quite a good time to learn enough paeds while also studying pathology. I decided to revise haematology (as part of path) alongside paediatrics, because there were quite a few childhood leukaemia cases and clinics to make it relevant. Since we were free to roam around the hospital and manage our time, I also organised some adult haematology clinics, which were really useful. Retrospectively, I should have also paid more attention to the paediatric aspects of histopathology at the time, but I was not yet organised enough since it was my first placement. I’d therefore definitely recommend working through the Histopath paeds column as well or to use at least it for guidance for general paediatrics revision.

Which books to use


Lissauer is the standard textbook that is worth using throughout the placement, even though it’s quite prosaic. For revision, I used Paediatrics at a Glance, which I found much more high yield and containing more than enough information to fill a three-minute viva.

From time to time, I also used Neonatology at a Glance (also by Lissauer) as well as Crash Course Paediatrics, but these are not essential in my opinion.

To carry around on the wards, I’d recommend the Oxford Handbook of Clinical Specialties, which I even preferred over the separate Oxford Handbook of Paediatrics. The former contains enough paeds while also giving the opportunity to look up other topics, especially obstetrics, as there is quite a lot of overlap. It was also useful to read up on pathology, e.g. screening etc. However, as the separate Oxford Handbook of Paediatrics is written by a Cambridge author, I’d borrow this one from the library as well. It was quite useful in the final stages of revision and I was thinking that it could have been useful earlier in the year.

For GPland, I’d recommend the Oxford Handbook of General Practice, which is especially useful for community case presentations, issues around child abuse and preparation for the case-based learning station.

How to use the resources on medportal


(Medportal is an internal Cambridge site with information for medical students.)

On the site of the paediatrics placement, there is a massive list of subjects to work through, organised in a week-by-week timetable. I looked at this in the first week, and was discouraged by the huge amount of bullet points. What I found particularly disheartening was the appearance of exotic sounding topics in the early weeks, e.g. sweet and salt water drowning, which I thought were less important at a time one is trying to gain a general overview of the subject.  Hence I abandoned the list and thankfully, I still managed to pass. However, congrats to anyone who manages to tackle this beast!

Instead, I allocated each week to a particular system, such as cardiology, respiratory, neurology, development etc., and found this worked quite well for me.

I also worked with the paediatrics podcasts and you will be able to find a summary of these soon on this website. The podcasts are relatively short and pain free, and useful in highlighting what is absolutely essential knowledge.

The podcasts listed under paeds-pathology are also ok - perhaps not as a starting point, but as material to take on board later in the year after you’ve appreciated the basics of haematology etc.



You are supposed to write a critical appraisal of a topic of your choice, as well as to discuss an ethical case. I’d recommend starting the critical appraisal quite early, since it requires a few days work if you want to do it well. E-mail me if you'd like me to send you my submissions as an example. You also need to pass an online MCQ for which you have as many attempts as you like.

What came up in the exam


The paediatrics exam is a single OSCE held at the end of the academic year. It usually has 9 stations of 12 minutes, most of them 11 minutes with 1 minute reading time. Often, there is a 3 minute viva included in the 11 minutes of action. The following is a summary of what has come up in previous years, excluding 2012 (if you have info of that year, please e-mail me and I'll add it to the summary):

Examination stations - usually 2 each year

* Developmental assessment (2013, 2011, 2010, 2008, 2007)

* Abdominal examination (2013, 2010) - no pathology, hepatosplenomegaly, PEG lines

* Cardiovascular examination (2010, 2009, 2007) - no pathology, aortic stenosis, all ages

* Respiratory examination (2009, 2008) - no pathology, asthma

Communication skills stations - usually 1 history each year

* Hx of child with a limp (2013)

* Post-streptococcal glomerulonephritis Hx (2011)

* Musculoskeletal Hx (2010)

* Nocturia Hx (2009)

* Neonatal Hx (2008)

* Cardiovascular Hx (2008)

* Neonatal jaundice Hx (2007)

Explanation and planning station - usually 1 station with time to prepare prior to the exam

* Newborn with raised TSH (2013)

* Angry mother of child with asthma (2010)

* Viral gastroenteritis (2009)

* Childhood obesity (2007)

* Infantile convulsions (2007)

Case-based learning / Community case - 1 each year

* Teenage pregnancy with potential case of abuse, other health issues (2013)

* Down syndrome (2011)

* Cerebral palsy (2009)

DVD / Data interpretation stations - 1-2 each year

* Video of child with intercostal recession, CXR of boot-shaped heart, audio file of heart murmur (2013) - followed by viva

* Febrile seizure (2011)

* Pictures of rashes (2013, 2011, 2010, 2007) - meningococcal, VZV, HSP, NAI, treatment, types of referral

* Cerebral palsy (2010, 2009, 2008) - signs, diagnosis, treatment

* Acute paediatric emergency (2008)

Practical Skills Station - 1-2 each year

* Baby check (2013) - focusing on hips, eyes, growth chart, viva on vaccinations and routine examinations

* Explain to a father how to use an inhaler on his 3y-old daughter and discuss worries about steroid use (2013) - this was a mixed practical skills and ad hoc explanation and planning station

* Inhaler or peak flow (2011, 2007)

* Growth charts (2013, 2011, 2009, 2008)

How to prepare for the exam


Unfortunately, paeds was the specialty I managed to find least time for once exams approached. I think many others had the same problem. Therefore, my revision was very focused on what had come up in previous exams (see above). Nevertheless, I felt very confident during the paeds exam, probably because thorough preparation for path and working steadily throughout the year did pay off in the end. I therefore suggest to stay calm and not to worry too much even if you feel like you should have made more time for paeds in the final stages.

A very useful way of preparation was a paediatrics course at the BMA (Essential Paediatrics by AskDrClarke), which I attended halfway through the year. I’d definitely recommend this to everyone as it really drummed in the most important principles (these are sometimes left out in Cambridge teaching at the cost of much specific detail).


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