Paediatrics is an 8-week placement of 6 weeks in the hospital and 2 weeks at the GP.
How you will spend your time
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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
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.
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
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.
What came up in the exam
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
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).