Making the case for a diploma in child health
Should you be chasing another diploma or practising? Dr David Hall gives his view
My top tips
lPlanning is paramount. Involve other professionals. Child-related tutorials with your trainer, sessions with the health visitor, visit the local paediatric audiology services, arrange to sit in on specialist paediatric outpatients, and get paediatric registrars and consultants to teach you on common conditions and test you on clinical skills.
lUseful textbooks include Notes for the DCH by Gilbertson and Walker, and Self-Assessment for the Diploma in Child Health by Wai-Ching Leung and Adrian Minford. Although aimed at the Royal College of Paediatrics and Child Health exams, the book titled MRCPCH Part 1 Practice MCQs with Individual Subject Summaries by Mark Beattie is a useful and up-to-date resource.
lLeave yourself plenty of time to prepare. Check with your VTS office how much study leave you are allowed and remember you will see plenty of children in your daily surgeries to develop your consultation skills and examination technique.
lLocal paediatric guidelines can be insightful, including diagnosis and management of topics such as asthma, bronchiolitis, gastro-oesophageal reflux, jaundice, UTI, diabetes, febrile convulsions, eczema, meningitis, SIDS, pyloric stenosis, gastroenteritis, Kawasaki disease and child abuse.
lSpeak to people who have done
the exam before, read the guidelines
and handbook available from the RCPCH website, and learn the key topics.
Preparing to pass the exam
The diploma consists of two written parts and one clinical. Written paper 1 is a two-hour exam and consists of 60 multiple-choice questions. Part 2 is a three-hour exam with 10 short note questions (for instance: you suspect a child has speech delay, how do you manage this situation?), and two case commentaries answering questions around an unfolding scenario. You must pass paper 1 to get through to the clinical part of the exam.
The clinical has a long case and here the emphasis is on history taking and examination, assessment of growth and development. You have 40 minutes with the child and parent followed by 20 minutes with two examiners discussing the case, its management and further investigation if appropriate. This in turn may lead on to general questioning on important topics. In your clerking, time spent on psychosocial aspects and educational needs is time well spent.
Try to leave yourself time towards the end of the 40 minutes to prepare for the examiners. Check through your clerking, make a summary, think about issues relating to the child's problems and consider any potential discussion points that might come up with the examiners. The short cases last 30 minutes and will involve developmental testing, examination technique and spot diagnosis. This is to assess whether you have competent clinical skills, looks at your approach to patient and parent, and your ability to recognise and interpret signs.
The college website (http://www.rcpch.ac.uk) provides very useful information and forms.