Information for Candidates on the Diploma in Child Health Examination (DCH)

Conjoint Board of the Royal College of Surgeons in Ireland and the Royal College of Physicians of Ireland

Information for Candidates on the Diploma in Child Health Examination (DCH)

1. General Information

Prior to application, candidates must have completed 4 months training in a recognised full-time paediatric post. The training must be post-registration, internship training is not eligible. The paediatric unit should contain at least 20 acute beds. Candidates who apply online must immediately follow-up their applications with the necessary paperwork i.e. certification of four months paediatric training signed and stamped original Licence of registration, medical council certificate and two passport size photographs. Those candidates who apply online and are not eligible will be charged 200 euro administration fee.

The Diploma in Child Health is an exam of relevance to paediatric trainees, paediatric surgical trainees, GP trainees and others who wish to have some exposure to and experience of acute hospital based paediatrics, child development and child health surveillance. The RCSI DCH is delivered in spring and autumn each year. The governing body of the examination is the Conjoint Board of the RCSI and RCPI. The rules state that candidates must have performed six months paediatric residency in a recognised post prior to applying.

The DCH is of relevance particularly to GP trainees and to paediatric trainees. The emphasis in the Diploma in Child Health is put on acute common paediatric illnesses, prevention of paediatric illnesses including injuries, immunization, child growth and development, well child surveillance. It also includes paediatric surgery, common paediatric psychiatric conditions and child protection. The examination is usually taken in the first year of training and includes an MCQ, written paper and clinical examination.

We now wish to formally incorporate the DCH into paediatric training in year one of basic specialist training to ensure that paediatric trainees have a detailed knowledge of all the core competencies in paediatrics and child health . GP trainees likewise need these basic competencies to look after children in a primary care setting in the future

For overseas trainees it is a useful introduction to the British and Irish model of clinical examination and is taken in the first year or second year of training.

This short document includes information regarding the DCH. The Examination Office, RCSI, takes examination queries.

2. Who should do the DCH?

Paediatric trainees, GP trainees, public health doctors and other doctors who want experience of child health.

Why;

Useful test of child health and basic clinical skills. Allows the candidate to be assessed on his/her knowledge of core skills/competencies in Paediatrics

When;

April and September each year (see calendar on RCSI website)

Where;

Written component in the Royal College of Surgeons in Ireland, 123. St. Stephen’s Green Dublin 2. The college is located in Central Dublin with numerous tram and bus connections. The Clinical component is held in the Children’s University Hospital Temple Street (North Central Dublin) and Our Lady’s Hospital for Sick Children, Crumlin, Dublin 12 (West Dublin – about 8 kilometres from city centre)

How to apply?

Complete an application form which can either be downloaded from the College website or apply online to the Examinations Office RCSI. Candidates who pass the examination are required to pay a further Diploma fee before their Diploma is granted.

3. General advice to candidates.

a. Ask questions during your paediatric rotation and view your theory knowledge of paediatrics based on whatever text you used for the Final Medical Examination.

b. Give thought to community paediatrics, preventive paediatrics, some basic child psychiatry and child behavioural problems.

c. Know the common surgical conditions to include appendicitis, torsion of the testes, intussusceptions, hernias, circumcision, pyloric stenosis, in other words, common paediatric surgical conditions that can present to any hospital during your paediatric rotation.

d. Be familiar with the immunization schedule and national immunisation guidelines.

e. Familiarise yourself with some basic childhood nutrition, particularly iron deficiency anaemia, failure to thrive, obesity, caloric needs to children.

f. Go through MCQ questions on your own or with colleagues.

g. Write model answers to typical questions and have your performance appraised by an experienced colleague.

h. Practice clinical examination of systems. The examiners have noted in the DCH that some candidates appear without having rehearsed or practised their clinical skills for some years and hope it will be all right on the day. It often is not.

i. On the day make sure you know the hospital you are going to, allow plenty of time to get there and arrive before the time you are expected. Please obey instructions by the invigilators and do not communicate with your colleagues if you are so asked.

4. When undertaking the Clinical exam only, candidates should bring with them:

· STETHOSCOPE

· SOME SIMPLE THINGS FOR DEVELOPMENTAL ASSESSMENT

· EXAMINATION CARD AND NUMBER.

5. Diploma in Child Health; Core topics

a. Basic paediatric medicine. Common childhood illnesses.

b. Basic paediatric surgery.

c. Behavioural problems in childhood.

d. Child growth and development.

e. Child protection – laws, child abuse, prevention.

f. Early childhood nutrition.

g. Preventive paediatrics : screening, immunization, injuries and health promotion.

h. Mental and physical handicap in children: causes, consequences, services.

i. Social paediatrics: society, family, basic health economics.

j. Communication skills.

k. Disability – hearing, speech, vision, etc.

l. Child health surveillance and screening

m. Infectious diseases of childhood

n. Nutritional problems – iron deficiency, failure to thrive, obesity (etc)

6. DCH Candidate information.

· DCH overseen by Conjoint Board RCPI/RCSI

· Application to Examination Office, RCSI.

E mail:

Fax: 4022454

Tel: 4022214

· Application for admission to the examination must be accompanied by the full amount of fee payable. Candidates who pass the examination are required to pay a further Diploma fee before their Diploma is granted.

· Any candidate wishing to cancel his application either before or after the closing date will forfeit their fee in FULL.

· Any representation, which a candidate may wish to make with regard to the conduct of the examination, must be addressed to the Examinations Officer and under no circumstances to any of the Examiners.

· The Conjoint Board may refuse to admit to the Examination or to proceed with the Examination of any candidate who infringes any regulations of the Board or who is considered by the Examiners to have been guilty of behaviour prejudicial to the proper conduct and management of the examination.

· As the number of entries to the examination is limited to 80 candidates, early application is advised.

· The maximum number of opportunities offered to each candidate to sit the exam is four.

· Important: Candidates are advised to make arrangements for Visas (if appropriate) before the closing date for entry to the examination.

· DCH standard based on knowledge, skills, attitude of paediatric and GP trainees in basic paediatric medicine and common childhood illnesses

7. Model Timetable

Friday 09.30 – 11.30 MCQ

12.00 – 13.00 Written

Location: 123, St. Stephen’s Green, Dublin 2.

Monday 08.30 Clinicals – Children’ University

Hospital Temple Street and Our Lady’s Hospital, Crumlin.

Tuesday: As above

Please note the clinical exam is held over two days (Monday and Tuesday). Candidates will only be required to attend on 1 day.

NOTE;

· DCH ID card must be shown at written and clinical examinations.

8. DCH Examination - Model paper

The examination will consist of an MCQ lasting 2 hours and an essay section lasting 1 hour as below:

Examination format:

1. Written Section

a. Multiple Choice Paper (MCQ)

50-question True/False MCQ paper

No negative marking

- Consists of approximately 10 medical questions

10 surgical questions

10 community questions

10 development/psychiatry/behaviour questions

10 miscellaneous

MCQ = 60 marks

b. One Problem-Based Question

PBQ = 20 Marks

c. One Short Notes Question

Marks = 20 Marks

Total Written marks = 100

Pass Mark = 50

2. Clinical Section

The Clinical examination is subdivided into 4 different stations, with students rotating and being examined in each of those sections. They are:

a. Clinical Station

- Focus on clinical skills, e.g. a rash, heart, joint, abdomen

- Time: 10 minutes

Clinical Station = 20 Marks

b. DVD / Picture Station

- A candidate would be asked to view a short DVD or picture in the presence of two examiners, e.g. a child with a seizure , a child with acute respiratory distress or a developmental video

- Time : 10 minutes

DVD / Picture Station = 10 Marks

c. Communication Station

- In the presence of two examiners you will be given a scenario (eg an eight year old with recurrent headaches) and the examiners will act as parents asking you a series of questions

- Time: 10 minutes

Communication Station = 10 Marks

d. Data Interpretation Station

- Candidates will be expected to interpret Centile Charts, EEG Report,

Urine Report, Chest x-ray, etc

- Time: 10 Minutes

Data Interpretation Station = 10 Marks

Total Clinical mark = 100 Marks

Pass Mark = 50

3. Overall Result

Pass / 50 or over in theory ( 45 or over is compensatable)
50 or over in clinical & pass 3 of the 5 clinical stations
Clinical Fail / Total mark less than 50 in clinical stations
Fail in 3 of the 5 clinical stations even if total mark is above 50%
Bad fail i.e. less than 7.5 in both short case stations
Overall Fail / Fail in Clinical (clinical failure not compensatable)
Theory mark less than 45 (non compensatable fail)
Combined mark less than 100

9. DCH recommended reading

a. A basic Paediatric text such as Illustrated Textbook of Paediatrics by Tom Lissauer, Mosby Wolfe 2004 or alternative of your choice such as Hull, Levene, Robinson etc..

b. Paediatric and Child Health. A textbook for the DCH. M Bellman Harcourt 2000.

c. Health for all children. David Hall. Oxford University Press 2003.

d. From Birth to Five Years. Mary Sheridan. Routledge 1997.

e. Community Paediatrics. Polnay