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Self-assessment for the Diploma in Child Health.
  1. N GREWAL
  1. Department of Paediatrics, Horton Hospital, Banbury, UK

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    Self-assessment for the Diploma in Child Health. By W-C Leung, A Minford. (Pp201; £14.99). Arnold, 1997. ISBN 0 340 67720 1 .

    The diploma in child health (DCH) is allegedly the most difficult of the several diplomas in clinical medicine offered by the Royal Colleges. A senior colleague remarked that the DCH has a “significant failure rate” and is “really a mini-membership exam”. As such, it demands a deal of respect.

    Most candidates for the DCH are general practitioner trainees, of whom the majority will have had at most a six month senior house officer post in hospital paediatrics. Thus, many candidates come to the DCH with a shortfall in experience of community paediatrics, with little teaching dedicated to “DCH style” topics, and with variable advice on suitable reading lists.As the DCH only has two sittings each year, it is likely that by the time of the examination, the candidate will no longer be working in paediatrics. For many, it is their first experience of a rigorous postgraduate examination.

    These are the problems. The authors have produced a compact and functional book which claims to be the only revision book specifically for the DCH. Having sat the examination in 1998, I can readily verify that the questions are convincingly of the “College style” and the formats are accurate reproductions.

    With one mock examination presented after another (five in all), the book is clearly not a browser. The model answers to the questions are annotated and concise—as indeed they need to be. The authors rightly emphasise that all parts of the written papers are compulsory and that correct allocation of time under pressure is essential. For the candidate early in his revision, however, there is no referencing of the answers for further reading. Indeed the matter of a bibliography is peculiarly avoided altogether.

    In the written paper it is essential to get “on the right wavelength” of the question and then, in response, to throw the net as widely as possible. The discussion must be broadened beyond hospital paediatrics or else many marks stand to be lost. The syllabus of the DCH is extremely broad but my own tips are: (1) be spot on with paediatric emergencies; (2) remember parents’ consent; and (3) be aware of the possibility of child abuse and non-accidental injury. Child protection laws and procedures and the exact roles of the “multidisciplinary team” require specific research and memorisation. Advice on how to answer multiple choice questions is hackneyed but most authorities advise the “play your hunches” approach.

    Of course, the DCH has a separate clinical examination about which this book offers detailed and practical advice, but does so without diagrams or colour plates. A well constructed table of developmental milestones is given, as is a useful algorithm for the inevitable cardiovascular short case.

    Overall, it is a well priced and practical book which would be invaluable in the final weeks of revision for the DCH written papers. Its mock tests are faithful and its model answers are thorough and accurate.

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