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Folio edition · Set in Instrument Serif & Archivo

Paeds · Cases

Cases

829 units across 27 domains — Long-case, short-case, and clinical-station preparation.

Back to PaedsJump to first domain
Paediatrics Fellowship Cases
Plate — paedsMedVellum Press
829Units
27Domains
infectious-diseasesclinical-assessment-and-reasoninginvestigations-procedures-and-technologypreventive-and-community-paediatricspaediatric-dermatologyfetal-neonatal-and-perinatalgrowth-development-and-behaviourgastroenterology-hepatology-and-nutritionnephrology-urology-fluids-and-electrolytesendocrinology-diabetes-and-growthmental-behavioural-and-psychosomaticgenetics-dysmorphology-and-metabolismneurology-neurodisability-and-neuromuscularadolescent-and-young-adult-medicineprofessional-practice-and-evidenceclinical-pharmacology-and-therapeuticsacute-care-resuscitation-and-toxicologyallergy-and-immunologyhaematology-oncology-and-transfusionent-hearing-and-oral-healthrheumatology-musculoskeletal-and-sportspain-palliative-and-end-of-life-carerespiratory-sleep-and-airwaycardiologychild-safety-and-social-paediatricsophthalmologyrural-remote-and-contextual-paediatrics
AtlasPaedsCases

Domain

infectious-diseases

39

structured clinical encounter

'It hurts at the line' — suspected central-line-associated bloodstream infection structured encounter

A bedside structured encounter testing recognition and surveillance definition of central-line-associated bloodstream infection, paired cultures and empiric therapy, the line-removal decision, antimicrobial de-escalation, communication and safe handover for a technology-dependent child.

Open

structured clinical encounter

'They're not themselves' — paediatric sepsis structured encounter

A bedside structured encounter testing recognition and classification of paediatric sepsis, delivery of the first-hour bundle, fluid and vasoactive escalation with reassessment, source control, communication and safe handover.

Open

paediatric long case

Animal bites, arthropod bites and zoonoses: Case

Clinical case of a school-age girl with cat scratch disease presenting as subacute regional lymphadenopathy after a kitten scratch, covering the inoculation lymphoreticulosis pathway, the differential of tender lymphadenopathy, the supportive and azithromycin decisions, and the safety-netting and follow-up plan.

Open

osce communication and clinical reasoning station

Approach to fever by age and immune status — OSCE

OSCE counselling and clinical reasoning station for a febrile young infant and parental concern.

Open

paediatric long case

Cellulitis, abscess and necrotising soft-tissue infection: Case

Clinical case of a febrile toddler with periorbital swelling found to have orbital cellulitis from ethmoid sinusitis, covering the periorbital versus orbital distinction, imaging, intravenous antibiotics, and the threshold for surgical drainage.

Open

paediatric long case

COVID-19 and multisystem inflammatory syndrome in children: Case

Clinical case of a school-age child presenting with persistent fever, abdominal pain, shock, and cardiac involvement three weeks after a household COVID-19 illness, covering recognition of MIS-C, the pivotal echocardiogram, cautious resuscitation, immunomodulation, anticoagulation, and cardiac follow-up.

Open

paediatric long case

Dengue and other arboviral infections: Case

Clinical long case of a school-age returned traveller with dengue with warning signs progressing to compensated dengue shock, covering the WHO 2009 classification, the haematocrit-driven fluid strategy, the harmful-no-bolus principle, transfusion thresholds, recovery-phase fluid taper, and family safety-netting.

Open

osce communication and shared planning

Explain a suspected brain abscess to a worried parent — OSCE

OSCE communication and shared-planning station: explaining the recognition of a suspected brain abscess to a parent, the imaging and surgery, the antibiotics and the recovery course, and the source-control plan — with empathy, honesty and without overpromising the prognosis.

Open

osce communication and shared planning

Explain PFAPA and the management plan to parents — OSCE

OSCE communication station: explaining periodic fever and PFAPA to parents, the meaning of a rise-then-fall CRP, how to abort attacks with a single dose of steroid, the role of tonsillectomy, and the safety-net features that would warrant urgent review.

Open

osce communication safety-net

Explaining a negative malaria film and the plan to repeat it — OSCE

Communication OSCE on explaining to a worried family why a single negative malaria blood film does not exclude malaria, why the film must be repeated, and what the safety-net plan is — delivered in plain, non-alarmist language that holds the family's trust through an anxious waiting period.

Open

osce communication diagnosis treatment prevention

Explaining a positive antenatal syphilis screen — OSCE

Communication and structured-discussion OSCE on explaining a positive antenatal syphilis screen in pregnancy to a woman at 30 weeks gestation, covering what the diagnosis means, why immediate benzathine penicillin treatment is needed and why it must be completed at least four weeks before delivery, the Jarisch-Herxheimer reaction, the neonatal plan at delivery, partner treatment, and how screening and treatment prevent congenital infection.

Open

osce communication safety-net

Explaining a positive hepatitis B result and the household plan — OSCE

Communication OSCE on explaining to a newly arrived refugee family that their well-looking daughter's hepatitis B surface antigen test is positive, what chronic hepatitis B means, what further tests are needed, the household-contact vaccination plan, and the safety-net for the long term — delivered through a trained interpreter in plain, non-alarmist language that holds the family's trust and frames the result as a manageable, monitored condition rather than a crisis.

Open

osce communication diagnosis prophylaxis feeding

Explaining an HIV-exposed infant's diagnosis and feeding plan — OSCE

Communication and structured-discussion OSCE on explaining the management of an HIV-exposed newborn to a mother newly diagnosed in pregnancy, covering why the baby's antibody test is not yet meaningful, the nevirapine prophylaxis and cotrimoxazole plan, the PCR testing schedule, the feeding decision, and how the mother's own viral suppression protects the baby.

Open

osce communication diagnosis treatment surveillance

Explaining congenital CMV, valganciclovir and hearing surveillance — OSCE

Communication and structured-discussion OSCE on explaining a diagnosis of congenital cytomegalovirus to the parents of a 10-day-old baby, covering the nature of the infection, the need to confirm it with saliva PCR within the 21-day window, the decision to treat with valganciclovir for six months, the importance of long-term audiology surveillance because hearing loss can be late-onset, and the prevention of CMV in a future pregnancy.

Open

osce communication diagnosis counselling high-risk-contact

Explaining fifth disease and protecting the pregnant contact — OSCE

Communication and structured-discussion OSCE on explaining a diagnosis of erythema infectiosum (fifth disease, parvovirus B19) in a well 6-year-old to a parent, covering the benign course and the fluctuating lacelike rash, the paradox that the child is contagious before and not after the rash, and why the child's mother — who is twenty weeks pregnant — needs same-day parvovirus B19 serology and fetal-medicine referral because a non-immune mother is at risk of fetal hydrops and intrauterine death.

Open

osce communication diagnosis infectivity prevention

Explaining hand-foot-and-mouth disease — OSCE

Communication and structured-discussion OSCE on explaining a diagnosis of hand-foot-and-mouth disease in a toddler to a parent, covering the nature of the illness, the febrile and infectious period, why the child must be excluded from childcare, what red flags should bring them straight back (the EV71 brainstem signs), and why there is no routine vaccine despite vaccines existing in China.

Open

osce communication invasive candidiasis line removal

Explaining invasive fungal disease and central-line removal — OSCE

Communication and structured-discussion OSCE on explaining an episode of candidaemia and central-line removal to the parents of a neutropenic oncology child, covering why the line must come out, why an intravenous antifungal is needed, what the retinal examination is for, what the duration of therapy means, and how the next cycle will be protected by prophylaxis.

Open

osce communication isolation outbreak response

Explaining isolation and an outbreak response — OSCE

Communication and structured-discussion OSCE on explaining a norovirus gastroenteritis outbreak on a paediatric ward to a parent: why the bay is closed, why the family's visiting is restricted, why staff are washing with soap and water rather than using alcohol gel, and how the unit protects a vulnerable sibling with a central line — framed within standard and transmission-based precautions, the WHO 5 Moments and the stepwise outbreak response.

Open

osce communication diagnosis isolation prevention

Explaining measles isolation and a pregnant contact — OSCE

Communication and structured-discussion OSCE on explaining a diagnosis of measles in an unvaccinated 4-year-old to a parent, covering the nature of the illness, the airborne-isolation and four-day exclusion rule, why a household contact who is eight weeks pregnant needs urgent serological assessment, and how the two-dose MMR schedule and herd immunity prevent the next case.

Open

osce communication isolation prophylaxis catch-up vaccination

Explaining measles isolation, prophylaxis and catch-up vaccination — OSCE

Communication and structured-discussion OSCE on a suspected measles case in an unvaccinated school-age child: explaining the diagnosis, the airborne isolation and four-day exclusion rule, why the household — including a pregnant aunt and an infant sibling — needs urgent assessment and post-exposure prophylaxis within its window, why the unvaccinated schoolmates need MMR within 72 hours, and how the catch-up vaccination campaign that lifts coverage above the herd-immunity threshold prevents the next outbreak.

Open

osce communication diagnosis isolation prevention

Explaining mumps, isolation and the MMR strategy — OSCE

Communication and structured-discussion OSCE on explaining a diagnosis of mumps in a 7-year-old to a parent, covering the nature of the illness and its complications, the five-day isolation and exclusion rule, why the household contacts — including a pregnant aunt and an immunocompromised grandparent — need review, and how the two-dose MMR schedule and the waning-immunity problem fit the prevention picture.

Open

osce communication neonatal hsv exposure pathway

Explaining neonatal HSV and the exposed-neonate pathway — OSCE

Communication and structured-discussion OSCE on explaining a maternal genital HSV exposure at delivery to new parents, covering why their day-old baby needs assessment and surface swabs, why empirical aciclovir may be started, what the three neonatal disease classes mean, the six-month suppression after CNS or disseminated disease, and how future pregnancies are protected by suppressive aciclovir and caesarean.

Open

osce communication diagnosis isolation prophylaxis

Explaining pertussis, isolation and prophylaxis — OSCE

Communication and structured-discussion OSCE on explaining a diagnosis of pertussis in a 7-year-old to a parent, covering the nature of the illness, the five-day isolation and exclusion rule, why the household — including a newborn sibling and a pregnant aunt — needs prophylaxis, and how vaccination and the mother's own maternal-Tdap history fit the prevention picture.

Open

osce communication safety-net

Explaining the fever-after-travel rule and prophylaxis adherence — OSCE

Communication OSCE on explaining to a visiting-friends-and-relatives family why malaria prophylaxis must be taken as prescribed and continued after return, why the child still needs bite avoidance despite the tablets, and what the fever-after-travel rule is — delivered in plain, non-alarmist language that holds the family's trust and converts advice into a plan they can act on.

Open

osce communication hepatitis B exposed neonate pathway

Explaining the hepatitis B exposed-neonate pathway — OSCE

Communication and structured-discussion OSCE on explaining to new parents why their day-old baby, born to an HBsAg-positive mother, needs the hepatitis B birth-dose vaccine and immunoglobulin within 24 hours, what chronic hepatitis B means and its long-term sequelae, how maternal tenofovir and a future pregnancy are protected, and what follow-up testing at nine to twelve months confirms.

Open

osce communication diagnosis exclusion prophylaxis

Explaining varicella, exclusion and post-exposure prophylaxis — OSCE

Communication and structured-discussion OSCE on explaining a diagnosis of varicella in a vaccinated child to a parent, covering the nature of breakthrough illness, the exclusion-until-crusted rule, why a pregnant family friend and a newborn niece need urgent assessment and post-exposure prophylaxis, and how vaccination and household immunity fit the prevention picture.

Open

osce communication and clinical reasoning station

Infections in immunocompromised children — OSCE

OSCE communication and clinical reasoning station for a newly diagnosed oncology child and parental counselling on the fever action plan.

Open

paediatric long case

Influenza and antiviral treatment: Case

Clinical case of a 6-year-old boy with asthma who develops influenza and progresses to viral pneumonia and a biphasic secondary bacterial pneumonia, covering risk-stratified antiviral use, escalation of respiratory support, empirical antibiotic selection, and prevention through vaccination and prophylaxis.

Open

paediatric long case

Malaria in children: Case

Clinical case of a febrile returned traveller found to have uncomplicated vivax malaria, covering the travel history, blood film and rapid diagnostic test interpretation, artemisinin-combination therapy, primaquine radical cure after glucose-6-phosphate dehydrogenase testing, and relapse surveillance.

Open

paediatric long case

Meningitis and encephalitis: Case

Clinical case of a febrile infant with non-specific signs found to have group B streptococcal meningitis, covering recognition, CSF interpretation, neonatal empiric therapy, complications, and developmental follow-up.

Open

paediatric long case

Parasitic infections in children: Case

Clinical case of a recently arrived refugee child with iron-deficiency anaemia and eosinophilia found to have hookworm and Strongyloides coinfection, covering the screening approach, stool microscopy interpretation, treatment with albendazole and ivermectin, and the essential principle of screening before immunosuppression.

Open

osce communication and clinical reasoning

Prolonged fever in a returned traveller — communication OSCE

OSCE on counselling a family through a suspected diagnosis of extensively drug-resistant enteric fever: blood culture before antibiotics, antibiotic stewardship, safety-netting for complications, and vaccine and public-health follow-up.

Open

paediatric long case

Staphylococcal scalded skin syndrome: Case

Clinical case of a neonate in a postnatal ward who develops generalised desquamation from a staphylococcal conjunctival focus, covering the diagnosis of Ritter disease, the distinction from drug-induced epidermal necrolysis, the search for a nursery carrier, and the antibiotic and skin-care management.

Open

structured clinical encounter

The antibiotic that won't stop — antimicrobial stewardship structured encounter

A bedside structured encounter testing empiric antimicrobial selection, developmental dosing, therapeutic drug monitoring, de-escalation, IV-to-oral switch, penicillin allergy assessment and delabeling, and duration review within an antimicrobial stewardship framework.

Open

structured clinical encounter

The well-appearing child with a positive culture at 24 hours — structured encounter

A structured clinical encounter testing the modern approach to bacteraemia and occult bloodstream infection: assessment and risk-stratification of a well-appearing febrile child, a defensible discharge with a safety-net and named result ownership, and the response when a blood culture turns positive at 24 hours, including the distinction of pathogen from contaminant.

Open

osce assessment and communication station

Tuberculosis in children — OSCE assessment and communication station

Observed structured encounter testing classification of childhood tuberculosis on the exposure-infection-disease spectrum, symptom-and-contact assessment, chest radiograph and Xpert MTB/RIF investigation interpretation, the 4-month SHINE regimen for non-severe disease and 6-month regimen for severe disease, emergency recognition of tuberculous meningitis, and the public-health duty of notification, contact tracing and source-case finding.

Open

structured-oral

Undifferentiated fever and fever without a source in infants and children — formative case

A MedVellum formative structured clinical encounter assessing the candidate's approach to a 40-day-old febrile infant without a localising source. Tests risk-stratification, investigation selection, prediction-rule application, empiric antibiotic choice and safety-netting. Not an official board station.

Open

paediatric long case

Urinary tract infection and pyelonephritis: Case

Clinical case of a febrile young infant with vomiting and irritability found to have Escherichia coli pyelonephritis, covering urine sampling before antibiotics, urinalysis and culture interpretation, empiric therapy and the oral versus intravenous decision, and selective follow-up imaging.

Open

structured clinical encounter

Viral upper respiratory tract infection and the common cold — structured clinical encounter

Structured encounter testing the assessment and management of a child with an uncomplicated viral cold whose parents expect an antibiotic, and the recognition of an evolving complication in a younger sibling, with emphasis on red-flag assessment, antimicrobial stewardship and safety-netting.

Open

Domain

clinical-assessment-and-reasoning

26

osce-structured-encounter

‘Please just check her ears’ — structured PE OSCE

OSCE-style encounter testing age-adapted examination sequencing in a febrile infant, measurement technique, incomplete-exam honesty, red-flag conversion and caregiver communication.

Open

structured clinical encounter

‘They’re not themselves’ — seriously ill child structured encounter

A bedside structured encounter testing recognition of serious illness, PAT, focused ABCDE, communication, early escalation, safeguarding, handover and disposition.

Open

osce communication and history station

Age-adapted history OSCE — toddler fever and adolescent confidentiality

Observed structured encounter testing multi-party paediatric history, interpreter use, confidential adolescent technique, teach-back and safety-netting.

Open

osce skills station

Age-specific normal vital signs and physiological ranges — OSCE

OSCE station.

Open

osce clinical reasoning and communication station

Bayesian test-selection OSCE — neonate residual risk and caregiver counselling

Observed structured encounter testing pre-test estimation, selective investigation, residual-risk counselling after a negative marker, and handover of pending results.

Open

structured clinical encounter

Contested discharge and retrieval — structured clinical encounter

Structured encounter testing pre-discharge reassessment, caregiver concern, capability-matched disposition, I-PASS/ISBAR handover, retrieval decision and safety-netting teach-back.

Open

osce communication and clinical reasoning station

Failure to thrive and faltering growth: diagnostic approach — OSCE

OSCE counselling and management station for faltering growth.

Open

osce communication and clinical reasoning station

Fatigue and lethargy in children and adolescents — OSCE

OSCE counselling and clinical reasoning station for adolescent fatigue.

Open

osce skills station

Growth measurement, charting and interpretation — OSCE

OSCE station.

Open

osce communication and clinical handover station

Handover and consultation OSCE — ED to ward with residual risk

Observed structured encounter testing I-PASS handoff, ISBAR surgical consult, interpreter use and residual-risk communication.

Open

structured clinical encounter

Home-ventilated child with night alarms — structured clinical encounter

Structured encounter testing CMC recognition, technology-dependent ABCDE, device-versus-disease reasoning, emergency care planning, polypharmacy reconciliation, caregiver partnership and safe disposition.

Open

osce communication and clinical reasoning station

Incidental findings OSCE — trauma CT cyst counselling and cascade control

Observed structured encounter testing classification of an incidental imaging finding, cascade control, residual-risk counselling and safe handover without underdiagnosis.

Open

osce communication and clinical reasoning station

Interpreting common paediatric laboratory reference ranges — OSCE

OSCE station on interpreting flagged paediatric laboratory results and counselling caregivers.

Open

osce communication and clinical reasoning station

Lymphadenopathy and organomegaly: diagnostic approach — OSCE

OSCE counselling station for paediatric lymphadenopathy and EBV-related organomegaly concerns.

Open

osce communication and systems station

Medical home and continuity OSCE — complex care discharge and transition counselling

Observed structured encounter testing continuity assessment, care-coordination planning, ED loop closure and transition counselling.

Open

osce communication and systems station

Medication reconciliation OSCE — complex discharge counselling

Observed structured encounter testing BPMH skills, discrepancy prioritisation and discharge medication teach-back for a child with medical complexity.

Open

structured clinical encounter

Not their normal — multimorbidity and diagnostic overshadowing structured encounter

A bedside structured encounter testing multimorbidity framing, refusal of diagnostic overshadowing, baseline-aware assessment, pain search, polypharmacy safety, communication and residual-risk handover.

Open

osce communication and clinical reasoning station

Oedema in children: diagnostic approach — OSCE

OSCE counselling and clinical reasoning station for new-onset paediatric oedema.

Open

osce communication and remote assessment station

Paediatric telehealth OSCE — video triage and rural consult

Observed structured encounter testing telehealth readiness checks, remote examination coaching, stewardship, EMS activation language and safety-netting.

Open

osce communication and clinical reasoning station

Pallor in children: diagnostic approach — OSCE

OSCE counselling and management station for paediatric pallor.

Open

osce history management and communication station

Poor feeding OSCE — neonate triage and preschool feeding plan

Observed structured encounter testing threat-first assessment of neonatal poor feeding and communication of a multidisciplinary plan for chronic selective feeding with growth faltering.

Open

osce clinical reasoning and communication station

Problem representation OSCE — infant return visit and residual-risk counselling

Observed structured encounter testing one-sentence problem representation, threat-first differential, diagnostic pause, residual-risk counselling and handover.

Open

structured clinical encounter

Rising PEWS overnight — structured clinical encounter

Bedside structured encounter testing PEWS interpretation, incomplete observations, caregiver concern, age-adapted ABCDE, MET activation, handover, disposition and systems reflection.

Open

osce communication and systems station

Shared-care planning OSCE — multi-level co-management and loop closure

Observed structured encounter testing shared-care assessment, written plan design, oncology hub-and-spoke counselling and transition communication.

Open

osce development and communication

Toddler speech concern — developmental surveillance OSCE

OSCE on surveillance, screening choice and referral counselling.

Open

osce communication and clinical reasoning station

Weight loss in children and adolescents — OSCE

OSCE counselling and clinical reasoning station for adolescent weight loss.

Open

Domain

investigations-procedures-and-technology

34

structured clinical encounter (resuscitation leadership)

4 J per kg and resume — shockable arrest

A bedside structured clinical encounter testing recognition of a shockable cardiac arrest rhythm, the decision to deliver an unsynchronised 4 joules per kilogram defibrillation shock, correct pad placement and mode selection, the shockable-arrest drug sequence, immediate resumption of compressions, and the distinction from synchronised cardioversion and transcutaneous pacing.

Open

structured clinical encounter (resuscitation leadership)

60 seconds, then the bone — intraosseous access

A bedside structured clinical encounter testing recognition of the 60 to 90 second rule for failed intravenous access in a shocked child, the decision to place an intraosseous needle, the proximal tibial landmark and weight-based needle, confirmation, drug administration at intravenous doses, the conscious-child lidocaine regimen, and the prevention of extravasation, compartment syndrome and infection.

Open

imaging decision station

Acute abdominal imaging decision — OSCE

OSCE procedural station: assess an 8-year-old child with suspected appendicitis, define the clinical question that the imaging must answer, choose the first-line modality, apply the ALARA principle, and outline the pathway for the equivocal case and the contrast-study scenario.

Open

paediatric short case

Airway suction, oxygen devices and nebuliser technique: Case

Clinical case of a bronchiolitic infant failing low-flow oxygen, covering gentle suction technique, oxygen device classification and escalation to high-flow nasal cannula, and the principles of inhaled drug delivery.

Open

osce clinical reasoning and shared decision station

Artificial intelligence and clinical decision support in paediatrics — OSCE

OSCE clinical-reasoning and communication station in which the candidate works through three AI and decision-support scenarios with the ward team: a deterioration score that reads low in a sick child, a drug-interaction alert burden driving an override culture, and a deep-learning retinal image flag in the nursery — and reaches a safe, accountable plan for each.

Open

procedural skills station

Aspirate a suspected septic hip in a child — OSCE

OSCE procedural station: assess a 3-year-old febrile child with a suspected septic hip, score the prediction rule, exclude the relative contraindications, and outline the ultrasound-guided aspiration, the synovial fluid handling, the complications and the disposition.

Open

structured clinical encounter (minor trauma and procedural skill)

Assess, clean, anaesthetise, close, dress — simple laceration repair

A bedside structured clinical encounter testing the structured assessment of a frightened child with a clean facial laceration, the topical-first approach to analgesia with LET, the choice of closure method by tension and site, safe local anaesthetic dosing, and family-centred aftercare. The station also pivots to a contaminated dog bite to the hand to test the candidate's judgement on closure, antibiotics, and tetanus.

Open

paediatric short case

Bag-mask ventilation and basic airway adjuncts: Case

Clinical case of an apnoeic, bradycardic post-ictal infant needing immediate airway and ventilation, covering airway opening, mask sizing, the slow squeeze, ventilation rate by context, adjunct selection, and escalation to a two-person technique.

Open

osce procedural-planning station

Central venous and arterial access in children — OSCE

OSCE procedural-planning station for a child requiring central venous access, with a structured oral of site selection, ultrasound-guided Seldinger technique, and complication management.

Open

procedural skills station

Chest decompression in a ventilated neonate — OSCE

OSCE procedural station: recognise tension pneumothorax in a ventilated premature neonate who suddenly deteriorates with rising airway pressures, run the differential of sudden deterioration in a ventilated child, choose between needle aspiration and a small pigtail drain, identify the safe triangle and the above-the-rib-below rule, and outline drain management and the never-clamp rule.

Open

communication and decision-making station

Choose and consent a genetic test after a normal microarray — OSCE

OSCE communication and decision-making station: escalate from a normal microarray to trio whole-exome sequencing in a 4-year-old with global developmental delay, take consent for the full result space including an incidental actionable secondary finding, and explain the principles of newborn bloodspot screening for a sibling in the maternity unit.

Open

communication and procedural readiness station

Consent and prepare a child for a procedure — OSCE

OSCE communication and procedural-readiness station: assess a 4-year-old for intravenous cannulation on the ward, take valid consent and assent, deliver the developmentally matched preparation conversation, assemble the bedside comfort bundle, and explain the restraint-versus-comfort-position distinction and the documentation that makes the encounter defensible.

Open

communication and decision-making station

Counsel a parent about radiation risk and consent for a paediatric CT — OSCE

OSCE communication and decision-making station: apply the principles of radiation protection to a child referred for a CT, justify or substitute the request, counsel the anxious parent about the radiation risk in plain language, and apply the ALARA principle and the imaging-stewardship pathway.

Open

communication and decision-making station

Decide on neuroimaging after a paediatric head injury — OSCE

OSCE communication and decision-making station: apply the PECARN head injury prediction rule to a 3-year-old after a fall, decide on imaging, counsel the parent about the radiation risk of a head CT, and apply the ALARA principle.

Open

procedural skills station

Drain a paediatric skin abscess — OSCE

OSCE procedural station: assess a 6-year-old with a cutaneous abscess, perform the structured pre-drainage safety check including the red flags of necrotising fasciitis, calculate the weight-based local anaesthetic dose, choose between packing and the loop drainage technique, outline the drainage and aftercare, and discuss complications.

Open

structured clinical encounter (resuscitation leadership)

Failing airway, failing oxygen — paediatric intubation

A bedside structured clinical encounter testing recognition of the indication for a definitive airway in a child with bacterial tracheitis, the age-based tube and blade selection, the seven-step rapid sequence intubation procedure, waveform capnography confirmation, the rapid sequence drug regimen, and the prevention of hypoxia, oesophageal intubation, right main bronchus intubation and post-extubation stridor.

Open

structured clinical encounter (interpretation and management leadership)

Five steps to the diagnosis — blood gas interpretation in a sick child

A bedside structured clinical encounter testing the five-step systematic blood gas method, the choice between arterial, venous and capillary samples, Winter's formula for compensation, the anion gap and the KULT differential, the corrected sodium in hyperglycaemia, and the cerebral-oedema-safe management of diabetic ketoacidosis. The candidate must interpret the gas aloud, defend each step, and lead the fluid and insulin plan.

Open

osce emergency-management station

Gastrostomy, tracheostomy and central-line troubleshooting — OSCE

OSCE emergency-management station for a technology-dependent child with a tracheostomy that cannot be suctioned, covering the National Tracheostomy Safety Project algorithm, tract-maturity reasoning, and a late-bleed complication.

Open

radiology interpretation station

Interpret a paediatric chest radiograph — OSCE

OSCE radiology interpretation station: assess the technical quality of a child's chest radiograph, apply the ABCDEFGH systematic approach, recognise the normal paediatric thymus, and outline the radiation-aware principle that governs whether the film should have been requested.

Open

investigation interpretation station

Interpret a paediatric ECG — OSCE

OSCE investigation-interpretation station: interpret a 12-lead ECG of a 14-year-old girl with exertional and emotional syncope, apply the systematic age-referenced read, recognise the prolonged QTc, give the differential and the disposition, and outline the technical principles of paediatric ECG acquisition.

Open

investigation interpretation station

Interpret a paediatric echocardiogram report — OSCE

OSCE investigation-interpretation station: interpret a paediatric echocardiogram report of a six-year-old boy with a bicuspid aortic valve, apply the systematic read, calculate the valve gradient with the modified Bernoulli equation, interpret the Z-scores, give the differential and the disposition, and outline the prostaglandin resuscitation of a duct-dependent neonate.

Open

investigation interpretation and counselling station

Interpret a referred newborn hearing screen — OSCE

OSCE investigation-interpretation and counselling station: a 5-week-old infant referred on the newborn hearing screen. Interpret the diagnostic audiogram, tympanogram, otoacoustic emissions and auditory brainstem response together, recognise the OAE-present-ABR-absent pattern of auditory neuropathy spectrum disorder, explain the 1-3-6 milestones, and counsel the anxious parents.

Open

osce communication and shared-decision station

Medical devices, digital health and remote monitoring — OSCE

OSCE communication-and-shared-decision station in which the candidate counsels a family on the validity, equity pitfalls and deployment of three digital-health devices: a parent's smartwatch rhythm flag, a continuous glucose monitor with night-time alarms, and a home pulse oximeter for a dark-skinned infant with bronchopulmonary dysplasia.

Open

osce assessment and procedural-planning station

Paediatric venepuncture and peripheral intravenous access — OSCE

OSCE assessment and procedural-planning station for a dehydrated toddler requiring peripheral intravenous access, with a structured oral of site and gauge selection, the comfort bundle, ultrasound escalation and complication management.

Open

procedural skills station

Perform a bedside point-of-care lung ultrasound — OSCE

OSCE procedural station: perform a bedside point-of-care lung ultrasound on a febrile, tachypnoeic infant to distinguish community-acquired pneumonia from bronchiolitis. Covers probe selection, image-quality controls, the eight-zone scan, the lung artefact repertoire, integration into management, and the pitfalls of over-reliance on a single scan.

Open

procedural skills station

Perform a lumbar puncture on an infant — OSCE

OSCE procedural station: assess a 4-month-old febrile infant for a diagnostic lumbar puncture, perform the pre-LP safety check, position the child, choose the needle, and outline the technique, opening pressure measurement, sample handling and complications.

Open

procedural skills station

Perform procedural sedation for a fracture reduction — OSCE

OSCE procedural station: assess a 5-year-old before procedural sedation for an urgent forearm fracture reduction, perform the pre-sedation safety check, choose and dose the agent, set up the monitoring and rescue equipment, and outline the management of deterioration and the recovery and discharge criteria.

Open

structured clinical encounter (neonatal vascular access and procedural safety)

Place the right line at the right depth — umbilical venous and arterial catheterisation

A bedside structured clinical encounter testing safe umbilical catheterisation in a sick preterm infant — the vessel anatomy and courses, the Shukla birth-weight depth formula with the calculation for a 1000-gram infant, the high and low arterial positions with the high preferred and the reason, the venous target at the diaphragm, the radiographic confirmation of the tip, and the recognition and immediate management of a white limb, persistent hypertension, and line sepsis, with the dwell-time limits of five days for arterial and fourteen days for venous catheters.

Open

communication and procedural-planning station

Plan a comfort bundle for an infant cannulation — OSCE

OSCE communication and planning station: assess a 6-month-old infant before a venepuncture and cannulation, choose and time the topical anaesthetic, plan the multi-modal comfort bundle (sucrose or breastfeeding, distraction, comfort positioning), counsel the anxious parent, and outline when to escalate to procedural sedation.

Open

procedural objective structured clinical examination

Suprapubic aspiration and urinary catheterisation: Case

Clinical case of a 5-month-old febrile infant who undergoes a suprapubic aspiration with the point-of-care ultrasound guidance, covering the choice of the collection method, the landmark and the technique, the management of a small initial bladder volume, the interpretation of the culture, and the counselling of the family.

Open

structured clinical encounter (developmental assessment and communication)

Three acts, one pathway — developmental assessment in clinic

A bedside structured clinical encounter testing the principle that surveillance, screening and diagnostic assessment are three different acts, the correct choice of tool for a toddler with speech and social-communication concern, the interpretation of a positive M-CHAT-R/F, the standard-score model, and the urgent response to regression with audiology in the work-up.

Open

structured clinical encounter (interpretation and procedural leadership)

Three tests at the bedside — point-of-care glucose, ketone and urinalysis in a sick child

A bedside structured clinical encounter testing the performance and interpretation of the three core paediatric point-of-care tests. The candidate must defend the capillary glucose meter chemistry and the neonatal confirmation rule, apply the blood beta-hydroxybutyrate over the urine acetoacetate with the ISPAD diagnostic thresholds, and interpret the urine dipstick leukocyte esterase and nitrite in a febrile infant with the screen-versus-culture principle and the falsely reassuring results.

Open

structured clinical encounter (procedural leadership and consent)

Two samples, one site — bone marrow aspiration and biopsy

A bedside structured clinical encounter testing the principle that aspirate and trephine are complementary samples taken at one sitting at the posterior superior iliac spine, the handling of the first aspirate pull for morphology and cytogenetics, periosteal local anaesthetic with lidocaine and procedural sedation, the interpretation of a dry tap, and the bleeding-risk management in the thrombocytopenic child.

Open

osce clinical decision and communication

Verify a nasogastric tube before a feed — OSCE

OSCE clinical-decision and communication station: verifying a nasogastric tube at the bedside before a feed, applying the aspirate pH rule at a threshold of 5.5 or less, recognising and rejecting the deprecated whoosh test, deciding whether to feed or to escalate to radiography, documenting the verification correctly, and explaining the safety check and the Never Event risk to the nurse and the parent in plain language.

Open

Domain

preventive-and-community-paediatrics

37

osce history management and communication

4-month health supervision OSCE

OSCE on structured 4-month visit including sleep counselling, growth, development and maternal mood.

Open

osce communication and preventive counselling

Aboriginal child health partnership — communication OSCE

OSCE on culturally safe engagement, ear and wet-cough counselling, and ACCHO-shared planning with an Aboriginal family.

Open

osce communication and management

Absolute risk and vaccine catch-up counselling — OSCE

OSCE on absolute versus relative risk, herd immunity limits, and non-coercive immunisation catch-up planning for a mobile family.

Open

osce communication and clinical station

Adolescent preventive visit OSCE — confidentiality, HEADSS and safety planning

Observed structured encounter testing time alone, conditional confidentiality, HEADSS interviewing, positive-screen safety action and shared planning.

Open

structured clinical encounter

Bilateral newborn hearing refer before rural discharge — structured clinical encounter

Structured encounter testing bilateral refer counselling, 1-3-6 pathway planning, residual-risk concepts and rural follow-up design for newborn hearing screening.

Open

osce communication and preventive counselling

Childcare exclusion counselling — communication OSCE

OSCE on gastroenteritis return-to-care counselling, exclusion principles and avoidance of inappropriate clearance.

Open

structured clinical encounter

Critical bloodspot result before rural discharge — structured clinical encounter

Structured encounter testing incomplete card recognition, critical TSH action in a well neonate, galactosaemia feed safety if introduced, and rural safety-netting.

Open

osce communication and preventive counselling

Culturally safe Indigenous child health visit — communication OSCE

OSCE on rapport, reframing non-compliance, OM/hearing plan and partnership with community-controlled care.

Open

osce communication and screening-counselling station

Developmental screening OSCE — tool pathway and counselling

OSCE on 18-month screening visit: general and autism-specific tools, result counselling, equity and closed-loop referral.

Open

osce preventive counselling

Elevated BP and family early MI — OSCE

OSCE on paediatric CV risk screening counselling.

Open

osce communication and preventive counselling

Environmental health counselling — communication OSCE

OSCE on environmental history, private-well and pesticide prevention, and declining unvalidated toxin panels.

Open

osce communication and preventive counselling

Food and housing needs counselling — communication OSCE

OSCE on non-stigmatising screening, Hunger Vital Sign, housing safety and closed-loop referral.

Open

osce global child health prioritisation and equity communication

Global child health catch-up and malnutrition risk — OSCE

OSCE on prioritising dehydration care, catch-up immunisation and nutrition support for a migrant toddler.

Open

osce communication and preventive counselling

Heat-wave and sports heat counselling — communication OSCE

OSCE on heat-stroke recognition teaching, cool-first principles, sports acclimatisation and equity-aware heat-wave plans.

Open

osce advocacy communication and systems planning

Housing letter and catchment advocacy — OSCE

OSCE on acute social advocacy for one family plus ethical community needs-assessment planning.

Open

osce preventive care and communication station

Immunisation principles OSCE — well-child multi-antigen visit and schedule reasoning

Observed structured encounter testing immunisation status reconciliation, valid-dose decisions, same-day dosing, documentation and principle-level schedule comparison.

Open

osce history management and communication station

Infant health supervision 6–12 months OSCE — well visit and conversion

Observed structured encounter testing a complete 9-month health-supervision visit and recognition of when a booked well visit must convert to acute care.

Open

osce history management and communication station

Infant health supervision OSCE — early weight check and 2-month counselling

Observed structured encounter testing day-5 feeding and jaundice decisions plus 2-month safe-sleep and maternal mental-health counselling with teach-back.

Open

osce communication and preventive counselling

Injury-prevention counselling OSCE — restraints, helmets and safe storage

OSCE on multi-domain anticipatory guidance for passenger restraints, bicycle helmets, pedestrian supervision and firearm storage.

Open

osce communication and preventive counselling

Lead exposure counselling — communication OSCE

OSCE on explaining elevated blood lead, source control and honest limits of chelation.

Open

structured clinical encounter

Newborn preventive package before rural discharge — structured clinical encounter

Structured encounter testing completion of newborn preventive care, CCHD fail recognition, hearing refer counselling and safety-netting for a rural family.

Open

osce communication and management

Positive newborn screen counselling — OSCE

OSCE on explaining a positive screen, residual risk language, and confirmatory pathway without overcalling diagnosis.

Open

osce preventive visit and communication

Preschool school-entry check — OSCE

OSCE on preschool health supervision, speech concern counselling and referral.

Open

osce rural equity communication and disposition planning

Rural disposition and medical-home planning — OSCE

OSCE on rural capability-matched disposition, telehealth versus transfer counselling and medical-home loop closure.

Open

osce communication and preventive counselling

Safe sleep counselling — communication OSCE

OSCE on non-judgemental safe-sleep history, hazard counselling and teach-back.

Open

osce school-health communication and planning

School health plan and nurse call — OSCE

OSCE on school health planning, anaphylaxis readiness counselling and clinic–school coordination.

Open

osce communication and management station

School-age health supervision — OSCE

OSCE station: school-age well visit counselling and structured assessment.

Open

osce communication and preventive counselling

Smoke-free home and youth vaping counselling — communication OSCE

OSCE on non-judgemental SHS history, smoke-free home and car counselling, and adolescent vaping dual-use screening.

Open

osce communication and preventive counselling

Sun protection counselling — communication OSCE

OSCE on layered photoprotection counselling, indoor tanning refusal and vitamin D messaging.

Open

osce communication and preventive counselling

Te Tiriti-informed well-child visit — communication OSCE

OSCE on Hui Process engagement, cultural safety, SUDI/smoke counselling and closed-loop equity planning with a Māori whānau.

Open

osce preventive visit and communication

Toddler 18-month well visit — OSCE

OSCE on toddler health supervision, positive autism screen counselling and injury guidance.

Open

osce communication and preventive counselling

Toddler home injury prevention — communication OSCE

OSCE on non-judgemental home hazard history, passive-first anticipatory guidance and teach-back.

Open

osce history management and communication

Uncertain vaccination history — catch-up counselling OSCE

OSCE on reconstructing history, explaining catch-up, and booking multi-visit plan.

Open

osce communication station

Vaccine hesitancy OSCE — MMR delay counselling station

Communication OSCE testing recommendation style, elicitation of autism concern, tailored response, negotiation of plan and documentation of refusal.

Open

osce communication and acute safety station

Vaccine safety OSCE — pre-vaccination screen, anaphylaxis drill and false-contraindication counselling

Observed structured encounter testing vaccine safety screening, emergency anaphylaxis response and counselling through false contraindications.

Open

osce communication and preventive counselling

Water-safety counselling — communication OSCE

OSCE on non-judgemental water-risk history, layered drowning prevention and teach-back.

Open

osce communication and health-supervision station

Well-child visit OSCE — health supervision and conversion counselling

OSCE testing well-child visit structure, developmental action, social determinant response and acute conversion judgement.

Open

Domain

paediatric-dermatology

21

long case structured discussion drug avoidance pharmacogenetic screening

A child recovering from carbamazepine-induced SJS-TEN overlap — long case

Long-case and structured-discussion OSCE on a 9-year-old girl recovering from carbamazepine-induced Stevens-Johnson syndrome-toxic epidermal necrolysis overlap: the acute recognition and immediate drug withdrawal, SCORTEN severity scoring and burn-unit disposition, the supportive-care-centred management with early ophthalmology, the no-proven-benefit position on immunomodulation, the ocular and skin long-term sequelae, lifelong carbamazepine and cross-reactive anticonvulsant avoidance, MedicAlert identification, and HLA-B*15:02 screening of at-risk relatives.

Open

long case structured discussion thrombocytopenia safeguarding

A child with bruising and a low platelet count — long case

Long-case and structured-discussion OSCE on a four-year-old boy with sudden bruising, petechiae and a platelet count of 10 × 10⁹ per litre: the sick-versus-well triage, the full-blood-count and film workup that confirms immune thrombocytopenia and excludes leukaemia, the ASH 2019 risk-based management from observation through corticosteroids or intravenous immunoglobulin, the safety-netting for intracranial haemorrhage, the recognition of IgA vasculitis and the safeguarding assessment of bruising with the TEN-4 FACES pattern.

Open

structured clinical encounter

Alopecia and hair disorders in children — structured clinical encounter

Structured encounter testing the approach to an eight-year-old with a smooth bald patch and exclamation-mark hairs: the recognition of alopecia areata, the autoimmune thyroid association, the stepwise management ladder and the poor-prognostic features, with a pivot to a twelve-year-old with trichotillomania and a question on distinguishing tinea capitis at the bedside.

Open

osce communication and clinical reasoning station

Approach to rash in infants and children — OSCE

OSCE communication and clinical reasoning station for a parent bringing an infant with a rash.

Open

osce communication and shared decision-making

Counsel a parent on managing their infant's nappy dermatitis — OSCE

OSCE communication and counselling station: explaining to the parent of a nine-month-old boy what a candidal nappy dermatitis is, why it followed the antibiotic course, how to apply the barrier and the antifungal in the right order, and how to prevent the recurrence — addressing the guilt, the fear of a serious condition, and the practical nappy-care advice, in plain language.

Open

osce communication and shared decision-making

Counsel a parent on their newborn's large congenital melanocytic naevus — OSCE

OSCE communication and counselling station: explaining to the parent of a six-week-old girl with a large congenital melanocytic naevus on the upper back with satellite lesions what the lesion is, why the size and the location matter for the melanoma and the neurocutaneous-melanocytosis risk, what the surveillance involves, and why the observation and the monitoring rather than the immediate surgery is the usual approach — addressing the fear of cancer, the cosmetic concern, and the practical plan, in plain language.

Open

structured clinical case

Epidermolysis bullosa and inherited blistering disorders — clinical case

A structured clinical case of severe generalised recessive dystrophic epidermolysis bullosa presenting in an older child, illustrating the mitten deformity, oesophageal stricturing, chronic anaemia, squamous cell carcinoma surveillance and multidisciplinary management.

Open

osce communication and shared planning

Explain a severe drug eruption to a parent — OSCE

OSCE communication and shared-planning station: explaining to a parent that their child has DRESS (a severe drug reaction to an anticonvulsant), what it means, why the drug must never be used again, the treatment with corticosteroid, and the plan for ongoing epilepsy care — with empathy, honesty and without overpromising.

Open

osce communication and shared planning

Explain allergic contact dermatitis and patch testing to a parent — OSCE

OSCE communication and shared-planning station: explaining the diagnosis of allergic contact dermatitis to a parent, the meaning of the patch test, why the usual eczema creams have not worked, and the avoidance and treatment plan, with empathy, honesty and without overpromising.

Open

osce communication diagnosis systemic-link referral

Explaining a cutaneous sign of systemic disease — OSCE

Communication and structured-discussion OSCE on explaining to a family that a child's skin sign may reflect an underlying internal disease, covering the recognise, investigate and refer framework, the targeted work-up the lesion dictates, the rationale for blood tests and specialist referral, and the reassurance that the skin often improves as the systemic disease comes under control.

Open

osce communication diagnosis safety-net

Explaining a neonatal pustular eruption and giving a safety-net — OSCE

Communication and structured-discussion OSCE on a two-day-old term neonate with scattered pustules on an erythematous base across the trunk, sparing the palms and soles, in an otherwise well baby. The candidate must explain the likely diagnosis of erythema toxicum, why no tests or treatment are needed, the natural history, and a clear safety-net, while demonstrating the recognition of the dangerous blistering presentations (neonatal herpes simplex, staphylococcal scalded skin syndrome) that would demand escalation.

Open

osce communication diagnosis treatment safety-netting

Explaining a neurocutaneous syndrome — Sturge-Weber OSCE

Communication and structured-discussion OSCE on explaining a new diagnosis of Sturge-Weber syndrome to a family after a forehead port-wine stain is found in their newborn, covering the somatic mosaic GNAQ biology and the reassurance that the condition is sporadic and non-recurrent, the leptomeningeal angioma and glaucoma screening that the forehead and upper-eyelid distribution triggers, the seizure and developmental surveillance, and the pulsed-dye laser and glaucoma management pathway.

Open

osce communication diagnosis treatment red-flags

Explaining a suspected fungal toenail and the confirm-before-treat principle — OSCE

Communication and structured-discussion OSCE on a thickened, discoloured toenail in a 9-year-old, covering the nail unit anatomy and the site-based diagnostic principle, the confirm-before-treat principle for suspected onychomycosis (mycology before systemic therapy), the conservative-first and weight-based therapy ladder, the prevention through household contact treatment, and the red flags that would prompt urgent referral.

Open

osce communication diagnosis treatment comorbidity

Explaining chronic plaque psoriasis and topical therapy — OSCE

Communication and structured-discussion OSCE on explaining a new diagnosis of chronic plaque psoriasis in an 11-year-old to a parent, covering the nature of the chronic immune-mediated disease, the potency-matched topical corticosteroid plus calcipotriol treatment and the face and flexure caution, the comorbidity screen for obesity, juvenile psoriatic arthritis and psychosocial burden, and the long-term partnership and escalation pathway to phototherapy and systemic therapy.

Open

osce communication diagnosis treatment exclusion

Explaining impetigo, school exclusion and household care — OSCE

Communication and structured-discussion OSCE on explaining a diagnosis of impetigo in a 4-year-old to a parent, covering the nature of the illness, the five-day topical treatment and school-exclusion rule, why the sibling and a household member need assessment and a decolonisation strategy, the late complication of post-streptococcal glomerulonephritis, and how atopic dermatitis as the portal of entry fits the prevention picture.

Open

osce communication diagnosis treatment safety-netting

Explaining infantile haemangioma, propranolol and safety-netting — OSCE

Communication and structured-discussion OSCE on explaining a diagnosis of a problematic infantile haemangioma to a parent, covering the tumour-versus-malformation distinction and the proliferate-then-involutive natural history, the decision to start oral propranolol and its hypoglycaemia and feeding safety-netting, why a large facial lesion needs a PHACE syndrome workup, and how the long-term outcome and any residue will be managed.

Open

structured clinical case

Molluscum contagiosum and viral warts — clinical case

A clinical case of a child with both molluscum contagiosum and a common viral wart in the setting of atopic dermatitis, illustrating conservative-first assessment, counselling, and shared decision-making.

Open

osce communication and shared decision-making

Negotiate the acne treatment plan with an adolescent — OSCE

OSCE communication and shared decision-making station: explaining the moderate inflammatory acne to a withdrawn 15-year-old and his mother, agreeing the stepwise plan of the topical retinoid and the benzoyl peroxide and the oral doxycycline, counselling the adherence and the photoprotection, naming the antibiotic stewardship, addressing the psychosocial impact and the scarring worry, and setting the clear pathway to the isotretinoin.

Open

osce communication and shared decision-making

Reassure and counsel a parent about cradle cap — OSCE

OSCE communication and counselling station: explaining to the anxious parent of a six-week-old boy what cradle cap is, why it is not an infection and not a hygiene problem, why no swab or test is needed, how to manage it with the gentle scalp care, and when to return — addressing the parental distress, the borrowed potent steroid, and the expected clearance by six to twelve months, in plain language.

Open

structured clinical case

Scabies, lice and infestations — clinical case

A clinical case of classic scabies in a young child from a remote, crowded household, illustrating the 2020 IACS criteria, the permethrin regimen, household treatment and the link between scabies and streptococcal skin disease.

Open

structured clinical encounter

Tinea and fungal skin infection — structured clinical encounter

Structured encounter testing the approach to a five-year-old with a scaly bald scalp patch and broken hair stubs: the recognition of tinea capitis, the species-guided oral therapy with terbinafine or griseofulvin, household carrier screening, the avoidance of tinea incognito, and a pivot to a four-year-old with a painful boggy kerion after contact with a kitten.

Open

Domain

fetal-neonatal-and-perinatal

59

osce neonatal haematology scenario

A jaundiced infant at 12 hours of an RhD-sensitised pregnancy — OSCE

OSCE on the neonatal management of haemolytic disease of the newborn, testing first-24-hour jaundice recognition, the hour-specific nomogram, the phototherapy-IVIG-exchange ladder, and the prevention of bilirubin neurotoxicity.

Open

osce neonatal respiratory scenario

A rising-FiO2 preterm on CPAP — OSCE

OSCE on managing a 27-week preterm whose inspired oxygen climbs on nasal CPAP, testing the surfactant threshold, the LISA approach, oxygen targeting and the prevention of bronchopulmonary dysplasia.

Open

neonatal long case

Apnoea of prematurity — clinical case

Clinical case of a very preterm infant with recurrent apnoea who deteriorates at one week of age, illustrating exclusion of secondary causes and caffeine-first management.

Open

structured clinical encounter

Birth trauma and brachial plexus injury — structured clinical encounter

Structured encounter testing the approach to a newborn with a brachial plexus birth injury after shoulder dystocia: Narakas grading, the immediate management and coexisting-injury exclusion, the monthly Active Movement Scale monitoring, and the 3-month threshold for microsurgical referral.

Open

long-case-clinical-reasoning

Bronchopulmonary dysplasia and chronic neonatal lung disease

Clinical case of a preterm infant with severe BPD and pulmonary hypertension.

Open

neonatal long case

Congenital and perinatally acquired infections: Case

Clinical case of congenital syphilis in an infant of a mother with late antenatal presentation, covering recognition, investigation, treatment, public-health management, and surveillance.

Open

structured clinical encounter

Congenital heart disease presenting in the newborn — structured clinical encounter

Structured encounter testing the approach to a day-three collapsed neonate with a duct-dependent obstructive lesion: the bedside split, the prostaglandin-first resuscitation, the investigation bundle, and parent communication.

Open

neonatal long case

Conjugated jaundice and neonatal cholestasis: Case

Clinical case of a five-week-old infant with biliary atresia, covering recognition of conjugated jaundice and acholic stools, the diagnostic pathway, the Kasai portoenterostomy, postoperative care, and long-term prognosis.

Open

osce neonatal birth-injury scenario

Diffuse scalp swelling and pallor after vacuum delivery — subgaleal haemorrhage

OSCE on a term newborn delivered by vacuum extraction who develops a diffuse boggy scalp swelling with pallor and tachycardia, testing the suture-line discriminator, the recognition of subgaleal haemorrhage, the resuscitate-before-investigate principle, coagulation correction, and the prevention and counselling bundle.

Open

osce examination and communication

Dysmorphic newborn — assessment and counselling OSCE

OSCE on assessing a dysmorphic term newborn, choosing the diagnostic ladder, and counselling the parents about a likely syndrome.

Open

osce communication and counselling station

Extremely preterm infant viability and periviable counselling — OSCE

OSCE station: antenatal counselling of parents facing imminent delivery at 23 weeks gestation, balancing honest outcome data with empathy and shared decision-making.

Open

long-case-clinical-reasoning

Family-integrated developmental care in NICU

Clinical case of a preterm infant whose mother, participating in a FiCare programme, develops stress and depressive symptoms with suboptimal infant weight gain, requiring integrated clinical and family-centred management.

Open

long case with communication

Fetal growth restriction and small-for-gestational-age infant — case

Long case and communication station.

Open

osce communication and management station

Follow-up after high-risk birth and NICU discharge — OSCE

OSCE station: counselling parents of a former extremely preterm infant at the two-year corrected-age visit about why follow-up must continue to school age despite a reassuring Bayley score, and how corrected age, sensory surveillance and educational support will be coordinated.

Open

osce communication and management station

Gestational age assessment and preterm classification — OSCE

OSCE station: explaining to parents how their baby's gestational age was determined, what the classification means, and why it shapes care and follow-up.

Open

neonatal long case

Hearing loss in high-risk neonates — clinical case

Clinical case of an extremely preterm NICU graduate who refers on AABR screening and is found to have auditory neuropathy spectrum disorder, illustrating the screening rationale, diagnostic confirmation, and early-intervention pathway.

Open

long-case-clinical-reasoning

Human milk, fortification and preterm nutrition

Clinical case of a preterm infant with extrauterine growth restriction managed with intensified fortification.

Open

structured clinical encounter

Hypoplastic left heart syndrome — antenatal planning structured clinical encounter

Structured encounter testing antenatal planning for a ductal-dependent cardiac lesion: place, time and capability of delivery, prostaglandin readiness, the staged surgical strategy, and capability-matched rural follow-up design.

Open

structured clinical encounter

Hypoxic-ischaemic encephalopathy and therapeutic hypothermia — structured clinical encounter

Structured encounter testing the approach to an encephalopathic term infant eligible for cooling: Sarnat staging, the cooling eligibility assessment, the 72-hour protocol, supportive neurocare, and MRI prognostication.

Open

structured clinical encounter

Intraventricular haemorrhage and periventricular leukomalacia — structured clinical encounter

Structured encounter testing the approach to a preterm infant with a sudden deterioration from a large intraventricular haemorrhage: recognition, Papile grading, immediate management, and the prevention and prognostic-counselling discussion.

Open

long case with communication

Large-for-gestational-age infant and infants of diabetic mothers — case

Long case and communication station.

Open

osce communication and management station

Late-preterm infant: risks and corrected-age follow-up — OSCE

OSCE station: counselling parents of a 35-week late-preterm infant on why their baby is not yet ready for discharge, what the discharge criteria mean, and how follow-up will run in corrected age.

Open

structured clinical encounter

Maternal disease, medication and substance effects on the fetus — structured clinical encounter

Structured encounter testing pre-conception counselling of a woman on valproate for epilepsy who is planning pregnancy, covering medication switching, folic acid, surveillance and the neonatal plan.

Open

clinical reasoning

Meconium aspiration syndrome — clinical reasoning case

Clinical reasoning case of a term infant with meconium aspiration syndrome progressing to oxygen-refractory hypoxaemia with PPHN and pneumothorax, testing the escalation ladder and supportive care.

Open

long case with communication

Neonatal acute kidney injury — case

Long case and communication station.

Open

neonatal long case

Neonatal anaemia, polycythaemia and thrombocytopenia: Case

Clinical case of an infant of a diabetic mother presenting with polycythaemia and hyperviscosity symptoms, covering diagnosis, the partial exchange transfusion controversy, and family counselling.

Open

neonatal long case

Neonatal bacterial infection and sepsis: Case

Clinical case of a preterm infant with late-onset sepsis from a coagulase-negative staphylococcus line infection, covering recognition, investigation, management, and antibiotic stewardship.

Open

structured clinical encounter

Neonatal cyanosis and collapsed neonate — structured clinical encounter

Structured encounter testing the approach to a day-3 term infant with sudden central cyanosis: recognition, the pre-/post-ductal and hyperoxia assessment, the time-critical use of prostaglandin E1 before echo, and the parallel sepsis cover.

Open

long case with communication

Neonatal fluid, electrolyte and nutritional management — case

Long case and communication station.

Open

neonatal long case

Neonatal gastro-oesophageal reflux and aspiration — clinical case

Clinical case of a thriving preterm infant with posseting and feed-related desaturations, illustrating the conservative-first management, restraint with acid suppression, and the distinction between physiologic reflux and disease.

Open

long case with communication

Neonatal hypoglycaemia — case

Long case and communication station.

Open

structured clinical encounter

Neonatal hypotonia and neuromuscular weakness — structured clinical encounter

Structured encounter testing the approach to a weak, areflexic, alert infant with spinal muscular atrophy: the central/peripheral split, the genetic confirmation, and the timing and evidence of disease-modifying therapy.

Open

neonatal long case

Neonatal jaundice: unconjugated hyperbilirubinaemia: Case

Clinical case of a late-preterm exclusively breastfed infant who develops severe hyperbilirubinaemia requiring intensive phototherapy, covering risk assessment, investigation, management, and kernicterus prevention.

Open

structured clinical encounter

Neonatal pain assessment and procedural comfort - structured clinical encounter

Structured encounter testing the approach to procedural comfort in a preterm infant undergoing repeated heel lances: the neuroscience, the validated assessment tool, the comfort ladder with the sucrose regimen, and the unit-wide quality standard.

Open

osce communication and management station

Neonatal palliative care and end-of-life decision-making — OSCE

OSCE station: leading a neonatal palliative care and comfort-plan conversation with the parents of a newborn with a life-limiting condition, applying the best-interests balance, building an overall comfort plan rather than an isolated resuscitation order, and identifying the ethics and court escalation pathway.

Open

structured clinical encounter

Neonatal respiratory distress — diagnostic approach — structured clinical encounter

Structured encounter testing the diagnostic approach to a preterm infant with respiratory distress: recognition, CXR interpretation, the CPAP-first and surfactant decision, and exclusion of a complicating pneumothorax and sepsis.

Open

structured clinical encounter

Neonatal seizures and encephalopathy — structured clinical encounter

Structured encounter testing the approach to an encephalopathic term infant with neonatal seizures: recognition, cooling eligibility, the antiseizure-medication ladder and the role of continuous EEG.

Open

long case with communication

Neonatal skin disorders and birthmarks — case

Long case and communication station on a newborn with a segmental facial haemangioma and PHACE considerations.

Open

structured clinical encounter

Neonatal stroke and intracranial haemorrhage — structured clinical encounter

Structured encounter testing the approach to a term infant with focal seizures and a normal cranial ultrasound: recognition that PAIS requires MRI, supportive neuroprotection, and the prognostic and follow-up pathway.

Open

osce examination and communication

Newborn examination — focused newborn check OSCE

OSCE on performing a focused newborn examination, completing the universal screens, and escalating an abnormal finding while communicating with the parent.

Open

structured clinical encounter

No-call cell-free DNA result in a higher-risk pregnancy — structured clinical encounter

Structured encounter testing non-directive counselling of a no-call cell-free DNA result, screen-versus-diagnosis reasoning, choice between repeat and diagnostic testing, and capability-matched rural follow-up design.

Open

long case with communication

Parenteral nutrition in neonates — case

Long case and communication station.

Open

long case with communication

Perinatal infection screening and prevention — case

Long case and communication station.

Open

neonatal acute presentation

Persistent pulmonary hypertension of the newborn

Clinical case of a term infant with meconium aspiration and persistent pulmonary hypertension, covering recognition and stepwise management.

Open

long case with communication

Poor feeding and feeding intolerance in the neonate — case

Long case and communication station.

Open

structured clinical encounter

Posterior urethral valves — newborn management structured clinical encounter

Structured encounter testing newborn management of a male infant with antenatally detected bilateral hydronephrosis, a thick-walled bladder and oligohydramnios: risk-stratification, urgent ultrasound timing, prophylaxis, VCUG confirmation of posterior urethral valves, valve ablation, and the design of long-term renal surveillance.

Open

osce communication and management station

Preterm infant — OSCE

OSCE station: counselling parents of a very preterm infant about the immediate NICU course and longitudinal follow-up plan.

Open

osce neonatal resuscitation scenario

Resuscitating a non-vigorous meconium infant — OSCE

OSCE on resuscitating a non-vigorous term infant born through thick meconium-stained liquor, testing the ventilation-first principle, the abandonment of routine suction, and the cooling referral.

Open

long-case-clinical-reasoning

Retinopathy of prematurity

Clinical case of an extremely preterm infant reaching the Type 1 ROP treatment threshold.

Open

structured clinical encounter

Routine care of the healthy newborn — structured clinical encounter

Structured encounter testing golden hour care, vitamin K counselling, late-preterm risk assessment, feeding evaluation and discharge readiness for a first-time family.

Open

osce neonatal air-leak scenario

Sudden deterioration in a ventilated preterm — tension pneumothorax

OSCE on a ventilated preterm infant with an acute tension pneumothorax, testing the decompress-before-image principle, needle aspiration technique, definitive chest-drain choice, and the prevention bundle.

Open

osce neonatal hypothermia scenario

The cold preterm on admission — moderate hypothermia with hypoglycaemia

OSCE on a 28-week preterm infant who arrives in the neonatal unit at 35.0 C with a glucose of 1.6 mmol/L, testing the WHO classification, the four heat-loss pathways, the metabolic cascade, active external rewarming, glucose correction, and the delivery-room warm chain and plastic wrap.

Open

osce neonatal abdominal emergency

The deteriorating preterm — suspected necrotising enterocolitis

OSCE on a preterm infant with established NEC, testing modified Bell staging, the medical bundle, the surgical trigger, the primary peritoneal drainage versus laparotomy decision, and the prevention bundle — with a contrast branch to spontaneous intestinal perforation.

Open

osce neonatal abstinence syndrome scenario

The opioid-exposed newborn with evolving withdrawal — methadone maintenance

OSCE on a 36-week infant of a mother on a methadone maintenance programme who at 48 hours develops a high-pitched cry, tremor on handling and poor feeding, testing the neuroadaptive mechanism, the Eat Sleep Console functional assessment, the Finnegan threshold, the non-pharmacologic first-line bundle, and the morphine-versus-buprenorphine pharmacologic ladder.

Open

osce neonatal haemodynamics scenario

The preterm infant who stops weaning — a haemodynamically significant PDA

OSCE on a ventilated preterm infant with a haemodynamically significant patent ductus arteriosus, testing the assessment of significance, the expectant-first management ladder, the drug doses, the trial evidence, and the exclusion of a duct-dependent circulation.

Open

osce neonatal surgical obstruction scenario

The surgical newborn — bilious vomiting with a double-bubble

OSCE on a term newborn with antenatal polyhydramnios and a double-bubble, testing recognition of bilious vomiting as obstruction, the immediate decompression and resuscitation pathway, the imaging interpretation, the duodenal atresia diagnosis with Down syndrome association, and the definitive surgical plan.

Open

structured clinical case

Transient tachypnoea of the newborn — clinical case

A clinical case of transient tachypnoea of the newborn in a late-preterm infant of a diabetic mother, illustrating diagnostic reasoning and supportive management.

Open

structured clinical encounter

Transition at birth and delayed cord clamping — structured clinical encounter

Structured encounter testing the preterm cord-management plan: deferral timing, the milking contraindication, thermoregulation, and intact-cord resuscitation for a 27-week infant.

Open

osce neonatal transport scenario

Triaging and stabilising a neonatal transport request — OSCE

OSCE on taking a neonatal transport referral, triaging urgency, running the STABLE pretransport stabilisation, and deciding fitness to move, with a cooling-in-transport twist.

Open

Domain

growth-development-and-behaviour

34

osce communication and developmental counselling

AAC counselling — communication OSCE

OSCE on early AAC counselling, myth-busting, feature-match planning and partner training for a child with complex communication needs.

Open

osce communication and management station

Attention-deficit hyperactivity disorder — OSCE

OSCE station: ADHD assessment counselling and shared decision-making for multimodal care.

Open

osce communication and clinical reasoning station

Autism spectrum disorder — OSCE

OSCE counselling station after suspected autism spectrum disorder assessment.

Open

osce history-management and communication station

Behavioural assessment OSCE — function formulation and family counselling

OSCE on multi-setting behavioural assessment, function hypothesis, PBS/FCT counselling and medication thresholds.

Open

osce clinical and counselling station

Cerebral palsy surveillance OSCE — clinic visit and family counselling

OSCE on GMFCS IV surveillance visit: domain checklist, hip counselling, tone goals and closed-loop plan.

Open

osce communication and developmental counselling

Confirmed bilateral hearing loss — counselling OSCE

OSCE on counselling after diagnostic confirmation of permanent bilateral hearing loss and early intervention planning.

Open

osce communication and clinical-reasoning station

DCD OSCE — assessment counselling and school plan

OSCE on suspected DCD: history and exam priorities, red-flag screen, counselling, task-oriented plan and school adaptations.

Open

osce communication and behaviour-planning station

Defiance management OSCE — parent counselling and behaviour plan

OSCE on multi-informant formulation, parent training counselling, school plan and medication boundaries for oppositional behaviour.

Open

osce communication and clinical reasoning station

Developmental delay: global diagnostic approach — OSCE

OSCE counselling and management station for global developmental delay.

Open

osce communication and acute counselling

Disability-aware acute care — communication OSCE

OSCE on caregiver partnership, reasonable adjustments, pain assessment and anti-overshadowing in ED.

Open

osce communication and shared planning

Explain school refusal plan and possible SSRI to parents — OSCE

OSCE communication station: school refusal psychoeducation, functional return plan, CBT, SSRI monitoring, collaborative non-blaming family framing.

Open

osce communication and developmental counselling

Family-centred goal setting — communication OSCE

OSCE on co-producing developmental goals with F-words language and fewer SMART targets.

Open

osce history management and communication station

Feeding problems OSCE — selective eating counselling and ARFID/PFD plan

Observed structured encounter testing history, growth interpretation, caregiver counselling to stop force-feeding, and multidisciplinary planning for selective eating with ARFID/PFD features.

Open

osce short clinical and communication station

Floppy infant OSCE — localisation, safety and family counselling

OSCE on floppy infant assessment: bedside localisation, red-flag recognition, urgent pathway and closed-loop counselling.

Open

osce communication and clinical reasoning

GMs and HINE counselling — OSCE station

OSCE on explaining GMs and HINE findings and acting on high-probability CP risk.

Open

osce communication and clinical reasoning

High-probability CP counselling — OSCE station

OSCE on early CP recognition, classification language and family counselling.

Open

osce communication and management station

Intellectual developmental disorder OSCE — diagnosis counselling and care planning

OSCE on explaining IDD criteria, opening supports, outlining aetiological evaluation and safety-netting.

Open

osce development and communication

Late walker and non-crawler counselling — development OSCE

OSCE on counselling WHO motor windows, healthy variation and when to recheck or escalate.

Open

osce development history and communication

Lost words at 20 months — regression OSCE

OSCE on history, threat triage, counselling and urgent plan for developmental regression.

Open

osce communication and developmental counselling

Neurodiversity-affirming care — communication OSCE

OSCE on affirming language, environment fit and co-producing school adjustments without abandoning medical vigilance.

Open

osce communication and management

Night wetting and soiling — OSCE

OSCE on non-punitive assessment and counselling for enuresis with constipation-related soiling.

Open

osce skills and communication station

Normal growth from fetal life through adolescence — OSCE

OSCE skills and counselling station on growth measurement interpretation and parent explanation.

Open

osce communication and preventive counselling

School supports for a child with disability — communication OSCE

OSCE on functional school planning, letter content and emergency preparedness with family.

Open

osce communication and developmental counselling

Sensory differences counselling — communication OSCE

OSCE on validating sensory concerns, excluding mimics, environmental plans and honest therapy evidence.

Open

osce communication and clinical-reasoning station

Specific learning disorders OSCE — evaluation and family counselling

OSCE on school-age academic underachievement: history, sensory exclusion, SLD counselling, rejection of vision therapy as primary treatment, and school–health plan.

Open

osce communication and developmental-counselling station

Speech and language delay OSCE — assessment and counselling

OSCE on toddler speech-language concern: history, observation, hearing pathway, counselling and closed-loop referral.

Open

osce communication and management

Starting early intervention before the label — OSCE

OSCE on counselling parallel early intervention referral, family goals and waitlist safety-netting without cure promises.

Open

osce communication and behavioural-counselling station

Tantrums and aggression OSCE — assessment, parenting counsel and safety

OSCE on preschool multi-setting tantrums/aggression: structured history, ABC function, positive parenting without corporal punishment, safety planning and closed-loop referral.

Open

osce development and communication

Toddler language concern — normal communication OSCE

OSCE on normal language/social milestone assessment, red flags and counselling.

Open

osce development and communication

Toddler meltdowns and school-readiness worry — development OSCE

OSCE on counselling normal cognitive-emotional development, temperament and escalation.

Open

osce development and communication

Toddler social communication concern — autism recognition OSCE

OSCE on autism red flags, screening limits, hearing check and referral counselling.

Open

osce development and communication

Toddler speech concern — developmental assessment OSCE

OSCE on developmental history, examination plan, tool choice and counselling.

Open

osce transition communication and planning

Transition planning clinic — OSCE

OSCE on counselling a family and young person about structured transition for neurodevelopmental disability.

Open

osce communication and clinical reasoning station

Visual impairment and development — OSCE

OSCE counselling and management station for childhood visual impairment.

Open

Domain

gastroenterology-hepatology-and-nutrition

40

structured clinical encounter

Abdominal wall and umbilical disorders — structured clinical encounter

Structured encounter testing the approach to a newborn delivered at a tertiary centre with bare bowel protruding beside a normal cord: the recognition of gastroschisis, the resuscitation and bowel protection, the surgical pathway of primary closure versus silo, the distinction from omphalocele and its cardiac and chromosomal work-up, and a pivot to an incarcerated inguinal hernia in an ex-preterm infant.

Open

paediatric short case

Acute abdominal pain in children: Case

Clinical case of an adolescent girl with acute right lower quadrant abdominal pain and the gynaecological differential, working through the active exclusion of ovarian torsion, the use of pelvic ultrasound with Doppler, the exclusion of pregnancy, the parallel diagnosis of appendicitis, early analgesia, and a concrete safety-net.

Open

structured clinical encounter

Acute gastroenteritis and infectious diarrhoea — structured clinical encounter

Structured encounter testing the approach to an 18-month-old with two days of watery diarrhoea and vomiting who is mildly-to-moderately dehydrated: the clinical grading of dehydration, the exclusion of surgical and metabolic mimics, the design of oral rehydration therapy with low-osmolarity solution and nasogastric back-up, the adjuncts of ondansetron and zinc with early feeding, the recognition of severe dehydration needing intravenous resuscitation, and the safety-netting and disposition conversation with the family.

Open

intensive care long case

Acute liver failure: Case

Clinical case of a sixteen-year-old girl with an acetaminophen overdose presenting with acute liver failure, covering the resuscitation, empirical N-acetylcysteine, the dynamic trajectory of the international normalised ratio, and the decision to avoid or pursue transplantation.

Open

paediatric short case

Acute vomiting in infants and children: Case

Clinical case of a toddler with acute vomiting and dehydration from gastroenteritis, working through clinical dehydration assessment, oral rehydration and the selective use of ondansetron, the active exclusion of surgical and metabolic mimics, disposition thresholds, and a concrete family safety-net.

Open

structured clinical encounter

Appendicitis and surgical abdomen — structured clinical encounter

Structured encounter testing the approach to a previously well nine-year-old with migratory right iliac fossa pain, anorexia and localised tenderness: the recognition of the migratory pattern and the anorexia clue, the exclusion of the surgical mimics including testicular torsion, the Pediatric Appendicitis Score and the ultrasound-first imaging pathway, resuscitation and analgesia that do not delay diagnosis, laparoscopic appendicectomy against the non-operative option by shared decision, and the safety-netting and recurrence conversation with the family.

Open

outpatient long case

Ascites and peritoneal disease: Case

Clinical case of a three-month-old infant presenting with progressive abdominal distension and milky ascitic fluid, covering the diagnosis of congenital chylous ascites, its differentiation from cirrhotic and nephrotic ascites using the serum-ascites albumin gradient and fluid analysis, and the conservative management with a medium-chain triglyceride diet.

Open

structured clinical encounter

Bilious vomiting and intestinal obstruction — structured clinical encounter

Structured encounter testing the approach to a term neonate with sudden bilious vomiting: the recognition of malrotation with midgut volvulus as the emergency to exclude, the resuscitation and nasogastric decompression, the urgent upper gastrointestinal contrast study, the Ladd procedure, the differential of high and low obstruction, and the safety-netting and retrieval decisions for a rural family.

Open

structured clinical encounter

Breastfeeding medicine and lactation support — structured clinical encounter

Structured encounter testing the approach to a mother at three weeks postpartum with fever and a hot, tender breast: the recognition of the mastitis spectrum, the stepwise management from continued milk removal to antibiotics, the red flags of abscess, the assessment of latch and transfer, and the counselling of the mother on continued breastfeeding and follow-up, with a pivot to a late-preterm infant needing intensified support.

Open

outpatient long case

Chronic and recurrent abdominal pain: Case

Clinical case of a nine-year-old with recurrent periumbilical pain and school avoidance, covering the alarm-feature approach, targeted investigation, a positive functional diagnosis, and a stepwise biopsychosocial management plan.

Open

outpatient long case

Chronic liver disease, cirrhosis and portal hypertension: Case

Clinical case of a nine-year-old boy with biliary atresia and progressive portal hypertension who presents with splenomegaly, ascites, and digital clubbing, covering the assessment of portal hypertension severity, hepatopulmonary syndrome evaluation, PELD scoring, and the decision for liver transplantation.

Open

structured clinical encounter

Coeliac disease — structured clinical encounter

Structured encounter testing the approach to a fourteen-year-old with iron-deficiency anaemia refractory to oral iron, short stature and a family history of coeliac disease: recognising the non-classic presentation, the immunoglobulin A anti-tissue-transglutaminase-first workup with total immunoglobulin A, the ESPGHAN 2020 no-biopsy pathway, the gluten-on-board rule, and the management and counselling plan.

Open

outpatient long case

Constipation and faecal incontinence: Case

Clinical case of a six-year-old with chronic constipation and overflow soiling, covering the positive functional diagnosis, red-flag screening, and a disimpaction-then-maintenance polyethylene glycol plan with behavioural support and school liaison.

Open

osce communication and shared decision-making

Counsel parents of a neonate with suspected midgut volvulus — OSCE

OSCE communication and shared-planning station: breaking the news to the frightened parents of a three-day-old neonate whose sudden bilious vomiting has led to an urgent upper gastrointestinal contrast study confirming malrotation with midgut volvulus, explaining the danger to the blood supply of the bowel in plain language, outlining the need for an emergency operation called the Ladd procedure, and giving honest prognostic framing while addressing fear and the speed of events.

Open

structured clinical encounter

Dysphagia and oesophageal disorders — structured clinical encounter

Structured encounter testing the approach to a teenager with a food bolus impaction, solid-food dysphagia and atopy: the recognition and diagnosis of eosinophilic oesophagitis with biopsy at the impaction endoscopy, the exclusion of mimics, the first-line treatment ladder and the role of dupilumab and dilation, the monitoring to histological remission, and the conversation with the family about a chronic relapsing condition.

Open

structured clinical encounter

Enteral feeding tubes and home enteral nutrition — structured clinical encounter

Structured encounter testing the approach to a four-year-old with severe cerebral palsy, an unsafe swallow and faltering growth referred for a gastrostomy: choosing the device, the pre-gastrostomy reflux and nutritional assessment, the device options and conversion, and the home enteral nutrition programme, with a parallel scenario on nasogastric tube verification.

Open

structured clinical encounter

Feeding assessment and paediatric dysphagia — structured clinical encounter

Structured encounter testing the approach to a six-year-old with severe cerebral palsy, faltering growth and recurrent pneumonia whose bedside feed is cough-free: recognising silent aspiration, the limitation of the clinical feeding evaluation, the videofluoroscopic swallow study as the arbiter, the Eating and Drinking Ability Classification System, and the multidisciplinary plan including enteral feeding.

Open

structured clinical encounter

Food protein-induced enterocolitis and enteropathy — structured clinical encounter

Structured encounter testing the approach to an infant with a recurrent delayed, pallid vomiting collapse after a new food: recognising acute food protein-induced enterocolitis syndrome, applying the 2017 consensus diagnostic criteria, separating it from sepsis and IgE-mediated allergy, resuscitating the acute reaction, and planning the avoidance pathway with a substitute feed and a supervised oral food challenge.

Open

structured clinical encounter

Formula feeding and complementary feeding — structured clinical encounter

Structured encounter testing the approach to a six-month-old starting complementary foods and a young infant with iron deficiency anaemia from early whole cow's milk: taking a focused feeding history, confirming developmental readiness and safe formula preparation, counselling on the texture and allergen ladder, and recognising and correcting the never-before-twelve-months hazards.

Open

outpatient long case

Functional abdominal pain and irritable bowel syndrome: Case

Clinical case of an eleven-year-old with recurrent pain, altered bowel habit, and school avoidance, covering the Rome IV diagnosis of IBS, targeted investigation with faecal calprotectin, and a stepwise biopsychosocial management plan.

Open

general paediatric outpatient case

Gastro-oesophageal reflux and reflux disease — clinical case

Clinical case of a thriving unsettled formula-fed infant with posseting and back-arching, illustrating the conservative-first management ladder, exclusion of cow's milk protein allergy, and restraint with acid suppression.

Open

structured clinical encounter

Gastrointestinal bleeding — structured clinical encounter

Structured encounter testing the approach to a toddler with painless bright red rectal bleeding: the upper versus lower split, the recognition of a bleeding Meckel diverticulum, the Meckel scan, resuscitation and transfusion thresholds, surgical resection, and the safety-netting and retrieval decisions for a rural family.

Open

structured clinical encounter

Hirschsprung disease — structured clinical encounter

Structured encounter testing the approach to a term neonate with delayed passage of meconium and abdominal distension: the recognition of Hirschsprung disease, the suction rectal biopsy as the gold-standard diagnostic test, the contrast enema and its limitations, the preoperative decompression with rectal washouts, the definitive pull-through surgery, and the recognition and emergency management of Hirschsprung-associated enterocolitis.

Open

outpatient long case

Inflammatory bowel disease: Case

Clinical case of a fourteen-year-old girl with bloody diarrhoea, fatigue, and weight loss who develops acute severe ulcerative colitis, covering the PUCAI-driven approach to diagnosis, intravenous corticosteroids, and the decision for rescue therapy.

Open

structured clinical encounter

Intussusception — structured clinical encounter

Structured encounter testing the approach to a previously well seven-month-old with rhythmic colicky screaming, vomiting and a sausage-shaped mass: the recognition of the telescoping pattern, the exclusion of surgical mimics, the ultrasound target sign, the resuscitation before reduction, air enema as first-line therapy with the peritonitis contraindication, and the safety-netting and recurrence conversation with the family.

Open

hepatology long case

Liver transplantation in children: Case

Clinical case of an Epstein-Barr-virus-seronegative infant who developed post-transplant lymphoproliferative disorder after living-donor liver transplantation for biliary atresia, covering the pretransplant listing by the PELD score, the tacrolimus-anchored immunosuppression, the recognition of PTLD on surveillance, and the management by immunosuppression reduction.

Open

structured clinical encounter

Malnutrition: nutritional rehabilitation and monitoring — structured clinical encounter

Structured encounter testing the approach to a 16-month-old with severe acute malnutrition who refuses food: the anthropometric recognition of SAM, the complicated-versus-uncomplicated disposition decision, the WHO phased rehabilitation from F-75 stabilisation to F-100 catch-up, the prevention of refeeding syndrome through phosphate, potassium and magnesium monitoring and thiamine, the immediate threats of hypoglycaemia, hypothermia and infection, and the discharge and relapse-prevention plan.

Open

structured clinical encounter

Micronutrient deficiencies — structured clinical encounter

Structured encounter testing the approach to a two-year-old with pallor, pica, a microcytic anaemia and excessive cow's milk intake: recognising iron-deficiency anaemia, the confirmatory iron studies with a C-reactive protein, the oral iron dose and timeline, the dietary advice, the differential of microcytic anaemia, and the rationale for universal screening at twelve months.

Open

structured clinical encounter

Non-alcoholic fatty liver disease in children — structured clinical encounter

Structured encounter testing the approach to an eleven-year-old overweight boy found on screening to have a mildly raised alanine aminotransferase: recognising the misleading laboratory range, applying the NASPGHAN sex-specific thresholds, confirming persistence, excluding mimics, delivering family-based lifestyle therapy, and framing the cardiovascular-predominant prognosis.

Open

outpatient long case

Normal nutritional requirements across childhood: Case

Clinical case of a fifteen-year-old girl on a strict vegan diet who presents with fatigue and pallor, covering the nutritional assessment of an adolescent, the energy and micronutrient requirements of adolescence, and the planning of an adequate vegan diet across the requirement spectrum.

Open

structured clinical encounter

Nutritional management of chronic disease — structured clinical encounter

Structured encounter testing the approach to a four-month-old cardiac infant with a large ventricular septal defect, tachypnoea and failure to thrive: recognising the increased-demand mechanism, the anthropometric assessment on z-scores, the energy target and fortified-feed strategy, the early nasogastric feeding, and why nutrition is an outcome of congenital heart disease care.

Open

structured clinical encounter

Oesophagitis, caustic ingestion and oesophageal injury — structured clinical encounter

Structured encounter testing the approach to an 18-month-old with a suspected oesophageal button battery: recognition and the two-hour rule, the radiological signs, honey mitigation and emergent removal, and the surveillance and counselling for the delayed aorto-oesophageal fistula.

Open

structured clinical encounter

Paediatric feeding disorder: nutritional and gastrointestinal management — structured clinical encounter

Structured encounter testing the nutritional and gastrointestinal management of a three-year-old with cerebral palsy whose food refusal, faltering growth and poorly controlled reflux have been labelled behavioural: recognising the four domains of paediatric feeding disorder, treating the medical driver first, applying structured behavioural intervention, and deciding on enteral feeding with a tube-weaning plan.

Open

structured clinical encounter

Pancreatitis and pancreatic disorders — structured clinical encounter

Structured encounter testing the approach to an eight-year-old boy on valproate who presents with acute pancreatitis: recognising the drug trigger, applying the NASPGHAN two-of-three diagnostic criteria, delivering early aggressive hydration and early enteral feeding, stopping the offending drug, and planning the follow-up to prevent recurrence.

Open

structured clinical encounter

Parenteral nutrition and refeeding syndrome — structured clinical encounter

Structured encounter testing the approach to a malnourished adolescent with anorexia nervosa admitted for refeeding whose phosphate falls on day two: the definition and biochemistry of refeeding syndrome, the ASPEN risk stratification, the thiamine and conservative-calorie prevention, the daily electrolyte monitoring, and a pivot to a premature infant on long-term parenteral nutrition with a rising conjugated bilirubin assessed for the lipid strategy and the prevention of intestinal failure-associated liver disease.

Open

osce communication and clinical reasoning station

Peptic disease and Helicobacter pylori — OSCE

OSCE counselling and clinical reasoning station for a child with confirmed H. pylori-associated peptic disease.

Open

structured clinical encounter

Persistent and chronic diarrhoea — structured clinical encounter

Structured encounter testing the approach to a nine-year-old with chronic diarrhoea, a distended abdomen, iron-deficiency anaemia and faltering growth: recognising the organic red flags, distinguishing coeliac disease from inflammatory bowel disease, the stool-directed and serological workup, the gluten-on-board rule, and the management and counselling plan.

Open

outpatient long case

Polyps and inherited gastrointestinal cancer syndromes: Case

Clinical case of a ten-year-old with cramping abdominal pain, anaemia, and characteristic lip and buccal pigmentation, covering the bedside recognition of Peutz-Jeghers syndrome, the small-bowel and cancer risks, and the surveillance and genetic-testing plan.

Open

structured clinical encounter

Short-bowel syndrome and intestinal failure — structured clinical encounter

Structured encounter testing the approach to a premature neonate after necrotising enterocolitis with a high-output jejunostomy and rising conjugated bilirubin: the definition and classification, the sodium principle, the trophic role of enteral feeding and glucagon-like peptide 2, the prevention of intestinal failure-associated liver disease, and a pivot to an older child on home parenteral nutrition assessed for teduglutide, serial transverse enteroplasty and transplant.

Open

structured clinical encounter

Viral, autoimmune and metabolic hepatitis — structured clinical encounter

Structured encounter testing the approach to a thirteen-year-old girl with fatigue, jaundice, amenorrhoea and arthralgia: recognising the insidious presentation of type 1 autoimmune hepatitis, applying the simplified International Autoimmune Hepatitis Group score, initiating the prednisolone-and-azathioprine induction with the thiopurine methyltransferase safety check, excluding overlap with autoimmune sclerosing cholangitis, and counselling on the relapsing course and the monitoring.

Open

Domain

nephrology-urology-fluids-and-electrolytes

34

osce communication and clinical reasoning station

Acid-base disorders in children — OSCE

OSCE communication and clinical reasoning station for the parents of a child newly diagnosed with type 1 diabetes presenting in diabetic ketoacidosis, covering the blood gas interpretation in plain terms, the DKA management, the role of bicarbonate and why it is not used, and the safety-net and sick-day rules for the future.

Open

intensive care long case

Acute kidney injury: Case

Clinical case of a nine-year-old boy with septic shock and acute kidney injury, covering the KDIGO staging, the staged emergency management of hyperkalaemia, the assessment of volume status and the choice of resuscitation fluid, the progression to renal replacement therapy, and the long-term nephrology follow-up.

Open

structured clinical encounter

Acute nephritic syndrome and glomerulonephritis — structured clinical encounter

Structured encounter testing the approach to a six-year-old with classic post-streptococcal glomerulonephritis: confirmation of the glomerular source, interpretation of the low C3 with normal C4, the streptococcal eradication regimen, the supportive-care plan, and the safety-net of the eight-week C3 recheck that separates a self-limiting illness from a progressive complement-mediated disease.

Open

nephrology long case

Antenatal hydronephrosis and postnatal evaluation: Case

Clinical case of an infant with the increased-risk UTD A2-3 antenatal hydronephrosis from a ureteropelvic junction obstruction, covering the antenatal detection, the correctly timed postnatal ultrasound, the investigation pathway, the conservative management and surveillance, and the criteria for the surgical intervention.

Open

osce communication and clinical reasoning station

Calcium, magnesium and phosphate disorders — OSCE

OSCE communication and clinical reasoning station for the family of a child newly diagnosed with X-linked hypophosphataemic rickets presenting with short stature, leg bowing and a low phosphate, covering the diagnosis, the role of fibroblast growth factor 23, the burosumab treatment plan, and the safety-net.

Open

paediatric nephrology long case

Chronic kidney disease and progression: Case

Clinical long case of a seven-year-old boy with posterior urethral valves and progressive chronic kidney disease, covering KDIGO staging with the Schwartz estimate, the nephroprotective bundle of blood-pressure control and ACE inhibitor therapy, the management of growth failure, anaemia, acidosis and mineral-bone disease, and planning toward pre-emptive transplantation.

Open

nephrology long case

Congenital anomalies of the kidney and urinary tract: Case

Clinical case of an infant with a unilateral multicystic dysplastic kidney and contralateral vesicoureteral reflux, covering the antenatal detection, the postnatal investigation pathway, the conservative management and surveillance, and the long-term risk of hyperfiltration injury and chronic kidney disease.

Open

emergency department long case

Dehydration and oral or intravenous rehydration: Case

Clinical case of a 16-month-old with severe hypernatraemic dehydration from acute gastroenteritis, covering the clinical dehydration scale, the decision between oral and intravenous therapy, the staged intravenous protocol, the slow correction of the sodium to avoid cerebral oedema, and the safe transition to maintenance fluid and oral feeding.

Open

osce communication and clinical reasoning station

Fluid maintenance and deficit replacement — OSCE

OSCE communication and clinical reasoning station for the parents of a child admitted with dehydration, explaining the fluid prescription, why the bag has changed from a clear hypotonic bag to a saline bag, the daily weight checks, and the safety-net for recurrence.

Open

structured clinical encounter

Haematuria: diagnostic approach — structured clinical encounter

Structured encounter testing the approach to a school-age child with cola-coloured urine two weeks after a sore throat: the glomerular versus non-glomerular fork, the recognition of post-streptococcal glomerulonephritis, the complement pattern, management of hypertension and fluid overload, and the safety-netting and follow-up decisions.

Open

paediatric nephrology long case

Haemolytic uraemic syndrome: Case

Clinical case of a three-year-old with STEC-associated haemolytic uraemic syndrome following bloody diarrhoea, covering the diagnostic triad, the distinction from DIC and TTP using coagulation studies and ADAMTS13, the supportive care approach, and the transition to a hypothetical diarrhoea-negative scenario requiring eculizumab for atypical HUS.

Open

osce communication and clinical reasoning station

Hypokalaemia and hyperkalaemia — OSCE

OSCE communication and clinical reasoning station for the parents of a child newly diagnosed with Gitelman syndrome presenting with hypokalaemia, tetany and hypomagnesaemia, covering the diagnosis, the role of magnesium, the lifelong supplementation plan, and the safety-net.

Open

osce communication and clinical reasoning station

Hyponatraemia and hypernatraemia — OSCE

OSCE communication and clinical reasoning station for the family of a child with diabetes insipidus and hypernatraemia, covering the diagnosis, the role of desmopressin, the importance of free-water access, the safety-net for illness, and the slow-correction principle.

Open

paediatric urology long case

Hypospadias, cryptorchidism and common male genital disorders: Case

Clinical case of a boy with a left palpable undescended testis and a distal hypospadias, covering the clinical assessment, the no-circumcision rule, the disorder-of-sex-development considerations, the germ-cell rationale for the orchidopexy window, and the long-term fertility and cancer surveillance.

Open

paediatric nephrology long case

IgA nephropathy and IgA vasculitis nephritis: Case

Clinical long case of a teenager with synpharyngitic macroscopic haematuria and biopsy-proven IgA nephropathy, covering the distinction from post-infectious glomerulonephritis by timing and complement, the Oxford MEST-C classification and prediction tool, the supportive and disease-specific treatment ladder, and a counterfactual shift to the systemic presentation of IgA vasculitis nephritis.

Open

paediatric nephrology long case

Inherited tubulopathies: Case

Clinical long case of an infant with nephropathic cystinosis presenting as Fanconi syndrome with failure to thrive, polyuria, hypophosphataemic rickets and glycosuria, covering the diagnostic Fanconi screen, the leukocyte cystine and slit-lamp confirmation, the high-dose bicarbonate and phosphate replacement, the disease-modifying role of cysteamine, and the surveillance for progressive renal failure.

Open

paediatric intensive care and nephrology long case

Kidney replacement therapy and dialysis in children: Case

Clinical case of a post-cardiac surgery child who develops severe acute kidney injury needing continuous renal replacement therapy, covering the AEIOU indications, the rationale for continuous therapy over intermittent haemodialysis, the prescription and anticoagulation, and the transition to recovery, with a counterfactual contrasting an infant managed with peritoneal dialysis.

Open

paediatric nephrology long case

Kidney transplantation in children: Case

Clinical case of an eight-year-old girl with end-stage kidney disease from renal hypodysplasia who receives a preemptive living-donor kidney transplant from her father, covering the rationale for preemptive living donation, the standard tacrolimus-based immunosuppression regimen, the investigation of a rising creatinine in the early post-transplant period distinguishing acute T-cell-mediated rejection from calcineurin inhibitor toxicity and BK nephropathy, and the principles of long-term follow-up and transition.

Open

paediatric nephrology long case

Lupus nephritis and systemic disease: Case

Clinical case of a 13-year-old girl with proliferative Class IV lupus nephritis presenting with oedema, active urinary sediment, low complement, and positive anti-dsDNA, covering the ISN/RPS classification, the induction-maintenance treatment paradigm with mycophenolate mofetil, the treat-to-target goals, the reproductive counselling, and the transition to a hypothetical refractory scenario requiring rituximab.

Open

osce communication and clinical reasoning station

Nephrolithiasis and nephrocalcinosis — OSCE

OSCE communication and clinical reasoning station for the parents of an adolescent newly diagnosed with recurrent calcium oxalate stones and hypercalciuria, covering the diagnosis, the metabolic workup, the fluid and dietary prevention plan, the role of thiazide, and the safety-net.

Open

nephrology urology long case

Neurogenic bladder and dysfunctional voiding: Case

Clinical case of an infant with a neurogenic bladder from myelomeningocele whose urodynamics show a hostile high-pressure bladder, covering the proactive management with clean intermittent catheterisation and an anticholinergic, the escalation to intravesical botulinum toxin, the upper-tract surveillance, and the lifelong renal and continence implications.

Open

structured clinical encounter

Nocturnal enuresis — structured clinical encounter

Structured encounter testing the approach to a 7-year-old with monosymptomatic nocturnal enuresis: the definition and classification, the voiding diary and urinalysis, the choice between the enuresis alarm and desmopressin first-line, the desmopressin dose and fluid-restriction safety rule, and the red flags that reclassify the problem.

Open

structured clinical encounter

Oedema and nephrotic syndrome — structured clinical encounter

Structured encounter testing the approach to a four-year-old presenting with new periorbital and ankle oedema and heavy proteinuria: the KDIGO 2021 confirmation, the assumption of minimal change disease and the initial prednisolone regimen, the education of the family in home urine testing, and the vigilance for the three complications of peritonitis, thromboembolism and acute kidney injury.

Open

emergency short case

Oliguria, anuria and urinary obstruction: Case

Clinical case of a male infant with posterior urethral valves presenting with anuria and a palpable bladder, covering the urine output definition of anuria, the emergency catheter decompression, the hyperkalaemia management, the post-obstructive diuresis, and the life-long nephrology follow-up for the chronic kidney disease risk.

Open

osce clinical reasoning and communication station

Paediatric kidney assessment OSCE — febrile infant, bag culture and residual-risk counselling

Observed structured encounter testing urine collection method choice, dipstick and microscopy interpretation, reliable-sample confirmation, and family counselling after an equivocal culture in a febrile infant.

Open

paediatric nephrology long case

Polycystic kidney disease and inherited nephropathies: Case

Clinical long case of a neonate with the perinatal form of autosomal recessive polycystic kidney disease from a homozygous PKHD1 mutation, covering the neonatal management of respiratory distress and hypertension, the surveillance of congenital hepatic fibrosis with portal hypertension, the genetic confirmation and family counselling, and the planning for combined liver-kidney transplantation.

Open

osce communication and clinical reasoning station

Polyuria and polydipsia — OSCE

OSCE communication and clinical reasoning station for the parents of a 4-month-old boy newly diagnosed with congenital nephrogenic diabetes insipidus, covering the diagnosis, the importance of free water and a low-solute diet, the thiazide-based drug regimen, the recognition of dehydration, and the safety-net.

Open

paediatric nephrology long case

Post-infectious glomerulonephritis: Case

Clinical case of a six-year-old with post-streptococcal glomerulonephritis two weeks after a sore throat, covering the acute nephritic presentation, the low C3 with normal C4 recovering within eight weeks, the supportive management with fluid restriction, frusemide, and amlodipine plus streptococcal eradication, and the transition to an atypical scenario in which persistent hypocomplementaemia mandates biopsy.

Open

nephrology urology long case

Posterior urethral valves: Case

Clinical case of a late-presenting boy with posterior urethral valves, covering the recurrent urinary tract infection and poor stream, the MCUG diagnosis, the endoscopic valve ablation, the urodynamic assessment of the valve bladder, and the long-term chronic kidney disease surveillance driven by the nadir creatinine.

Open

diagnostic-reasoning

Proteinuria: diagnostic approach — case

A clinical reasoning case on a 14-year-old girl found to have proteinuria at a school sports screen, applying the repeat first-morning confirmation discipline, the quantification with UPr/Cr, the classification of orthostatic proteinuria, and the long-term monitoring plan.

Open

osce communication and clinical reasoning station

Renal tubular acidosis — OSCE

OSCE communication and clinical reasoning station for the parents of an infant newly diagnosed with hereditary distal renal tubular acidosis presenting with failure to thrive, polyuria, hypokalaemia and nephrocalcinosis, covering the diagnosis, the need for lifelong alkali therapy to protect growth and the kidney, the role of genetic testing and hearing assessment, and the safety-net.

Open

urology surgical short case

Scrotal pain and testicular torsion: Case

Clinical case of an adolescent boy with high-probability testicular torsion, covering the recognition and the TWIST score, the immediate surgical exploration with detorsion and bilateral orchidopexy, and the long-term fertility surveillance and the counselling of the boy and the family.

Open

nephrology urology long case

Vesicoureteric reflux: Case

Clinical case of a 2-year-old girl with grade IV vesicoureteric reflux, recurrent febrile urinary tract infection, renal scarring, and bladder and bowel dysfunction, covering the grading, the RIVUR trial evidence, the management ladder, and the long-term surveillance for reflux nephropathy.

Open

paediatric gynaecology short case

Vulvovaginal and common prepubertal gynaecological disorders: Case

Clinical case of a 3-year-old girl with labial adhesions discovered during bathing, covering the clinical assessment, the distinction from congenital anomalies, the conservative management with topical estrogen, the counselling on natural resolution at puberty, and the indications for manual separation.

Open

Domain

endocrinology-diabetes-and-growth

32

osce communication and clinical reasoning station

Acquired hypothyroidism and Hashimoto thyroiditis — OSCE

OSCE counselling and management station for a newly diagnosed adolescent with Hashimoto thyroiditis.

Open

structured clinical encounter

Adrenal insufficiency and adrenal crisis — structured clinical encounter

Structured encounter testing the approach to a pigmented, losing-weight adolescent who collapses with primary adrenal insufficiency: the diagnosis, the empiric hydrocortisone-first resuscitation, the cortisol-ACTH-renin work-up, and parent communication about autoimmune Addison disease and a lifelong stress-dose plan.

Open

osce communication and clinical station

Childhood obesity assessment and staged management OSCE — classification, comorbidity screening and weight-neutral planning

Observed structured encounter testing childhood obesity classification using BMI-for-age, systematic comorbidity screening, selective secondary-cause exclusion, weight-neutral family counselling with motivational interviewing, and staged management planning with parallel comorbidity-directed care.

Open

osce communication and shared decision-making

Communicating a new Graves disease diagnosis — OSCE

OSCE communication and shared decision-making station: explaining to a thirteen-year-old girl and her mother what a new Graves disease diagnosis means, how the antibody caused the palpitations, weight loss, tremor, anxiety and eye changes, what the immediate and long-term plan is (a beta-blocker for symptoms, carbimazole first-line with the two drug dangers warned about, the two-to-three-year course and the relapse reality), what the definitive options are if the drugs do not hold, and how the school, growth and transition will be supported — while addressing fear, the burden of a years-long regimen, the cosmetic worry about the eyes, and the search for a cure.

Open

structured clinical encounter

Congenital adrenal hyperplasia — structured clinical encounter

Structured encounter testing the approach to a genitally normal male neonate who collapses with salt-wasting at two weeks: the diagnosis, the hydrocortisone-first resuscitation, the confirmatory work-up, and parent communication about a missed screen and lifelong treatment.

Open

osce communication and shared decision-making

Counsel a family given a new diagnosis of glucocorticoid-induced osteoporosis — OSCE

OSCE communication and shared-planning station: breaking the news of glucocorticoid-induced osteoporosis in a steroid-treated boy with Duchenne muscular dystrophy who has a vertebral compression fracture, explaining the cause and the reassurance that the steroids are still needed, outlining the calcium and vitamin D preparation and the zoledronic acid treatment in plain language, and arranging bone surveillance.

Open

osce communication and shared decision-making

Counsel a family given a new diagnosis of vitamin D deficiency rickets — OSCE

OSCE communication and shared-planning station: breaking the news of a vitamin D deficiency rickets diagnosis in an exclusively breastfed infant, explaining the cause and the reassurance that exclusive breastfeeding was right, outlining the cholecalciferol and calcium treatment and the monitoring in plain language, and arranging prevention for the siblings and the mother.

Open

osce communication and shared decision-making

Counsel a family on a new diagnosis of central precocious puberty — OSCE

OSCE communication and shared decision-making station: explaining to the parents of a 6-year-old girl what a new diagnosis of progressive central precocious puberty means, why a brain MRI is needed, what a GnRH analog does and does not do, what the height and psychosocial prognosis is, and how the treatment is monitored and eventually stopped — while addressing the parents' anxiety about a 'too-early' puberty, their fear of injections, and the temptation to 'wait and see' when the bone age is already advancing.

Open

osce communication and shared decision-making

Counsel an adolescent boy and his family on delayed puberty — OSCE

OSCE communication and shared decision-making station: counselling a distressed fourteen-year-old boy and his parents on constitutional delay of growth and puberty — explaining the natural history honestly, addressing the psychosocial burden, and laying out the option of a short course of testosterone while keeping reassurance as the default.

Open

osce communication and shared decision-making

Counsel parents given a new diagnosis of congenital hypothyroidism — OSCE

OSCE communication and shared-planning station: breaking the news of a congenital hypothyroidism diagnosis confirmed after an abnormal newborn bloodspot screen, explaining the screening result and the meaning of the venous thyroid function tests, outlining the levothyroxine treatment and the dose-for-growth monitoring in plain language, and offering honest prognostic framing while addressing fear.

Open

osce communication and shared decision-making

Counsel parents given a new finding of atypical genitalia — OSCE

OSCE communication and shared-planning station: breaking the news of a disorder of sex development to the parents of a two-day-old infant with atypical genitalia, explaining that no gender or surgical decision will be made that day, naming the work-up, addressing the fear and the shame honestly, and building a shared plan with the multidisciplinary team.

Open

osce communication and shared decision-making

Counsel parents of a tall child referred for overgrowth assessment — OSCE

OSCE communication and shared-planning station: counselling the parents of a seven-year-old boy referred because he is the tallest in his class and has been flagged for overgrowth assessment, navigating the tension between the reassuring familial explanation (tall parents, well child) and the subtle features that may redirect toward a syndromic overgrowth disorder, explaining the assessment plan and the next steps in plain language, and managing the anxiety that the word 'syndrome' provokes.

Open

osce communication and shared decision-making

Counselling a family starting recombinant growth hormone therapy — OSCE

OSCE communication and shared decision-making station: explaining to parents what a new growth hormone deficiency diagnosis means for their 6-year-old son, why the low growth velocity and delayed bone age were the clues, what the recombinant growth hormone therapy involves including the dose, route, monitoring and safety, what the long-term outlook is, and what the transition to adult care will mean — while addressing parental anxiety, injection burden, and the practicalities of daily therapy.

Open

osce communication and shared decision-making

Counselling the family of a survivor starting hormone replacement — OSCE

OSCE communication and shared decision-making station: explaining to the parents of a 9-year-old medulloblastoma survivor what the new endocrine late effects mean — why the slowing growth velocity and delayed bone age are growth hormone deficiency from the cranial radiation, what the recombinant growth hormone therapy involves including the prerequisite magnetic resonance imaging, the dose, the route and the monitoring, what the sick-day hydrocortisone education means for the concurrent ACTH deficiency, and what the lifelong surveillance and the transition to adult care will involve — while addressing parental anxiety about recurrence, injection burden, and the long-term outlook.

Open

structured clinical encounter

Cushing syndrome in children — structured clinical encounter

Structured encounter testing the approach to an obese adolescent whose height has fallen off the centiles: the growth-arrest discriminator, the three-test confirmatory work-up, the ACTH localisation fork, transsphenoidal surgery, and the perioperative glucocorticoid replacement that prevents adrenal crisis.

Open

osce communication and clinical reasoning station

Diabetes insipidus and polyuria-polydipsia — OSCE

OSCE communication and clinical reasoning station for the parents of a child newly diagnosed with central diabetes insipidus after removal of a craniopharyngioma, explaining desmopressin, fluid safety, and the broader pituitary plan.

Open

structured clinical encounter

Endocrine emergencies: integrated approach — structured clinical encounter

Structured encounter testing the integrated approach to a 4-year-old with undiagnosed new-onset DKA who develops cerebral oedema during treatment: the recognition, the bedside triage, the empiric resuscitation with fluids and an insulin infusion, the cerebral-oedema protocol, and parent communication about new-onset diabetes and the sick-day plan.

Open

osce communication and shared decision-making

Explaining a constitutional delay of puberty diagnosis to an adolescent and his family — OSCE

OSCE communication and shared decision-making station: explaining to a 14-year-old boy and his parents what constitutional delay of growth and puberty means, why he is short and prepubertal when his peers are not, what the investigations show, what the management options are including short-course testosterone, why the prognosis for final height and fertility is excellent, and how the plan addresses the bullying and distress he is experiencing at school.

Open

structured clinical encounter

Hypercalcaemia and hyperparathyroidism — structured clinical encounter

Structured encounter testing the approach to an adolescent with stones, bone pain and an inappropriately normal parathyroid hormone: the PTH fork, the urine calcium-to-creatinine clearance ratio, the localising work-up, parathyroidectomy with intraoperative hormone monitoring, and the hungry bone syndrome that follows.

Open

osce communication and clinical reasoning station

Hypocalcaemia and hypoparathyroidism — OSCE

OSCE communication and clinical reasoning station for the parents of a newly diagnosed infant with 22q11.2 deletion syndrome (DiGeorge) presenting with neonatal hypocalcaemia and seizures.

Open

osce communication and shared decision-making

Hypoglycaemia-prevention plan for school — OSCE

OSCE communication and shared decision-making station: explaining to the parents and a school teacher of a seven-year-old with type 1 diabetes what hypoglycaemia is and why it recurs, the rule of 15 and the school hypoglycaemia plan, when and how to give glucagon, the role of continuous glucose monitoring and hybrid closed-loop in prevention, and the importance of two-to-three-week hypoglycaemia avoidance to restore the warning — while addressing fear, guilt, and the wish to keep glucose high.

Open

structured clinical encounter

Hypopituitarism and pituitary lesions — structured clinical encounter

Structured encounter testing the approach to a child with short stature, a falling height velocity, morning headache and a visual field defect: the recognition of a suprasellar lesion, the paired-hormone and dynamic work-up, the imaging and germ-cell markers, the safe replacement order, and the conversation with a family facing a pituitary tumour and lifelong hormone replacement.

Open

structured clinical encounter

Lipid disorders and familial hypercholesterolaemia — structured clinical encounter

Structured encounter testing the approach to a well 9-year-old boy found to have an LDL-C of 6.2 mmol per litre and a father with a myocardial infarction at 48: the diagnostic thresholds, the secondary-cause work-up, the statin-first plan, and the cascade-screening conversation with the family.

Open

structured clinical encounter

Monogenic diabetes and neonatal diabetes — structured clinical encounter

Structured encounter testing the approach to a six-week-old with persistent insulin-requiring hyperglycaemia found during a febrile illness: the recognition that diabetes under six months is almost never type 1, the acute stabilisation on insulin, the genetic testing pathway, the confirmation of a potassium-channel mutation, and the family conversation about switching to oral glibenclamide.

Open

acute management and communication

New-onset DKA in a district hospital — OSCE

OSCE clinical management and communication station: managing new-onset diabetic ketoacidosis in a child at a district hospital before retrieval, delivering the ISPAD fluid, insulin and potassium plan, monitoring for cerebral oedema, and explaining the new diagnosis of diabetes to a frightened family.

Open

structured clinical encounter

Phaeochromocytoma and endocrine hypertension — structured clinical encounter

Structured encounter testing the approach to a hypertensive adolescent with episodes of severe headache, sweating and palpitations: the metanephrines-first diagnostic rule, the imaging strategy, the alpha-before-beta preoperative preparation, the hereditary gene panel, and the family conversation about lifelong surveillance.

Open

osce skills and communication station

Short stature and poor linear growth — OSCE

OSCE skills and counselling station on growth measurement, chart interpretation and parent explanation for a short child.

Open

osce communication and clinical reasoning station

SIADH and disorders of water balance — OSCE

OSCE communication and clinical reasoning station explaining hospital-acquired hyponatraemia and SIADH, the fluid-restriction plan, and the prevention of overcorrection to the parents of an unwell child.

Open

osce communication and management station

Thyroid nodules, goitre and thyroid cancer — OSCE

OSCE station: communicating the risk-stratification and multidisciplinary pathway for an adolescent thyroid nodule.

Open

structured clinical encounter

Type 1 diabetes: diagnosis and initial management — structured clinical encounter

Structured encounter testing the diagnosis and first management of a six-year-old with a two-week history of thirst, polyuria and weight loss who is alert and not acidotic with a glucose of 22 mmol/L: confirming the diagnosis on glucose, excluding ketoacidosis at the bedside, naming the type with autoantibodies and C-peptide, starting subcutaneous basal-bolus insulin, delivering structured family education, and explaining the honeymoon phase and the rule that insulin is never stopped.

Open

structured clinical encounter

Type 1 diabetes: insulin therapy, technology and ambulatory care — structured clinical encounter

Structured encounter testing the ambulatory care of a seven-year-old on an insulin pump who presents with abdominal pain, vomiting and ketones, with a normal-looking cannula site: recognition of the pump-cannula pitfall, the immediate pen correction and site change, the sick-day education that reinforces never stopping insulin, the HbA1c and time-in-range targets, and the communication with a frightened family about a near-miss.

Open

structured clinical encounter

Type 2 diabetes and metabolic syndrome in youth — structured clinical encounter

Structured encounter testing the approach to a thirteen-year-old boy whose metformin monotherapy for type 2 diabetes is failing: the recognition of the rapid beta-cell decline, the stepwise escalation of pharmacotherapy, the early nephropathy signalled by raised blood pressure and albuminuria, and the family-based and culturally safe communication about a fast, aggressive disease.

Open

Domain

mental-behavioural-and-psychosomatic

26

osce communication and behavioural-emergency management station

Acute behavioural disturbance and agitation — OSCE communication and management station

Observed structured encounter testing environmental safety, verbal de-escalation as first-line treatment, the least-restrictive ladder, organic-cause exclusion, restraint minimisation and a trauma-informed recovery and debrief.

Open

osce communication and counselling

Attachment disorders and relational trauma — OSCE

OSCE communication-and-counselling station assessing a four-year-old placed in foster care six weeks ago after chronic neglect, who will not seek comfort from his carer yet wanders off with strangers — testing the two-disorder structure, caregiving-history assessment, the no-first-line-medication and no-holding-therapy counselling, and a safeguarding conversion when ongoing contact-visit harm is disclosed.

Open

osce communication and clinical station

Avoidant restrictive food intake disorder OSCE — boundary, safety and evidence-based care

Observed structured encounter testing an ARFID consultation: holding the boundary with anorexia nervosa, assessing medical and refeeding safety, classifying the driver pattern, and co-building an evidence-based CBT-AR or FBT plan that stops coercion.

Open

osce communication and risk-assessment station

Child and adolescent suicide and self-harm assessment — OSCE communication station

Observed structured encounter testing direct questioning, structured risk stratification, co-built safety planning, means restriction counselling and a lawful, ethical override.

Open

osce communication and counselling

Children of parents with mental illness or substance use — OSCE

OSCE communication-and-counselling station assessing an eight-year-old whose mother has treatment-resistant depression, who has begun a hidden young-carer role and is missing school — testing the risk framing, the two-generational evidence, the young-carer trap, and a safeguarding conversion when parental intoxication is disclosed.

Open

osce communication and clinical station

Chronic fatigue and post-viral fatigue syndromes OSCE — validation, energy management and school reintegration

Observed structured encounter testing a validating, function-first chronic-fatigue consultation: biopsychosocial assessment, recognising post-exertional malaise, excluding mimics once, explaining the energy envelope, an individualised management plan with CBT, declining rigid graded exercise, and a graded return-to-school.

Open

osce risk-assessment and disposition station

Emergency mental-health assessment and disposition — OSCE risk-assessment and disposition station

Observed structured encounter testing the rapid safety and medical screen, structured suicide-risk assessment with a validated tool, risk stratification, matching the level of care to risk, safety planning with means restriction, and the management of intoxication, capacity and a follow-up safety-net.

Open

osce communication and shared planning

Explain a first episode of psychosis to a young person and family — OSCE

OSCE communication station: explaining a first episode of psychosis as a treatable medical illness, the duration-of-untreated-psychosis rationale for prompt specialist referral, first-line antipsychotic treatment and metabolic monitoring, and cannabis as a modifiable risk factor, framed without blame.

Open

osce communication and shared planning

Explain adolescent cannabis use disorder and the cannabis-psychosis question to parents — OSCE

OSCE communication and shared-planning station: explaining a clinical, criteria-based diagnosis of cannabis use disorder, the role of screening, motivational interviewing and structured therapy, the cannabis-and-psychosis evidence framed honestly, and the recovery-oriented plan.

Open

osce communication and shared planning

Explain adolescent depression and the fluoxetine decision to parents — OSCE

OSCE communication and shared-planning station: explaining a criteria-based diagnosis of adolescent depression, suicide-risk assessment and safety planning, the role of CBT and fluoxetine, and the black-box warning framed as careful treatment rather than avoidance.

Open

osce communication and shared planning

Explain childhood anxiety and the stepped-care plan to parents — OSCE

OSCE communication station: anxiety psychoeducation, the worry cycle, multi-informant assessment, exposure-based CBT, when an SSRI such as sertraline is considered, and activation and suicidality monitoring, framed without blame.

Open

osce communication and shared planning

Explain conduct disorder and the parenting-first plan to a frightened parent — OSCE

OSCE communication and shared-planning station: explaining the rights-violation definition of conduct disorder, the developmental trajectory in honest but hopeful terms, the safety-first and safeguarding plan, the role of an evidence-based parenting programme and of treating comorbid ADHD, and why medication is not the first move.

Open

osce communication and shared planning

Explain disruptive mood dysregulation disorder to parents — OSCE

OSCE communication and shared-planning station: explaining a criteria-based diagnosis of DMDD, ruling out bipolar, the behaviour-therapy-first plan with parent training and child CBT, when a drug is justified for comorbidity, and why an antipsychotic is not the routine first step.

Open

osce communication and shared planning

Explain paediatric delirium and the ABCDEF plan to parents — OSCE

OSCE communication and shared-planning station: explaining the diagnosis of paediatric delirium in a post-cardiac surgery child, the cause-first approach, the ABCDEF prevention bundle, why benzodiazepines are being changed, and the honest role of antipsychotics as last resort.

Open

osce communication and shared planning

Explain the collaborative-care plan and the CAMHS partnership to a family — OSCE

OSCE communication station: explaining collaborative care, the stepped plan, shared medication management, consent and information-sharing, the care coordinator role, and the acute-risk safety-net, framed without blame for a family whose earlier referral was lost.

Open

osce communication and counselling

Family assessment and family interventions — OSCE

OSCE communication-and-counselling station assessing a single mother whose 8-year-old son with ADHD has escalating aggression despite an optimised stimulant — testing systematic family assessment, the coercive-cycle mechanism, intensity-matched intervention selection (parent training first-line), the parent-blaming trap, and a safeguarding conversion when ongoing family violence is disclosed.

Open

osce communication and management-planning station

Functional neurological symptoms — OSCE: diagnosis conversation and coordinated plan

OSCE on a young person with a positive diagnosis of motor FND: validating diagnosis conversation, avoidance of the investigation cascade, and delivery of a single coordinated multidisciplinary and school plan.

Open

osce communication and counselling

Grief, bereavement and adjustment disorder in children — OSCE

OSCE communication-and-counselling station assessing a nine-year-old fourteen months after his mother's sudden death, with persistent longing, avoidance of reminders, identity disruption and functional impairment — testing the prolonged-grief-versus-adjustment distinction, the no-first-line-medication counselling, evidence-based CBT for PGD, and a suicidality conversion when a disclosure is made.

Open

osce communication and management station

Obsessive-compulsive disorder in children — OSCE

OSCE station: OCD assessment counselling and shared decision-making for stepped CBT-with-ERP care.

Open

osce communication and clinical station

Paediatric mental state examination OSCE — observing, interviewing alone, and a same-visit safety assessment

Observed structured encounter testing observation of the domains, securing time alone with an adolescent, integrating a brief screen, and delivering a same-visit response to a positive mood and suicide-risk finding.

Open

osce communication and clinical station

Pica and rumination disorder OSCE — harm gate, discriminator and behavioural plan

Observed structured encounter testing a pica and rumination disorder consultation: running the harm gate before the label, distinguishing the behaviours from developmental mouthing and reflux, treating reversible drivers, and co-building a behavioural replacement plan without punitive restraint.

Open

osce communication and counselling

Post-traumatic stress disorder and trauma responses — OSCE

OSCE communication-and-counselling station assessing a seven-year-old child six weeks after a serious motor-vehicle crash with persistent intrusion, avoidance, sleep disturbance and school decline — testing the reaction-to-disorder distinction, trauma-informed assessment, first-line trauma-focused CBT, rejection of single-session debriefing, and a safeguarding conversion when domestic violence is disclosed.

Open

osce communication and clinical station

Psychological impact of chronic illness and disability OSCE — assessment, stepped plan and safeguarding

Observed structured encounter testing a biopsychosocial, resilience-oriented assessment of the psychological impact of a chronic illness: biopsychosocial history and screening, the adjustment-to-disorder continuum, a stepped family-centred and school-inclusive plan, diagnostic overshadowing in a non-verbal child, and a suicide-risk interrupt.

Open

osce communication and prescribing-safety station

Psychopharmacology and psychotropic medicines in children and adolescents — OSCE communication station

Observed structured encounter testing shared decision-making to start an SSRI in an adolescent with depression, including counselling on the suicidality warning, expected timeline, side effects and review schedule; and a deterioration requiring recognition of SSRI activation and a safety response.

Open

osce communication and management station

Selective mutism — OSCE

OSCE station: selective mutism assessment counselling and shared decision-making for behavioural-intervention-first care with the school.

Open

osce communication and clinical station

Somatic symptom and related disorders OSCE — validation, function-first plan and safeguarding

Observed structured encounter testing a validating, function-first somatic-symptom consultation: biopsychosocial assessment, single red-flag screen, the symptom-amplification reframe, an interdisciplinary plan with school reintegration, avoidance of opioid escalation, and recognition of fabricated/induced illness as a safeguarding presentation.

Open

Domain

genetics-dysmorphology-and-metabolism

34

osce communication and shared decision-making

Acute metabolic decompensation in propionic acidaemia — OSCE

OSCE communication and shared decision-making station: explaining to parents what a new propionic acidaemia diagnosis means for their neonate who survived a high-anion-gap metabolic acidosis crisis, why the toxic organic acids were so dangerous, what the emergency and long-term management involves, the role of liver transplantation, and what the autosomal recessive inheritance means for future pregnancies — while addressing guilt, the fear of recurrence, and the practical realities of a protein-restricted diet and emergency sick-day plan.

Open

long-case

Acute metabolic decompensation: recognition and stabilisation

Clinical case mapping recognition and resuscitation of a neonatal hyperammonaemic crisis onto the 15-examiner-dimension framework.

Open

osce communication and shared decision-making

Communicating a new congenital hyperinsulinism diagnosis — OSCE

OSCE communication and shared decision-making station: explaining to parents what a new congenital hyperinsulinism diagnosis means for their neonate who presented with hypoglycaemic seizures, why the hypoglycaemia was so dangerous, what the diazoxide and surgical options involve, the difference between focal and diffuse disease, and the recurrence risk for future pregnancies — while addressing guilt, the fear of surgery, and the search for a cure.

Open

osce communication and shared decision-making

Communicating a new glycogen storage disease type I diagnosis — OSCE

OSCE communication and shared decision-making station: explaining to parents what a new glycogen storage disease type Ia (von Gierke) diagnosis means for their infant who presented with fasting hypoglycaemia and a seizure, why the metabolic tetrad arose, what the dietary and metabolic management involves (cornstarch, continuous overnight glucose, the sick-day plan), the long-term complications that need surveillance, and what the autosomal recessive inheritance means for future pregnancies — while addressing fear, the burden of a lifelong dietary regimen, and the search for a cure.

Open

osce communication and shared decision-making

Communicating a new MCAD deficiency diagnosis after a metabolic crisis — OSCE

OSCE communication and shared decision-making station: explaining to parents what a new medium-chain acyl-CoA dehydrogenase deficiency diagnosis means for their toddler who survived a hypoketotic hypoglycaemic crisis, why the low glucose with absent ketones was so dangerous, what the emergency and long-term management involves, what the newborn screening result means for the family, and why the prognosis is excellent with fasting avoidance — while addressing parental guilt, the fear of recurrence, and the practicalities of the sick-day plan.

Open

osce communication and shared decision-making

Communicating a new ornithine transcarbamylase deficiency diagnosis — OSCE

OSCE communication and shared decision-making station: explaining to parents what a new ornithine transcarbamylase deficiency diagnosis means for their neonate who survived a hyperammonaemic crisis, why the ammonia was so dangerous, what the emergency and long-term management involves, the role of liver transplantation, and what the mother's carrier status means for her health and future pregnancies — while addressing guilt, the search for a cure, and the fear of recurrence.

Open

osce communication and shared decision-making

Communicating a new Wilson disease diagnosis — OSCE

OSCE communication and shared decision-making station: explaining to the parents of a 13-year-old boy what a new Wilson disease diagnosis means, why copper accumulated and caused the tremor and liver changes, what the lifelong treatment involves and why it must never be stopped, what the Kayser-Fleischer rings tell the clinician, the family screening obligations for his siblings, and the role of liver transplantation - while addressing guilt, the fear of a restricted life, and the question of cure.

Open

osce communication and shared decision-making

Counsel a consanguineous couple on genetic risk to a future pregnancy — OSCE

OSCE communication and shared decision-making station: counselling a consanguineous couple who lost a child to an undiagnosed autosomal recessive illness, framing consanguinity as a risk modifier rather than a blame, quantifying the recurrence risk honestly, drawing the pedigree with the family, and laying out the reproductive options non-directively.

Open

osce communication and shared decision-making

Counsel a family on a new fragile X diagnosis and cascade testing — OSCE

OSCE communication and shared decision-making station: explaining to parents what a new fragile X syndrome diagnosis means for their three-year-old son, why a normal microarray did not detect it, what FMR1 testing involves, what the supportive management looks like, why cascade testing of the wider family matters, and what the mother's premutation carrier status means for her health and future pregnancies — while addressing guilt, the search for a cure, and the temptation to defer family testing.

Open

osce communication and shared decision-making

Counsel a family on a new Prader-Willi diagnosis and the trajectory ahead — OSCE

OSCE communication and shared decision-making station: explaining to parents what a new Prader-Willi syndrome diagnosis means for their hypotonic two-week-old neonate, why a normal karyotype did not detect it, what methylation testing involves, what the syndrome-specific management looks like including growth hormone therapy, why the molecular subtype matters for family recurrence risk, and what the trajectory from neonatal feeding failure to hyperphagia and obesity will look like — while addressing grief, guilt, fear about the future, and the demand for a cure.

Open

osce communication and shared decision-making

Counsel a family on a new Williams syndrome diagnosis and anaesthetic safety — OSCE

OSCE communication and shared decision-making station: explaining to parents what a new Williams syndrome diagnosis means for their eight-month-old daughter, why the heart and the coronary arteries are the overriding concern, why her planned dental and ear-nose-throat procedures cannot be done in a community day-case setting, what the chromosomal microarray and the elastin gene result mean, and what lifelong surveillance involves — while addressing the relief of a diagnosis, the fear of sudden death, and the temptation to underestimate her needs because she is sociable.

Open

osce communication and shared decision-making

Counsel a young woman with Marfan syndrome who wishes to conceive — OSCE

OSCE communication and shared decision-making station: counselling a young woman with Marfan syndrome and an aortic root of 4.4 cm who wishes to conceive, on the risk of pregnancy-related dissection, the role of pre-pregnancy valve-sparing root repair, beta-blockade and a planned delivery, reproductive options including cascade testing, and a strengths-based framing that addresses fear without dismissing it.

Open

osce communication and shared decision-making

Counsel an adolescent and her family on a new Turner syndrome diagnosis — OSCE

OSCE communication and shared decision-making station: explaining to a 13-year-old girl and her parents what a new Turner syndrome diagnosis means, what the karyotype found, what the growth-hormone and oestrogen management involves, why the aortic surveillance is lifelong, what the fertility implications are, and how the family can support her — while addressing the parents' grief, the adolescent's anxiety about being different, and the temptation to defer fertility and cardiac conversations because she is young.

Open

osce communication and shared decision-making

Counsel new parents given a postnatal diagnosis of Down syndrome — OSCE

OSCE communication and shared-planning station: breaking the news of a postnatal Down syndrome diagnosis, explaining the genetic mechanism and the meaning of the karyotype, outlining the age-stratified surveillance schedule in plain language, and offering strengths-based framing and a support pathway while addressing fear and avoiding deficit language.

Open

osce communication and shared decision-making

Counsel new parents given a postnatal diagnosis of Noonan syndrome — OSCE

OSCE communication and shared-planning station: breaking the news of a postnatal Noonan syndrome diagnosis, explaining the RAS/MAPK pathway and the meaning of the multigene panel result, outlining the genotype-aware surveillance schedule in plain language, and offering strengths-based framing and a support pathway while addressing fear and avoiding deficit language.

Open

osce communication and shared decision-making

Counsel parents after an abnormal newborn bloodspot screen for X-linked adrenoleukodystrophy — OSCE

OSCE communication and shared decision-making station: explaining an abnormal newborn bloodspot screen for X-linked adrenoleukodystrophy in plain language, conveying the difference between a screen and a confirmed diagnosis, managing uncertainty around variants of uncertain significance and late-onset phenotypes, and outlining the urgent confirmatory and surveillance pathway while supporting frightened parents.

Open

osce communication and shared decision-making

Counsel parents given a new diagnosis of 22q11.2 deletion syndrome — OSCE

OSCE communication and shared-planning station: breaking the news of a 22q11.2 deletion syndrome diagnosis confirmed after a neonatal cardiac presentation, explaining the multisystem nature and the meaning of the chromosomal microarray, outlining the live-vaccine rule and the age-based surveillance plan in plain language, and offering honest prognostic framing while addressing fear.

Open

osce communication and shared decision-making

Counsel parents given a prenatal diagnosis of 47,XXY Klinefelter syndrome — OSCE

OSCE communication and shared-planning station: counselling parents given a prenatal diagnosis of 47,XXY Klinefelter syndrome on cell-free DNA screening confirmed by amniocentesis. Explain the phenotype variability, the meaning of the karyotype, the limitations of the published literature, the lifespan surveillance framework, and the fertility prospects including micro-TESE, using balanced, non-directive, strengths-based language while addressing fear and avoiding deficit framing.

Open

osce communication and shared decision-making

Counsel parents given an abnormal newborn bloodspot screen for Krabbe disease — OSCE

OSCE communication and shared decision-making station: explaining an abnormal newborn bloodspot screen for a lysosomal storage disorder in plain language, conveying the difference between a screen and a confirmed diagnosis, managing uncertainty around pseudodeficiency and late-onset variants, and outlining the urgent confirmatory and treatment pathway while supporting frightened parents.

Open

osce communication and shared decision-making

Counsel parents of a newborn with suspected syndromic craniosynostosis — OSCE

OSCE communication and shared-planning station: breaking the news of a probable syndromic craniosynostosis identified on the postnatal ward, explaining the genetic basis and the meaning of the head-face-limb fingerprint, outlining the airway-eye-pressure safety triad and the age-based staged surgical plan in plain language, and offering honest prognostic framing while addressing fear about appearance and development.

Open

osce communication and shared decision-making

Counsel parents on a genomic test result, a secondary finding, and cascade testing — OSCE

OSCE communication and shared decision-making station: explaining to parents what their son's trio exome result means, why the normal microarray did not detect it, what a likely pathogenic variant is, what a secondary finding is and why it was reported, what cascade testing of the wider family involves, and why periodic re-analysis matters — while addressing parental guilt, anxiety about a cardiac finding, and the temptation to over-interpret uncertainty.

Open

osce communication and shared decision-making

Counselling a family after a new maple syrup urine disease diagnosis — OSCE

OSCE communication and shared decision-making station: explaining to parents what a new maple syrup urine disease diagnosis means for their neonate who survived a ketoacidotic crisis, why the leucine was so dangerous, what the emergency sick-day regimen involves, the role of liver transplantation, and the 25 percent recurrence risk for future pregnancies — while addressing guilt, the fear of a sudden death at home, and the search for a cure.

Open

long-case

Dietary, cofactor and emergency management of metabolic disease

Long case walking a child with an inherited metabolic disease through the dietary, cofactor, and emergency pillars onto the 15-examiner-dimension framework.

Open

osce communication and shared decision-making

Discuss vosoritide therapy with the parents of a child with achondroplasia — OSCE

OSCE communication and shared decision-making station: explaining vosoritide therapy for achondroplasia in plain language, setting realistic expectations about growth, balancing the daily injection burden against the benefit, integrating the therapy with the broader surveillance plan, and supporting parents through a decision that shapes their child's trajectory.

Open

long-case

Ethical issues in genomic diagnosis and cascade testing

Long case mapping the ethics of diagnostic genomic testing, a variant of uncertain significance, secondary findings, and cascade testing onto the 15-examiner-dimension framework.

Open

osce communication and shared decision-making

Explain an abnormal newborn bloodspot screen for MPS I (Hurler) — OSCE

OSCE communication and shared decision-making station: explaining an abnormal newborn bloodspot screen for mucopolysaccharidosis type I (Hurler) in plain language, conveying the difference between a screen and a confirmed diagnosis, managing uncertainty around pseudodeficiency and attenuated variants, and outlining the urgent confirmatory and treatment pathway — including the transplant window — while supporting frightened parents.

Open

osce communication and shared decision-making

Explain the workup and the treatable-subset principle to the parents of a regressing child — OSCE

OSCE communication and shared decision-making station: explaining to frightened parents that their child's loss of milestones is neurological regression requiring a tiered metabolic-and-genomic workup, conveying the principle that a treatable inborn error of metabolism must be excluded before any degenerative label is accepted, managing uncertainty while keeping urgency, and outlining the diagnostic pathway and the support available.

Open

long-case

Mitochondrial disease

Long case mapping the recognition, tiered investigation, dual-genome counselling, and supportive multidisciplinary management of mitochondrial disease onto the 15-examiner-dimension framework.

Open

long-case

Neurofibromatosis type 1 — clinical case

A clinical case of neurofibromatosis type 1: a preschool child with multiple cafe-au-lait macules and freckling presenting with a painful enlarging leg lump, illustrating the diagnostic criteria, the surveillance plan, and the recognition of malignant peripheral nerve sheath tumour.

Open

osce communication and shared decision-making

Normal microarray and developmental delay — genomic testing strategy OSCE

OSCE on counselling a family through a normal chromosomal microarray, justifying escalation to whole-exome or whole-genome sequencing, consent for the variant of uncertain significance and secondary findings, and the plan for re-analysis.

Open

long-case

Tuberous sclerosis complex — clinical case

A clinical case of tuberous sclerosis complex: a seven-month-old boy presenting with infantile spasms and hypomelanotic macules, illustrating the diagnostic criteria, the immediate vigabatrin-first management, the mTOR mechanism, and lifelong surveillance including everolimus for a later growing subependymal giant cell astrocytoma.

Open

osce clinical assessment and communication

Unusual face and developmental delay — dysmorphology examination OSCE

OSCE on a structured dysmorphology examination plan, anomaly classification, tiered testing and family communication.

Open

long-case

Usher syndrome — clinical case

A clinical case of Usher syndrome type I: a five-year-old girl with congenital profound sensorineural hearing loss managed with cochlear implantation who now presents with night blindness and progressive visual field constriction, illustrating the two-wave presentation, the electroretinographic and molecular confirmation, and the multidisciplinary management of dual sensory loss.

Open

structured clinical encounter

Variant of uncertain significance on prenatal microarray — structured clinical encounter

Structured encounter testing non-directive counselling of a variant of uncertain significance on prenatal microarray, parental testing strategy, phenotype correlation, and honest uncertainty management without over-interpretation.

Open

Domain

neurology-neurodisability-and-neuromuscular

40

paediatric emergency long case

Acute neuromuscular respiratory failure: Case

Clinical case of a 7-year-old boy with acute neuromuscular respiratory failure from Guillain-Barre syndrome, covering the ascending areflexic presentation, the normal oxygen saturation with falling forced vital capacity and bulbar weakness, the Lawn twenty-thirty-forty thresholds driving intubation, the avoidance of suxamethonium and use of rocuronium, the exclusion of acute flaccid myelitis and cord compression, the first-line intravenous immunoglobulin, and the paediatric recovery and rehabilitation course.

Open

outpatient long case

Ataxia in children: Case

Clinical case of a fourteen-year-old boy with Friedreich ataxia, covering the bedside diagnosis from the cardinal constellation, the genetic confirmation with the GAA repeat expansion in the FXN gene, the multidisciplinary management built on cardiac and endocrine surveillance, and the omaveloxolone evidence from the MOXIe trial.

Open

paediatric emergency long case

Autoimmune encephalitis: Case

Clinical case of a 13-year-old girl with anti-NMDA receptor encephalitis, covering the staged presentation from psychiatric change to seizures and movement disorder, the diagnostic workup with paired CSF and serum antibodies, the first-line immunotherapy ladder, the ovarian teratoma search and removal, the escalation to second-line therapy at 10 to 14 days, the management of dysautonomia and hypoventilation in intensive care, and the prolonged cognitive and school reintegration.

Open

paediatric intensive care long case

Brain death, death by neurological criteria and organ donation: Case

Clinical case of a child who reaches brain death after a severe traumatic brain injury, covering the prerequisite checks and the correction of the confounders, the bedside brainstem reflex examination, the apnoea test with the PaCO2 thresholds, the two clinical evaluations separated by the observation period, and the donation after brain death pathway with the dead donor rule and the family counselling.

Open

paediatric neurology long case

Cerebral vascular malformations: Case

Clinical case of a term neonate presenting with high-output cardiac failure from a vein of Galen aneurysmal malformation, covering the bedside recognition, the imaging pathway, the Bicetre neonatal evaluation score, the medical management of the heart failure, the staged transarterial embolisation, and the long-term developmental follow-up.

Open

structured clinical encounter

Concussion and mild traumatic brain injury — structured clinical encounter

Structured encounter testing the assessment of an eleven-year-old girl whose daily headache, fatigue, poor concentration, and sensitivity to noise have persisted for six weeks after a scooter fall, found to have persistent post-concussion symptoms: the definition and the four week threshold, the predictors of a prolonged course including migraine and anxiety, and the active rehabilitation that replaces further rest with sub-symptom threshold exercise, vestibular and ocular therapy, psychological support, and school liaison.

Open

paediatric neuromuscular long case

Congenital myopathies and muscular dystrophies: Case

Clinical case of a 6-month-old girl with merosin-deficient congenital muscular dystrophy from LAMA2, covering the markedly raised creatine kinase, the diffuse white matter change, the epilepsy, the next-generation sequencing panel confirmation, the multidisciplinary management of respiratory, nutritional, and orthopaedic care, the genetic counselling, and the prognosis.

Open

osce communication and shared decision-making

Counsel a family on a new diagnosis of juvenile myoclonic epilepsy — OSCE

OSCE communication and shared decision-making station: explaining a new diagnosis of juvenile myoclonic epilepsy to a fifteen-year-old girl and her parents, addressing the syndrome and its EEG, the medicine choice and the valproate rule, the lifestyle triggers, the lifelong framing, the comorbidities, and the transition to adult care in plain language.

Open

osce communication and shared decision-making

Counsel a family on starting levetiracetam for newly diagnosed focal epilepsy — OSCE

OSCE communication and shared decision-making station: explaining the selection, titration and adverse-effect monitoring of levetiracetam to the family of a ten-year-old boy with newly diagnosed focal epilepsy, addressing the behavioural adverse effects, the favourable interaction profile, the monitoring schedule, and the principle of syndrome-driven selection in plain language.

Open

osce communication and shared decision-making

Counsel the parents of a child with a first demyelinating event — OSCE

OSCE communication and shared decision-making station: explaining to frightened parents that their six-year-old's drowsiness, irritability, and hemiparesis four days after a viral illness is acute disseminated encephalomyelitis - a first demyelinating event - conveying the immediate treatment with high-dose corticosteroids, the antibody-led workup that will determine the long-term diagnosis, and the principle that the long-term treatment depends on the antibody result, while managing uncertainty and keeping urgency without alarming the family.

Open

paediatric neuromuscular long case

Duchenne and Becker muscular dystrophy: Case

Clinical case of a boy with Duchenne muscular dystrophy presenting with delayed motor milestones, calf pseudohypertrophy, and a markedly elevated creatine kinase, covering the genetic confirmation by multiplex ligation-dependent probe amplification, the glucocorticoid backbone with prednisolone or deflazacort started at the motor plateau, the cardiac and respiratory surveillance, the precision therapies, and the family counselling and the multidisciplinary plan.

Open

osce communication and shared decision-making

Examining and counselling the family of a high-risk infant — OSCE

OSCE communication and shared decision-making station: examining a four-month-old infant born preterm in the neonatal follow-up clinic, explaining to the family what the increased tone and the absent fidgety movements mean, what the General Movements Assessment and Hammersmith Infant Neurological Examination are for, why an early magnetic resonance imaging and a referral are being arranged, and what the trajectory and the safety-net are — while addressing fear, guilt, and the question of whether something was missed.

Open

structured oral long case with family counselling

Explain a Dravet syndrome diagnosis and its medication rules to a family — long case / structured oral

Long-case / structured-oral station: explaining a new diagnosis of Dravet syndrome to a family, the genetic basis, the medicines that must be avoided, the emergency plan for prolonged seizures, and the developmental outlook, with empathy and accurate counselling.

Open

osce communication and shared decision-making

Explain the scan and the transplant decision to the parents of a boy with cerebral adrenoleukodystrophy — OSCE

OSCE communication and shared decision-making station: explaining to frightened parents that their son's school decline and a contrast-enhancing brain lesion is cerebral X-linked adrenoleukodystrophy, an inherited inflammatory white-matter disorder in which a bone-marrow transplant can halt the disease if performed early, conveying urgency while managing fear, and outlining the diagnostic confirmation, the adrenal assessment, and the support available.

Open

osce communication and shared decision-making

Explain the workup and the treatable-cause principle to the parents of a regressing adolescent — OSCE

OSCE communication and shared decision-making station: explaining to frightened parents that their adolescent's subacute psychiatric change, seizures, and movement disorder is developmental regression requiring an urgent workup, conveying the principle that a treatable autoimmune encephalitis must be excluded and treated early, managing uncertainty while keeping urgency, and outlining the diagnostic pathway and the support available.

Open

emergency short case

Febrile seizures: Case

Clinical case of a 20-month-old boy with a prolonged febrile convulsion progressing to febrile status epilepticus, covering the classification, the staged acute termination, the exclusion of meningitis, the FEBSTAT evidence on hippocampal injury, and the counselling on prognosis and the avoidance of prophylaxis.

Open

structured clinical encounter

First seizure and seizure mimics — structured clinical encounter

Structured encounter testing the approach to a nine-year-old girl referred after a first generalised tonic-clonic seizure: the seizure-versus-mimic decision built from the eyewitness history, the classification and selective cause search led by a sleep electroencephalogram, the quantification of recurrence risk and its effect on the definition of epilepsy, and the shared decision with the family about waiting versus starting a daily antiseizure medication.

Open

paediatric emergency long case

Guillain-Barré syndrome and acute flaccid paralysis: Case

Clinical case of a 6-year-old boy with Guillain-Barré syndrome after Campylobacter jejuni gastroenteritis, covering the ascending areflexic presentation, the falling forced vital capacity and bulbar weakness triggering intensive care, the first-line intravenous immunoglobulin 2 g per kg over two to five days, the exclusion of acute flaccid myelitis, the intensive care course with ventilation and autonomic monitoring, and the paediatric recovery and rehabilitation.

Open

outpatient long case

Headache and migraine in children: Case

Clinical case of a 14-year-old girl with chronic migraine and medication-overuse headache, covering the ICHD-3 diagnosis, the reversal of analgesic overuse, the acute abortive plan, and the stepped prophylaxis built on lifestyle and cognitive behavioural therapy in light of the CHAMP trial.

Open

paediatric emergency long case

Hydrocephalus and shunt emergencies: Case

Clinical case of a child presenting with an obstructed ventriculoperitoneal shunt, covering the recognition of raised intracranial pressure, the shunt series and the CT head compared to baseline, the shunt tap, the hyperosmolar bridge to theatre, the operative revision, and the family counselling and the discharge safety-net.

Open

paediatric neurocritical care long case

Hypoxic-ischaemic brain injury: Case

Clinical case of a comatose child after a drowning-related out-of-hospital cardiac arrest, covering the primary versus secondary injury, the initiation of hypothermic targeted temperature management, the neurocritical care bundle with continuous EEG, the drowning-specific considerations, and the multimodal neuroprognostication and family communication deferred to at least 72 hours.

Open

long-case

Infantile spasms and developmental epileptic encephalopathy — clinical case

A clinical case of infantile spasms (West syndrome): a six-month-old boy presenting with two weeks of clustered flexor spasms on waking and developmental regression, illustrating the West syndrome triad, the urgent sleep-EEG and MRI workup, the tuberous sclerosis decision fork, and the first-line vigabatrin-versus-hormonal therapy choice driven by the time-to-treatment effect on developmental outcome.

Open

osce acute-care and communication

Lead the emergency response to a child with a suspected cord compression — OSCE

OSCE acute-care and structured-oral station: leading the first-hour emergency response for a nine-year-old with three days of nocturnal thoracic back pain, a weak left leg, and acute urinary retention, with a T10 sensory level. The candidate must recognise the cord emergency, secure the emergency whole-spine MRI without delay, separate the compressive from the inflammatory fork, start the matched corticosteroid, and make the neurosurgical and oncological referrals in parallel, while counselling frightened parents about urgency and prognosis without false reassurance.

Open

paediatric emergency long case

Moderate and severe traumatic brain injury: Case

Clinical case of a child with severe traumatic brain injury and impending herniation, covering the structured primary survey with intubation and cervical spine immobilisation, the immediate lowering of the intracranial pressure with 3 percent saline, the intracranial pressure management ladder in the paediatric intensive care unit, the prevention of secondary brain injury, and the appraisal of the hypothermia and decompressive craniectomy evidence and the family counselling.

Open

paediatric neurology long case

Movement disorders, dystonia and chorea: Case

Clinical case of an 8-year-old boy with known dystonic cerebral palsy who presents with status dystonicus, covering the recognition and triage of the emergency, the creatine kinase and rhabdomyolysis surveillance, the hunt for a precipitant, the escalation ladder from benzodiazepine and enteral anti-dystonia drugs through sedation and ventilation to intrathecal baclofen, the acute dystonic reaction as a contrasting emergency, and the family communication, dystonia action plan, and long-term functional management.

Open

paediatric long case

Myasthenia gravis and neuromuscular junction disorders: Case

Clinical case of a 14-year-old girl with autoimmune myasthenia gravis, covering the fluctuating fatigable ocular and bulbar weakness with preserved reflexes and pupils and a positive ice pack test, the falling forced vital capacity and bulbar weakness triggering intensive care, the antibody panel and repetitive nerve stimulation, pyridostigmine dosing, the low-start corticosteroid with early steroid-sparing, intravenous immunoglobulin 2 g per kg over two to five days for the threatened crisis, the exclusion of a thymoma and the thymectomy decision, and the paediatric prognosis and transition plan.

Open

paediatric neonatal neurology long case

Neural tube defects and spinal dysraphism: Case

Clinical case of a newborn with an open lumbosacral myelomeningocele and the Chiari II malformation with hydrocephalus, covering the latex-free neonatal resuscitation, the neurosurgical closure within 24 to 72 hours, the shunt for the hydrocephalus, the neurogenic bladder management, and the family counselling and the discharge plan.

Open

paediatric neurogenetic long case

Neurogenetic conditions and precision diagnosis: Case

Clinical case of a 3-year-old girl with developmental regression, drug-resistant epilepsy, and a paroxysmal movement disorder after normal early development and a normal chromosomal microarray, illustrating tiered genomic testing, the move from microarray to trio exome, the role of deep phenotyping and a cerebrospinal fluid glucose, the interpretation of variants through the American College of Medical Genetics five-tier framework, the treatable neurogenetic conditions unlocked by a molecular diagnosis with glucose transporter one deficiency and the ketogenic diet, and the plan for periodic reanalysis and genetic counselling.

Open

paediatric rehabilitation long case

Neurorehabilitation and acquired brain injury: Case

Clinical case of a child in the subacute phase of recovery from a moderate to severe traumatic brain injury, covering the multidisciplinary goal-directed rehabilitation plan across the motor, the spasticity, the cognitive, and the participation domains, the upper limb therapy and the spasticity ladder with the botulinum toxin-A dosing, the cognitive rehabilitation and the graded return to school, and the counselling of the family on the recovery curve and the late-emerging executive deficits.

Open

structured clinical encounter

Non-epileptic events and functional seizures — structured clinical encounter

Structured encounter testing the approach to a fifteen-year-old girl referred for daily spells unresponsive to two escalating antiseizure drugs: the recognition of the semiology of a functional seizure, the positive confirmation by video-electroencephalogram, the management of coexisting epilepsy, and the leadership of the explanation, supervised drug withdrawal and cognitive behavioural therapy pathway.

Open

paediatric neurology long case

Paediatric stroke and cerebral sinovenous thrombosis: Case

Clinical case of a child presenting with cerebral sinovenous thrombosis following an ear infection, covering the classification, the imaging pathway with MRV, the decision to anticoagulate despite haemorrhagic venous infarction, the treatment of the underlying infection, and the rehabilitation and follow-up.

Open

paediatric neurodisability long case

Pain, feeding and respiratory care in severe neurodisability: Case

Clinical long case of a 9-year-old non-verbal boy with severe cerebral palsy at GMFCS level V presenting with behavioural change that is pain until proven otherwise, an unsafe swallow with failure to thrive, and recurrent respiratory illness with sleep-disordered breathing, covering the observational pain assessment and head-to-toe search, the videofluoroscopic swallow study and the decision for gastrostomy with reflux control, the respiratory prevention bundle of airway clearance antisialogogues and non-invasive ventilation, and the prognosis and multidisciplinary and advance care planning with the family.

Open

paediatric neurology long case

Peripheral neuropathies: Case

Clinical case of a 10-year-old boy with Charcot-Marie-Tooth disease type 1A presenting with bilateral foot drop, pes cavus, and an affected father, covering the nerve conduction study interpretation showing uniform slowing under thirty-eight metres per second, the PMP22 duplication genetic testing, the Yiu 2022 paediatric management guideline with ankle-foot orthoses and physiotherapy, the distinction from chronic inflammatory demyelinating polyradiculoneuropathy, the autosomal dominant inheritance counselling, and the vincristine precaution for future chemotherapy.

Open

structured clinical encounter

Secondary headache and raised intracranial pressure — structured clinical encounter

Structured encounter testing the assessment of a fourteen-year-old girl who presents with obesity, a three-month history of daily headache, transient visual obscurations, pulsatile tinnitus, and new double vision, found on fundoscopy to have bilateral papilloedema: the recognition of the red-flag pattern, the Friedman 2013 diagnostic work-up with magnetic resonance imaging and venography and a lumbar puncture opening pressure, the separation of idiopathic from secondary intracranial hypertension, and the stepwise management that protects vision with weight advice, acetazolamide, and serial visual surveillance.

Open

outpatient long case

Sleep disorders with neurological disease: Case

Clinical case of a nine-year-old girl with narcolepsy type 1 presenting with irresistible daytime sleep and laughter-triggered cataplexy, covering the bidirectional mechanism of orexin loss, the multiple sleep latency test and cerebrospinal fluid orexin diagnostic pathway, the stepped management with naps, wake-promoting agents, and the emerging orexin receptor 2 agonists, and the favourable prognosis with early diagnosis.

Open

paediatric neurodisability long case

Spasticity, dystonia and tone management: Case

Clinical case of a 6-year-old girl with spastic diplegic cerebral palsy at GMFCS II presenting with adductor and calf spasticity causing scissoring, tip-toe gait and difficult care, covering the goal-directed assessment with the Modified Tardieu Scale and the GMFCS, the first-line focal botulinum toxin type A with its non-interchangeable dosing and twelve-week interval, the selective dorsal rhizotomy option with the McLaughlin and Tedroff evidence, the intrathecal baclofen withdrawal emergency, the dystonia pathway to GPi deep brain stimulation, and the multidisciplinary prevention of contracture hip subluxation scoliosis and pain.

Open

paediatric neuromuscular long case

Spinal muscular atrophy: Case

Clinical case of a 4-month-old infant with type 1 spinal muscular atrophy presenting with progressive floppiness, covering the bright-and-floppy pattern of symmetric proximal weakness with absent reflexes and tongue fasciculations and spared intellect, the genetic diagnosis by homozygous SMN1 deletion with SMN2 copy number, the respiratory resuscitation for neuromuscular ventilatory failure, the urgent disease-modifying therapy choice between nusinersen risdiplam and onasemnogene abeparvovec using the ENDEAR FIREFISH and STR1VE evidence, the multidisciplinary respiratory nutritional and orthopaedic care, and the prognosis and family counselling with the one in four recurrence risk.

Open

paediatric emergency long case

Status epilepticus: Case

Clinical case of a child presenting in established convulsive status epilepticus, covering the stepwise pathway from benzodiazepine to second-line levetiracetam, the reversible-cause search, the trial evidence for the second-line choice, the escalation to refractory management with rapid sequence intubation and continuous EEG, and the family counselling and follow-up.

Open

outpatient long case

Tics and Tourette syndrome: Case

Clinical case of an 11-year-old boy with Tourette disorder and comorbid attention-deficit or hyperactivity disorder and obsessive-compulsive disorder, covering the DSM-5 diagnosis, the distinction of his tics from stereotypies and restless overactivity, the stepped management built on Comprehensive Behavioural Intervention for Tics with alpha-2 agonists and antipsychotics, and the favourable prognosis that tics peak around 10 to 12 years and improve through adolescence.

Open

paediatric neurodisability long case

Transition and advance care planning in neurodisability: Case

Clinical case of a seventeen-year-old young woman with severe cerebral palsy approaching the paediatric to adult boundary with no transition plan, covering the distinction between transition and transfer, the Got Transition Six Core Elements with the age milestones of twelve fourteen eighteen and twenty-one, the assessment of transition readiness with the TRAQ or Ready Steady Go, the named transition coordinator and the portable summary, the dangerous transition gap, and the parallel paediatric advance care planning conversation for a child with a life-limiting neurodisability across the four domains of goals of care ceiling of treatment resuscitation decisions and preferred place of care.

Open

Domain

adolescent-and-young-adult-medicine

28

osce communication and clinical station

Adolescent chronic pain and functional symptoms OSCE — validation, function-first plan and school reintegration

Observed structured encounter testing a validating, function-first adolescent chronic-pain consultation: biopsychosocial assessment, red-flag screening once, central-sensitisation reframing, an interdisciplinary plan with school reintegration, and avoidance of opioid escalation.

Open

osce communication and ethics station

Adolescent consent for research and sensitive services — OSCE communication station

Observed structured encounter testing research-enrolment consent (assent plus parental permission, waiver of parental permission), sensitive-services consent, bedside capacity assessment, and a lawful, ethical confidentiality override.

Open

osce communication and clinical station

Adolescent consultation OSCE — time alone, confidentiality, HEEADSSS and a safety plan

Observed structured encounter testing negotiation of time alone, conditional confidentiality, structured HEEADSSS interviewing, same-visit response to a positive screen, and shared safety planning.

Open

osce communication and clinical station

Adolescent contraceptive consult OSCE — confidentiality, 5 Ps, method choice and a coercion disclosure

Observed structured encounter testing private time, conditional confidentiality, the 5 Ps, LARC-first counselling, dual protection and a controlling-partner safety assessment.

Open

osce communication and safeguarding station

Adolescent health care for young people in out-of-home care — OSCE communication and safeguarding station

Observed structured encounter testing trauma-informed engagement, consent-authority clarification, the entry-to-care assessment, a lawful confidentiality override, and transition planning for a care-experienced adolescent.

Open

osce communication and clinical station

Adolescent health in rural and remote settings OSCE — engineered confidentiality, tiered care and retrieval

Observed structured encounter testing a rural-optimised HEEADSSS with engineered confidentiality, a telehealth-supported plan, and early retrieval activation for a suicidal adolescent in a one-doctor town.

Open

osce communication and clinical station

Adolescent obesity and body-image concerns OSCE — assessment, weight-neutral counselling and staged planning

Observed structured encounter testing adolescent obesity classification, comorbidity and body-image screening, weight-neutral lifestyle counselling with motivational interviewing, and staged management planning with a parallel mental-health track.

Open

osce communication and clinical station

Adolescent PCOS OSCE — diagnostic reasoning, lifestyle counselling and management planning

Observed structured encounter testing adolescent PCOS diagnostic reasoning, mimic exclusion, lifestyle-first counselling with mental health awareness, and shared management planning.

Open

osce communication and clinical station

Adolescent pregnancy and parenting OSCE — confirmation, options, safeguarding and postpartum care

Observed structured encounter testing a non-judgemental adolescent pregnancy consultation: confirmation, options counselling, safeguarding, and a postpartum contraception and mood station.

Open

osce communication and clinical station

Adolescent risk assessment and harm minimisation OSCE — screening, brief intervention and the harm bundle

Observed structured encounter testing HEADSS, validated screening, motivational-interviewing brief intervention, and assembly of a domain-specific harm-reduction bundle with a safety override.

Open

osce communication and clinical station

Adolescent STI encounter OSCE — confidentiality, site-based testing and safety

Observed structured encounter testing private time, conditional confidentiality, the 5 P's history, risk- and anatomy-based testing, pregnancy-aware treatment and a PID red-flag assessment.

Open

osce communication and clinical station

Adolescent substance-use SBIRT OSCE — screening, brief intervention and the harm bundle

Observed structured encounter testing universal substance-use screening (S2BI/CRAFFT), motivational-interviewing brief intervention, assembly of a domain-specific harm-reduction bundle, and a confidentiality decision in the fentanyl era.

Open

osce communication station

Chronic disease self-management OSCE — adolescent adherence and motivational interviewing

Observed structured encounter testing objective adherence assessment, motivational interviewing, shared goal-setting and transition planning with an adolescent living with a chronic condition.

Open

osce communication and ethics station

Consent and confidential care for adolescents — OSCE communication station

Observed structured encounter testing time alone, conditional confidentiality, bedside capacity assessment, lawful override and electronic-record confidentiality.

Open

osce communication and clinical station

Digital media, gaming and cyberbullying OSCE — screening, the function filter and a safeguarding exit

Observed structured encounter testing non-judgemental digital-media screening, the function filter, motivational-interviewing brief intervention, and recognition of the safeguarding exit for cyberbullying-suicidality and online exploitation.

Open

structured clinical encounter

Dysmenorrhoea and heavy menstrual bleeding — structured clinical encounter

Structured encounter testing the approach to a 13-year-old with heavy menstrual bleeding from menarche: quantifying the bleeding, recognising the bleeding-disease screen, applying the FIGO PALM-COEIN classification, and running the management ladder with iron repletion and follow-up.

Open

osce communication and clinical station

Eating disorders: recognition and medical instability — OSCE communication and clinical station

Observed structured encounter testing recognition of an eating disorder, application of SCOFF, bedside instability assessment, red-flag triage, and engaging an ambivalent adolescent and their family.

Open

osce communication and clinical station

Eating disorders: refeeding and multidisciplinary-care OSCE — risk stratification, refeeding-syndrome prevention and family engagement

Observed structured encounter testing a safe refeeding plan for a malnourished adolescent: risk stratification, micronutrient and electrolyte management, recognition of refeeding syndrome, and family engagement in family-based treatment.

Open

osce communication and shared planning

Explain school refusal and bullying plan to an adolescent and parent — OSCE

OSCE communication station: explaining overlapping school refusal and bullying victimisation in plain language, a graded return and anti-bullying response, when an SSRI such as sertraline might help, and safety monitoring — without blame.

Open

osce communication and clinical station

Gender-affirming adolescent care OSCE — assessment, staging and a family conversion request

Observed structured encounter testing an affirming, developmentally appropriate assessment of a peripubertal trans adolescent, a pubertal-suppression eligibility decision, bone-health and fertility planning, and a respectful refusal of a family conversion request.

Open

osce communication station

Inclusive care OSCE — the affirming consultation and the mother's direct question

Observed communication station testing an affirming adolescent consultation: establishing confidentiality, asking attraction, identity and behaviour separately, behaviour-based screening, responding to a parent's direct question without breaching confidentiality, and acute risk management.

Open

osce communication and clinical station

Medication adherence and treatment fatigue OSCE — assessment, measurement and the tailored plan

Observed structured encounter testing a non-judgemental adherence assessment, multimodal measurement interpretation, barrier mapping, and a tailored adherence-promotion plan with a safety override.

Open

osce communication and clinical station

Menstrual disorders in adolescents — OSCE: heavy menstrual bleeding assessment and plan

Observed structured encounter testing confidential adolescent history, objective FIGO description of heavy menstrual bleeding, a focused work-up rationale, and a shared mechanism-based plan.

Open

short case with communication station

Normal puberty and adolescent development — short case and counselling station

Observed structured encounter testing pubertal staging, recognition of a normal variant, counselling on timing, and safe identification of a presentation that requires referral.

Open

short case with communication station

Sleep, fatigue and circadian disorders in adolescents — short case and counselling station

Observed structured encounter testing adolescent sleep assessment, recognition of the dominant mechanism, stepped-care management, and safe identification of a presentation that requires urgent referral.

Open

osce communication and clinical station

Tobacco, vaping and nicotine dependence OSCE — dependence assessment, brief intervention and the cessation plan

Observed structured encounter testing universal screening of all nicotine products, dependence grading with DSM-5 and the Hooked on Nicotine Checklist, motivational-interviewing brief intervention, and assembly of an evidence-based cessation plan with an EVALI safety override.

Open

osce transition communication and planning

Transition planning clinic — OSCE

OSCE on counselling a young person and family about structured transition from paediatric to adult care.

Open

osce communication and clinical station

Youth violence, risky behaviour and injury prevention OSCE — private screening, tiering, lethal-means counselling and the safety override

Observed structured encounter testing a private violence and safety screen, prevention-tiered brief advice, lethal-means counselling, and an immediate-safety override.

Open

Domain

professional-practice-and-evidence

35

osce communication and clinical station

Adolescent confidentiality OSCE — conditional script, override and the portal breach

Observed structured encounter testing the conditional-confidentiality script, time alone, capacity assessment, a safety override decision and a portal-breach repair.

Open

osce critical appraisal and shared decision

Appraising a trial for a shared decision — OSCE

OSCE on appraising a randomised trial and applying its evidence to a shared decision with a family.

Open

osce critical appraisal and shared decision

Appraising design and bias at the bedside — OSCE

OSCE on identifying study design, assessing bias, and judging applicability of evidence to a child and family.

Open

osce communication and management station

Best-interests decisions and treatment limitation — OSCE

OSCE station: leading a goals-of-care and treatment-limitation conversation with the family of a child with a progressive life-limiting condition, applying the best-interests balance and avoiding an isolated resuscitation decision.

Open

osce communication and management station

Consent, parental responsibility and mature-minor frameworks — OSCE

OSCE station: obtaining parental permission and child assent for a lumbar puncture in a school-age child, managing dissent and disagreement.

Open

osce shared decision and stewardship counselling

Counselling a family toward high-value care — OSCE

OSCE on explaining restraint and shared decision-making to a family requesting a low-value test and treatment.

Open

osce communication and shared decision

Counselling a positive newborn screen — OSCE

OSCE on translating a positive newborn screen into a positive predictive value and a confirmatory plan with a family.

Open

osce professional boundaries communication

Declining a boundary challenge from an adolescent patient — OSCE

OSCE on declining a social media friend request from a 14-year-old patient and redirecting an after-hours message from her mother, maintaining the therapeutic frame with warmth and clarity.

Open

osce breaking bad news communication

Delivering a new diagnosis — OSCE

OSCE on delivering a new serious diagnosis to parents using a structured SPIKES approach, with attention to setting, emotion and follow-up.

Open

osce implementation planning

Designing and defending a paediatric implementation plan — OSCE

OSCE on designing and defending a paediatric implementation project to close an evidence-practice gap: diagnosing barriers with Cabana and CFIR, selecting ERIC strategies, measuring Proctor implementation outcomes with RE-AIM, and protecting equity and sustainability.

Open

osce communication station

Developmentally appropriate communication OSCE — preschool engagement and adolescent confidentiality

Observed structured encounter testing developmentally appropriate engagement of a preschooler through play, interpreter-supported communication, confidential adolescent interviewing with limits of confidentiality, behavioural pain reading and teach-back.

Open

osce medication safety disclosure

Disclosing a medication error to a family — OSCE

OSCE on disclosing a tenfold opioid infusion error to a parent, with attention to immediate safety, honest open disclosure, system analysis and second-victim support.

Open

osce patient-safety communication

Disclosing a medication error to a family — OSCE

OSCE on the system response and open disclosure after a paediatric medication error, with attention to the Swiss cheese model, the response pathway and the second victim.

Open

osce communication and management station

Ethical allocation of resources in paediatrics — OSCE

OSCE station: explaining a fair-allocation decision to the family of a child who did not receive a scarce PICU bed during a surge, applying the triage principles, the comfort-care guarantee and the appeal pathway.

Open

osce risk and benefit communication

Explaining a treatment's risks and benefits — OSCE

OSCE on communicating the risks and benefits of a preventive medication to parents using evidence-based risk-communication tools, with attention to framing, numeracy, uncertainty and teach-back.

Open

osce communication and management station

Family-centred and child-rights-based care — OSCE

Communication and management OSCE station: delivering a family-centred, rights-based encounter with a child with special health care needs and a family who speak a language other than English.

Open

osce communication station

Goals-of-care conversation OSCE — adolescent oncology and a child with no plan

Observed communication encounter testing a structured goals-of-care conversation using the Serious Illness Conversation Guide, age-appropriate advance care planning, prognostic disclosure, documentation, and management of a family who wants everything.

Open

osce communication station

Health literacy and accessible information OSCE — liquid-medication counselling and complex discharge

Observed communication encounter testing health literacy universal precautions, teach-back, millilitre dosing with an oral syringe and pictogram, accessible discharge communication, and professional interpreter use.

Open

osce critical appraisal and shared decision

Interpreting a meta-analysis for a shared decision — OSCE

OSCE on interpreting a meta-analysis and a guideline recommendation and applying them to a shared decision with a family.

Open

osce team leadership communication

Leading a paediatric resuscitation team — OSCE

OSCE on leading a paediatric resuscitation team and defending how you build a high-performing interprofessional team: role allocation, closed-loop communication, shared mental model, psychological safety, TeamSTEPPS and SBAR, structured handover, conflict and the evidence for team training.

Open

osce communication and conflict de-escalation

Managing an angry parent at the bedside — OSCE

OSCE on de-escalating a distressed but non-violent parent on the ward using a structured verbal approach, with attention to safety, acknowledgement and follow-up.

Open

osce communication and ethics

Negotiating a parental refusal of a blood transfusion — OSCE

OSCE on navigating a Jehovah's Witness family's refusal of a life-saving blood transfusion for their bleeding child, with attention to the harm-principle threshold, emergency treatment in best interests, respectful engagement and escalation.

Open

osce open disclosure communication

Open disclosure after a medication error — OSCE

OSCE on staged open disclosure after a tenfold medication error, addressing acknowledgement, apology, language access and follow-up.

Open

osce communication and consultation

Paediatric consultation with child, young person and family — communication OSCE

OSCE on structuring a triadic, developmentally-adapted paediatric consultation: rapport before examination, eliciting ICE, adolescent time alone and HEEADSSS, and safety-netted closure.

Open

osce quality improvement planning

Presenting and defending a quality improvement plan — OSCE

OSCE on designing and defending a paediatric quality improvement project using the Model for Improvement: aim, measures, PDSA testing, run-chart interpretation and sustainability, with attention to equity and evidence appraisal.

Open

osce statistical appraisal and shared decision

Reading a paediatric trial result for a shared decision — OSCE

OSCE on reading a paediatric statistical result — confidence interval, p-value, effect size and clinical importance — and conveying it to a family in a shared decision.

Open

osce communication station

Research ethics and assent OSCE — paediatric trial enrolment and emergency deferred consent

Observed communication encounter testing permission versus assent terminology, risk-benefit categorisation, screening for therapeutic misconception, and management of a child's dissent and a deferred-consent emergency scenario.

Open

osce trauma-informed care communication

Responding to a distressed child in the ED — OSCE

OSCE on applying a trauma-informed approach to a distressed child in the ED requiring a procedure, with attention to the SAMHSA framework, procedural adaptation and follow-up.

Open

osce medicolegal communication

Responding to a subpoena and writing a safeguarding statement — OSCE

OSCE on the immediate response to a subpoena, the principles of medicolegal documentation for a child-protection statement, and preparing to give evidence, with the duty-to-the-court framing.

Open

observed structured encounter safety and communication station

Safety station — infusion error rescue, incident report, systems analysis and family disclosure

Structured clinical encounter testing immediate rescue after a paediatric medication adverse event, blame-free incident reporting, systems analysis with strong actions, and open disclosure to the family.

Open

osce communication station

Shared decision-making and assent OSCE — imaging choice and chronic-disease disagreement

Observed communication encounter testing shared decision-making, assent, decision-aid use, capacity assessment and management of disagreement with an adolescent.

Open

osce clinician wellbeing and second-victim support

Supporting a fatigued colleague after a near miss — OSCE

OSCE on supporting a fatigued trainee who is the second victim of an intercepted tenfold opioid near miss, with attention to immediate patient safety, second-victim support, the demands-resources mechanism, and a systems response.

Open

osce communication station

Teaching, supervision and feedback OSCE — procedural error and the deteriorating registrar

Observed communication and supervision encounter testing structured feedback, the educational alliance, entrustment decisions, safe correction of practice and the struggling learner versus learner in difficulty distinction.

Open

osce critical appraisal and shared decision

Translating an effect estimate into a shared decision — OSCE

OSCE on computing and interpreting measures of effect and applying them to a shared decision with a family.

Open

osce communication station

Working with interpreters and culturally responsive communication OSCE — emergency consent and adolescent confidentiality

Observed communication encounter testing professional interpreter use, the avoidance of child interpreters, teach-back, a cultural competence framework and the protection of adolescent confidentiality.

Open

Domain

clinical-pharmacology-and-therapeutics

22

osce management and communication station

Adverse drug reactions OSCE — suspected anaphylaxis and reporting

Observed structured encounter testing recognition and immediate management of a suspected drug reaction, causality reasoning, family communication, and the duty to report through the national pharmacovigilance system.

Open

structured clinical encounter (medication safety leadership)

Anticipate before you prescribe — drug interactions and reconciliation

A bedside structured clinical encounter testing anticipation of a cytochrome P450-mediated drug interaction, prediction of the direction and timing of inhibition, choosing among avoid-substitute-adjust-monitor, building a Best Possible Medication History, and performing a safe, plain-language discharge reconciliation.

Open

osce communication cam history and counselling

Asking about complementary and traditional medicines — OSCE

Communication OSCE on taking a respectful, non-judgemental complementary and alternative medicine history from a parent, screening for interactions and contamination, counselling honestly, and building a shared safety plan for a child with chronic illness.

Open

osce clinical decision and communication

Assess and correct a child's inhaler technique — OSCE

OSCE clinical-decision and communication station: assessing and correcting a child's inhaler technique when an inhaled corticosteroid appears to fail, applying the SEAL check, distinguishing a delivery problem from non-adherence and disease severity, defending the plan to re-teach before escalating the dose, and explaining the plan to the child and family in plain language.

Open

osce clinical decision and communication

Build a precision-prescribing plan for a child starting azathioprine — OSCE

OSCE clinical-decision and communication station: building a TPMT and NUDT15-guided thiopurine plan for a child with newly diagnosed Crohn disease, ordering the right tests, translating the result into a phenotype, defending the dose action, and explaining the result and the plan to the family in plain language.

Open

structured clinical encounter (supportive oncology pharmacology planning)

Chemotherapy and supportive pharmacology — formative case

A MedVellum formative structured clinical encounter following a child starting a doxorubicin and cisplatin regimen, assessing the dexrazoxane cardioprotection decision, the antiemetic ladder, febrile neutropenia prophylaxis and the front-door plan, and the non-negotiable vincristine-intravenous-only route rule. It is not an official board format.

Open

osce communication formulation and adherence

Counselling a family about a medicine the child cannot take — OSCE

Communication OSCE on reframing a child's erratic disease control as a formulation-and-adherence problem, assessing how the medicine is actually taken, identifying the barrier, and co-designing a formulation and regimen plan with the family, including escalation to the pharmacist for an age-appropriate alternative.

Open

osce medication safety disclosure

Counselling a family after a neonatal morphine error — OSCE

OSCE on disclosing a developmental pharmacology medication error to a parent: explaining why a 'standard' dose caused toxicity in a term neonate and how it will be prevented.

Open

osce communication off-label counselling

Counselling a family that a medicine is off-label — OSCE

Communication OSCE on explaining to a parent that a medicine is being prescribed outside its product licence for their child, covering informed consent, the evidence base, the formulation choice, monitoring and the pharmacovigilance plan.

Open

osce clinical reasoning and communication station

Endocrine and diabetes medicines OSCE — DKA insulin and fluid prescribing with family counselling

Observed structured encounter testing the DKA insulin and fluid prescribing sequence, the rationale for the insulin infusion rate and no-bolus rule, pump-failure safety counselling, and structured transition of an adolescent insulin regimen to adult care.

Open

communication and consent OSCE

Explaining procedural sedation, fasting and risk to a family — communication OSCE

Communication OSCE on explaining procedural sedation medicines to a family before a painful fracture reduction: the agent, the fasting decision, the monitoring, and the realistic risks and recovery.

Open

osce clinical decision and communication

Interpret and act on an out-of-range vancomycin level — OSCE

OSCE clinical-decision and communication station: interpreting an out-of-range vancomycin level in a child with serious MRSA infection, applying the area-under-the-curve target, excluding sampling and timing errors, defending the dose-adjustment plan, and explaining the plan to the nurse and family in plain language.

Open

structured clinical encounter (antidote-safety leadership)

Pick the right antidote — poisoning antidotes and toxicology pharmacology

A bedside structured clinical encounter testing recognition of an opioid toxidrome and the weight-based naloxone response, the decision to start N-acetylcysteine for a staggered paracetamol ingestion, and the construction of a safe antidote plan that avoids the flumazenil trap.

Open

osce clinical decision and communication

Recognise and manage adrenal crisis in a steroid-dependent child — OSCE

OSCE clinical-decision and communication station: recognising adrenal crisis in a steroid-dependent child who collapses with hypoglycaemia during a febrile illness, applying the age-banded stress-dose hydrocortisone, running resuscitation in parallel, and explaining the diagnosis and the emergency plan to the family in plain language.

Open

osce clinical reasoning and communication station

Renal and hepatic dose adjustment OSCE — child with CKD, a high-risk antibiotic and family counselling

Observed structured encounter testing bedside Schwartz eGFR calculation, KDIGO staging, a renal dose-adjustment decision for a high-risk antibiotic, level interpretation, and family counselling on a non-standard dose.

Open

communication and patient-safety OSCE

Responding to a high-alert medication error — communication and systems OSCE

OSCE on responding to a high-alert medication error in a child: immediate management, open disclosure to the family, and the system changes that prevent recurrence.

Open

osce clinical decision and communication

Resuscitate a cyanotic neonate with prostaglandin E1 — OSCE

OSCE clinical-decision and communication station: recognising a duct-dependent neonate, starting prostaglandin E1 at the weight-based dose, anticipating the adverse effects of apnoea, fever and hypotension, defending the target saturation, and explaining the plan to the nurse and family in plain language.

Open

structured clinical encounter (chronic-disease medication initiation)

Screen before you prescribe — immunosuppressive and biologic therapy

A bedside structured clinical encounter testing the safe initiation of methotrexate in juvenile idiopathic arthritis and the pre-biotic screen before a tumour necrosis factor inhibitor, including the weekly-versus-daily distinction, folic acid, full-blood-count and liver-enzyme monitoring, dual tuberculosis screening, the live-vaccine rule, and communication with the family.

Open

structured clinical encounter (preventive vaccination and catch-up)

Screen before you vaccinate — vaccines and immunobiology

A bedside structured clinical encounter testing safe childhood vaccination — the prevaccination screen for immunocompromise, pregnancy, severe allergy, and the interval since any live vaccine or blood product; the live-versus-inactivated distinction; the four-week spacing rule; the rotavirus age limits; the premature-infant chronological-age rule; the catch-up minimum-interval principle; and the recognition of anaphylaxis after a vaccine.

Open

structured clinical encounter (medication safety leadership)

Stop the codeine — opioids and acute pain medicines

A bedside structured clinical encounter testing recognition of the codeine contraindication after tonsillectomy, defence of the CYP2D6 prodrug mechanism, and construction of a safe weight-based morphine regimen with paired monitoring, constipation prophylaxis, and a naloxone plan.

Open

structured clinical encounter (prescribing leadership)

The right dose, the right cap, the right child — analgesic and antipyretic prescribing

A bedside structured clinical encounter testing the safe choice, calculation and prescription of a paediatric analgesic and antipyretic: obtaining a measured weight, scoring the pain, calculating the paracetamol and ibuprofen doses with the adult ceiling, taking a position on alternating agents, respecting the aspirin and codeine restrictions, escalating to a monitored opioid for severe pain, and closing the loop with a written discharge dose and a safety-net for the family.

Open

structured clinical encounter (prescribing leadership)

Weigh it, cap it, check it — weight-based dosing and dose calculation

A bedside structured clinical encounter testing the safe calculation and verification of a paediatric drug dose: obtaining a measured weight and height, choosing between weight-based and body-surface-area dosing, working the Mosteller formula, applying the maximum adult-dose cap, applying the leading-zero and no-trailing-zero writing rules, arranging an independent double check, and running the therapeutic drug monitoring loop for a level-guided antimicrobial, alongside clear communication with the family.

Open

Domain

acute-care-resuscitation-and-toxicology

31

paediatric short case

Airway assessment and basic airway management: Case

Clinical case of an unconscious toddler with tongue airway obstruction after a seizure, covering bedside airway assessment, head tilt-chin lift, oropharyngeal airway sizing, two-person bag-valve-mask ventilation, and escalation triggers.

Open

structured clinical encounter (resuscitation leadership)

Bleed first, diagnose later — hypovolaemic and haemorrhagic shock

A bedside structured clinical encounter testing recognition of haemorrhagic shock before hypotension, bleeding control, activation of the paediatric massive transfusion protocol, tranexamic acid dosing and timing, prevention of the lethal triad, damage control resuscitation, early surgical and retrieval escalation, communication, safeguarding in parallel, and structured handover.

Open

osce paediatric resuscitation scenario

Box jellyfish sting — OSCE

OSCE on the immediate first aid and hospital management of a child with a box jellyfish sting and evolving cardiorespiratory compromise, testing vinegar dousing, tentacle removal, the indication for box jellyfish antivenom, and the principle of resuscitating until help arrives.

Open

communication and bereavement support station

Breaking bad news and supporting a bereaved family after a SUDI — communication OSCE

Communication OSCE station: breaking the news of an unexpected infant death to the parents using SPIKES, offering family time and memory-making, explaining the coronial and multi-agency process, and arranging bereavement follow-up.

Open

structured clinical encounter (retrieval team leadership)

Bring intensive care to the child — rural retrieval of a deteriorating child

A bedside structured clinical encounter testing recognition of a deteriorating child in a rural hospital, the stay-and-stabilise retrieval principle, a pre-transport stabilisation checklist, management of the physics of altitude, vibration and cold, the choice of mode and escort, communication, a rehearsed contingency, and a structured handover.

Open

structured clinical encounter (toxicology assessment and leadership)

By the product, not the symptom — household chemical exposure station

A bedside structured clinical encounter testing recognition of a household chemical exposure, identification of the product from the container, application of the contraindications (no induced emesis, no gastric lavage for hydrocarbons, no neutralisation for caustics), running the six-hour hydrocarbon observation, and arranging early endoscopy within twenty-four hours for a caustic comparator.

Open

emergency resuscitation case

Cardiogenic and obstructive shock: Case

Clinical case of a 14-year-old adolescent who develops tension pneumothorax while ventilated for severe asthma, covering the clinical diagnosis, the immediate finger thoracostomy decompression, the cautious fluid strategy for the obstructive shock, and the subsequent insertion of a chest drain and transfer to PICU.

Open

structured clinical encounter (resuscitation leadership)

Check the glucose, measure the brain — altered conscious state in children

A bedside structured clinical encounter testing recognition of a child with an altered conscious state, securing the airway, screening with AVPU and converting to an age-adapted Glasgow Coma Scale, checking and correcting the bedside glucose immediately, treating an ongoing convulsion at five minutes, recognising raised intracranial pressure, communication, early escalation, safeguarding in parallel, handover and disposition.

Open

structured clinical encounter (burns resuscitation leadership)

Cool, resuscitate, safeguard — a scalded child in the resuscitation bay

A bedside structured clinical encounter testing recognition of a burned child, correct cooling, age-adjusted TBSA estimation, modified-Parkland fluid resuscitation titrated to urine output, recognition of the evolving airway, safeguarding in parallel, communication, and structured handover.

Open

structured clinical encounter (resuscitation leadership)

De-escalate before you sedate — humane restraint and behavioural support in emergency care

A structured clinical encounter in which the candidate leads the emergency department response to an adolescent with acute behavioural disturbance after an unknown ingestion, covering the team-led primary survey, the exclusion of medical and toxicological causes, verbal and environmental de-escalation, the oral-first pharmacological approach, escalation to parenteral rapid tranquillisation with cautions, restraint as a last resort, monitoring, and the mandatory post-event debrief and safeguarding review. Designed to test leadership, safety, communication and clinical reasoning under pressure.

Open

osce paediatric resuscitation scenario

Exertional heat stroke — OSCE

OSCE on the recognition and rapid cooling of exertional heat stroke in a young athlete, testing the heat-stroke definition, the cool-first-transport-second principle with cold-water immersion to a core below thirty-nine degrees within thirty minutes, the avoidance of antipyretics and dantrolene, and the multi-organ disposition.

Open

acute resuscitation long case

Fluid bolus therapy and vasoactive support — long case

A long case following a three-year-old in septic shock through aliquot-based crystalloid resuscitation with reassessment after each bolus, the transition to vasoactive support for fluid-refractory shock, cold versus warm shock phenotyping and agent selection, the FEAST caution in a rural setting, fluid overload recognition, and the structured handover to retrieval.

Open

osce paediatric resuscitation scenario

Hypothermic submersion cardiac arrest — OSCE

OSCE on the resuscitation of a child in profound hypothermic submersion cardiac arrest, testing the rescue-breath-first sequence, the Swiss staging, the rewarming ladder, the hypothermic defibrillation and drug rules, and the principle of resuscitating until warm.

Open

osce paediatric resuscitation scenario

Leading a paediatric arrest — OSCE

OSCE on leading the resuscitation of a 4-year-old in cardiac arrest with ventricular fibrillation, testing the BLS sequence, the ALS loop with defibrillation and adrenaline, reversible-cause search, and post-arrest temperature management.

Open

acute management and escalation station

Manage a child after cardiac arrest in PICU — OSCE

OSCE management station: stabilising a comatose school-age child after return of spontaneous circulation, delivering the post-arrest bundle, and planning delayed multimodal prognostication.

Open

acute management and escalation station

Manage a child with a difficult airway in the emergency department — OSCE

OSCE management station: anticipating and preparing for an anticipated-difficult paediatric airway, delivering the recognise-oxygenate-escalate-rescue sequence, recognising deterioration, rescuing with the supraglottic airway, and preparing for the rare cannot-intubate-cannot-oxygenate event.

Open

structured clinical encounter

Mechanical ventilation principles in children — structured clinical encounter

Structured encounter testing the approach to an 8-year-old with severe pneumonia evolving into paediatric acute respiratory distress syndrome: confirming tube placement, choosing lung-protective settings against the PALICC-2 targets, monitoring plateau pressure and the oxygenation index, and planning ventilator liberation with post-extubation support.

Open

osce assessment and communication station

Oxygen, high-flow and non-invasive respiratory support — OSCE

OSCE assessment and communication station for a child with bronchiolitis escalating to high-flow nasal cannula, with an anxious parent.

Open

structured clinical encounter (toxicology assessment and leadership)

Plot the level, respect the time — paediatric paracetamol poisoning

A bedside structured clinical encounter testing recognition of a significant paracetamol ingestion, taking a precise ingestion history, applying the Rumack-Matthew nomogram at four hours, giving activated charcoal early, starting intravenous N-acetylcysteine on or above the treatment line, managing an anaphylactoid reaction, tracking the ALT and INR trend, and escalating when King's College criteria appear.

Open

structured clinical encounter (neuroprotection leadership)

Protect the brain — initial stabilisation of major paediatric head injury

A bedside structured clinical encounter testing recognition of severe paediatric traumatic brain injury, leadership of the neuroprotective primary survey with cervical spine control, airway threshold, ventilation target, fluid strategy, raised intracranial pressure management, communication, early neurosurgical escalation and safe transfer.

Open

osce assessment and procedural-planning station

Rapid sequence intubation in children — OSCE

OSCE assessment and procedural-planning station for a child requiring rapid sequence intubation, with a structured oral of preparation, drug choice and complication management.

Open

structured clinical encounter (resuscitation leadership)

Read the acidosis, choose the antidote — iron, salicylate and toxic alcohol poisoning

A bedside structured clinical encounter testing recognition of a child with a mixed overdose producing a high-anion-gap metabolic acidosis, the reading of the poison-specific signature, the choice of decontamination and weight-based antidote (desferrioxamine for iron, urinary alkalinisation for salicylate, fomepizole for the toxic alcohols), the avoidance of the three lethal traps, communication, early escalation to dialysis and retrieval, and safeguarding in parallel.

Open

structured clinical encounter (acute care leadership)

Read the halo, beat the clock — oesophageal button battery in a toddler

A bedside structured clinical encounter testing recognition of an oesophageal button battery from the anteroposterior radiograph halo sign, two-hour emergency endoscopy timing, the honey demulcent adjunct and its contraindications, communication with the family, and the written safety net for delayed aorto-oesophageal fistula.

Open

structured clinical encounter (resuscitation leadership)

Read the strip, choose the antidote — cardiotoxic and psychotropic medication poisoning

A bedside structured clinical encounter testing recognition of a child with a mixed cardiotoxic overdose, the reading of the ECG and the toxidrome, the choice of weight-based antidote (sodium bicarbonate for the tricyclic widened QRS, calcium and high-dose insulin euglycaemic therapy for the calcium channel blocker), the avoidance of the class Ia and Ic antiarrhythmic trap, the rescue role of lipid emulsion and extracorporeal support, communication, early escalation to retrieval, and safeguarding in parallel.

Open

structured clinical encounter (resuscitation leadership)

Recognise shock from the whole child — physiology and classification

A bedside structured clinical encounter testing recognition of compensated shock from the whole child rather than a blood pressure number, grading severity, classifying the haemodynamic phenotype, applying the fluid-as-a-ceiling principle, recognising warm versus cold shock, early escalation to vasoactive support and retrieval, communication, safeguarding in parallel, handover and disposition.

Open

structured clinical encounter (resuscitation leadership)

Recognise the pattern, not the bottle — paediatric drug toxicity

A bedside structured clinical encounter testing recognition of the opioid toxidrome, leadership of an ABCDE primary survey with oxygen, ventilation, bedside glucose and access, naloxone titrated to effective ventilation with an infusion for a long-acting opioid, the decision to decline flumazenil for a possible co-ingestion, communication with an adolescent and parent, and a structured handover and disposition.

Open

structured clinical encounter (resuscitation and toxicology leadership)

Resuscitate before you decontaminate — the poisoned child

A bedside structured clinical encounter testing recognition of a poisoned child, resuscitation before decontamination, taking the four-question ingestion history, reading the toxidrome, calling the Poisons Information Centre, deciding on activated charcoal within the first hour, communicating, safeguarding in parallel, handover and disposition.

Open

structured clinical encounter (resuscitation leadership)

Resuscitate the circulation, not the number — paediatric septic shock

A bedside structured clinical encounter testing recognition of paediatric septic shock, running the first-hour bundle of oxygen, access, reassessed fluid aliquots and antibiotics within the hour, choosing adrenaline for cold shock, recognising fluid accumulation injury, communication, early escalation to retrieval, and a structured handover and disposition.

Open

structured clinical encounter (resuscitation leadership)

Run the survey, not the label — ABCDE of the acutely ill child

A bedside structured clinical encounter testing recognition of an acutely ill child, a hands-on ABCDE primary survey that treats each threat as found, age-appropriate oxygen, fluid and glucose decisions, recognising the tiring child, communication, early escalation, safeguarding in parallel, handover and disposition.

Open

structured clinical encounter (trauma team leadership)

Run the survey, not the label — major trauma and the trauma team

A bedside structured clinical encounter testing recognition of the injured child, leadership of a team-led <C>ABCDE trauma primary survey, catastrophic-haemorrhage-first reasoning, weight-based fluid with early blood, protecting the cervical spine, communication, early escalation, safeguarding in parallel, handover and disposition.

Open

structured clinical encounter (resuscitation leadership)

Two hours, not two days — button-battery and magnet ingestion

A bedside structured clinical encounter testing recognition of a child with a suspected oesophageal button battery, securing the airway, taking the localising radiograph and identifying the halo sign, leading the two-hour endoscopic removal pathway, giving the honey adjunct in the eligible child with its limits, anticipating the multiple-magnet counterpoint, recognising delayed complications, communication, safeguarding in parallel, handover and disposition.

Open

Domain

allergy-and-immunology

25

paediatric long case

Allergic disease in children: integrated approach: Case

Clinical long case of a school-age child with multisystem atopic disease (severe eczema, peanut allergy with prior anaphylaxis, poorly controlled asthma and allergic rhinitis), covering IgE versus non-IgE classification, the shared type-2 mechanism and atopic march, the anaphylaxis and adrenaline-autoinjector decision, early-introduction prevention for siblings, the skin-barrier KEEP versus BEEP nuance, and the shared decision around oral immunotherapy.

Open

structured clinical case

Allergic rhinitis and rhinoconjunctivitis — clinical case

A clinical case of seasonal allergic rhinoconjunctivitis in an atopic school-aged child, illustrating ARIA classification, stepwise management and the link to asthma.

Open

structured clinical case

Atopic dermatitis and the atopic march — clinical case

A clinical case of infantile atopic dermatitis in a child with a strong atopic family history, illustrating diagnostic criteria, stepwise management and the atopic march.

Open

osce communication and shared decision-making

Counsel a family on a cow's-milk protein allergy diagnosis and formula choice — OSCE

OSCE communication and shared-planning station: explaining a cow's-milk protein allergy diagnosis to a family, the elimination-and-rechallenge approach, the stepwise formula ladder, why goat's-milk and A2 formulas are not appropriate alternatives, and how tolerance is built over time — without making the family fear anaphylaxis in a non-IgE-mediated phenotype.

Open

osce communication and shared decision-making

Counsel a family on a new X-linked agammaglobulinaemia diagnosis — OSCE

OSCE communication and shared-planning station: explaining a new antibody-deficiency diagnosis to a family, the need to confirm the defect with a functional vaccine response and genetic testing before starting immunoglobulin, what lifelong immunoglobulin replacement involves, the family implications of carrier testing, and the generally good prognosis with consistent therapy — while addressing fear and avoiding the over-diagnosis trap.

Open

osce communication and shared decision-making

Counsel a family on deferring live vaccines while SCID is excluded — OSCE

OSCE communication and shared decision-making station: explaining to a frightened family why the four-month-old's routine live vaccines must be deferred while a combined T-cell defect is excluded, what the tests involve, why inactivated vaccines will still go ahead, how the household can cocoon the infant, and what the likely outcome is — while addressing fear and the temptation to 'just get the needles over with'.

Open

osce communication and shared decision-making

Counsel a family on recurrent meningococcal disease and a terminal complement deficiency — OSCE

OSCE communication and shared-planning station: explaining a likely terminal complement deficiency to a family after a child's second episode of invasive meningococcal disease, the need to confirm the defect with a CH50 and component assay before committing to a label, what meningococcal vaccination and antibiotic prophylaxis involve, the family implications of screening (including the X-linked properdin question), and the generally good prognosis with consistent prevention — while addressing fear and the instinct to dismiss recurrent meningococcaemia as 'unlucky'.

Open

osce communication and shared decision-making

Counsel a family on rituximab-related secondary hypogammaglobulinaemia and prophylaxis — OSCE

OSCE communication and shared-planning station: explaining secondary immunodeficiency arising from a biologic (rituximab) given for nephrotic syndrome, why immunoglobulin replacement is driven by infection burden rather than a single low number, the role of antimicrobial prophylaxis and safe vaccination, and the generally good prognosis with consistent follow-up — while addressing fear and avoiding the over-treatment trap.

Open

osce communication and shared decision-making

Counsel and plan with a family switching from IVIG to home SCIG — OSCE

OSCE communication and shared-planning station: explaining a route switch from hospital intravenous to home subcutaneous immunoglobulin to the family of a boy with X-linked agammaglobulinaemia, the pharmacokinetic and quality-of-life rationale, what home therapy involves and how the family will be trained and supported, and the breakthrough-infection reassessment plan — while addressing the family's fear of self-infusion and the travel burden they currently carry.

Open

paediatric long case

Egg, wheat, soy, fish and shellfish allergy: Case

Clinical long case of a school-age child with egg allergy and moderate eczema on an over-restrictive elimination diet, covering the IgE-mediated mechanism, skin-prick and specific-IgE interpretation, component-resolved diagnostics with ovomucoid, the baked-egg ladder, correction of the unnecessary multi-food elimination, an ASCIA anaphylaxis action plan and adrenaline autoinjector, and family safety-netting.

Open

osce communication and shared decision-making

Explain a food allergy diagnostic plan and challenge to an anxious parent — OSCE

OSCE communication station: explaining the food allergy diagnostic pathway — the role of clinical history, targeted testing, component-resolved diagnostics, and oral food challenge — to a parent anxious about her child's positive allergy test, while addressing the difference between sensitisation and clinical allergy and planning a safe diagnostic pathway.

Open

osce communication delabelling antibiotic stewardship

Explaining a false penicillin-allergy label and the delabelling pathway — OSCE

Communication and structured-discussion OSCE on a 6-year-old with community-acquired pneumonia and a long-standing, unverified penicillin-allergy label (a childhood rash during a viral illness). The candidate must explain to a parent that the label is most likely false, outline the safe delabelling pathway with PEN-FAST risk stratification and a supervised oral amoxicillin challenge, explain the stewardship benefit of restoring first-line penicillin, and address the parent's surprise and concerns about challenging a child they were told was allergic.

Open

osce communication diagnosis immunoglobulin-replacement genetic-counselling

Explaining a primary immunodeficiency diagnosis and immunoglobulin replacement — OSCE

Communication and structured-discussion OSCE on explaining a new diagnosis of common variable immunodeficiency to the family of an eight-year-old girl referred for recurrent sinopulmonary infection and emerging bronchiectasis — including what the diagnosis means, why immunoglobulin replacement is needed, the practicalities of long-term therapy, infection-prevention and vaccination strategy, genetic counselling and the school and transition plan, and addressing the family's anxiety about the lifelong nature of the condition and the father's hope that the recurrent infections were 'just a phase'.

Open

osce communication cgd transplant genetic-counselling prophylaxis

Explaining chronic granulomatous disease and the transplant decision — OSCE

Communication and structured-discussion OSCE on explaining to the parents of a four-year-old boy — admitted with a staphylococcal liver abscess and a prior Serratia pneumonia, and confirmed to have X-linked chronic granulomatous disease (CGD) on dihydrorhodamine flow cytometry and CYBB genetic testing — what CGD is, why his neutrophils cannot kill catalase-positive organisms, what lifelong prophylaxis means, why the live BCG vaccine must be avoided, what the transplant involves and when it is offered, and what the genetic implications are for the family, including the mother's guilt about carrying the gene and the father's hope that prophylaxis alone will be enough.

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osce communication scid transplant newborn-screening genetic-counselling

Explaining SCID and the transplant urgency — OSCE

Communication and structured-discussion OSCE on explaining to the parents of a six-week-old boy — referred after a low TREC newborn screen and confirmed to have X-linked SCID on flow cytometry and genetic testing — what SCID is, why it is a medical emergency, what the live-vaccine and blood-product rules mean, what the transplant involves and why it must happen before infection, and what the genetic implications are for the family, including the mother's anxiety about her son surviving and the father's belief that the family history is irrelevant.

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osce communication counselling device-technique action-plan

Explaining the ASCIA action plan and demonstrating the autoinjector — OSCE

Communication OSCE on explaining the red ASCIA Anaphylaxis Action Plan and demonstrating adrenaline autoinjector technique to the parent of a 6-year-old child newly diagnosed with peanut anaphylaxis, while the child's class teacher watches — covering the green-to-red escalation, the lie-flat positioning, the outer-thigh intramuscular injection held for three seconds, the five-minute repeat rule, and the mandatory ambulance and observation after every community device use.

Open

osce acute-safety and communication station

Food allergy OSCE — acute reaction drill and early-introduction prevention counselling

Observed structured encounter testing emergency anaphylaxis management, the written-action-plan ladder, and counselling a high-risk infant's family on early allergen introduction.

Open

osce communication and clinical reasoning station

Immune dysregulation, lymphoproliferation and autoinflammatory disease — OSCE

OSCE communication and clinical reasoning station for a four-year-old with chronic painless lymphadenopathy and a falling platelet count, and parents frightened of cancer.

Open

osce perioperative safety and communication station

Latex allergy OSCE — perioperative safety and family counselling

Observed structured encounter testing preoperative latex-risk assessment of a child with spina bifida, latex-safe surgery planning, and counselling a family about latex avoidance and latex-fruit syndrome.

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osce communication and shared decision-making

Peanut allergy diagnosis and action plan — communication OSCE

OSCE on confirming a new nut allergy diagnosis without overdiagnosis, explaining sensitisation versus clinical allergy, co-designing an action plan with an adrenaline autoinjector, and framing prevention for a younger sibling.

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osce triage and communication station

Pollen-food allergy syndrome OSCE — oral itch triage and systemic-risk counselling

Observed structured encounter testing triage of a local oral reaction, the low-risk dietary pathway, and counselling a family whose adolescent carries the lipid-transfer-protein systemic-risk phenotype.

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osce communication prevention autoinjector action-plan

Teaching adrenaline autoinjector and action-plan use — OSCE

Communication and structured-discussion OSCE on teaching the family of a six-year-old — newly diagnosed with peanut anaphylaxis after a reaction in the emergency department — how and when to use the adrenaline autoinjector, what the written ASCIA action plan says, how to keep him safe at school and at home, and how to respond to a second reaction at home, including the mother's anxiety about giving the injection and the father's belief that the first reaction was a one-off.

Open

structured clinical encounter

The child with a delayed triad after an antibiotic — structured encounter

A structured clinical encounter testing the approach to a serum-sickness-like reaction: eliciting the latency, confirming the triad, excluding the dangerous drug-reaction mimics, applying stepwise symptomatic management, and building an individualised, challenge-informed avoidance decision rather than a blanket lifelong label.

Open

structured clinical encounter

The child with recurrent facial swelling and a family airway history — structured encounter

A structured clinical encounter testing the approach to recurrent angioedema without wheals: recognising the bradykinin pathway, using the C4 screen, confirming hereditary angioedema, explaining why antihistamines fail, and building an on-demand treatment and prophylaxis plan that protects the airway and screens the family.

Open

long case systemic sting anaphylaxis venom immunotherapy prevention

The stung schoolboy — long case on insect-sting hypersensitivity

Long case on insect-sting (Hymenoptera venom) hypersensitivity: an eight-year-old boy who collapsed after a wasp sting at school and required intramuscular adrenaline, presenting the candidate with the acute recognition and management, the differentiation of a systemic reaction from a large local reaction, the four-to-six-week workup of venom-specific immunoglobulin E, skin testing and baseline tryptase with its mastocytosis implications, and the venom immunotherapy prevention decision and discharge package, including the parents' questions about whether he will grow out of it, whether the school needs an autoinjector, and whether venom immunotherapy is worth three to five years of injections.

Open

Domain

haematology-oncology-and-transfusion

34

osce clinical reasoning and communication station

Anaemia: diagnostic approach — OSCE

OSCE reasoning and counselling station for the MCV-based approach to a confirmed paediatric anaemia.

Open

paediatric haematology long case

Aplastic anaemia and bone-marrow failure: Case

Clinical case of a six-year-old boy with Fanconi anaemia presenting as severe aplastic anaemia, covering the Camitta criteria, the diepoxybutane chromosomal breakage test, the radial ray anomalies and café-au-lait spots on examination, the reduced intensity fludarabine based transplant conditioning, the family counselling on the autosomal recessive inheritance and the cancer risk, and the long term surveillance for the head and neck squamous cell carcinoma.

Open

paediatric long case

Bleeding child: diagnostic approach: Case

Clinical case of a 4-year-old boy presenting with sudden petechiae and bruising after a viral illness, worked up for immune thrombocytopenia, covering the exclusion of leukaemia and the safety-netting pathway.

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paediatric transfusion long case

Blood-component therapy in children: Case

Clinical case of a preterm neonate and an older transfused child, covering the per-kilogram doses, the restrictive thresholds of the TOP and PlaNeT-2 MATISSE trials, the special products for the neonate and the immunocompromised child, the prevention of alloimmunisation, and the recognition and management of transfusion-associated circulatory overload.

Open

paediatric neuro-oncology long case

Brain and spinal tumours: Case

Clinical long case of a seven-year-old girl presenting with progressive early morning headache, vomiting, a new squint and ataxia from a posterior fossa medulloblastoma with obstructive hydrocephalus, covering the recognition of raised intracranial pressure, the urgent magnetic resonance imaging of the brain and whole neuraxis, the perioperative stabilisation with dexamethasone and the management of hydrocephalus, the maximal safe resection and the molecular risk stratification, the risk-adapted craniospinal irradiation and chemotherapy, and the long-term survivorship plan.

Open

paediatric oncology supportive care case

Cancer therapy complications and supportive care: Case

Clinical case of a six-year-old boy with T-cell acute lymphoblastic leukaemia on day eight of a high emetogenic induction who presents with breakthrough chemotherapy-induced nausea and vomiting, severe oral mucositis of WHO grade 3, and febrile neutropenia, covering the emetogenic risk stratification and the three-drug antiemetic combination, the mucositis grading and the evidence-based prevention, the febrile neutropenia pathway with the antibiotic within one hour, and the dexrazoxane cardioprotection and the echocardiographic surveillance.

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paediatric oncology long case

Childhood cancer warning signs and diagnostic pathways: Case

Clinical long case of a four-year-old boy presenting with six weeks of progressive night leg pain attributed to growing pains and a firm thigh mass, covering the framing of the bone or soft-tissue tumour cluster, the persistent-progressive principle, the five red-flag clusters, the primary-care investigations, the urgent referral pathway, the oncologic emergencies, and the family counselling and the safety-netting that prevents the delay.

Open

osce communication and shared decision-making

Counsel an adolescent and family on a new diagnosis of osteosarcoma — OSCE

OSCE communication and shared decision-making station: explaining a new diagnosis of a distal femoral osteosarcoma to a fourteen-year-old boy and his parents, addressing the diagnosis and the radiograph, the biopsy and the staging, the neoadjuvant chemotherapy and the limb-salvage surgery, the fertility implications, the prognosis, and the survivorship in plain language.

Open

osce communication and shared planning

Counsel the family of a newly diagnosed adolescent with von Willebrand disease — OSCE

OSCE communication and shared-planning station: explaining a new diagnosis of type 1 von Willebrand disease to an adolescent girl and her parent, the meaning of von Willebrand factor and the autosomal inheritance, the role of desmopressin and tranexamic acid, the management of heavy menstrual bleeding, the warning signs that mean coming to hospital, and the importance of comprehensive care, school planning and the avoidance of certain medications.

Open

osce communication and shared planning

Counsel the family of a newly diagnosed child with haemophilia A — OSCE

OSCE communication and shared-planning station: explaining a new diagnosis of severe haemophilia A to a parent, the meaning of factor VIII deficiency and the X-linked inheritance, the role of primary prophylaxis with factor concentrate or subcutaneous emicizumab, the management of bleeds at home including the emergency response to a head injury, the avoidance of intramuscular injections and certain medications, and the importance of comprehensive care, school planning and transition.

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paediatric haematology critical-care case

Disseminated intravascular coagulation: Case

Clinical case of a child with sepsis-induced disseminated intravascular coagulation presenting with purpura fulminans, covering the ISTH overt-disseminated intravascular coagulation score of five points or more, the cause-driven management with the broad-spectrum antibiotics and the source control, the blood components reserved for the bleeding child, and the heparin for the thrombosis-dominated course.

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osce communication and shared planning

Explain a new diagnosis of catheter-related thrombosis and anticoagulation to a parent — OSCE

OSCE communication station: explaining a new diagnosis of central-venous-catheter-related deep vein thrombosis to the parent of a child with leukaemia, the meaning of a provoked clot, the treatment with low molecular weight heparin injections and the anti-factor Xa monitoring, the option of oral rivaroxaban, the warning signs of pulmonary embolism and bleeding, the plan for the central line, and the selective approach to thrombophilia testing.

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osce communication and shared planning

Explain hereditary spherocytosis and the splenectomy decision to a parent — OSCE

OSCE communication and shared-planning station: explaining the diagnosis of hereditary spherocytosis to a parent, the role of folic acid, the meaning of the spherocytes and the splenic destruction, the decision about splenectomy and its timing, the pre-splenectomy vaccination bundle and lifelong antibiotic prophylaxis, and the warning signs of the aplastic crisis and post-splenectomy infection.

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paediatric long case

Febrile neutropenia and infection in oncology: Case

Clinical long case of a child presenting with febrile neutropenia complicating induction chemotherapy for acute lymphoblastic leukaemia, covering the definition and the first-hour empiric bundle, the indications for adding vancomycin, the high-risk versus low-risk stratification and its implications for disposition and duration, the persistent-fever pathway and the empiric versus pre-emptive antifungal strategy, the management of a central-line infection and the line-removal decision, and the supportive-care strategy of prophylaxis, oral hygiene and family-centred safety-netting.

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structured clinical encounter

Full blood count and blood-film interpretation in children — structured clinical encounter

Structured encounter testing the interpretation of a paediatric full blood count: a printout that must be read against age-specific ranges, the physiological anaemia of infancy, the mean-cell-volume sort of a microcytic anaemia with iron dosing and the thalassaemia distinction, a child with isolated thrombocytopenia, an EDTA artefact, and a film that demands urgent oncology review.

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paediatric long case

G6PD deficiency and enzymopathies: Case

Clinical case of a school-age boy of Mediterranean ancestry who presents with an acute haemolytic crisis after eating fava beans, covering the recognition of oxidative haemolysis, the blood film and the direct antiglobulin-test-negative interpretation, the falsely normal assay pitfall, the transfusion decision, and the lifelong trigger-avoidance counselling and family screening under the 2023 Clinical Pharmacogenetics Implementation Consortium guideline.

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paediatric oncology long case

Germ-cell tumours: Case

Clinical long case of a fifteen-year-old girl presenting with abdominal pain and a large pelvic mass from a stage three ovarian yolk sac tumour with a markedly raised alpha-fetoprotein, covering the serum marker and the imaging pathway, the fertility-sparing surgery, the platinum-based PEB chemotherapy, the marker response and the late-effects and the fertility surveillance.

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paediatric haematology long case

Haematopoietic stem-cell transplantation: Case

Clinical long case of a six-year-old boy with relapsed B-cell precursor acute lymphoblastic leukaemia undergoing an allogeneic haematopoietic stem-cell transplant, covering the donor selection, the conditioning, the graft-versus-host prophylaxis, the engraftment, the acute graft-versus-host disease, the sinusoidal obstruction syndrome, the febrile neutropenia, the donor chimerism and the family counselling.

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paediatric long case

Haemolytic anaemia: diagnostic approach: Case

Clinical case of an 8-year-old boy presenting with chronic intermittent jaundice and splenomegaly, worked up for hereditary spherocytosis, covering the confirmatory testing pathway and family counselling.

Open

osce communication and clinical reasoning station

Iron deficiency anaemia — OSCE

OSCE communication and clinical reasoning station for the parents of a 20-month-old boy newly diagnosed with iron deficiency anaemia from excessive cow's milk intake, covering the diagnosis, the role of cow's milk, the iron regimen and expected response, the dietary changes, and the safety-net for the refractory case.

Open

paediatric haematology long case

Leukaemia in children: Case

Clinical long case of a four-year-old boy presenting with pallor, bruising and fever and a trilineage cytopenia with circulating lymphoblasts, covering the recognition of the emergency, the resuscitation with irradiated leucodepleted red cell and platelet transfusion, the tumour lysis prophylaxis with hyperhydration and rasburicase, the empiric antipseudomonal cover for the febrile neutropenia, the diagnostic pathway with flow cytometry and cytogenetics, the risk stratification and the risk-adapted therapy, and the family counselling.

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paediatric oncology survivorship long case

Long-term follow-up and late effects of childhood cancer: Case

Clinical long case of a twenty-two-year-old woman presenting to the survivorship clinic fifteen years after the treatment of a childhood Hodgkin lymphoma with a cumulative anthracycline dose and chest radiation, covering the treatment-summary-driven and risk-stratified surveillance, the anthracycline cardiomyopathy, the radiation-associated breast cancer surveillance, the endocrine and the fertility late effects, and the structured transition to the adult late-effects service.

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paediatric haematology long case

Lymphoma in children: Case

Clinical long case of a fifteen-year-old boy presenting with a painless enlarging supraclavicular node, B symptoms and a large anterior mediastinal mass, covering the airway-protective diagnostic pathway with the excision biopsy and the flow cytometry, the Ann Arbor staging with the contrast CT and the PET-CT, the risk-adapted combination chemotherapy with the response-adapted radiotherapy de-escalation, the survivorship surveillance for the late effects, and the contrast with the Burkitt lymphoma and its tumour lysis risk.

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paediatric haematology long case

Megaloblastic and macrocytic anaemia: Case

Clinical case of an infant with vitamin B12 deficiency presenting with pallor, developmental regression, and a tremor, covering the metabolite interpretation that separates B12 from folate deficiency, the British Society for Haematology hydroxocobalamin replacement schedule, the two safety rules of hypokalaemia monitoring and never giving folate alone, and the family counselling and the maternal treatment and supplementation.

Open

paediatric oncology long case

Neuroblastoma: Case

Clinical long case of a two-year-old girl presenting with a firm abdominal mass crossing the midline, irritability and periorbital bruising, covering the urinary catecholamine confirmation, the International Neuroblastoma Risk Group staging with the iodine-123 MIBG scan, the MYCN amplification status, the risk-adapted treatment from surgery to the intensive multimodal therapy of high-risk disease, and the contrast with the opsoclonus-myoclonus-ataxia syndrome and the spontaneous regression of stage MS.

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paediatric long case

Neutropenia and neutrophil disorders: Case

Clinical long case of an infant presenting with recurrent mouth ulcers and skin infections in whom severe congenital neutropenia is diagnosed, covering the recognition of a congenital production-failure neutropenia, the severity grading, the neutrophil kinetic model, the marrow maturation arrest, the inherited neutropenia gene panel with an ELANE result, the lifelong granulocyte colony-stimulating factor management and the annual marrow surveillance for myelodysplastic syndrome and acute myeloid leukaemia, and the family counselling.

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paediatric haematology long case

Pancytopenia and marrow infiltration: Case

Clinical long case of a four-year-old boy presenting with pallor, bruising and fever and a trilineage cytopenia with circulating blasts, covering the empty-versus-full marrow distinction, the urgent diagnostic pathway from full blood count and film to bone marrow aspirate and trephine biopsy with flow cytometry and cytogenetics, the stabilisation with irradiated leucodepleted red cell and platelet transfusion, tumour lysis prophylaxis with hyperhydration and rasburicase, empiric antipseudomonal cover for febrile neutropenia, and the cause-specific definitive therapy for acute lymphoblastic leukaemia, with the family counselling and the multidisciplinary plan.

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paediatric haematology acute case

Sickle cell acute complications: Case

Clinical case of a four-year-old boy with HbSS sickle cell disease who develops acute chest syndrome on the second day of a pain-crisis admission, covering the diagnosis from the new infiltrate with hypoxia, the resuscitation with oxygen and antibiotics, the cautious-versus-exchange transfusion decision, the avoidance of over-hydration and over-transfusion, and the prevention with hydroxyurea and chronic transfusion.

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paediatric haematology long case

Sickle cell disease: diagnosis and health maintenance: Case

Clinical case of a boy with sickle cell anaemia diagnosed on newborn screening, covering the FS pattern on high-performance liquid chromatography, the penicillin prophylaxis schedule with exact doses, the encapsulated-organ immunisation, the hydroxyurea decision from nine months, the annual transcranial Doppler with chronic transfusion for the abnormal result, and the family counselling and the multidisciplinary plan.

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paediatric haematology long case

Thalassaemia syndromes: Case

Clinical case of a boy with beta-thalassaemia major managed from infancy, covering the haemoglobin electrophoresis diagnosis, the regular transfusion programme with its exact target, the iron chelation with deferasirox and the cardiac T2 star surveillance, the endocrine late effects, and the discussion of curative therapy.

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paediatric haematology long case

Thrombocytopenia and immune thrombocytopenia: Case

Clinical case of a boy with newly diagnosed immune thrombocytopenia who presents with sudden bruising and petechiae after a viral illness, covering the diagnosis of isolated thrombocytopenia under 100 times ten to the nine per litre, the ASH 2019 observation-first principle, the first-line therapy doses, and the safety-netting and the family counselling.

Open

paediatric haematology emergency case

Transfusion reactions and massive transfusion: Case

Clinical case of an oncology child with an acute transfusion reaction and a separate trauma child needing the massive transfusion protocol, covering the stop-the-transfusion rule, the investigation and mechanism of the acute haemolytic reaction, the bedside distinction of TACO from TRALI, and the balanced ratio and the hazard prevention of the paediatric massive transfusion protocol.

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paediatric oncology long case

Tumour lysis syndrome and oncologic emergencies: Case

Clinical long case of a seven-year-old boy with a Burkitt lymphoma and a high tumour lysis risk, covering the risk assessment, the prophylaxis with the hyperhydration and the rasburicase before the first dose, the recognition and the management of the tumour lysis syndrome by the Cairo-Bishop definition, the airway-first principle for the anterior mediastinal mass, and the urgent imaging and steroid for the spinal cord compression.

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paediatric oncology long case

Wilms tumour and renal malignancies: Case

Clinical long case of a three-year-old girl presenting with a painless abdominal mass found at the bath time, with the hypertension, from a localised favourable-histology Wilms tumour, covering the recognition of the renal tumour, the first-line ultrasound with the Doppler of the cava, the cross-sectional imaging and the staging, the Children's Oncology Group do-not-biopsy strategy of the upfront radical nephrectomy, the risk-adapted vincristine and dactinomycin chemotherapy, and the long-term survivorship plan.

Open

Domain

ent-hearing-and-oral-health

21

structured clinical encounter

Ankyloglossia and infant feeding — structured clinical encounter

Structured encounter testing the approach to a two-week-old breastfed infant with feeding failure — poor weight gain, a painful clicking latch, a mother with cracked nipples and engorgement, and a short tight anterior frenulum: the functional assessment, the conservative-first principle, securing feeding and milk supply, the frenotomy decision and the evidence, with attention to excluding a submucous cleft palate before any division, and a pivot to a suspected posterior tongue-tie and an overdiagnosis counselling scenario.

Open

osce communication and shared decision-making

Counsel a family on a newborn cleft lip and palate — OSCE

OSCE communication and shared decision-making station: explaining the diagnosis of a unilateral cleft lip and palate to the parents of a newborn, the feeding technique with a squeeze bottle, the staged surgical pathway from lip repair at three months through palatoplasty and alveolar bone grafting, the hearing management with grommets, and the safety-net and multidisciplinary follow-up, in plain language that builds confidence.

Open

osce communication and shared decision-making

Counsel a family on a small, malformed ear and the hearing pathway — OSCE

OSCE communication and shared decision-making station: explaining the diagnosis of grade III microtia with aural atresia in a newborn with a normal contralateral ear, the meaning of the conductive hearing loss and why the inner ear is spared, the reassuring outlook for speech and language through the good ear, the staged reconstructive pathway across childhood, the role of the Jahrsdoerfer CT score in deciding between atresiaplasty and a bone-conduction device, and the safety-net and multidisciplinary follow-up, in plain language that builds confidence.

Open

structured clinical encounter

Dental caries and oral-health prevention — structured clinical encounter

Structured encounter testing the approach to a three-year-old with brown, cavitated upper front teeth and a bedtime bottle: the case definition and pattern of early childhood caries, the caries-risk assessment, the fluoride, diet and dental-home prevention ladder, and the developmental enamel defect differential, with a pivot to a four-year-old with a swollen face, fever and trismus from a necrotic molar representing a spreading odontogenic infection.

Open

structured clinical encounter

Dental trauma and avulsed teeth — structured clinical encounter

Structured encounter testing the approach to an eight-year-old boy who has just knocked out a permanent upper central incisor on the playground and has brought the tooth wrapped in a tissue: the scene history and prognostic factors, the IADT 2020 immediate first-aid and storage media, the definitive dental management of replantation, flexible splinting, root canal treatment and antibiotics, and the complications of root resorption, with a pivot to a three-year-old who has knocked out a primary incisor representing the never-replant-a-primary-tooth rule and the safeguarding consideration.

Open

structured clinical encounter

Epistaxis in children — structured clinical encounter

Structured encounter testing the approach to a four-year-old with an active profuse nosebleed brought in tilted backward with pressure on the bony bridge: the recognition and correction of the first-aid errors, the resuscitation and stepwise escalation to cautery and packing, and the one-side-of-the-septum rule, with a pivot to a seven-year-old with recurrent epistaxis, bruising and a family history of bleeding representing an underlying bleeding disorder and the caution before cautery.

Open

osce communication and shared management

Explain a persistent neck lump and the safety-net to a parent — OSCE

OSCE communication station: explaining to a parent why their child's neck lump needs an ultrasound, what the four-to-six-week rule and a supraclavicular location mean, what to watch for, and when to return urgently with the red flags for a deep neck abscess or a malignancy.

Open

osce communication and shared management

Explain acute otitis media and a safety-net plan to a parent — OSCE

OSCE communication and shared-management station: explaining acute otitis media to a parent, why antibiotics are not always needed, what to give for pain, what to watch for at home, and when to return urgently.

Open

osce communication and shared management

Explain drooling and an unsafe-swallow plan to a parent — OSCE

OSCE communication and shared-management station: explaining drooling (sialorrhoea) and an unsafe swallow to the parent of a child with severe cerebral palsy, why the chest matters more than the wet chin, the stepwise plan, and the warning signs that mean returning urgently.

Open

osce communication and shared management

Explain facial swelling and the safety-net to a parent — OSCE

OSCE communication station: explaining to a parent why their child's facial swelling of dental origin needs the source tooth treated rather than antibiotics alone, what to give for pain, and the red flags of Ludwig angina that mean an immediate return.

Open

osce communication and shared management

Explain sore throat and the safety-net to a parent — OSCE

OSCE communication station: explaining to a parent why their child's sore throat does not always need antibiotics, what the McIsaac score and swab achieve, what to give for pain, and when to return urgently with signs of a peritonsillar or deep neck complication.

Open

osce communication diagnosis treatment safety-net

Explaining acute bacterial rhinosinusitis, the antibiotic decision and the safety-net — OSCE

Communication and structured-discussion OSCE on explaining a diagnosis of acute bacterial rhinosinusitis in a 5-year-old to a parent, covering why an antibiotic is now needed after the cold has run on beyond ten days and worsened, the high-dose amoxicillin-clavulanate course with saline irrigation and an intranasal corticosteroid, the reassessment at forty-eight to seventy-two hours, and a clear safety-net for the orbital and intracranial complications.

Open

osce communication diagnosis watchful-waiting safety-net

Explaining glue ear and the watchful-waiting plan — OSCE

Communication and structured-discussion OSCE on explaining a diagnosis of otitis media with effusion (glue ear) in a 2-year-old to a parent, covering the distinction from acute ear infection, the watchful-waiting plan with hearing advice and a safety-net, why most fluid clears on its own within three months, why no antibiotics or surgery are needed yet, and the features that would bring the child back sooner or prompt earlier referral.

Open

osce communication diagnosis treatment safety-net

Explaining mastoiditis, admission and the surgical decision — OSCE

Communication and structured-discussion OSCE on explaining a diagnosis of acute mastoiditis in a 14-month-old to a parent, covering the need for admission and intravenous antibiotics, the myringotomy for the intact drum, the 48-hour reassessment and the possible cortical mastoidectomy, the contrast temporal-bone CT decision, the safety-net for intracranial complications, and how the mastoid complication relates to the underlying acute otitis media.

Open

structured clinical encounter

Hearing assessment and childhood hearing loss — structured clinical encounter

Structured encounter testing the approach to a baby who refers on the newborn hearing screen: the 1-3-6 milestones, the diagnostic auditory brainstem response and how it distinguishes conductive from sensorineural loss, the search for congenital CMV, and the family-centred plan for early intervention and rehabilitation.

Open

structured clinical encounter

Nasal foreign body and button-battery injury — structured clinical encounter

Structured encounter testing the approach to a two-year-old with a missing button battery and a disc wedged against the nasal septum: the emergency-removal decision that does not wait for fasting, the alkaline-electrolysis mechanism, the avoidance of a blind finger sweep, and the second-battery check and ENT referral after removal, with a pivot to a four-year-old with a unilateral foul discharge and a smooth bead testing the positive-pressure technique and the right-instrument choice.

Open

structured clinical encounter

Oral manifestations of systemic disease — structured clinical encounter

Structured encounter testing the approach to a pale tired six-year-old with swollen bleeding gums and palatal petechiae: the recognition of leukaemic gingival infiltration, the urgent full blood count and film, and the neutropenic-sepsis safety, with a pivot to a child with chalky symmetrical dental enamel defects and faltering growth requiring coeliac serology with a total IgA and the two-handed management of a gluten-free diet and oral care.

Open

structured clinical encounter

Oral ulcers and mucosal disease — structured clinical encounter

Structured encounter testing the approach to a febrile drooling two-year-old with diffuse painful anterior gingival ulceration: the diagnosis of primary herpetic gingivostomatitis, the hydration-first assessment, and early oral aciclovir within 72 hours, with a pivot to a school-age child with recurrent scarring major aphthae requiring the deficiency and coeliac work-up and the differential of systemic aphthosis.

Open

structured clinical encounter

Otitis externa — structured clinical encounter

Structured encounter testing the approach to an eight-year-old swimmer with otalgia, otorrhoea and tragal tenderness: the canal-versus-middle-ear distinction, the analgesia-led topical-first management and the ear wick for the swollen canal, with a pivot to an immunocompromised six-year-old with severe unremitting otalgia, granulation at the bony-cartilaginous junction and a facial palsy representing necrotising (malignant) otitis externa with skull-base osteomyelitis.

Open

structured clinical encounter

Salivary gland disorders — structured clinical encounter

Structured encounter testing the approach to an under-immunised child with bilateral tender parotid swelling: the diagnosis of mumps, the supportive management, the five-day exclusion, and the complications including orchitis, meningitis and pancreatitis, with a pivot to a child with recurrent unilateral parotid swelling requiring the diagnosis and management of juvenile recurrent parotitis.

Open

outpatient long case

Tinnitus, vertigo and balance disorders in children: Case

Longitudinal clinical case of a thirteen-year-old girl with vestibular migraine, covering the diagnosis from the consensus criteria, the peripheral-versus-central assessment that excludes a dangerous cause, the audiological workup, the lifestyle and the prophylactic management, and the safeguarding of the red-flag screen.

Open

Domain

rheumatology-musculoskeletal-and-sports

31

long-case clinical reasoning

Assess a child with persistent bone pain for malignancy red flags — long case

Long-case structured assessment of a child with persistent, progressive, night-waking bone pain: running the red-flag screen, choosing the same-day basic investigations, reading the radiographic signature of osteosarcoma, applying the never-biopsy-outside-a-specialist-centre rule, and framing the prognosis and disposition for the family.

Open

osce communication and safety-netting

Counsel a family on a new diagnosis of IgA vasculitis and the renal monitoring — OSCE

OSCE communication and safety-netting station: explaining a new diagnosis of IgA vasculitis (Henoch-Schonlein purpura) to a five-year-old boy and his parents, addressing the diagnosis, the typical course, the prognosis, the role of the corticosteroids, and the critical importance of the blood pressure and urinalysis monitoring for at least six months.

Open

osce communication and shared decision-making

Counsel a family on CVID arthritis and the need for a dual plan — OSCE

OSCE communication and shared-planning station: explaining to a family that their daughter's arthritis and bruising are rheumatic fingerprints of a common variable immunodeficiency rather than ordinary juvenile idiopathic arthritis, that the immune defect must be confirmed before any biologic is started, that immunoglobulin replacement will control infection susceptibility but not the arthritis, and that the plan is to treat both the immune defect and the rheumatic manifestation in parallel with shared care between immunology and rheumatology.

Open

osce communication and shared decision-making

Counsel a family on load management for an overuse knee injury — OSCE

OSCE communication and shared-decision station: counselling the parents and the young adolescent athlete of a thirteen-year-old basketball player with Osgood-Schlatter disease on the overuse mechanism, the relative-rest and graded-return-to-play plan, the role of the injury-risk triad of specialization, training volume and recovery, and the safety-net for the red flags that demand earlier review.

Open

osce communication and shared decision-making

Counsel a parent after their child's concussion and agree on the return to school — OSCE

OSCE communication and shared-decision station: counselling the parent of a fourteen-year-old after a sport-related concussion, explaining the diagnosis and the twenty-four to forty-eight hours of relative rest, correcting the belief that prolonged strict rest is needed, agreeing on the return-to-learn-first plan and the six-stage return to sport, and giving the red-flag safety-net.

Open

osce communication and shared decision-making

Counsel a parent and a young athlete on low energy availability and the return-to-running plan — OSCE

OSCE communication and shared-decision station: explaining low energy availability and the Female Athlete Triad to the parent of a fifteen-year-old cross-country runner with a tibial stress injury and secondary amenorrhoea, outlining the energy-restoration pathway, the temporary training reduction, and the graded return to running in plain language, addressing the fear of losing the season and the worry about the oral contraceptive pill, and agreeing on a multidisciplinary plan guided by the symptom recovery and the energy balance.

Open

osce communication and shared decision-making

Counsel a parent on an adolescent's new diagnosis of spondylolysis and the activity plan — OSCE

OSCE communication and shared-decision station: explaining a new diagnosis of spondylolysis to the parent of a thirteen-year-old gymnast, outlining the activity cessation, the anti-lordotic brace, and the core-strengthening programme in plain language, addressing the fear of losing the competitive season and the worry about a permanent injury, and agreeing on a graded return guided by the symptoms and the imaging.

Open

osce communication and shared decision-making

Counsel a school sports coordinator on a heat-safety and emergency-action plan for the summer season — OSCE

OSCE communication and shared-decision station: explaining the prevention of exertional heat illness and sudden cardiac arrest to a school sports coordinator, outlining the heat-acclimatization protocol, the wet-bulb globe temperature activity modification, the hydration discipline, and the rehearsed emergency action plan with a defibrillator and a cold-water immersion tub, addressing the cost and the practicality concerns, and agreeing on a written and rehearsed plan for the summer season.

Open

osce communication and shared decision-making

Counsel an adolescent and her parent on a new scoliosis diagnosis and the bracing plan — OSCE

OSCE communication and shared-decision station: explaining a new diagnosis of a 32-degree adolescent idiopathic scoliosis to a 12-year-old girl and her parent, outlining the bracing plan and the follow-up in plain language, addressing the fear of surgery and the worry about the appearance and the activities, and agreeing on the brace wear through the remaining growth with the safety-net review.

Open

osce communication and shared decision-making

Counsel the adolescent who uses steroids — OSCE

OSCE communication and shared decision-making station: counselling a fifteen-year-old boy and his family after the disclosure of anabolic-androgenic steroid use bought online, addressing the body-image pressure, the cardiovascular growth and psychiatric harms, the slow supported cessation with a mental-health safety net, and the plan to meet his goals safely without the harm.

Open

osce communication and shared decision-making

Explain a clubfoot diagnosis and the Ponseti method to a parent — OSCE

OSCE communication and shared-decision station: explaining a new diagnosis of the idiopathic clubfoot to the parent of a one-week-old boy, outlining the Ponseti method from the serial casting through the percutaneous Achilles tenotomy to the foot-abduction brace in plain language, addressing the fear and the long-term commitment of the bracing without overwhelming, and securing the family-centred agreement to the protocol.

Open

osce communication and explanation

Explain a new diagnosis of granulomatosis with polyangiitis and the long-term plan — OSCE

OSCE communication station: explaining a new diagnosis of granulomatosis with polyangiitis to a 14-year-old boy and his parents after a pulmonary-renal presentation, addressing the diagnosis, the mechanism, the treatment plan, the side effects of the immunosuppression, the relapse risk, and the long-term surveillance and transition.

Open

osce communication and shared decision-making

Explain a positive newborn hip examination to a family — OSCE

OSCE communication and shared decision-making station: explaining the assessment and management of developmental dysplasia of the hip to the parents of a five-week-old breech-born girl with a clunk on Ortolani testing, addressing the Graf ultrasound grade, the Pavlik harness and its three-week check, the risk of avascular necrosis if the harness is continued when not reduced, and the reassuring prognosis of a hip treated early.

Open

osce communication and shared decision-making

Explain a pre-participation sports clearance and the exertional-syncope restriction to an athlete and parent — OSCE

OSCE communication and shared-decision station: explaining to a fifteen-year-old basketball player and his parent why a pre-participation evaluation that uncovered exertional syncope and a family history of sudden death means he cannot be cleared today and needs a cardiology work-up, addressing the disappointment and the fear, explaining what the work-up involves, and giving a clear plan and a safety-net.

Open

osce communication and shared decision-making

Explain a septic arthritis diagnosis and the urgent theatre plan to a parent — OSCE

OSCE communication and shared-decision station: explaining a new diagnosis of septic arthritis of the hip to the parent of a three-year-old boy, outlining the urgent arthrotomy and washout and the intravenous antibiotics in plain language, addressing the fear and the urgency without overwhelming, and securing consent for the operation.

Open

osce communication and shared decision-making

Explain a torus fracture and the soft-bandage plan to a parent — OSCE

OSCE communication and shared-decision station: explaining a distal radius buckle or torus fracture to the parent of an eight-year-old, outlining why a soft bandage rather than a rigid cast is recommended and the evidence behind it, addressing the parent's expectation of a cast, and giving clear safety-netting advice on when to return.

Open

osce communication and shared decision-making

Explain acute osteomyelitis management to a family — OSCE

OSCE communication and shared decision-making station: explaining the diagnosis and management of acute haematogenous osteomyelitis to the parents of a three-year-old boy, addressing the role of magnetic resonance imaging, the intravenous-to-oral antibiotic strategy, the need for blood cultures before antibiotics, and the plan for follow-up and early switch to oral therapy.

Open

osce communication and shared decision-making

Explain an unstable slipped capital femoral epiphysis and the urgent operation to a parent — OSCE

OSCE communication and shared-decision station: explaining a new diagnosis of an unstable slipped capital femoral epiphysis to the parent of a thirteen-year-old boy, outlining the urgent reduction and single-screw fixation and the avascular necrosis risk in plain language, addressing the fear and the urgency without overwhelming, and securing consent for the operation.

Open

osce communication and shared planning

Explain juvenile dermatomyositis to a worried parent — OSCE

OSCE communication and shared-planning station: explaining the diagnosis of juvenile dermatomyositis to a parent, the reason for the muscle enzymes and magnetic resonance imaging, the corticosteroid and methotrexate treatment, the risk of calcinosis and why early treatment matters, and the follow-up and multidisciplinary plan, with empathy and honesty and without overpromising.

Open

osce communication and shared decision-making

Explain Perthes disease to a family — OSCE

OSCE communication and shared decision-making station: explaining the diagnosis and the long course of Legg-Calve-Perthes disease to the parents of a six-year-old boy, addressing the persistent limp, the knee-referred pain, the four phases over two to three years, and the plan for observation or a containment decision based on the lateral pillar grade and the child's age.

Open

osce communication and shared decision-making

Explain the Kocher prediction rule to a family with an irritable hip — OSCE

OSCE communication and shared decision-making station: explaining the assessment and management of a suspected septic hip to the parents of a five-year-old boy, addressing the Kocher prediction rule in plain language, the need for urgent aspiration and washout, the reassurance about transient synovitis when the score is low, and the plan for follow-up.

Open

paediatric rheumatology long case

Juvenile idiopathic arthritis: Case

Clinical long case of a three-year-old girl presenting with a swollen right knee for ten weeks, stiff in the morning and improving with activity, covering the ILAR oligoarticular classification, the persistent-versus-extended split, the chronic anterior uveitis and the three-monthly slit-lamp screening, the methotrexate at ten to fifteen milligrams per square metre per week, the etanercept and adalimumab biologics, the Wallace clinically inactive disease criteria, and the septic-arthritis mimic.

Open

paediatric rheumatology long case

Pain amplification, juvenile fibromyalgia and complex regional pain syndrome: Case

Clinical long case of a thirteen-year-old girl with juvenile fibromyalgia and her fourteen-year-old sister with complex regional pain syndrome, covering the central sensitization mechanism, the 2010 American College of Rheumatology criteria, the Budapest clinical criteria and the multidisciplinary management.

Open

osce communication and clinical reasoning station

Periodic fever and autoinflammatory syndromes — OSCE

OSCE communication and clinical reasoning station for a six-year-old of Lebanese background with familial Mediterranean fever, and parents frightened by the father's amyloidosis and renal transplant.

Open

paediatric rheumatology long case

Reactive arthritis and post-infectious inflammatory syndromes: Case

Clinical long case of a nine-year-old boy presenting with an asymmetric lower-limb oligoarthritis with enthesitis three weeks after a Campylobacter gastroenteritis, covering the one-to-four-week latency, the HLA-B27 association, the molecular-mimicry mechanism, the exclusion of the septic arthritis, the distinction from the post-streptococcal reactive arthritis and the acute rheumatic fever, and the stepwise management from the non-steroidal anti-inflammatory drugs through the intra-articular corticosteroid to the escalation for the persistent disease.

Open

osce communication and shared decision-making

Reassure a parent about a toddler's bow legs and intoeing — OSCE

OSCE communication and shared-decision station: reassuring the parent of a two-year-old with physiologic genu varum and internal tibial torsion that the bowing and the intoeing are normal developmental variants, explaining the Salenius and Vankka curve and the natural history in plain language, addressing the fear that the child needs braces or special shoes, and agreeing on a safety-net review.

Open

osce communication and shared decision-making

Reassure and counsel a parent after reducing a nursemaid's elbow — OSCE

OSCE communication and counselling station: explaining to the parent of a two-year-old girl what a nursemaid's elbow is, why no X-ray is needed, what was just done at the bedside, and how to prevent the roughly-one-in-three recurrence — addressing the guilt, the fear of a fracture, and the practical lifting advice, in plain language.

Open

osce communication and shared decision-making

Reassure and safety-net a transient synovitis diagnosis with a parent — OSCE

OSCE communication and shared-decision station: explaining a diagnosis of transient synovitis of the hip to the parent of a five-year-old boy after septic arthritis has been excluded, outlining the rest and the non-steroidal anti-inflammatory drug, the expected one-to-two-week resolution, and the safety-net features that demand urgent return, addressing the fear without dismissing it and without falsely reassuring away the small residual risk of a mimic.

Open

paediatric rheumatology long case

Scleroderma, mixed connective-tissue disease and overlap syndromes: Case

Clinical long case of a six-year-old boy presenting with the linear scleroderma of the right lower limb, covering the recognition of the active localised disease, the Zulian classification, the methotrexate first-line therapy with the corticosteroid bridging, the physiotherapy for the contracture, and the contrast with the juvenile systemic sclerosis and the mixed connective-tissue disease across the spectrum.

Open

paediatric rheumatology long case

Systemic juvenile idiopathic arthritis and macrophage activation syndrome: Case

Clinical long case of a four-year-old girl with systemic juvenile idiopathic arthritis who develops macrophage activation syndrome, covering the ILAR classification, the 2016 MAS criteria, the interleukin-one and interleukin-six blockade, the paradoxical MAS under the tocilizumab, and the escalation pathway.

Open

paediatric rheumatology long case

Systemic lupus erythematosus: Case

Clinical case of a 13-year-old girl with childhood-onset systemic lupus erythematosus presenting with a malar rash, oral ulcers, non-erosive arthritis, autoimmune haemolytic anaemia, positive anti-dsDNA, and low complement, covering the EULAR/ACR 2019 classification, the hydroxychloroquine backbone with retinopathy screening, the stepwise escalation to mycophenolate, the reproductive counselling, and the transition to a refractory scenario requiring belimumab.

Open

Domain

pain-palliative-and-end-of-life-care

13

communication and pain assessment station

Assess a child's pain across developmental and cognitive ability — OSCE

OSCE assessment station: assess the pain of a non-verbal child with severe cerebral palsy on day one after spinal fusion, select and apply the individualised observational tool, involve the parent as the expert on baseline behaviour, set the reassessment and documentation plan, and explain how the plan changes if the child is admitted to the PICU and requires neuromuscular blockade.

Open

paediatric chronic pain long case

Chronic primary and secondary pain in children: Case

Clinical long case of a thirteen-year-old girl with eight months of widespread aching, fatigue, unrefreshing sleep and falling school attendance and a folder of normal tests, covering the framing as chronic primary pain, the mechanism of central sensitisation, the biopsychosocial assessment and red-flag screen, the interdisciplinary rehabilitation plan, the opioid-sparing counselling, and the prognosis framed around function.

Open

osce communication and shared decision-making

Hold the goals-of-care conversation for care in the last days of life — OSCE

OSCE communication station for care in the last days of life: open the conversation, explore understanding, make a clear recommendation, address fear of abandonment, and agree a documented plan.

Open

osce communication and shared decision-making

Hold the goals-of-care conversation for grief, bereavement and sibling support — OSCE

OSCE communication station for grief, bereavement and sibling support: open the conversation, explore understanding, make a clear recommendation, address fear of abandonment, and agree a documented plan.

Open

osce communication and shared decision-making

Hold the goals-of-care conversation for organ and tissue donation in children — OSCE

OSCE communication station for organ and tissue donation in children: open the conversation, explore understanding, make a clear recommendation, address fear of abandonment, and agree a documented plan.

Open

osce communication and shared decision-making

Hold the goals-of-care conversation for palliative care in neurodisability and genetic disease — OSCE

OSCE communication station for palliative care in neurodisability and genetic disease: open the conversation, explore understanding, make a clear recommendation, address fear of abandonment, and agree a documented plan.

Open

osce communication and shared decision-making

Hold the goals-of-care conversation for withholding and withdrawing life-sustaining treatment — OSCE

OSCE communication station for withholding and withdrawing life-sustaining treatment: open the conversation, explore understanding, make a clear recommendation, address fear of abandonment, and agree a documented plan.

Open

communication and decision-making station

Introduce paediatric palliative care and refer at diagnosis — OSCE

OSCE communication and decision-making station: introduce paediatric palliative care to the parents of a 6-year-old newly diagnosed with relapsed high-risk neuroblastoma, correct the misconception that palliative care means giving up, explain the parallel-care model and the four domains of suffering, and outline the referral pathway and bereavement follow-through.

Open

outpatient long case

Neuropathic pain in children: Case

Clinical case of a 14-year-old girl with complex regional pain syndrome of the lower limb complicated by opioid escalation, school absence, and a fixed dystonic posture, covering the clinical diagnosis, the exclusion of dangerous alternatives, the reversal of opioid-driven harm, the intensive exercise-based rehabilitation plan, and the cautious off-label use of gabapentin against the background of the limited paediatric evidence base.

Open

osce communication and shared decision-making

Open the goals-of-care conversation with an adolescent with relapsed cancer and the family — OSCE

OSCE communication and shared decision-making station: opening the goals-of-care and advance care planning conversation with a sixteen-year-old with relapsed cancer and the family, addressing the concurrent disease-directed and palliative care, the prognosis, the symptom control, the place of care, and the honest and hopeful communication in plain language.

Open

structured clinical encounter (prescribing and monitoring leadership)

Right dose, right monitoring, right rotation — paediatric opioid stewardship

A bedside structured clinical encounter testing paediatric opioid stewardship: setting up a morphine patient-controlled analgesia device with the weight-based parameters, gating every dose on the pain score and the sedation score, building the multimodal opioid-sparing backbone, recognising and reversing opioid-induced respiratory depression with titrated naloxone, and rotating to an oral opioid with the equianalgesic principle and the incomplete cross-tolerance reduction, with a safe discharge prescription and disposal plan.

Open

structured clinical encounter (acute pain leadership)

Score, found, titrate, monitor, wean — leading acute nociceptive pain management on the ward

A structured clinical encounter testing the leadership of acute nociceptive pain management on the paediatric ward: scoring the pain, building the multimodal foundation up the WHO two-step ladder, titrating a morphine patient-controlled analgesia with sedation-score monitoring, recognising and responding to opioid-induced respiratory depression with naloxone, and closing the loop with a planned wean and a written discharge safety-net.

Open

long-case communication and symptom management station

Symptom control in a seriously ill child — long-case communication station

Long-case communication and management station: a 9-year-old with relapsed metastatic sarcoma and escalating pain, breathlessness, nausea and agitation. The candidate must conduct a goals-of-care conversation, design a stepwise symptom-control plan with weight-based morphine, manage opioid-induced neurotoxicity by rotation, match an antiemetic to the emetic pathway, exclude reversible causes of delirium before sedating, prescribe an anticipatory box for home, and explain the proportionate use of palliative sedation and the doctrine of double effect.

Open

Domain

respiratory-sleep-and-airway

35

structured clinical encounter

Asthma diagnosis and long-term control — structured clinical encounter

Structured encounter testing the approach to a 6-year-old with recurrent cough and wheeze: confirming the diagnosis objectively, classifying phenotype and level of control, building an inhaled-corticosteroid-based controller plan with the anti-inflammatory reliever, counselling on the growth evidence, and delivering a written action plan and review.

Open

structured clinical encounter

Behavioural insomnia and circadian rhythm disorders — structured clinical encounter

Structured encounter testing the approach to a 15-year-old with delayed sleep-wake phase disorder and school refusal: recognition of a circadian rather than behavioural problem, the sleep history and diary, exclusion of organic disease and screening for mood disorder, and combined fixed wake time, morning bright light and timed low-dose evening melatonin therapy.

Open

respiratory long case

Bronchiectasis in children — clinical case

Clinical case of a school-aged child with a chronic wet cough progressing to bronchiectasis, illustrating the suppurative lung disease continuum, the aetiological work-up, and airway-clearance-and-antibiotic management.

Open

structured clinical encounter

Central sleep apnoea and hypoventilation syndromes — structured clinical encounter

Structured encounter testing the approach to a term neonate who breathes adequately while awake but hypoventilates and desaturates during sleep with a structurally normal heart and clear lungs and cannot wean from support: the recognition of a central control-of-breathing disorder, the ventilate-not-oxygenate principle, PHOX2B confirmation of congenital central hypoventilation syndrome, the ladder of lifelong home ventilation, the multisystem surveillance, and the conversation with the family about a technology-dependent future.

Open

respiratory long case

Chronic cough in children — clinical case

Clinical case of a preschool child with a chronic wet cough illustrating the wet-versus-dry branch point, the antibiotic trial for protracted bacterial bronchitis, and escalation when it recurs.

Open

respiratory long case

Congenital lung and airway malformations — clinical case

Clinical case of a child with recurrent same-site pneumonia found to have a congenital lung malformation, illustrating the structural-lesion pathway, the diagnostic role of contrast CT, and definitive resection.

Open

paediatric long case

Epiglottitis and bacterial tracheitis: Case

Clinical case of an incompletely immunised toddler with acute epiglottitis, covering do-no-harm recognition, controlled airway management in theatre, empiric antibiotics, and public health follow-up including contact prophylaxis.

Open

structured clinical encounter

Exercise-induced bronchoconstriction — structured clinical encounter

Structured encounter testing the approach to a 10-year-old who coughs and wheezes with sport: confirming exercise-induced bronchoconstriction objectively, classifying it, controlling the underlying asthma, prescribing a warm-up and pre-exercise reliever, and counselling the family that full participation in sport is the goal.

Open

osce communication and shared management

Explain a child's pneumonia and its home treatment to a worried parent — OSCE

OSCE communication and shared-planning station: explaining community-acquired pneumonia to an anxious parent, why oral antibiotics rather than admission or a drip are appropriate, why a chest X-ray is not needed, what to watch for at home, and when to return urgently.

Open

osce communication and shared management

Explain a positive newborn cystic fibrosis screen to worried parents — OSCE

OSCE communication and shared-planning station: explaining a positive newborn bloodspot screen for cystic fibrosis to anxious parents of a well baby, why a positive screen is not a diagnosis, what the confirmatory sweat test involves, and the plan and support while awaiting results.

Open

osce communication and shared management

Explain bronchiolitis and its home care to a worried parent — OSCE

OSCE communication and shared-planning station: explaining bronchiolitis to a frightened parent, why antibiotics and inhalers are not being given, what supportive care will happen, what to watch for at home, and when to return urgently.

Open

osce communication and shared management

Explain chronic aspiration and a feeding plan to a parent — OSCE

OSCE communication and shared-planning station: explaining to a parent why their child with cerebral palsy keeps getting chest infections, what silent aspiration means, why a swallow study is needed, and how a feeding, saliva and lung-protection plan will work.

Open

osce communication and shared management

Explain croup and its home care to a worried parent — OSCE

OSCE communication and shared-planning station: explaining croup to a frightened parent, why a single steroid dose is enough, why humidified steam is not recommended, what to watch for at home, and when to return urgently.

Open

osce communication and shared management

Explain daily cystic fibrosis treatment and a new CFTR modulator to a parent — OSCE

OSCE communication and shared-planning station: explaining to a parent why daily airway clearance, nebulisers, enzymes and antibiotics all matter in cystic fibrosis, what a new CFTR modulator does and does not replace, why the first Pseudomonas is treated at once, and when to seek help urgently.

Open

osce communication and shared management

Explain empyema and its treatment to a worried parent — OSCE

OSCE communication and shared-planning station: explaining a parapneumonic empyema to a frightened parent, why the chest drain and fibrinolytics are needed, why the illness is taking so long, and the excellent long-term outlook.

Open

structured clinical encounter

Foreign-body aspiration — structured clinical encounter

Structured encounter testing the approach to a toddler brought in after a witnessed choking episode on a peanut with a normal chest radiograph: recognition and the choking-history reasoning, the imaging caveats, the choking algorithm if he deteriorates, and the decision to proceed to rigid bronchoscopy with a prevention plan.

Open

respiratory long case

Interstitial lung disease in children — clinical case

Clinical case of an infant with persistent tachypnoea and diffuse lung disease reaching a diagnosis of neuroendocrine cell hyperplasia of infancy, illustrating the chILD syndrome, the exclusion-HRCT-genetics pathway, and supportive management within a specialist chILD centre.

Open

paediatric long case

Laryngomalacia, tracheomalacia and vocal-cord dysfunction: Case

Clinical long case of an infant with severe laryngomalacia and faltering growth, covering the localisation of stridor, the awake flexible laryngoscopy diagnosis, the recognition of red flags and a synchronous airway lesion, the indications for supraglottoplasty, and the safety-net and family communication.

Open

acute management and escalation station

Manage a child with acute severe asthma in the emergency department — OSCE

OSCE management station: assessing and treating a school-age child with acute severe asthma who is not responding to home reliever, delivering the stepwise pathway, recognising deterioration, escalating to intravenous therapy and critical care, and planning safe discharge and prevention.

Open

structured clinical encounter

Narcolepsy and hypersomnolence — structured clinical encounter

Structured encounter testing the approach to a school-aged child with three months of irresistible daytime sleepiness who loses muscle tone in the head and knees when laughing and has gained weight rapidly: the recognition of cataplexy and narcolepsy type 1, the exclusion of secondary sleepiness, the confirmatory polysomnography, multiple sleep latency test and cerebrospinal fluid orexin, the layered management of sleepiness and cataplexy, the monitoring, and the conversation with the family about a lifelong condition and its impact on school and safety.

Open

structured clinical encounter

Neuromuscular respiratory failure and airway clearance — structured clinical encounter

Structured encounter testing the approach to a boy with Duchenne muscular dystrophy with morning headaches, daytime sleepiness and recurrent chest infections: the recognition of the two-part pump-and-cough failure, the monitoring of vital capacity, peak cough flow and nocturnal carbon dioxide, the two parallel treatments of non-invasive ventilation and mechanical insufflation-exsufflation, the chest-infection rule to clear secretions and ventilate rather than merely oxygenate, and the anticipatory home and transition plan.

Open

structured clinical encounter

Non-invasive ventilation and home respiratory support — structured clinical encounter

Structured encounter testing the approach to a boy with Duchenne muscular dystrophy and nocturnal hypoventilation: recognising the problem, using a sleep study with carbon dioxide monitoring, starting nocturnal bilevel ventilation, assessing and supporting a weak cough, and planning safe home ventilation.

Open

structured clinical encounter

Obstructive sleep apnoea in children — structured clinical encounter

Structured encounter testing the approach to a preschooler with loud snoring, witnessed apnoeas and faltering growth: recognition of obstructive sleep apnoea, the sleep history and examination, the role of polysomnography and oximetry, adenotonsillectomy as first-line treatment, and anticipating the high-risk airway and residual disease.

Open

structured clinical encounter

Oxygen therapy and home oxygen in children — structured clinical encounter

Structured encounter following an ex-preterm infant with chronic lung disease of prematurity from a hospital oxygen requirement to a home oxygen programme and its weaning: setting the saturation target, choosing the device, recognising the readiness criteria for home oxygen, arranging the equipment and safety, planning the weaning day then sleep then off, and counselling the family, with the acute principles of the hypoxaemic child woven through.

Open

structured clinical encounter

Paediatric sleep investigations: polysomnography, sleep-study interpretation and MSLT — structured case

Structured encounter working through the investigation of a snoring, poorly growing preschooler: choosing attended polysomnography over a limited study, interpreting the resulting report and its apnoea-hypopnoea index against paediatric thresholds, distinguishing obstructive from central events and confirming there is no hypoventilation on carbon dioxide, selecting adenotonsillectomy and follow-up, and finally pivoting to a sleepy adolescent to test the prerequisites and interpretation of the multiple sleep latency test.

Open

osce assessment and communication station

Pneumothorax and air-leak syndromes — OSCE

OSCE assessment and communication station for an adolescent with a spontaneous pneumothorax and an anxious parent.

Open

structured clinical encounter

Primary ciliary dyskinesia — structured clinical encounter

Structured encounter testing the approach to a preschooler with a lifelong wet cough, chronic ear and nasal disease and situs inversus: recognition of primary ciliary dyskinesia, exclusion of cystic fibrosis, the specialist diagnostic pathway, and the multidisciplinary airway-clearance-centred management including infection control and azithromycin prophylaxis.

Open

respiratory long case

Pulmonary haemorrhage and haemoptysis — clinical case

Clinical case of an infant with recurrent occult alveolar haemorrhage, iron-deficiency anaemia, and faltering growth, illustrating the exclusion-based work-up, the diagnosis of Heiner syndrome, and cause-specific management.

Open

respiratory long case

Recurrent pneumonia in children — clinical case

Clinical case of a toddler with recurrent same-site pneumonia illustrating the same-site-versus-different-site branch point, the search for a structural cause, and bronchoscopy for an unwitnessed foreign body.

Open

structured clinical encounter

Recurrent wheeze in preschool children — structured clinical encounter

Structured encounter testing the approach to a frequently-wheezy preschooler brought for review: confirming the phenotype, applying the Asthma Predictive Index, excluding the mimics, deciding on a monitored preventive trial, and counselling the family on natural history and tobacco-smoke exposure.

Open

osce assessment and communication station

Respiratory distress and failure in children — OSCE

OSCE assessment and communication station for a child in respiratory distress with a worried parent.

Open

respiratory and oncology long case

Respiratory manifestations of systemic disease — clinical case

Clinical case of a child newly presenting with an anterior mediastinal mass and lymphoma, illustrating the peri-procedural airway danger, the malignancy limb of respiratory manifestations of systemic disease, and the disease-specific reflex.

Open

structured clinical encounter

Spirometry and paediatric pulmonary-function testing — structured clinical encounter

Structured encounter interpreting spirometry in an 11-year-old with cough and wheeze: judging the quality of the test, recognising the obstructive pattern and its bronchodilator response, using GLI z-scores rather than fixed cut-offs, explaining why the normal baseline value does not exclude asthma, and integrating the result with the clinical picture.

Open

paediatric long case

Tracheostomy care and emergencies: Case

Clinical case of a technology-dependent toddler at home with a tracheostomy who presents with a blocked tube, covering the emergency algorithm, home care and go-bags, complications, and the path towards decannulation.

Open

structured clinical encounter

Upper-airway obstruction and stridor — structured clinical encounter

Structured encounter testing the approach to a two-year-old presenting with a barking cough and stridor that progresses to severe obstruction: recognition and severity grading of croup, the do-not-distress principle, dexamethasone and nebulised adrenaline with doses, and the escalation and safety-netting plan.

Open

Domain

cardiology

35

paediatric cardiology long case

Atrioventricular septal defect — clinical case

Clinical case of a four-month-old girl with Down syndrome and a complete atrioventricular septal defect presenting in heart failure, illustrating anatomy, the pulmonary vascular window, and early surgical repair.

Open

structured clinical encounter

Cardiac transplantation and ventricular assist devices — structured clinical encounter

Structured encounter testing the approach to a four-month-old infant with a dilated cardiomyopathy who becomes refractory to medical therapy: recognition of refractory failure, the INTERMACS profile, the durable device decision with the Berlin Heart EXCOR evidence, the transplant-listing prerequisites, and the family counselling.

Open

structured clinical encounter

Cardiogenic shock and mechanical circulatory support — structured clinical encounter

Structured encounter testing the approach to a six-year-old boy who presents three days after a viral illness in compensated cardiogenic shock from fulminant myocarditis: the bedside distinction from distributive shock through the presence of congestion, the cautious-fluid principle and the inotrope resuscitation, the SCAI staging, the recognition of refractory shock, the escalation to venoarterial extracorporeal membrane oxygenation as a bridge to recovery, and the family conversation about the goal and prognosis of support and the complication burden.

Open

structured clinical encounter

Cardiomyopathies in children — structured clinical encounter

Structured encounter testing the approach to an adolescent who collapses during a race with a family history of sudden death: recognition of hypertrophic cardiomyopathy, the bedside and echocardiographic assessment, sudden-death risk stratification, the implantable defibrillator decision, and family cascade screening.

Open

structured clinical encounter

Coarctation and interrupted aortic arch — structured clinical encounter

Structured encounter testing the approach to a three-day-old neonate who was feeding well then collapses with shock, metabolic acidosis, weak femoral pulses and differential cyanosis: the prostaglandin-E1-first resuscitation rule, the echocardiographic confirmation, the ductal-dependent mechanism, the syndromic work-up, and the conversation with the family about the transfer to a cardiac centre.

Open

osce communication and shared planning

Counsel a young woman with a Fontan circulation on contraception, pregnancy, and staying in care — OSCE

OSCE communication and shared-planning station: a 19-year-old woman with a Fontan circulation returns after a gap in care and asks about contraception and a future pregnancy. The candidate must re-engage her without judgement, advise on safe contraception, counsel realistically on pregnancy risk using the modified WHO classification, address endocarditis prophylaxis, and secure lifelong ACHD follow-up.

Open

osce communication and shared decision-making

Counsel parents given a new diagnosis of transposition — OSCE

OSCE communication station: breaking the news of a duct-dependent cyanotic congenital heart diagnosis (transposition of the great arteries) in a stable, prostaglandin-infused neonate, explaining the parallel-circulation problem and the surgical plan in plain language, addressing fear honestly while building a shared plan, and outlining the path to a near-normal life after arterial switch repair.

Open

osce communication and shared decision-making

Counsel parents of a neonate with critical aortic stenosis — OSCE

OSCE communication and shared-planning station: breaking the news of a critical aortic stenosis diagnosis in a neonate who presented in shock, explaining the prostaglandin therapy, the balloon valvuloplasty, and the lifelong surveillance, while addressing the parents' fear for their baby's survival and future.

Open

osce communication and shared decision-making

Counsel parents of a newborn with a suspected duct-dependent cardiac lesion — OSCE

OSCE communication and shared-planning station: explaining to the parents of a newborn found to have a low saturation on pulse-oximetry screening the meaning of the finding, the immediate plan to start prostaglandin E1 and transfer to a cardiac centre before the echocardiogram, and the honest framing of prognosis while addressing fear.

Open

osce communication and shared planning

Counsel the family of an athlete disqualified from competitive sport for hypertrophic cardiomyopathy — OSCE

OSCE communication and shared-planning station: counselling the 16-year-old athlete and his parents after hypertrophic cardiomyopathy has been confirmed on a preparticipation workup, explaining the disqualification from competitive sport, the rationale in terms of sudden cardiac death risk, the permitted leisure activity within limits, the surveillance and treatment plan, the cascade screening of family members, and the psychosocial cost, with honesty and empathy.

Open

paediatric long case

Duct-dependent congenital heart disease: Case

Clinical case of a neonate with hypoplastic left heart syndrome presenting with shock on day 3 of life, covering the two-pathway split, the physiology of duct-dependent systemic circulation, emergency prostaglandin E1 therapy, the staged Norwood-Glenn-Fontan palliation, and long-term neurodevelopmental follow-up.

Open

structured clinical encounter

Ebstein anomaly and tricuspid valve disease — structured clinical encounter

Structured encounter testing the approach to a two-day-old cyanosed neonate with a massively enlarged heart, a loud tricuspid regurgitant murmur and functional pulmonary atresia: the prostaglandin-E1-first resuscitation rule, the echocardiographic grading with the GOSE score, the cone-versus-Starnes surgical decision, the arrhythmia and paradoxical-embolism counselling, and the transition to lifelong adult congenital heart disease surveillance.

Open

osce communication and counselling

Explain a pulmonary hypertension diagnosis to an adolescent and family — OSCE

OSCE communication and counselling station: explaining a new diagnosis of pulmonary arterial hypertension to a teenager and their family, outlining the combination therapy, the lifelong nature of the treatment, and the protected transition to adult care, in plain language while addressing fear and adherence.

Open

osce communication and shared planning

Explain a sudden cardiac arrest to an adolescent and his mother — OSCE

OSCE communication and shared-planning station: explaining to an adolescent and his mother the meaning of a cardiac arrest from ventricular fibrillation, the likely diagnosis of hypertrophic cardiomyopathy, the role of the implantable cardioverter defibrillator for secondary prevention, the implications for the family and for sport, and the plan for the coming days and years, with honesty, empathy, and an age-appropriate approach to the young person.

Open

osce communication and counselling

Explain a total anomalous pulmonary venous connection diagnosis to parents and plan the surgery — OSCE

OSCE communication and counselling station: explaining a new diagnosis of obstructed total anomalous pulmonary venous connection to the parents of a two-day-old cyanosed neonate, outlining the urgent surgery and the lifelong follow-up in plain language, and offering honest prognostic framing while addressing fear and guilt.

Open

osce communication and shared decision-making

Explain an acute rheumatic fever diagnosis to a parent and plan the prophylaxis — OSCE

OSCE communication and shared-planning station: explaining a new diagnosis of acute rheumatic fever to the mother of a nine-year-old Aboriginal boy, outlining the benzathine penicillin prophylaxis regimen and duration in plain language, addressing the fear and the guilt, and framing the disease as preventable with adherence to the injections.

Open

osce communication and shared planning

Explain an anomalous coronary and exercise restriction to a young athlete — OSCE

OSCE communication and shared-planning station: explaining an anomalous aortic origin of a coronary artery to a young athlete and his parent, the reason for exercise restriction, the role of further imaging and possible surgery, and the surveillance plan, with empathy, honesty and without overpromising.

Open

osce communication and shared decision-making

Explain an atrial septal defect diagnosis to parents and plan the closure — OSCE

OSCE communication and shared-planning station: explaining a new atrial septal defect diagnosis confirmed on echocardiography to the parents of an asymptomatic four-year-old, outlining the device closure option and the lifelong follow-up in plain language, and offering honest prognostic framing while addressing fear.

Open

osce communication and shared planning

Explain complete heart block and the pacemaker to a parent — OSCE

OSCE communication and shared-planning station: explaining the diagnosis of congenital complete heart block to a parent whose newborn has a slow heart rate and a maternal history of lupus, the meaning of the blocked electrical pathway and the slow escape rhythm, the pacemaker treatment and lifelong follow-up, the implications for siblings and future pregnancies, and the restrictions on activity, with empathy and honesty.

Open

osce communication and shared planning

Explain Kawasaki disease and its treatment to a frightened parent — OSCE

OSCE communication and shared-planning station: explaining the diagnosis of Kawasaki disease to a parent, the IVIG and aspirin treatment, the reason for the echocardiograms and the coronary risk, and the follow-up plan, with empathy, honesty and without overpromising.

Open

osce communication and shared planning

Explain long-QT syndrome to a parent after a near-drowning — OSCE

OSCE communication and shared-planning station: explaining the diagnosis of long-QT syndrome to a parent after their child collapsed during swimming, the meaning of the QT interval, the beta-blocker treatment and lifelong follow-up, the implications for siblings and the family, and the restrictions on sport and medication, with empathy and honesty.

Open

osce communication and shared planning

Explain supraventricular tachycardia to a frightened parent — OSCE

OSCE communication and shared-planning station: explaining the diagnosis of supraventricular tachycardia to a parent after acute termination in an infant, the long-term medication plan, the expected natural history, and what to watch for at home, with empathy, honesty and without overpromising.

Open

osce communication and shared planning

Explain tetralogy of Fallot and a tet spell to a frightened parent — OSCE

OSCE communication and shared-planning station: explaining the diagnosis of tetralogy of Fallot to a parent after an acute hypercyanotic spell, the planned surgery, the recovery and the lifelong follow-up, with empathy, honesty and without overpromising.

Open

osce communication and shared decision-making

Explaining a heart murmur to a family — OSCE

OSCE communication and shared decision-making station: explaining to the parents of a thriving four-year-old boy what the soft heart murmur found at a routine check means, how the examination showed it was innocent, why no echocardiogram is needed, what the family should watch for, and how the school and activity will be supported — while addressing fear, the search for reassurance, and the question of whether something has been missed.

Open

structured clinical encounter

Heart failure in infants and children — structured clinical encounter

Structured encounter testing the approach to a six-week-old infant presenting in overcirculation heart failure from a moderate-to-large ventricular septal defect: recognition, the four-to-eight-week pathophysiology, the modified Ross grading, immediate management with doses, and the closure and counselling plan.

Open

structured clinical encounter

Hypertension in children — structured clinical encounter

Structured encounter testing the approach to a six-year-old referred after a school health check found a stage 2 blood pressure: the confirmation and classification, the secondary-cause work-up driven by proteinuria and a small scarred kidney, the target-organ screen with echocardiography, and the shared decision with the family about an ACE inhibitor and long-term renal follow-up.

Open

structured clinical encounter

Hypoplastic left heart syndrome — structured clinical encounter

Structured encounter testing the approach to a three-day-old neonate who was feeding well then collapses with uniformly weak pulses, grey mottled skin and metabolic acidosis: the prostaglandin-E1-first resuscitation rule, the echocardiographic confirmation, the ductal-dependent mechanism, the staged palliation, and the conversation with the family about the transfer to a cardiac centre.

Open

structured clinical encounter

Infective endocarditis — structured clinical encounter

Structured encounter testing the approach to a nine-year-old girl with repaired tetralogy of Fallot who presents with two weeks of fever, fatigue, a new diastolic murmur, viridans streptococcal bacteraemia and an aortic-valve vegetation: the Modified Duke criteria, the culture-before-antibiotic discipline, the targeted antibiotic regimen and its duration, the surgical triggers of heart failure and aortic-root abscess, and the prophylaxis counselling for future procedures.

Open

osce communication and clinical reasoning station

Innocent murmurs and normal paediatric cardiovascular variants — OSCE

OSCE communication and clinical-reasoning station: a parent referred with a child found to have a murmur.

Open

structured clinical encounter

Myocarditis and pericarditis — structured clinical encounter

Structured encounter testing the approach to a nine-year-old boy who presents a week after a viral illness with central chest pain, breathlessness and palpitations, a gallop rhythm, a markedly raised troponin, widespread electrocardiographic changes and ventricular dysfunction: the diagnostic triad of troponin, electrocardiogram and echocardiogram, the cardiac magnetic resonance confirmation, the supportive-first management with activity restriction, the selective-immunotherapy reasoning, the fulminant escalation to mechanical circulatory support, and the conversation with the family about the recovery outlook and the return-to-sport plan.

Open

long-case

Patent ductus arteriosus — clinical case

A long-case discussion of a thriving 4-year-old referred with a continuous machinery murmur, walking through the assessment, the management decision, the device procedure, and the shared decision-making with the family.

Open

structured clinical encounter

Postural orthostatic tachycardia syndrome — structured clinical encounter

Structured encounter testing the approach to a 15-year-old girl with four months of daily orthostatic symptoms meeting POTS criteria: the orthostatic history, the cardiac red-flag screen, the 10-minute active stand test and its thresholds, the ECG-for-every-child rule, and the stepwise non-pharmacological then phenotype-guided management — with explicit contrast to the athletic boy who collapses sprinting.

Open

structured clinical encounter

Syncope and orthostatic intolerance — structured clinical encounter

Structured encounter testing the approach to a 13-year-old boy who collapses while sprinting with no prodrome and a family history of sudden death: the cardiac red-flag history, the ECG-for-every-child rule, the urgent cardiac work-up and sport restriction, the family screening conversation, and the contrast with the adolescent girl whose chronic daily symptoms meet POTS criteria.

Open

structured clinical encounter

Truncus arteriosus and single-ventricle physiology — structured clinical encounter

Structured encounter testing the approach to a four-week-old infant with mild neonatal cyanosis that has progressed to heart failure, bounding pulses, a wide pulse pressure and a single second heart sound: the truncus bedside reasoning, the prostaglandin-E1 decision, the falling-pulmonary-vascular-resistance mechanism, the complete neonatal repair and 22q11.2 testing, and the conversation with the family about the lifelong follow-up.

Open

structured clinical encounter

Ventricular septal defect — structured clinical encounter

Structured encounter testing the approach to an infant presenting in overcirculation heart failure from a moderate-to-large ventricular septal defect at six weeks: recognition, the four-to-eight-week pathophysiology, immediate management with doses, and the closure and counselling plan.

Open

Domain

child-safety-and-social-paediatrics

32

osce communication and clinical station

Child sexual abuse and assault assessment OSCE — acute adolescent assault and the non-acute normal examination

Observed structured encounter testing tempo recognition, conditional confidentiality, the staged acute assault bundle with its time-limited elements, and the interpretation and communication of a normal ano-genital examination.

Open

osce communication and safeguarding station

Children in out-of-home care and foster care — OSCE communication and safeguarding station

Observed structured encounter testing trauma-informed engagement with a young child and carer, consent-authority clarification, the entry-to-care assessment, a lawful safeguarding override, and permanency and transition planning for a care-experienced child.

Open

osce communication and safeguarding

Discuss a perplexing presentation with the safeguarding team — OSCE

OSCE communication and shared-planning station: presenting a suspected perplexing presentation with fabricated-or-induced-illness alerting features to the designated safeguarding lead, agreeing the multi-agency plan, the separation and observation strategy, the sibling assessment, and the principle of never confronting the suspected caregiver alone.

Open

osce communication and safeguarding

Discuss IPV exposure and safety planning with a non-offending parent — OSCE

OSCE communication and shared-planning station: explaining the recognition of intimate partner violence exposure and its impact on a child, the safety assessment and lethal-means question, the child-protection process, and how the child will be kept safe — while supporting the non-offending parent without blame and without making leaving the relationship a condition of help.

Open

osce documentation and communication station

Documentation OSCE — capturing a perishable finding to court standard

Observed structured encounter testing injury photodocumentation, the three-shot rule, secure storage governance, and the fact-versus-opinion distinction in suspected child maltreatment.

Open

osce communication station

Expert reports and court evidence in child protection — OSCE

OSCE station: explaining the role of an expert report and the duty to the court to the parents of an infant with inflicted injury, distinguishing fact from opinion, framing the process honestly, and outlining what the report and the proceedings will and will not determine.

Open

osce communication and shared decision-making

Explain a perplexing presentation and a safety-netted plan to an exhausted family — OSCE

OSCE communication and shared-planning station: explaining a perplexing presentation to the parents of a child with two years of unexplained, escalating symptoms, conveying diagnostic uncertainty honestly, presenting a balanced three-limb differential in plain language, refusing further harmful intervention, and agreeing a single named safety-netted plan — without accusation, with empathy and honesty.

Open

osce communication and safeguarding

Explain a sentinel oral injury and the safeguarding plan to a carer — OSCE

OSCE communication station: explaining that a sentinel oral injury requires a safeguarding workup, what the occult-trauma screen involves, and the mandatory-reporting duty, delivered with empathy, without accusation, and with a clear safety plan.

Open

osce communication and shared planning

Explain an inflicted immersion scald and the safeguarding plan to a non-offending parent — OSCE

OSCE communication and shared-planning station: explaining to a non-offending parent that their toddler's scald pattern is not consistent with the given history, why the safeguarding pathway must run in parallel with burn care, what the strategy discussion and admission to a place of safety mean, and how the team will keep the child safe while supporting the family.

Open

osce communication and safeguarding

Explain an unsafe-sleep presentation to a frightened parent — OSCE

OSCE communication and shared-planning station: explaining the recognition and management of an asphyxial collapse in an unsafe sleep environment to a distressed parent — the workup, the role of the child-protection team, why the team must investigate, why the baby cannot go home today, the safe-sleep message, and how the child will be kept safe — without accusation, with empathy and honesty.

Open

osce communication and safeguarding

Explain online sexual exploitation and the safety plan to an adolescent and parent — OSCE

OSCE communication and shared-planning station: explaining the recognition of online sexual exploitation (financial sextortion) to a frightened adolescent and his parent, the acute-safety and evidence-preservation plan, the dual reporting pathway, and how the team will pursue image removal — without blame, with empathy and honesty.

Open

osce communication and safeguarding

Explain suspected abusive head trauma to a frightened parent — OSCE

OSCE communication and shared-planning station: explaining the recognition of suspected abusive head trauma to a parent, the workup and safeguarding process, why the team must investigate, and how the child will be kept safe — without accusation, with empathy and honesty.

Open

osce communication and safeguarding

Explain suspected poisoning as maltreatment to a parent — OSCE

OSCE communication and safeguarding station: explaining the recognition of suspected poisoning as maltreatment to a parent, why the team must investigate and keep the child in hospital, what the toxicology and separation test are for, and how the child and siblings will be kept safe — without accusation, with empathy and honesty.

Open

osce communication family support

Explaining a family-support and prevention plan — OSCE

Communication and structured-discussion OSCE on offering a non-stigmatising, evidence-based prevention and family-support plan to a young first-time mother at the antenatal visit, explaining the rationale (the toxic-stress cascade and the buffering adult), and setting the boundary between support and protection.

Open

osce communication and clinical station

Female genital mutilation or cutting OSCE — the at-risk girl and the acute complication

Observed structured encounter testing recognition of FGM and its WHO type, the acute management of complications, the deinfibulation pathway, and the safeguarding, reporting, and sibling-protection duties.

Open

osce communication and assessment station

Homelessness and housing instability — OSCE

OSCE station: screening for and responding to housing instability in a family presenting with a child's recurrent asthma, applying the vital-sign screening principle, maintaining rapport and a trauma-informed, non-judgemental approach, building a portable health summary, and planning housing linkage and advocacy.

Open

osce communication and safeguarding

Inflicted fractures and other non-accidental musculoskeletal injury — OSCE

OSCE communication-and-safeguarding station assessing a six-month-old, pre-mobile infant with a spiral femur fracture and an implausible history, testing the recognition of high-specificity patterns, the skeletal-survey protocol with the follow-up survey, the differentials, and the safeguarding conversion when differing-age rib fractures emerge.

Open

osce communication and management station

Kinship care, adoption and permanency health assessments — OSCE

OSCE communication and management station: explaining the staged health assessment and care plan to the kinship carer of a newly placed Aboriginal child, confirming consent, applying a trauma-informed lens, and addressing the Child Placement Principle and cultural connection.

Open

osce communication and management station

Mandatory reporting and jurisdictional child-protection frameworks — OSCE

OSCE station: explaining a mandatory-reporting duty to the parents of an infant with a sentinel injury, applying the reasonable-belief threshold, maintaining a therapeutic relationship, and outlining the reporting pathway.

Open

osce communication and ethics

Medical neglect and refusal of care — OSCE

OSCE communication-and-ethics station assessing a four-year-old with newly diagnosed acute lymphoblastic leukaemia whose loving parents refuse the standard chemotherapy protocol in favour of herbal and dietary treatment — testing the omission-versus-rejection definitions, the Diekema harm-principle threshold, the stepped negotiate-to-escalate management, and the conversion from negotiation to legal escalation when the threshold is met and the treatment window is closing.

Open

osce communication and management station

Multidisciplinary child-protection case conference — OSCE

OSCE station: a registrar preparing for a child-protection case conference, explaining the process to a concerned colleague and articulating the paediatrician's role, the report standard, and the information-sharing principles.

Open

osce communication and safeguarding

Neglect and supervisory neglect — OSCE

OSCE communication-and-safeguarding station assessing a three-year-old who presents with a scald and a chaotic, multi-domain picture of unmet need — testing the omission-versus-commission definition, the six-domain classification, the neglect-versus-poverty distinction, the stepped multi-agency plan pairing support with mandatory reporting, and a safeguarding conversion when family violence is disclosed.

Open

osce communication and social-prescribing station

Poverty, food insecurity and social prescribing — OSCE communication and social-prescribing station

Observed structured encounter testing destigmatised screening for material hardship, use of the Hunger Vital Sign, co-design of a social prescription with the family, a diagnostic-overshadowing and safeguarding decision, and policy-level advocacy for children in poverty.

Open

osce communication and clinical station

Psychological and emotional abuse OSCE — recognition, safeguarding plan and safety

Observed structured encounter testing recognition of and response to psychological and emotional abuse: classifying the pattern using Glaser's framework, assessing the caregiving environment and concurrent maltreatment, building a stepped trauma-informed safeguarding plan, handling a fabricated-or-induced-illness overlap, and a suicide-risk interrupt.

Open

osce safeguarding communication

Recognising and responding to a sentinel injury — OSCE

Communication and structured-discussion OSCE on recognising a sentinel injury in a pre-mobile infant, explaining the concern and the plan to a non-offending parent, and running the recognition-to-response bundle including the mandatory report.

Open

osce communication and screening station

Refugee, asylum-seeking and newly arrived children — OSCE communication and screening station

Observed structured encounter testing trauma-informed, interpreter-mediated engagement with a newly arrived child and family, guardianship and consent clarification, the on-arrival screening bundle, a lawful confidentiality frame, and advocacy around the harm of immigration detention.

Open

osce communication and safeguarding station

Sentinel injury OSCE — recognising inflicted bruising in the non-mobile infant

Observed structured encounter testing recognition of inflicted bruising, the TEN-4 FACES-L rule, the bleeding-disorder differential and the safeguarding pathway.

Open

osce communication and clinical station

Suspected child sexual abuse with a positive STI — forensic evaluation, prophylaxis and safety planning OSCE

Observed structured encounter testing safety triage, trauma-informed history, grading of an STI as evidence of sexual contact, the forensic examination frame, prophylaxis reasoning and a mandated-reporting and safety plan.

Open

paediatric long case with safeguarding interface

Suspected inflicted abdominal injury — long case

Long case on a pre-verbal child with delayed presentation of a rigid abdomen: pattern recognition, occult-injury screening, concurrent trauma-and-safeguarding management and safe disposition.

Open

osce communication and safeguarding station

Trafficking, exploitation and forced marriage — OSCE

OSCE station: explaining to a young person alone in a cubicle why a child-protection report and a trafficking referral are being made, applying the principle that a child cannot consent to exploitation, maintaining trust through honest communication, and outlining the pathway to support.

Open

osce communication and clinical station

Trauma-informed examination and forensic documentation OSCE — the threat response and the court-admissible record

Observed structured encounter testing the trauma-informed response to a freeze during examination, the single trained forensic interview, the documentation standard that separates fact from opinion, and the safeguarding, reporting and disposition duties.

Open

osce communication and assessment station

Youth justice and detained young people — OSCE

OSCE station: performing an entry health screen and risk assessment for a young person newly admitted to detention, applying the equivalence-of-care principle, maintaining confidentiality and rapport in a custodial setting, and planning continuity and release handoff.

Open

Domain

ophthalmology

17

paediatric ophthalmology long case

Colour vision deficiency and inherited retinal disease: Case

Clinical long case of a ten-month-old infant presenting with the roving eye movements, the nystagmus and the poor fixation, covering the electroretinography and the molecular genetic testing, the RPE65 Leber congenital amaurosis, the voretigene neparvovec gene therapy, the genetic counselling, and the contrast with the benign congenital red-green colour vision deficiency of the older brother.

Open

osce communication and shared decision-making

Counsel a family on a new diagnosis of accommodative esotropia and amblyopia — OSCE

OSCE communication and shared-planning station: explaining a new diagnosis of accommodative esotropia with amblyopia in a young child, the meaning of the cycloplegic refraction and the hyperopic glasses, the amblyopia-first treatment sequence (occlusion or atropine penalisation), the realistic timeline and the rationale for possible surgery, in plain language that builds adherence while addressing fear.

Open

osce communication and shared decision-making

Counsel a family on a sticky watering eye and teach Crigler massage — OSCE

OSCE communication and shared-planning station: explaining the diagnosis of congenital nasolacrimal duct obstruction in a young infant, the meaning of the white quiet eye and the reflux on sac pressure, the reassuring natural history of spontaneous resolution, the teaching of Crigler lacrimal-sac massage and lid hygiene, the safety-net for the mimics and complications, and the plan for review and possible probing, in plain language that builds confidence and adherence.

Open

osce communication abnormal-red-reflex urgent-referral

Explaining an abnormal red reflex to a parent — OSCE

Communication and structured-discussion OSCE on a six-week-old infant with a dense white reflex found at a routine check, covering the technique and interpretation of the red-reflex test, the differential of leukocoria led by retinoblastoma and congenital cataract, the immediate management of urgent referral with no drops or ointment, the avoidance of alarming diagnostic labels when explaining the finding to a family, and the safety-netting and follow-up that close the referral loop.

Open

osce communication diagnosis management

Explaining cortical visual impairment and environmental adaptation — OSCE

Communication and structured-discussion OSCE on explaining a diagnosis of cortical visual impairment in a 10-month-old ex-preterm infant to a parent, covering that the visual difficulty arises from the brain rather than the eye despite a structurally normal eye, the paradoxical behaviours of light-gazing and distance-better-than-near vision, why there is no drug or surgery for the cortex and the hope of improvement through neuroplasticity, the practical environmental adaptations at home that immediately help the child use available vision, and the role of the multidisciplinary team.

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osce communication diagnosis treatment red-flags

Explaining progressive myopia and myopia control to a family — OSCE

Communication and structured-discussion OSCE on progressive myopia in an 8-year-old girl, covering the optical basis of myopia, why cycloplegic refraction confirms the prescription, the stepwise management with spectacles plus myopia control (outdoor time, reduced near work, low-dose atropine 0.05 percent from the LAMP trial, orthokeratology and defocus lenses), the reassurance that under-correction does not slow progression, and the red flags that would prompt urgent referral.

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osce communication diagnosis treatment safety-net

Explaining the difference between preseptal and orbital cellulitis — OSCE

Communication and structured-discussion OSCE on explaining a diagnosis of preseptal cellulitis in a 3-year-old to a parent, distinguishing it from orbital cellulitis, covering the oral antibiotic treatment and the 24-to-48-hour review plan, the safety-net features that mean the infection has crossed the septum, why the well child does not need a scan or admission, and how the sinus source and portal of entry fit the picture.

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osce communication diagnosis management exclusion

Explaining viral conjunctivitis, hygiene and the red flags — OSCE

Communication and structured-discussion OSCE on explaining a diagnosis of viral conjunctivitis in a 4-year-old to a parent, covering the self-limiting nature of the illness, the supportive-care and hygiene measures that limit spread, the school and swimming exclusion advice, why a topical antibiotic is not needed for a viral cause, the red-flag features that would demand urgent review, and how the atopic history fits the allergic differential.

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osce communication diagnosis treatment safety-net

Explaining why a normal-looking eye needs slit-lamp screening — OSCE

Communication and structured-discussion OSCE on explaining to a parent why a four-year-old child with oligoarticular ANA-positive juvenile idiopathic arthritis needs slit-lamp screening every three months despite a normal-looking eye, covering the silent nature of JIA-associated anterior uveitis, what the slit-lamp looks for (cells and flare), why screening prevents the irreversible complications of band keratopathy cataract glaucoma synechiae and amblyopia, the treatment plan if uveitis is found, and the safety-net features that mean an earlier review.

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osce communication acute-care irrigation-first safety-net

First aid for a chemical eye injury — OSCE

Communication and acute-care OSCE on a child who has had a household alkali splash to the eye, in which the candidate must explain and initiate immediate copious irrigation before any examination, reassure an anxious parent that the single most important treatment is irrigation and that delay is the enemy, outline the irrigation protocol and the next steps, and give a clear safety-net — covering the irrigation-first principle, removal of particulate matter, the pH endpoint, and urgent ophthalmology referral.

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paediatric ophthalmology long case

Leukocoria and retinoblastoma: Case

Clinical long case of a fourteen-month-old boy presenting with a white glow in the pupil noticed on flash photographs, covering the red reflex test and the urgent referral, the RB1 tumour suppressor gene on chromosome thirteen and the Knudson two-hit hypothesis, the International Intraocular Retinoblastoma Classification, the ophthalmic artery chemosurgery with melphalan and topotecan, the genetic counselling of the heritable disease, and the contrast with the trilateral retinoblastoma and the global disparity in the survival.

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structured clinical encounter

Ophthalmia neonatorum — structured clinical encounter

Structured encounter testing the approach to a three-day-old with profuse purulent discharge and lid oedema born to a mother with no documented screening: the recognition of gonococcal ophthalmia neonatorum, the emergency systemic treatment and ceftriaxone-versus-cefotaxime decision, the swab panel and maternal screening, with a pivot to a ten-day-old with mucopurulent discharge and a staccato cough representing chlamydial ophthalmia with pneumonia.

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paediatric ophthalmology long case

Ophthalmic manifestations of systemic disease: Case

Clinical long case of a four-year-old girl with the oligoarticular juvenile idiopathic arthritis and a positive antinuclear antibody, covering the silent sight-threatening uveitis and the ACR screening schedule, the stepwise management with the methotrexate and the adalimumab, and the contrast with the diabetic retinopathy screening, the neurofibromatosis optic pathway glioma and the metabolic eye signs.

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paediatric neuro-ophthalmology long case

Papilloedema and optic nerve disorders: Case

Clinical long case of a twelve-year-old girl presenting with the daily headache, the transient visual obscurations and the bilateral optic disc swelling, covering the fundoscopy and the Frisén grading, the neuroimaging before the lumbar puncture, the Friedman criteria with the opening pressure above two hundred and eighty millimetres of cerebrospinal fluid, the acetazolamide and the weight loss, the optic nerve sheath fenestration, and the contrast with the optic neuritis of the myelin oligodendrocyte glycoprotein antibody disease.

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osce communication diagnosis treatment red-flags

Recognising an absent red reflex and the urgency of congenital cataract — OSCE

Communication and structured-discussion OSCE on a 4-week-old infant with a dense unilateral cataract and absent red reflex, covering the performance of the red-reflex (Brückner) test, the cannot-miss differential of leukocoria including retinoblastoma, deprivation amblyopia and the critical-period surgical window, the Infant Aphakia Treatment Study on aphakia versus primary IOL, the lifelong glaucoma surveillance duty, and the family-centred amblyopia programme of patching and optical correction.

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paediatric ophthalmology long case

Urgent ophthalmology referral and childhood vision loss: Case

Clinical long case of a ten-month-old boy presenting with a white glow in the pupil noticed on the flash photographs, covering the red reflex test and the same-day referral, the amblyopia sensitive period, the red-flag presentations, the orbital cellulitis, the cortical visual impairment, the optic nerve hypoplasia of the septo-optic dysplasia, the papilloedema of the raised intracranial pressure, and the safety-net advice.

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structured clinical encounter

Visual development, amblyopia and vision screening in childhood — structured clinical encounter

Structured encounter testing the approach to a five-year-old found at school-entry screening to have reduced left eye acuity: the recognition of amblyopia as a cortical deficit, the sensitive period, the classification of amblyopia types, the stepwise management ladder and the Pediatric Eye Disease Investigator Group evidence, with a closing pivot to a two-month-old with leukocoria and an absent red reflex for the urgent deprivation red-flag pathway.

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Domain

rural-remote-and-contextual-paediatrics

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osce communication and shared decision-making

Lead the rural safety plan for advocacy, policy and health-service design for rural children — OSCE

OSCE station for advocacy, policy and health-service design for rural children.

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osce communication and shared decision-making

Lead the rural safety plan for avoiding racism and institutional bias in child health — OSCE

OSCE station for avoiding racism and institutional bias in child health.

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osce communication and shared decision-making

Lead the rural safety plan for child protection in small and remote communities — OSCE

OSCE station for child protection in small and remote communities.

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osce communication and shared decision-making

Lead the rural safety plan for disaster, outbreak and public-health response for children — OSCE

OSCE station for disaster, outbreak and public-health response for children.

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osce communication and shared decision-making

Lead the rural safety plan for environmental, occupational and agricultural child health — OSCE

OSCE station for environmental, occupational and agricultural child health.

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osce communication and shared decision-making

Lead the rural safety plan for implementing culturally safe indigenous care in rural and remote services — OSCE

OSCE station for implementing culturally safe indigenous care in rural and remote services.

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osce communication and shared decision-making

Lead the rural safety plan for refugee, immigrant and humanitarian paediatrics — OSCE

OSCE station for refugee, immigrant and humanitarian paediatrics.

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osce communication and shared decision-making

Lead the rural safety plan for remote prescribing and medication access — OSCE

OSCE station for remote prescribing and medication access.

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osce communication and shared decision-making

Lead the rural safety plan for retrieval coordination and transfer risk — OSCE

OSCE station for retrieval coordination and transfer risk.

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osce communication and shared decision-making

Lead the rural safety plan for rural developmental, disability and mental-health care — OSCE

OSCE station for rural developmental, disability and mental-health care.

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osce communication and shared decision-making

Lead the rural safety plan for rural general paediatric practice and scope — OSCE

OSCE station for rural general paediatric practice and scope.

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osce communication and shared decision-making

Lead the rural safety plan for rural newborn and acute paediatric care — OSCE

OSCE station for rural newborn and acute paediatric care.

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osce communication and shared decision-making

Lead the rural safety plan for stabilisation with limited paediatric resources — OSCE

OSCE station for stabilisation with limited paediatric resources.

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osce communication and shared decision-making

Lead the rural safety plan for telepaediatrics and remote specialist support — OSCE

OSCE station for telepaediatrics and remote specialist support.

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