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Psych CASC / OSCEForensic psychiatry — FII / medical child abuse

Psych CASC / OSCE · Forensic psychiatry — FII / medical child abuse

Explain FII concern and safeguarding plan to a paediatric consultant colleague — CASC communication station

MRCPsych/FRANZCP-style CASC: interprofessional communication about suspected fabricated or induced illness, balancing false-positive and false-negative risk, child safety first.

communication2 min readVerification in progress

Target exams

FRANZCPMRCPsychABPNMD-DNB
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Study tools

Target exams

FRANZCPMRCPsychABPNMD-DNB
Prompt
A senior paediatrician is uneasy about 'accusing a devoted mother' and wants either complete certainty of FDIA or discharge home. You must communicate the dual-frame model (child harm vs caregiver diagnosis), red flags, multi-agency process, and what happens next — without inventing statute section numbers or colluding to avoid reporting.

Station brief

Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar speaking with a paediatric consultant colleague (examiner role-player) about a 2-year-old with recurrent unexplained apnoeas clustering with maternal unsupervised access.[1][4]

Candidate instructions. Explain concern using behavioural language. Separate child-harm framework from FDIA diagnosis. Outline immediate safety, multi-source review, and multi-agency notification on reasonable suspicion. Acknowledge false-accusation risk and keep organic differential open. Resist demands for absolute certainty or premature discharge. Do not invent statute section numbers. Check understanding and agree next steps.[1][2][4]

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References6ShowHide
  1. [1]Bass C, Glaser D Early recognition and management of fabricated or induced illness in children Lancet, 2014.PMID 24612863
  2. [2]Flaherty EG, Macmillan HL Caregiver-fabricated illness in a child: a manifestation of child maltreatment Pediatrics, 2013.PMID 23979088
  3. [3]Stirling J Jr Beyond Munchausen syndrome by proxy: identification and treatment of child abuse in a medical setting Pediatrics, 2007.PMID 17473106
  4. [4]Tully J, Hopkins O, Smith A, et al. Fabricated or induced illness in children: A guide for Australian health-care practitioners J Paediatr Child Health, 2021.PMID 34310788
  5. [5]Wear KR, Li S Guideline review: RCPCH perplexing presentations, fabricated or induced illness in children guidance 2021 Arch Dis Child Educ Pract Ed, 2022.PMID 34728544
  6. [6]Sanders MJ, Bursch B Forensic assessment of illness falsification, Munchausen by proxy, and factitious disorder, NOS Child Maltreat, 2002.PMID 12020067
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