18^th November 2006

Dear Colleagues,

At the meeting of BAPS Council last week I was asked if I could send out the current distribution of questions that are in the bank for the section 1 of the Specialty Fellowship in Paediatric Surgery. As you know this examination has changed and there is now a written component( which took place yesterday) involving extended matching items (EMI) and single best answer style of MCQs (SBA).

The writing party is very keen to increase both the spectrum and the number of questions in both elements of the bank.

To remind you of the format, the single best answer MCQ involves a stem, a lead in, and then five options only one of which is correct but the other four are reasonable distracters. An example unrelated to our own specialty is below.

SBA (single best Answer)

Stem

A 32-year-old man has a four-day history of progressive weakness in his extremities. He has been healthy except for an upper respiratory tract infection ten days ago. His temperature is 37.8^oC (100^oF), blood pressure is 130/80mmHg, pulse is 94/min, and respirations are 42/min and shallow. He has symmetric weakness of both sides of the face and the proximal and distal muscles of the extremities. Sensation is intact. No deep tendon reflexes can be elicited; the plantar response are flexor.

Lead In

Which of the following is the most likely diagnosis?

Answers

a Acute disseminated encephalomyelitis

b Guillain-Barre syndrome

c Myasthenia gravis

d Poliomyelitis

e Polymyositis

(You need to provide us with the correct answer which (as in this case) may not always be obvious to all people, all the time)

EMIs

EMI. (Extended matching item.) includes identifying a theme, providing (up to and preferably)15 options, a lead- in question, and then 3 scenarios which match to one of the 15 options (if need be, it can be the same one on each occasion.) See below

Theme:- Age (years) for consent

Options

A 18

B 15

C 16

D 3

E 7

F 9

G 12

H None of above

I 21

Lead In. From each of the above options choose an age which best matches the statement below. Each option may be used once, more than once or not at all

1. Gillick competence is assured: (H)

2. The parents'responsibility for consent is shared with the child: (C)

3. Parental responsibility ceases: (A)

As you see the answer is provided each time

The current distribution of questions across the curriculum is as follows

SBA

Head & Neck 28

Respiratory / Thoracic 28

Hepatobiliary 16

Kidneys & Bladder 43

Genitalia 40

G.I. 13

Skin & Subcutaneous 9

Musculoskeletal 8

Multisystem 33

Miscellaneous 86

EMI

Head & Neck 21

Respiratory / Thoracic 14

Hepatobiliary 10

Kidneys & Bladder 11

Genitalia 24

G.I. 33

Skin & Subcutaneous 11

Musculoskeletal 7

Multisystem 41

Miscellaneous 70

Each MCQ has five questions and each EMI provides us with three, but we could do with substantially increasing the library pool. We would be very happy if you wish to share this e-mail with your trainees so that they can both see the format and also write questions for us. Obviously if they put in a significant number, the chances of getting their own back during the examination and increased!.

The questions should be sent to

s.baschiera@intercollegiate.org.uk

There are actually templates that can be obtained in advance from Serena if you would prefer . These make construction a little easier for some.

Once again many thanks for your help in this matter

Kind regards

George Youngson

Chairman Intercollegiate Board In Paediatric Surgery