2018-19

Year 4: Women, Children and Family (WCF)

Student Handbook
Reproductive Health Lead
Dr Victoria Logan
LoganV@cardiff.ac.uk
Child Health Lead
Dr Julian Forton
FortonJT@cardiff.ac.uk

Year 4 Administrator:
Hannah Caveney
UGMedicYr4@cardiff.ac.uk
1
Contents
Year 4: Women, Children and Family (WCF) ................................................................................................... 1
Introduction ..................................................................................................................................................... 3
Academic Dates for Phase 2 2018/19.............................................................................................................. 4
Review of Prior Learning.................................................................................................................................. 5
PHASE 1:........................................................................................................................................................... 5
Phase 2: Gynae Teaching associates (GTA) ..................................................................................................... 5
PHASE 2: APPLIED CLINICAL SCIENCES ............................................................................................................ 5
Structure of the Module .................................................................................................................................. 6
Aims and Objectives ........................................................................................................................................ 7
CHILD HEALTH .................................................................................................................................................. 7
REPRODUCTIVE MEDICINE............................................................................................................................... 8
Teaching Weeks in Cardiff ............................................................................................................................... 9
Learning Outcomes ........................................................................................................................................ 10
Science Outcomes.......................................................................................................................................... 10
Practice outcomes ......................................................................................................................................... 12
Professional behaviour outcomes ................................................................................................................. 13
Introduction Week Timetable........................................................................................................................ 14
Clinical Placements ........................................................................................................................................ 17
Absence during the block .............................................................................................................................. 17
child health .................................................................................................................................................... 18
REPRODUCTIVE MEDICINE............................................................................................................................. 19
My Progress ................................................................................................................................................... 21
Consolidation Week Timetable...................................................................................................................... 25
ASSESSMENTS (in a nutshell) ......................................................................................................................... 27
CLINICAL SKILLS LOG ................................................................................................................................. 27
child health and REPRODUCTIVE MEDICINE.................................................................................................. 27
Core Topics in Reproductive Medicine .......................................................................................................... 29
Core Topics and Skills in Child Health ............................................................................................................ 34
Reading List .................................................................................................................................................... 42
child health .................................................................................................................................................... 42
REPRODUCTIVE MEDICINE............................................................................................................................. 42
Prizes .............................................................................................................................................................. 45
child health .................................................................................................................................................... 45
REPRODUCTIVE MEDICINE............................................................................................................................. 45
Student societies............................................................................................................................................ 46
Feedback ........................................................................................................................................................ 46
2
Introduction
The overall aim of the Reproductive and Child Health module is to build on your learning from previous
years and to provide a strong foundation in these areas. As a qualified doctor practising in any area of
medicine you could have a child or pregnant / recently delivered woman as your patient. In addition you
will have occasions where women present with ambiguous abdominal / pelvic symptoms or abnormal
bleeding.
The focus of the reproductive health part of the module is on familiarising yourself with pregnancy and its
outcomes as well as other significant areas in women’s health. This will enable you to assess, triage and
treat women, recognising when you need to make an intelligent referral onwards to an appropriate
practitioner, and similarly accepting referral from an obstetrician/gynaecologist, midwife or specialist
nurse.

On many occasions your patient may be a child or adolescent. You need to be aware of the differences in
presentations and management required during this period of growth and development. You should be
confident to examine and communicate with children and adolescents and make safe judgements about
their care.

3
Academic Dates for Phase 2 2018/19

4
Review of Prior Learning
Please note: these topics have already been covered. Reviewing these areas should illustrate how much
you already know about these topics, enabling you to spiral back and build on your existing knowledge.

PHASE 1:

CASE 2: I WANT TO GO ON THE PILL

CASE 7: I’M WORRIED MY BABY MAY HAVE DOWN’S SYNDROME

CASE 8: I’VE COME FOR MY ANTENATAL CHECK-UP

CASE 9: I HAVE BROUGHT MY DAUGHTER FOR HER MMR VACCINE

PHASE 2: GYNAE TEACHING ASSOCIATES (GTA)

It is suggested that you review your learning from your GTA session (Year 3) early in the block. Since we
started the GTA sessions, students have consistently fed back that they feel more confident in intimate
examinations in the clinical setting. There is no planned revision of this session prior to placement, but
the models may be available if you wish to refresh. You should contact Dr Logan (loganv@cardiff.ac.uk)
or Mrs Parker (ParkerE8@cardiff.ac.uk) if you wish to have access to these models.

PHASE 2: APPLIED CLINICAL SCIENCES

WEEK 2: CLINICAL DIAGNOSTICS AND THERAPEUTICS

It is advised that you review the session on ‘Prescribing and Tailoring Medicines to the Patient’ that you
received as part of the Clinical Diagnostics and Therapeutics week in Applied Clinical Sciences. Areas of
particular importance are those on prescribing in pregnancy and childhood. There are also resources in
the same area on Learning Central regarding prescribing and pharmacokinetics in children. Sessions in the
intro week and experience during the clinical placements will build on this and will provide opportunities
to practice.

WEEK 4: PROTECTION OF THE VULNERABLE

It is advised that you review the sessions on ‘Injury in Infancy and Childhood’ and ‘Domestic and Intimate
Partner Violence’ (‘Archie and Alice’) that you received as part of the Protection of the Vulnerable week

5
in Applied Clinical Sciences (Week 4). Sessions in the intro and consolidation weeks, as well as experience
and study during the clinical placements, will build on this.

Structure of the Module

Reproductive Medicine and Child Health are integrated into a single 10 week module in year 4 of the
Medical course. There is an introductory week and consolidation week, during which both disciplines are
taught in parallel, but also together when there is clinical overlap and when there are shared learning
outcomes.

The overall structure of the module is shown below:

Weeks
1 2 3 4 5 6 7 8 9 10
Reproductive
Child Health
½ student INTRODUCTION WEEK Medicine CONSOLIDATION WEEK
Placement
cohort CARDIFF Placement CARDIFF
Reproductive
Child Health
½ student Medicine
Placement
cohort Placement

or

Weeks
1 2 3 4 5 6 7 8 9 10
½ student INTRODUCTION WEEK Integrated CONSOLIDATION WEEK
cohort CARDIFF Child Health CARDIFF
+
½ student Reproductive Medicine
cohort

The structure of the central eight week clinical placement is divided equally into 4 weeks of Reproductive
Medicine and 4 weeks of Child Health. There may be opportunity in some hospitals to gain clinical
exposure to both disciplines throughout the 8 week placement in a more integrated model, and local
timetables may therefore vary.

There is an element of core teaching within both specialities, based on 4 weeks in each area. This has been
designed so that there are common elements throughout placement hospitals that also allow students to
integrate with their own unique experiences.
Attendance at core teaching is mandatory and should be documented in ‘My Progress.’ There may also
be other teaching sessions in addition to the core programme, which may vary between hospitals.

6
Aims and Objectives
CHILD HEALTH

AIMS

• An introduction to paediatric practice - history taking, examination, diagnosis, communication

and practical procedures.
• To understand the process of normal growth and psychosocial development
• To develop an understanding of common and important diseases in children.
• To understand the impact that childhood illness may have on normal growth and psychosocial
development.
• To be aware of the consequences of childhood illness on the family and community, and what
resources are available to help.
• To develop an approach to health care where the child’s welfare is always paramount

OBJECTIVES

• To be able to take a paediatric history and perform a clinical examination on infants, toddlers
and older children, to formulate a differential diagnosis and identify relevant investigations.
• To be able to communicate appropriately with children, and effectively with parents and
colleagues.
• To be able to describe the pathophysiology, natural history, clinical findings, relevant
investigations and management approach for common and important paediatric conditions.
• To be able to carry out the paediatric skills identified in this handbook
CHILD HEALTH have developed a website to guide you and your teachers through the course. You will
need to register on this website. www.uhwchildren.com/student

7
REPRODUCTIVE MEDICINE

AIMS

• To provide an introduction to practice in Reproductive Health - history taking, examination,

diagnosis, communication and practical procedures.
• To develop an understanding of common and important conditions in pregnancy and specific to
sexual and reproductive health.
• To understand the impact that pregnancy and gynaecological / sexual health conditions may
have on overall health and psychosocial welfare.
• To be aware of the consequences of pregnancy and gynaecological / sexual health conditions on
the family and community, and what resources are available to help.
• To develop an holistic approach to health care where the patient’s welfare is always paramount

OBJECTIVES

• To be able to take an appropriate history and perform a clinical examination on women

presenting to healthcare services, recognising that the same process may be relevant regardless
of the clinical area where the patient is seen.
• To practice formulating differential diagnoses and identifying relevant investigations.
• To practice communicating appropriately and effectively with patients and colleagues.
• To be able to describe the pathophysiology, natural history, clinical findings, relevant
investigations and management approach for common and important conditions.
• To be able to carry out the specific skills identified in this handbook.

8
Teaching Weeks in Cardiff
BOOKEND WEEKS

All students will be in Cardiff for the ‘bookend weeks’ i.e. for the introductory and consolidation weeks
(weeks 1 and 10).

Attendance at introductory and consolidation week teaching sessions is monitored. It is YOUR

responsibility to ensure that you sign the register for the teaching session. If you are unable to attend any
of these sessions please inform the year co-ordinator. Many sessions will rely upon a full cohort of
students to get the best out of the session for all, and some are also given by external speakers who
have given up their own commitments to teach you. Please therefore be professional and courteous
and attend these sessions. It may not always be obvious from the session title what this has to do with
your learning, but remember we set your exams and have worked clinically as specialists for many years,
so there will always be something useful in every session.

Dates for Bookend weeks are available on MyTimetable.

9
Learning Outcomes
These should be related to the Core topics which are towards the end of the handbook (page 34
onwards). The LOs are necessarily broad – coverage of all the core topics will ensure that students
fulfil these outcomes.
SCIENCE OUTCOMES

Small Group Teaching

Scholarship/Science:

Professionalism
e-Learning
Placement
Bookends

Tutorials

Practice:
On successful completion of the module
students will be able to:

SDL
CHILD HEALTH
H1. Describe the physiological, biochemical, genetic
and social mechanisms that control human growth
and development throughout foetal life, infancy,
childhood and adolescence and normal variations
S
and common presentations of abnormal growth
and development
H2. Summarise the causes, investigation and S
management of common childhood acute and
chronic neuro-developmental, medical and surgical
conditions. (Cases 1,2,7,9,10)
H3. Apply an understanding of the growth and S
development of the child to formulations of
common presentations to health care services and
the psychological outcomes of acute and chronic
illness (Cases 1,2,7,8,9,10)
H4. Apply the principles underlying the process of S
reproduction and human embryonic development
in the management of normal and abnormal
pregnancy and childbirth and common neonatal
problems (Case 7 Yr 2, Downs, FAS Case 8)
H5. Recognise adolescence as a unique phase of S
growth and development and the specific issues
for adolescence including sexual health, risk taking
behaviour (smoking, drinking and drugs), and self
harm (Case 1 Yr 1, Case 2 Yr 1, Case 10)
H6. Explain the principles of therapeutics in children S
and adolescents showing an understanding of
positive and negative impacts on disease and
growth and development
H7. Explain the determinants of child health and S
disease and the implications for adult health (Cases
2, 7, 10)

10
 Scholarship/Science:
Specific Tutorials
Small Group Cases

Professionalism
Prior learning

e-Learning
Placement
Bookends

Teaching

Practice:
On successful completion of the module
students will be able to:

SDL
OBSTETRICS
H8. Describe normal and abnormal progress of S
pregnancy, labour and delivery

H9. Describe normal physiological changes of S

pregnancy (Case 8 Yr 2) (8a)

H10. Recognize and discuss the impact of disease on S

pregnancy and vice versa, and describe basic
principles of investigation and treatment (8a-g)
H11. Explain and evaluate the role of antenatal care S
(Case 7 Yr 2) (9,11d,f,i)
H12. Explain and evaluate normal and abnormal S
patterns of in-utero growth and assessment of
fetal wellbeing (Case 8, Yr 2) (8a-g)
H13. Describe the risks and potential complications of S
delivery and the postnatal period, including most
common causative factors (8a-g)
H14. Recognize and discuss the causes of maternal S
deaths and their prevention, and causes of
perinatal morbidity and mortality, including the
global perspective (8a-g, 9, 10, 11)
GYNAECOLOGY
H15. Describe the pathophysiological basis of abnormal S
menstrual bleeding and cyclical mood changes
(case 2 year 1) (8a-g)
H16. Discuss the importance of sexual health on a S
woman’s wellbeing, revising the microbiology of
common STIs, their identification, treatment and
implications on future health (Case 2 Yr 1) (8b-f,
9b, d, e, 10b, d, e, 11, 14, 17)
H17. Evaluate and recommend different methods of S
contraception for individual cases (Case 2 Yr 1) (8a,
e, f, 9a-c, e, 10b, e, 12c, 14, 17)
H18. Explain the relevance of pelvic floor anatomy for S
disease states (incontinence, prolapse),
appropriate investigation and the impact these
conditions have on a woman’s daily life. Describe
the basic principles of conservative, medical and
surgical management of these conditions

11
 (Anatomy in PCS and Case 2 Y1) (8a, b, c, e, f, g, 9b,
d, e, 10b, c, d, e)
H19. Discuss the pathological basis of pelvic pain and be S
able to differentiate between gynaecological and
other causes (8, 14a-f)
H20. Explain the basic causes, initial investigations and S
principles of treatment for subfertility (male and
female), considering the condition and the social
and psychological implications of its treatment
(PCS, Case 2 Yr 1) (8a-d, 9b, f, 10b, c, 14)
H21. Recognize and evaluate the role and limitations of S
screening for gynaecological malignancy (8, 11)

H22. Describe the pathogenesis, presentation and initial S

management of gynaecological tumours (benign
and malignant), including the psychosocial
perspective (8, 9a-f, 14)

PRACTICE OUTCOMES

Small Group Learning

Scholarship/Science:
Prior learning

Placement

Professionalism
Tutorials
Bookends

SDL

e-Learning

Practice:
At the end of your Women Child Family module
you should be able to:

H23. Demonstrate safe and effective prescribing for

common women’s gynaecological health problems
P
and contraception, during pregnancy, infancy,
childhood and adolescence (17a-h)

H24. P
Recognise the acutely unwell child and distinguish
the key features, investigation and management of
common presentations in infancy, childhood and
adolescence (16, 17, 18)

H25. Demonstrate effective and sensitive history taking P

and examination of infants, children and adults
presenting to Healthcare services including (but not
limited to) Child Health, Obstetrics & Gynaecology,
Sexual Health Services and Primary Care (Case 2, Yr
1) (13, 14, 15)

H26. Recognise and evaluate symptoms and signs of P

complications in pregnancy, recognize a sick or
deteriorating patient and be able to demonstrate
initial management (13, 14, 15, 16, 17, 18)
H27. Recognise and evaluate cardinal symptoms and P
signs in gynaecological practice, recognising a sick

12
 or deteriorating patient and be able to demonstrate
initial management (13,14,15,16, 17, 18)
H28. Recognise the causes, presentation, investigation P
and management of common chronic childhood
illness (Case 10) (13, 14, 15, 17, 18)
H29. Recognise and be aware of your responsibility to P
safeguard children and vulnerable women (14i, 15g)
H30. Explain the roles in multi-disciplinary or multi- P
agency teams working to address health outcomes
for women and children (intro, placement (22)
H31. Demonstrate the necessary communication skills P
for managing patients presenting to Child Health
and Women’s Health services (15)

PROFESSIONAL BEHAVIOUR OUTCOMES

Professional behaviour is a key theme containing outcomes that are achieved throughout the MBBCh
course. The professional behaviour learning outcomes for Women, Child and Family are given below;
these overlap in some areas with other modules of Phase 2, and hence are not allocated a ‘H’ number.
Within this module, these behaviours should be practiced wherever possible. They will be formatively
assessed as part of your Tutor’s progress report and may be formally assessed via the ISCE at the end of
Year 4.
Small Group Learning

Scholarship/Science:
e-Learning
Placement

Professionalism
Tutorials
Lectures

SDL
At the end of your Women Child Family module

Practice:
you should be able to:

• Demonstrate professional behaviour towards

patients of all ages and abilities and towards
colleagues from health services and other
Prof
agencies.
• Behave according to ethical and legal principles Prof
and be able to understand the principles of
assessing capacity to consent in children and
adolescents and develop the ability to involve
children in their treatment
• Demonstrate patient centred approach to care Prof
whether the patient is a child, adolescent or adult
and be able to balance the needs of a developing
fetus or child with those of their parent/s or carers.
• Appreciate the role of, and work within, a Prof
multidisciplinary team to provide best care for
patients of all ages and their families.
• Acquire, assess, apply, integrate and reflect on new Prof
knowledge.

13
(TD09 20-23)

Introduction Week Timetable

During the introduction week of your block you will have a series of introductory sessions. These sessions
are designed to build on what you already know and give you some confidence going into your placement.
They are not designed to provide all knowledge about a subject but rather to highlight important areas
that you should study further as you see patients on placement.
Where there is clinical overlap and when there are shared learning outcomes, we have taken the
opportunity to integrate Reproductive and Child Health to allow you to view clinical cases in a holistic way
and understand how these two disciplines interface in real life.

REPRODUCTIVE MEDICINE
• Obstetric and gynaecological history taking
• Common and important problems on the emergency unit
• Obstetric assessment unit

CHILD HEALTH
• History and examination of the child
• Recognition of the sick child
• Growth and Psychosocial Development in childhood

COMBINED TEACHING SESSIONS

• Communication skills
• Prescribing
• Level 2 Safeguarding training

14
 INTRODUCTION WEEK
MONDAY TUESDAY (Group A) TUESDAY (Group B) WEDNESDAY THURSDAY FRIDAY
AM
The Paediatric Gynae virtual ED Level 2
Prescribing in Examination Safeguarding
COMMUNICATION Obstetrics
SKILLS Recognition of the
Prescribing in Child sick Child
Health (virtual ED)

Development in
Childhood

PM

Introduction to Prescribing in Growth in Virtual Obs SDL

WCF block Obstetrics COMMUNICATION Childhood and admissions unit
SKILLS Adolescence
Prescribing in Child
History taking Health
in Repro Med

History taking
in Child Health

This is a generic week timetable. Because of Progress Tests and bank holidays, your Introduction week
timetable may vary, but in all cases, all the above sessions will be offered.

MONDAY
Introduction to both specialties and a session on history taking for both disciplines

TUESDAY:
Communication Skills (see separate handbook)
These sessions will introduce straightforward consultations to help students settle in to history taking
and application of knowledge. These are integrated sessions with students and tutors from the School of
Midwifery.
Seminars in prescribing
This will be delivered by clinicians, with an emphasis on safe prescribing. This will build on the areas
covered in previous years.

WEDNESDAY:
Paediatric Examination
This session will introduce how to approach a child, what is different about children, and how to
perform an effective examination in all age groups.

15
Recognition of the Sick Child
This session will take the form of a virtual ED. Multiple cases are introduced and discussed in small
groups. Each case is followed by a relevant 10 minute lecture, highlighting the important learning points.
Growth in childhood and adolescence
A central component of Child Health and an essential session.

THURSDAY:
Gynae Virtual ED
Common and important emergency admissions and presentations will be discussed in an interactive
session where students will be able to apply their knowledge to investigate, diagnose and ‘treat’ a
variety of patients.
Virtual Obs Admissions unit
Much like the Gynae virtual ED – focussing on common, important and high risk presentations and how
to deal with them. There will also be a session from Obs Cymru on bleeding in pregnancy and labour

FRIDAY:
Development in Childhood
Understanding child development and how to make an assessment
Level 2 Safeguarding Training
A legal requirement when looking after vulnerable patients.
Certificates will be issued following this session.

16
Clinical Placements
Your clinical placement timetable will be determined by the local Undergraduate Team, and will involve
spending time in clinical settings with patients as well as more structured teaching sessions. You will
receive this timetable from the local coordinator when you arrive.

The structure of the central eight week clinical placement will vary between hospitals depending on the
clinical opportunities available locally, but all students should have equivalent (though not identical)
experiences.

Absence during the block

If you are unable to attend clinical placement or any compulsory element of the programme on any day
when you are timetabled to be present you must contact us to inform us of your absence. This is a
University requirement and is a part of acting professionally.

Notification of absence must be received on the first day of absence by 08.30.

Clinical Placements: Please call your Undergraduate Centre as per instruction given by them (usually
telephone the office by 08.30, so they can notify your clinical placement, avoiding any delays in clinical
work)

Cardiff University Teaching Weeks: Please call the generic Medical school number: 02920 68 8101 and
email your Year co-ordinator on UGMedicYear4@cf.ac.uk NO LATER than 08.30

For further details on absence, please refer to the Year 4 Generic Handbook

17
CHILD HEALTH

MANDATORY CORE TEACHING PROGRAMME

“3 PAEDIATRIC CASES” • The Normal Child

TEACHING SESSIONS • The Child with Chronic Disease
• The Child with Social needs

Four 90 minute sessions across the clinical placement will track 3

children through childhood - Common and important clinical
problems are addressed at each stage of childhood.
You will need to prepare for these sessions in advance.
These 60 minute sessions will cover multiple common clinical
SHORT CASE-BASED vignettes in paediatrics.
TEACHING SESSIONS You will need to prepare for these sessions in advance.
This is your opportunity to practise your paediatric history and
CLINICAL TUTOR : examination and complete your mandatory Mini CEXs. Use the
WEEKLY SMALL GROUP clinical skills in the core curriculum as a guide to your approach
BEDSIDE TEACHING
Your on-call evenings will be coupled to a dedicated opportunity for
AT LEAST 2 ON-CALL you to present the cases you saw (“Morning report”). This is your
EVENINGS opportunity to sign off on the two mandatory CBDs.
At least one clinic must be in community paediatrics.
4 PAEDIATRIC CLINICS
Each week you have 20 or so questions on-line to answer. These are
ON-LINE based directly on the topics you will have covered in the 3
SELF-ASSESSMENTS PAEDIATRIC CASES and short cased based questions that week. This
is a learning tool, not an assessment. You can repeat the tests as
many times as you like. There is feedback on your answers.

There may also be other paediatric timetabled teaching sessions in addition to the core teaching
programme, which will vary between hospitals. Your local Link Tutor and undergraduate team will provide
you with a timetable.

CLINICAL TUTOR
During your clinical attachment you will be allocated a consultant as your Child Health Clinical Tutor, who
will oversee your progress and deliver weekly small group bedside tutorials with one or two other
students. This is your opportunity to practise your paediatric history and examination - try and complete
the clinical skills in the core curriculum. It is your best opportunity to complete the two Mandatory
MiniCEXs (SLE).

18
REPRODUCTIVE MEDICINE

MANDATORY CORE TEACHING PROGRAMME

Attendance at all aspects of clinical placement is mandatory – this is part of professional behaviour.

4 CLINICAL CASES • Hypertensive disorders in pregnancy

• Abnormal vaginal bleeding
• Abnormal labour and delivery
• Gynaecological malignancy

Students will study a common clinical presentation on each week of

placement, all of which will focus on an acute presentation or
condition, and will have 2 tutorials on this. During the first tutorial they
will discuss a “virtual” patient, who will be presented either through a
short written vignette or a short video of a consultation. The role of
the facilitator is to guide you through analysing the patient’s case using
the Cardiff Framework, not to teach you everything on a subject.
Following this, your group should devise your own learning outcomes
for the week. Two students from each group should be nominated to
present a patient they have seen with a similar clinical problem at the
second tutorial, when the Cardiff Framework is completed. This should
be done orally, without any visual aids. In addition to presenting the
specific patient’s history there should also be a preconceived, succinct
learning focus based upon the Cardiff framework. You should choose a
different focus for every case seen. The reasons for any decisions are
discussed with the rest of the group, along with three key learning
points identified by the presenting students, who should seek to have
these signed off as CBDs.

You will need to prepare for these sessions in advance –

recommended reading is included in the cases which are available on
Learning Central, and in separate Cases handbooks for tutors.
Tutors may wish to provide a program of subject-specific tutorials and other
FORMAL TEACHING timetabled formal teaching to support students’ learning whilst on
placement. You should use these and your own reading to learn about
illnesses, and treatments patients receive, as well as the pathology and also
the social and psychological issues that may be relevant. These would be in
addition to the Case Based tutorials (above), but must be based on the
learning outcomes for the module. You should not expect that all core
topics or learning outcomes will be completely covered in formal teaching.

19
 Pregnancy and delivery (Obstetrics and midwifery)
CLINICAL WORK IN Antenatal clinics – general and specialist / multidisciplinary
ACUTE AREAS Antenatal ultrasound
Students are Obstetric assessment unit
expected to avail Inpatient antenatal / postnatal ward, including rounds
themselves of the Delivery suite
opportunities Midwife led unit
available in all Community midwife clinics
areas (note that
‘bedside teaching’
does not have to Gynaecology and sexual health
be in a hospital Early pregnancy assessment unit
ward – in O&G Acute gynae intake
this is increasingly Sexual Health clinic / contraception clinic
unlikely as the Outpatient clinics
specialty is Outpatient operating
significantly Day surgery unit
ambulatory in Inpatient operating theatre
nature): Gynaecology ward, including rounds

All of these areas provide rich learning opportunities for students. You
should get involved in taking histories, examining patients and
attempting diagnoses and theoretical management plans. You should
take the opportunity to discuss these whenever possible with clinical
staff and complete Supervised Learning Event records where
appropriate.
You are expected to use your clinical experiences to trigger your
learning of specific diseases, their pathology and pathophysiology,
investigation and management. You should expect to look at the
literature in the field and apply your skills in critical appraisal to
research papers that interest you.

Normal labour
CLINICAL CASES AND
PROCEDURES YOU
SHOULD AIM TO SEE Normal delivery
(YOU CAN RECORD
THESE IN THE Obstructed labour
‘PLACEMENT

20
 ACTIVITY’ AREA OF Instrumental delivery
‘MY PROGRESS)

Elective Caesarean section

Emergency caesarean in
labour
laparoscopy

hysteroscopy

Vaginal surgery

Management of miscarriage/ termination of pregnancy

+ any other interesting cases – all are learning experiences!

You should expect that you will be rostered onto out of hours shifts
OUT OF HOURS – there are real learning opportunities for you here and a chance to
SHIFTS get to know the full extent of the specialty, as well as sign off SLEs.

CLINICAL TUTOR

During your clinical attachment you will be allocated a consultant as your Reproductive Health Clinical
Tutor, who will be your point of contact for this specialty. This may be the link tutor or another consultant.
One clinical tutor may have more than one student, depending on local organisation of placements.

MY PROGRESS

My Progress includes forms for you to record your weekly placement activity, your mini-CEXs and CBD
forms (see further details below), reflective practice forms and communication skills forms. All of these
will be reviewed by your Educational Supervisor during your supervision meetings and considered in your
End of Placement meeting/sign off. The satisfactory completion and sign off of the End of Placement Form
is necessary for progression.
It is mandatory to complete at least 4 SLEs in each of Child Health and Reproductive Medicine, but you
are encouraged to do as many as possible.
Below is a list of core skills for each discipline to help you identify what is important to tackle while on
placement. Forms for these will be available on Learning Central and / or the Child Health website: it is
suggested that you download or fill these out electronically and append them in the placement activity
area of My Progress. It is absolutely manageable to complete all the core skills during your placement.

21
 • Take a family and social history
• Take a developmental history
• Communicate a skill to a patient or parent
• Approach to examining a febrile child
• Cardiac examination
• Respiratory examination
• Abdominal examination
CHILD HEALTH
• ENT examination
CORE CURRICULUM • Neurological examination
SKILLS LIST • Developmental examination
• Newborn screening examination

The weekly bedside teaching tutorials with your Clinical Tutor provide an
excellent opportunity to complete these examinations, but there will be
other opportunities with other doctors on the wards as well. It is your
responsibility to get these examinations assessed. More than one of these
examinations can clearly be performed in a single interaction with a child.

MINICEX
Mini-CEX are mini clinical examinations, performed under supervision, where you
are given immediate feedback on your performance. Students must perform 2
miniCEX assessments during their Child Health Module.
One of the MiniCEXs must be the developmental assessment of a young child. We
recommend that the other MiniCEX is an observed history (e.g. history of presenting
complaint, perinatal history, family and social history...), where your assessor can
CHILD HEALTH observe both your technique and your record keeping skills.
SUPERVISED
CBD
LEARNING EVENTS
You will be expected to complete 2 CBDs in Child Health. These CBDs should
be a full history, examination, differential diagnosis and management plan.
These patient clerkings might be best performed on-call and presented to your
assessor the next day.
In some hospitals this will be at a “morning Report” where the student
presents the case to the group. You will be assessed on how you present the
case, but also how you document the history and examination on paper.
There is specific paperwork that needs to be completed for MiniCEXs and
CBDs and these can be found in your clinical skills log.

CHILD HEALTH You should record your attendance at these sessions in the weekly
MANDATORY CORE placement activity area of ‘My progress’.
TEACHING
PROGRAMME

ON-LINE Each week you have 20 or so questions on-line to answer. These are based
SELF ASSESSMENTS directly on the topics you will have covered in the 3 PAEDIATRIC CASES and

22
 short cased based questions that week. This is a learning tool, not an
assessment. You can repeat the tests as many times as you like. There is
feedback on your answers.

• Obstetric history taking and examination

• Gynaecological history taking and examination
WOMEN’S HEALTH • 4 speculum / bimanual examinations (can be on patients who are
CORE SKILLS awake or under anaesthetic, but MUST have appropriate consent /
chaperone etc. – see generic handbook)
• There are forms for these on Learning Central

MINICEX
Mini-CEX are mini clinical examinations, performed under supervision, where you
are given immediate feedback on your performance They are used for observation
of patient interactions.
You should take every opportunity to get formative feedback on your performance
by undertaking formative mini CEX (supervised learning events) throughout each
clinical attachment, but will have to show satisfactory performance in a minimum
of 2 Mini CEX per clinical attachment in this module to satisfactorily complete the
attachment. (i.e. 2 mini CEx for ReproMed and 2 for Child Health). You should,
however, be recording each clinical encounter and asking for feedback. The
REPRO HEALTH feedback should be given by different people but can be from F2 to consultant.
SLES One of the MiniCEXs must be the assessment of a pregnant woman. This should
include an assessment of history taking, documentation and examination.

CBD
Students are expected to complete at least 2 CBDs in Reproductive Health.
During the closing session of the case of the week, students should be
expected to present a case to the group. Not all students will present each
week but during the placement each student will be expected to have
presented at least once.
CBDs should also be completed in discussion with senior staff where the
opportunity arises outside these tutorial sessions e.g. if a student has seen a
patient in clinic or on the ward and discusses the case afterwards.

REPRO HEALTH You should record your attendance at these sessions in the weekly placement
MANDATORY CORE activity area of ‘My progress.’
TEACHING

It is your responsibility to organise three brief feedback sessions with your

Educational supervisor (beginning, mid and end of placement). This will
EDUCATIONAL provide an opportunity to give you some constructive feedback on your
SUPERVISOR performance so far. Where placements are split with 4 weeks in each specialty,
FEEDBACK most placements sign off the first specialty at the end of the first 4 weeks and
SESSIONS / END OF the second at the end of the block. If your tutor in your first specialty is unable
PLACEMENT to sign you off at this (4 week) point, you should identify what your further
REPORT needs are with them (eg need more mini CEx) and endeavour to fulfil these

23
 during your second specialty placement – without compromising the second
placement. You should plan with your tutor how to accomplish this.

CONSOLIDATION WEEK CASE PRESENTATIONS

On the Friday of Consolidation week (week 10 – Cardiff), there is a mandatory teaching session, run by
students for students. The basis of the session is thirty 4 minute case presentations delivered by students,
and 60 associated SBA multiple choice questions.

WHAT YOU NEED TO DO

•In your child health clinical placement students will need to buddy up into groups of 3 – 5 students and
find an interesting case to present.
•The presentation can only be 4 PowerPoint slides long aside from the Introductory slide.
•One of the group will need to present the case on the Friday morning. The Introductory slide must
contain the name of your Placement Hospital and the names of all contributing students – one student
will be chosen on the day to deliver the talk – so all students will need to be present.
•There needs to be a snappy message to the talk as there is only 4 minutes to present it.
•The group will also need to develop 2 SBA questions relevant to the case.
•Case and questions need to be forwarded to Julian Forton (FortonJT@cardiff.ac.uk) and copy in
UGMedicYr4@cardiff.ac.uk in week 5 or 9 of the clinical placement (depending on whether you do child
health first or second).

24
Consolidation Week Timetable
The focus of the Consolidation week sessions is to bring together knowledge and experiences from the
block, and to extend that knowledge in areas that may not be available in all clinical placements. There is
also a focus on application of knowledge and skills gained, and opportunities to revisit the science
underpinning clinical presentation and practice. The sessions should also give you the opportunity to ask
questions and clarify anything you are unsure of.
Attendance at introductory and consolidation week teaching sessions is monitored. It is your
responsibility to ensure that you sign the register for the teaching session. If you are unable to attend any
of these sessions please inform the year 4 co-ordinator.

CONSOLIDATION WEEK
MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY
AM
COMUNICATION Speciality lecture series CLINICAL SKILLS:
Specialty lecture series SKILLS: Student
Embryology Simulation Case
Gynae Oncology (time assigned) Fetal medicine In Presentations
Paediatric surgery Paediatrics Formative
Paediatric oncology and SBAs
Paediatric Cardiology Self directed learning Reproductive medicine
Paediatric Neurology – prep for practical
sessions on (time assigned, morning or
Wednesday and afteroon, rest of day SDL)
Thursday: info on LC
and / or website

PM
Law, ethics and Human SCIENCE IN PRACTICE: SDL
rights in Women’s and
childrens’ Health Clinico-pathological
correlation

This is a generic week timetable. Because of Progress Tests and bank holidays, your consolidation week
timetable may vary, but in all cases, all the above sessions will be offered.

25
MONDAY:
Specialty Lecture Series
A series of speciality lectures covering gynaecological oncology, paediatric oncology, paediatric
cardiology and paediatric neurology.
Law, Ethics and Human Rights in Women’s and Children’s Health
A doctor has a legal obligation to inform if they believe a girl under 18 is at risk of, or has undergone FGM.
Human rights and rights of the child are important considerations in all fields of medicine and every
practicing doctor should be aware of these key issues. This session is therefore essential for future doctors
to inform themselves of the issues.

TUESDAY:
Communication Skills
A chance to practice what has been learned on placement with some more challenging scenarios
SDL: prep for practical sessions on Wednesday and Thursday
(see below and learning central) This prep work is essential in order for you to get the most out of the
sessions

WEDNESDAY
Specialty Lecture Series: Embryology, Fetal Medicine, Paediatric Surgery
Congenital abnormalities - diagnosis, antenatal counselling and care, postnatal treatment.
SCIENCE: Clinico-Pathological Correlation
This session is held in Biosciences, and is a chance to correlate clinical cases you may have seen with
pathological specimens. There is also opportunity to review rare historical specimens in order to
appreciate how advances in medical science have contributed to the virtual disappearance of some
conditions in developed countries.

THURSDAY
Simulation Session
These sessions are designed to build confidence with hands on simulation of managing the acutely
unwell patient. Skills training will include teamwork, application of knowledge and clinical management
in emergency situations.

FRIDAY
Student Case Presentations
Delivered to students by students in their allocated groups.
Mandatory Feedback Session
Your feedback is essential to the development of the course

26
ASSESSMENTS (in a nutshell)

CLINICAL SKILLS LOG

24/32 GMC-required practical procedures have been identified as being potentially available for sign off
during the reproductive health placement. 6 of these are expected to be signed off at ‘meets
expectation’ or above by the end of the fourth year. Therefore, it would be wise for you to make the
most of these opportunities when they arise on clinical placement, and ask qualified staff to assess
them. This can be nursing / midwifery / medical etc. staff – not necessarily consultants. In addition, if
you have already been signed off for procedures, you can show your clinical skills log to staff so that you
are allowed to perform procedures when the opportunity arises. This is one way of helping out and
feeling part of the team.

CHILD HEALTH AND REPRODUCTIVE MEDICINE

MY PROGRESS
This will be checked for completion – all sections must be completed and signed off to ensure
progression.
In addition, you should keep an appropriately anonymised record of all your patient clerkings in order
that you can reflect on your progress at the end of the year as well as using these patients to guide your
learning. These can be uploaded to My progress.

SUPERVISED LEARNING EVENTS (SLES)

The forms are within My Progress.

PROFESSIONAL BEHAVIOUR

This will be assessed during the placement. It will be based on the perception of all members of your
team. You must have the end of placement report signed off by your consultant/educational supervisors
at the end of your placement (Child Health and Reproductive Health). You must obtain a satisfactory end
of placement report for all of your fourth year placements to pass the year. Where professionalism
concerns are raised, your placement report and attendance rates at lectures/teaching sessions may be
taken into consideration. If students have poor attendance at introductory week lectures this
information may be passed on to their placement consultants.
Clinical Tutors have been advised that it is important that an ongoing assessment of students is made
and if any problems are identified, that these are discussed and an action plan agreed in a timely
fashion. The module leads may be informed of any issues and may arrange to interview students where
issues regarding professionalism are raised, on their return to Cardiff. If a student fails to obtain a
satisfactory report, this will be discussed with the Year 4 Director in the first instance, and may be
referred to the Programme Director and /or Dean of Medical Education for further assessment.

27
CLINICAL SKILLS AND COMPETENCY – YEAR 4 ISCE EXAMINATION

Reproductive and Child Health cases will form part of the integrated ISCE examinations at the end of
Year 4. All clinical interactions and SLEs should be seen as an opportunity to practice for this format of
exams. Please see the generic year 4 student guide for further information.

KNOWLEDGE AND UNDERSTANDING – PROGRESS TESTS

This is assessed throughout the year with Single Best Answer format progress papers. Please remember
that you should not be taking time out of placement to revise for these tests – they are designed to show
progress in your learning, not how much you can remember by cramming.

28
Core Topics in Reproductive Medicine
By the end of consolidation week in this placement, you should have knowledge of all the following areas.
Although this looks like a very long list, bear in mind that some of these areas have been covered earlier
in the course, and you will simply need to recap before adding to your knowledge (see Prior Learning to
review earlier). The core topics should be studied in conjunction with the Learning Outcomes and related
to them – e.g., the Core Topics in Obstetrics comprise a breakdown of areas that need to be studied in
order to attain the Learning Outcomes in Obstetrics.
Core Topics in Obstetrics
1. Normal pregnancy
Define and discuss:

• Basic obstetric definitions

• Normal physiological changes in pregnancy (revise Case 8)
• What routine antenatal care involves (risk assessment and “midwife-led care” versus “consultant-led
care”, antenatal screening tests, dating and anomaly scans) (revise Cases 7 and 8)
• How to counsel about Down’s screening and diagnostic tests (revise Case 7, but be aware of changes in
screening in the intervening time and update your knowledge appropriately)

2. Antepartum and postpartum haemorrhage (APH and PPH)

Discuss:
• Definition and causes of APH and PPH
• The diagnosis, investigation and treatment of APH and PPH including the emergency care required if
bleeding is heavy

3. Pre-eclampsia/eclampsia
Be able to:

• Explain the pathophysiology and epidemiology of hypertensive disorders in pregnancy

• Correctly diagnose and classify hypertension in pregnancy
• Demonstrate understanding of what investigations/monitoring are required in women with
hypertension in pregnancy, based on the maternal and fetal complications that can occur
• List the basic principles of management (including the commonly used drugs) of severe pre-
eclampsia/eclampsia incorporating prevention/treatment of seizures, control of BP and planning
of the delivery

4. Induction of Labour
Be able to:
• justify situations in which induction is / is not indicated
• describe the main methods of induction, their indications and contraindications

29
5. Normal Labour and Delivery
Discuss:

• The anatomy of the fetal skull and female pelvis relevant to labour
• The definition, mechanism and different stages of normal labour and delivery
• The level of monitoring required in low-risk pregnancy
• The options for pain relief in labour (review Case 8 as well)

6. High-risk Pregnancy
Be able to:
• identify a high-risk pregnancy and the principles of managing high-risk pregnancies ie. effect of pregnancy
on disease and effect of disease on pregnancy (eg diabetes, epilepsy, maternal obesity, haematological /
cardiac conditions, respiratory conditions) Consider normal physiology, how this changes in pregnancy
and pathology of the condition in question
• discuss the basic management of a twin pregnancy and its increased risks
• discuss the basic management of a diabetic pregnancy and its increased risks
• discuss the difference between “small-for-gestational-age” (SGA) and intrauterine growth restriction
(IUGR) the common causes for both, and basic management

7. Abnormal Labour
Explain:
• and justify basic management of pre-term labour/threatened pre-term labour
• the reasons for failure to progress and its management (related to (5) above)
• suspected fetal hypoxia and its management, relating back to physiology

8. Instrumental Delivery
Discuss:
• Indications for and prerequisites of instrumental delivery (relating to 5 and 7 above)
• The fetal and maternal complications (short and longer term)

9. Caesarean Section
Demonstrate knowledge of:
• Common indications
• The complications of caesarean section and ways to reduce risks
• The basic principles of vaginal birth after caesarean

10. Perinatal Mental Health (Taught in Psychiatric Medicine block, but also relevant here)

30
Core topics in Gynaecology

1. Abnormal early pregnancy (problem recognition, solving and counselling)

Discuss:
• Pathology, differential diagnosis, investigation, management and counselling in
o bleeding in early pregnancy
o pain in early pregnancy
o hyperemesis gravidarum
o miscarriage
o ectopic pregnancy
Within this you need to consider when referral to secondary / tertiary care is required, relating to physiology,
likely findings and referring to national / local guidance

2. Menstrual Disorders
Discuss:
• Normal physiology of the menstrual cycle (review Case 2, PCS)
• Definition of menorrhagia and its causes, investigations and management
• Differential diagnosis and management of oligo/amenorrhoea (primary and secondary)
• Clinical features and management options for premenstrual syndrome
Within this you need to consider when referral to secondary / tertiary care is required, relating to physiology,
likely findings and referring to national / local guidance

3. Pelvic Pain
Appreciate:
• The differential diagnoses of pelvic pain, including non gynae (acute and chronic)
• The pathology and clinical features of endometriosis
• The investigations and management options available in pelvic pain conditions (medical and surgical,
primary and secondary care)

4. Prolapse/incontinence
Explain:
• Pelvic floor anatomy in relation to uterovaginal support and continence
• The clinical features and management options for uterovaginal prolapse (medical and surgical)
• The clinical features of different types of urinary incontinence and first line management options

31
5. The Menopause
Discuss:
• Definition and features of the pre-, peri- and postmenopausal state
• Treatment of common menopausal symptoms including the risks associated with HRT

6. Contraception
Evaluate:
• Hormonal control of ovulation and the endometrium (revise Case 2)
• The range of contraceptive options, their advantages and disadvantages
• Contra-indications to the combined oral contraceptive

7. Reproductive tract infections

Demonstrate an understanding of:
• Common sexually transmitted infections and their clinical presentation (revise Case 2)
• Management of pelvic inflammatory disease and its long-term complications
• The risks involved with the Human Papillomavirus infection and its prevention

8. Gynaecological malignancy
Discuss:
• Basic management of a patient with postmenopausal bleeding
• Basic management of a patient with an adnexal/ovarian mass
• The risk factors, presentation, investigation and management for the most common gynaecological
malignancies: ovarian, endometrial and cervical (nb you would not be expected to know particular drug
names or doses of chemotherapy, but broadly what tumours are chemo / radiosensitive, why, and how
the choice of therapy, including surgery, is made)
• Screening programmes and management of pre-cancerous lesions related to gynaecology
• Preventive measures including vaccination

9. Hysteroscopy/Laparoscopy and the role of imaging in gynaecology

Explain:
• The indications for diagnostic and therapeutic hysteroscopy/laparoscopy
• Imaging in gynaecology – Ultrasound, CT, MRI and clinical situations where each may/not be appropriate

10. Subfertility
Discuss:
• Definitions relating to fertility
• Common causes of Subfertility

32
• How to request and interpret basic fertility investigations
• Outline treatment options available, working from first principles

33
Core Topics and Skills in Child Health

TEACHING
CHILD HEALTH
Core Topics and Skills 3
Short Clinical
PRIOR INTRODUCTION CLINICAL Case- Tutor CONSOLIDATION Self
Teaching and Assessment LEARNING WEEK 1 PLACEMENT
PAEDIATRIC
based Bedside WEEK 10 Directed
CASES
Teaching Teaching learning

The Child in Society

1 The Rights of the Child

2 Develop a holistic approach to paediatric problems which

considers the child’s welfare as paramount
Consider always, the impact of childhood illness in the
3 context of growth and psychosocial development, the
family and community
SAFEGUARDING
4 Safeguarding: What to do if you suspect non-accidental SESSION
LEVEL 2
injury or sexual abuse ACCREDITATION

Confidentiality in Child Health (particularly in regard to

5 child protection and adolescent health)
6 Childhood accident prevention

7 Understand what support services are available in the

community for children and their families
8 Public health: screening and vaccination
The social determinants of health and disease in child
9 populations, with reference to poverty, social inequalities,
violence, schools, and communities.
34
 10 Health seeking behaviour of parents and carers in the
management of illness in children.
11 The effects of the intrauterine environment and growth in
the first few years of life to later vulnerability to disease
12 The effect of maternal behaviour on health outcomes for
mother and baby
The psychological consequences of illness and
13 hospitalisation in children and young people, including
emotional development and attachment
14 The sick role
15 Palliative care in children
16 The Child Death Review Process

Adolescence
Recognise Adolescence as a unique phase of growth and
1 psychosocial development with specific issues relating to
sexual health, risk taking behaviour and self harm
2 Chronic illness and adolescence

3 Social and psychological theories behind chronic disease

management in adolescence
Capacity, Competence and Participation
1 How to Assess capacity in children
2 Consent for treatment in children and adolescents
3 Legal framework: competence and capacity of children

4 The process of transition to adult medical services

Approach to the Child - History, Examination and Communication

1 Work with children and families to provide child-centred
care

35
 2 Understand the principles of paediatric history and
examination
3 Demonstrate effective communication with child, parent,
and other professionals and agencies caring for children
4 Understand the principles of communicating distressing
news to parents
CLINICAL
5 Take a clinical history including social and family history SKILL
Perform physical examination at all ages through
childhood and adolescence
• Approach to examining a febrile child
• Cardiac examination
• Respiratory examination
• Abdominal examination
6 • ENT examination CLINICAL
• Neurological examination SKILL

• Developmental examination
• Newborn examination

7 Change a nappy, dress and undress a baby, feed a baby CLINICAL SKILL

Childhood Development
Understand the principles of developmental screening and
1 assessment in early childhood
2 Developmental delay - Cerebral Palsy, Trisomy 21
3 Developmental delay - Delayed walking
4 Developmental delay - Delayed talking

5 Developmental delay - Pervasive Communication

disorders

36
 CLINICAL
6 Take a developmental history SKILL
CLINICAL
7 Perform a developmental examination SKILL

Growth and Puberty

1 Normal growth and sexual development

2 Delayed Puberty
3 Short and tall stature
Plot a growth chart and explain normal variations and
CLINICAL
4 patterns of growth and puberty during childhood. SKILL

PAEDIATRIC DISEASE
At the end of your Child Health module you should be familiar with the following conditions

Bronchiolitis
Croup
Pneumonia ( the “silent pneumonia”)
1 Asthma
Chronic cough
Cystic Fibrosis
Acute life threatening event ( ALTE)
2 Understand what is meant by “signs of respiratory
distress”
3 Causes of stridor, stertor and wheeze
CLINICAL
4 Demonstrate how to use an asthma inhaler and spacer SKILL
CLINICAL
5 Explain and demonstrate how to use a peak flow meter SKILL

Cardiology
1 Age related changes in heart rate and blood pressure
2 Innocent murmurs

37
 3 Common forms of congenital heart disease
4 Left to right shunts and cardiac failure
5 Right to left shunts and cyanosis
6 Duct-dependant pathophysiology
Take blood pressure in a young child with the correct cuff CLINICAL
7
SKILL

Gastroenterology
1 Failure to thrive
2 Acute vomiting
3 Gastroenteritis
4 Gastro oesophageal reflux
5 Cow’s milk Protein intolerance
6 Chronic diarrhoea and malabsorption
7 Constipation/encopresis
8 Recurrent abdominal pain
9 Principles of rehydration using oral and intravenous fluids.
Haematology and Oncology
1 Iron deficiency anaemia
2 Haemophilia, Clotting disorders
3 Acute leukaemia
4 Wilms tumour
5 Neuroblastoma
6 Bleeding and Bruising
CLINICAL SKILL
7 An approach to the pale child or child with bruising
CLINICAL SKILL
8 Interpretation of full blood count and film

38
Endocrinology
1 Type 1 Diabetes
2 Hypothyroidism

3 Congenital adrenal hyperplasia and Abnormal sexual

development
4 Indications for Growth Hormone replacement
Infection and Immunity
1 Fever – assessment, investigation and treatment in
different age groups
2 Septicaemia – organisms, clinical findings, principles of
management
3 Meningitis and encephalitis– organisms, clinical findings,
principles of management
4
Respiratory tract infection (pneumonia, croup,
bronchiolitis, whooping cough)
5 Otitis Media
6 Basic microbiology and antibiotic use
7 Chicken Pox, Measles, Mumps, EBV
8 Kawasaki’s disease
9 Basic principles of immunodeficiency
10 The Childhood Immunisation Schedule
CLINICAL SKILL
11 Interpretation of CSF findings

Neurology
1 Seizures - including febrile convulsions
2 Management of the fitting or unconscious child
3 Cerebral haemorrhage
4 Hydrocephalus

39
 5 Headache/migraine
Neonatology
1 Physiological changes in the foetus during birth
2 Major congenital birth defects
3 Guthrie Card for disease screening
4 Care of the normal neonate

5 Common neonatal problems including neonatal jaundice,

feeding problems, poor weight gain, GORD, infection.
6 Care of the preterm infant: Common problems of
prematurity and long-term sequelae
7 Nutritional and other benefits of breast-feeding.
Factors influencing the prevalence of breast-feeding
CLINICAL
8 Routine examination of the neonate (1st day baby check) SKILL
CLINICAL SKILL
9 Observe a high risk delivery with the paediatrician

Nephrology
1 Urinary tract infection
2 Malformations of urinary tract
3 Nephrotic syndrome
4 Glomerulonephritis
5 Henoch Schonlein Purpura
6 Enuresis
Interpretation of routine urine testing and culture CLINICAL SKILL
7
Order appropriate subsequent investigations
Paediatric Surgery
1 Acute abdomen
2 Bilious vomiting

40
 3 Intussusception
4 Malrotation and small bowel volvulus
5 Pyloric stenosis
6 Acute scrotum and inguinal conditions
7 Neonatal surgical conditions

8 Supportive surgery:
Gastrostomy, Fundoplication, Portacath

Dermatology
1 Petechiae and purpura
2 Henoch Schonlein Purpura
3 Impetigo
4 Erythematous maculopapular rash ( enterovirus, exanthum
subitum, measles, EBV, Rubella, Kawasaki’s disease)
5 herpes simplex
6 Eczema
7 Nappy rash
Genetics
1 Modes of inheritance
2 Approach to antenatal diagnosis
3 Neonatal screening
4 Approach to dysmorphology
5 Principles of genetic counselling

Resuscitation
1 Recognition of the sick child
CLINICAL SKILL
2 Basic Life Support Skills- paediatric considerations

41
Reading List
In order to fully integrate practical learning with factual knowledge, you are advised to make full use of
the recommended texts below, as well as any other appropriate sources you identify yourselves. This
will help ensure confidence in exams and future practice.

CHILD HEALTH

THE RECOMMENDED TEXTBOOK

• Illustrated Textbook of Paediatrics. Lissauer and Clayden (Mosby)

OTHER STANDARD TEXTS

• Essential Paediatrics. Hull and Johnson (Churchill Livingstone)
• Clinical Paediatrics and Child Health. Candy, Davies & Ross (Saunders)
• Paediatrics: an illustrated colour text. Field et al. (Churchill Livingstone)
• Crash Course Paediatrics. Budd & Gardiner (Mosby)
• Core Paediatrics & Child Health. Haddad, Greene & Olver (Churchill Livingstone)

SHORT GUIDES TO CLINICAL EXAMINATION AND DEVELOPMENTAL ASSESSMENT

• Paediatric Clinical Examination: Gill & O’Brien
• Basic Developmental Screening: R S Illingworth

REFERENCES TEXTBOOKS
• Textbook of Pediatrics. Forfar and Arneil (Churchill Livingstone)
• Nelson’s Textbook of Pediatrics (Ed Behrman) (W B Saunders)
• Textbook of Neonatology. (Churchill Livingstone)
• The Normal Child. R S Illingworth.
• Development of the Infant and Young Child. R S Illingworth.
• Community Paediatrics. Polnay. (Churchill Livingstone)
• BNF for children

REPRODUCTIVE MEDICINE

RECOMMENDED TEXT
• Impey, L. and Child, T. 2017. Obstetrics & gynaecology. 5th ed. Chichester: Wiley-Blackwell. Also
available as an ebook.
OR
Magowan, B. et al. 2017. Clinical obstetrics & gynaecology. 4th ed. Edinburgh: Saunders
Elsevier. Also available as an ebook.
OR

42
 • Onwere, C., et al. 2014. Obstetrics and gynaecology. 3rd ed. Edinburgh: Mosby Elsevier. Also
available as an ebook.

OTHER TEXTS

• Guillebaud, J. and MacGregor, A. 2017. Contraception : your questions answered. 7th ed.
Amsterdam: Elsevier.

• Macdonald, S. et al. 2017. Mayes' Midwifery. 15th ed. London: Elsevier Limited. Also available as
an ebook.

• Symonds, I. and Arulkumaran, S. 2013. Essential obstetrics and gynaecology. 5th ed. Edinburgh:
Churchill Livingstone. Also available as an ebook.

Obstetric core topics additional reading:

NICE:
Antenatal care
Pregnancy – routine anti-D prophylaxis for rhesus negative women
Intrapartum care for healthy women and babies NICE guideline CG190
Induction of Labour
Diabetes in pregnancy: management from preconception to the postnatal period NICE guideline NG3
Caesarean section https://www.nice.org.uk/guidance/CG132
Hypertension in pregnancy: diagnosis and management https://www.nice.org.uk/guidance/cg107
Preterm labour and birth: https://www.nice.org.uk/guidance/ng25?unlid=9291036072016213201257

RCOG – green top

Amniocentesis and Chorionic Villus Sampling https://www.rcog.org.uk/en/guidelines-research-
services/guidelines/gtg8/
Postpartum Haemorrhage https://www.rcog.org.uk/en/guidelines-research-
services/guidelines/gtg52/
Small-for-Gestational-Age Fetus – investigation and management
https://www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg31/
Operative Vaginal Delivery
Birth After Previous Caesarean Birth

RCOG Consent Advice – Caesarean Section

Gynaecology core topics additional reading

NICE
Heavy menstrual bleeding: assessment and management http://www.nice.org.uk/guidance/ng88

Endometriosis: diagnosis and management: https://www.nice.org.uk/guidance/ng73

43
 Urinary Incontinence in women https://www.nice.org.uk/guidance/cg171
Ectopic pregnancy and miscarriage: diagnosis and initial management
https://www.nice.org.uk/guidance/CG154

Fertility problems: assessment and treatment https://www.nice.org.uk/guidance/cg156

Menopause: diagnosis and management https://www.nice.org.uk/guidance/ng23

RCOG Greentop
Diagnosis and management of Ectopic Pregnancy (Green top guideline No 21)
http://bit.ly/GTG21ePDF

Ovarian Cysts in Postmenopausal Women (Green-top 34)

European Society of Human Reproduction and Embryology (ESHRE) Guideline on the management of
women with endometriosis
https://www.eshre.eu/Guidelines-and-Legal/Guidelines/Endometriosis-guideline.aspx

British Association for Sexual Health and HIV (BASHH) UK National Guideline for the Management of
Pelvic Inflammatory Disease.

RCOG Consent Advice –

Diagnostic Hysteroscopy,
Diagnostic Laparoscopy,
Laparoscopic Tubal Occlusion,
Surgical Evacuation of the Uterus for Early Pregnancy Loss
Vaginal Surgery for Prolapse (Consent Advice 5)

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Prizes
Various prizes are awarded in both elements of the block – with the change in curriculum and assessments
some changes in how these prizes are allocated has had to occur. Up to date information on eligibility for
prizes can be obtained from the module leads (Dr Forton and Dr Logan), or may be published on Learning
Central as it becomes available. So look out for it!

CHILD HEALTH

THE DORA PENTOL PRIZE (YEAR 4)

The Dora Pentol prize will be awarded annually to the student submitting the best case or commentary
on a child suffering from a chronic or malignant disease.

THE ROSELLE HEWLETT PRIZE (YEAR 4 OR 4)

The Roselle Hewlett prize will be awarded to the student who achieves the best Year 3 or Year 4 SSC
project in Acute Child Health SSC. The competition will involve a short presentation

THE ROSEMARY ISAAC PRIZE (YEAR 3 OR 4)

The Rosemary Isaac prize will be awarded to the student who achieves the best Year 3 or Year 4 SSC
project in Community Child Health. The competition will involve a short presentation

THE ELIZABETH PIPE PRIZE (YEAR 4)

The Elizabeth Pipe Prize will be awarded for the best viva from those who have done well in their exams.
Applicants will be invited on the basis of performance in the Year 4 ISCE and Year 5 Knowledge Tests.

REPRODUCTIVE MEDICINE

PROF SHAW PRIZE

This prize is awarded to the student with the best overall performance in their O&G attachment.

AC TURNBULL PRIZE IN O&G

This prize is awarded to the student who shows the best evidence of clinical understanding and
judgement in O&G.

ROSENTYL AND BRYNELIN GRIFFITHS PRIZE IN O&G

This prize is awarded to the student who has achieved the highest standard in presentation of an O&G
commentary. The commentary is not a mandatory part of the course, and the prize is therefore only
awarded when there are entries of sufficient calibre.

JOHN MCLEAN PRIZE

The prize was endowed in December 1923 and is awarded ‘ to the student, taking into account a report
of the external examiner on the attainments of the candidates in the examination and a report of the
Professor of Obstetrics and Gynaecology on the work of the candidates during this period of study of the
subject.’ After nearly 100 years, and changes in assessments, we are contemplating how best to assess
for and award this prize, whilst remaining within the spirit with which it was endowed.

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Student societies
Cardiff University Paediatric Society (CUPS)
Contact: CUPSpresident@outlook.com
Website: www.cardiffstudents.com/activities/society/paediatric

Cardiff University Obstetrics and Gynaecology

President: Elinor Davies
Website: www.cardiffstudents.com/activities/society/ogsoc/
Facebook page:
Cardiff Women's Health, Obstetrics and Gynaecology Society
https://m.facebook.com/CardiffWomensHealthSociety/
Facebook group:
https://m.facebook.com/profile.php?id=1405651783097608

Feedback
Your feedback is essential to the development of the course. All of your comments and suggestions are
taken seriously and in confidence. The points you raise are discussed by the Module Leads and Phase
Leads and inform curriculum development.

We collect feedback in the following ways:

• You may be asked to complete feedback forms at the end of the introductory and consolidation
sessions.
• You will be asked to complete online feedback by the NHS Liaison office. THIS MUST BE
COMPLETED

You will receive both formal and informal feedback throughout your placements. It is essential that you
are proactive in obtaining this feedback.

You are encouraged to contact the year 4 coordinator or another member of the Module team (please
see front cover of this handbook) if you have any issues you would like to discuss.

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