The oral exam will cover 1 case, with 10 minutes of discussion allowed. The case will be chosen by the exam administrator from a list of ten possibilities. Students will be given a list of the possible case topics at the start of the clerkship. The details of the history and physical exam of the oral exam case will be delivered during the oral exam itself. There are predetermined criteria for evaluation of the oral exam performance that the evaluators (clerkship directors from each of the sites) will use. Students are not given these criteria or the details of the case history and physical exam ahead of time. Students are encouraged to prepare for the oral exam using the list of case possibilities.
Oral exam possible cases:
- A 13 month old with anemia.
- A four month old with failure to thrive.
- A 4 day old with jaundice.
- A 6 month old with lethargy.
- A 1 week old with fever.
- A 9 yo with abdominal pain.
- A 2 yo that refuses to bear weight.
- A 1 week old with vomiting.
- An 18 month old with difficulty breathing.
- A 15 yo girl with weight loss.
Students will be given more details of the history and physical exam of the patient then asked to develop a differential diagnosis and propose an initial evaluation and management plan for the patient.
After the oral exam, the student will be asked to respond to 14 written questions. A calculator will be provided. The questions will include:
- Plotting a set of growth data using growth curves
- Interpreting that growth curve. Students will be expected to answer if the child is growing normally, failing to thrive, obese, or displaying an abnormal pattern in any one growth parameter.
- Writing an appropriate maintenance fluid order for a child of a given size.
- Writing an appropriate fluid bolus for a child of a given size.
- Writing an appropriate order for medication, with use of provided references from MICROMEDEX for dosing.
- Determining necessary immunizations for a child in a given clinical setting. The immunization chart will be provided.
- Eight questions about the assigned CLIPP Cases:
- Case 5: 16-year-old girl's health maintenance visit
- Case 6: 16-year-old boy's pre-sport physical
- Case 15: 8-year-old and 4-week-old with vomiting.
- Case 18: 2-week-old with poor feeding
- Case 25: 2-month-old with apnea
- Case 28: 18-month-old with developmental delay
- Case 29: Infant with hypotonia
- Case 30: 2-year-old with sickle cell disease
To determine the final score of the exam, the oral response to the first question will be scored on a scale of 1-6. Appropriate responses to the fourteen additional questions will be worth one point each. This exam in total will be worth 10% of the final grade.