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4. The Royal Australasian College of Physicians (Divisional Clinical Examination (Paediatrics &amp; Child Health)): Study Tips

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 The Royal Australasian College of Physicians (Divisional Clinical Examination (Paediatrics &amp; Child Health)): Study Tips 
=============================================================================================================================

 A practical, case-based preparation plan for RACP Paediatrics &amp; Child Health DCE candidates.

  [     MDster Editorial Team ](https://mdster.com/about) ·      Jun 09, 2026  ·      5 min read  ·       902  

  [     Reviewed by Dr. Ali Ragab, MBBCH, MSc, MCAI ](https://mdster.com/medical-reviewers/dr-ali-ragab) [Editorial Policy](https://mdster.com/editorial-policy) \| [Corrections Policy](https://mdster.com/corrections) 

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 On this page

 1. [ Know What You Are Training For ](#know-what-you-are-training-for)
2. [ Build a Long Case System You Can Reproduce ](#build-a-long-case-system-you-can-reproduce)
3. [ Make Short Cases Automatic ](#make-short-cases-automatic)
4. [ Study Schedule Template ](#study-schedule-template)
5. [ Use Resources the Right Way ](#use-resources-the-right-way)
6. [ Common Pitfalls to Avoid ](#common-pitfalls-to-avoid)
7. [ Key Takeaways ](#key-takeaways)
8. [ Frequently Asked Questions ](#blog-faqs)
9. [ References ](#references-heading)

 On this page

 1. [ Know What You Are Training For ](#know-what-you-are-training-for)
2. [ Build a Long Case System You Can Reproduce ](#build-a-long-case-system-you-can-reproduce)
3. [ Make Short Cases Automatic ](#make-short-cases-automatic)
4. [ Study Schedule Template ](#study-schedule-template)
5. [ Use Resources the Right Way ](#use-resources-the-right-way)
6. [ Common Pitfalls to Avoid ](#common-pitfalls-to-avoid)
7. [ Key Takeaways ](#key-takeaways)
8. [ Frequently Asked Questions ](#blog-faqs)
9. [ References ](#references-heading)

Many paediatric trainees fail to convert good ward performance into exam performance because they practise “seeing patients” rather than practising the **RACP Paediatrics &amp; Child Health DCE format**. As of June 2026, you are preparing for real patient encounters: 2 Long Cases and 4 Short Cases, assessed against criterion-referenced performance standards, not against other candidates.

Know What You Are Training For
------------------------------

The Divisional Clinical Examination tests whether you can behave like a safe, organised paediatric registrar under observation. The Long Case rewards accurate history, examination, problem synthesis, family impact, and management planning. The Short Case rewards respectful interaction, efficient technique, accurate signs, interpretation, and sensible next steps.

Build your preparation around the clock:

- Long Case: 60 minutes with the patient, 10 minutes preparation, 25 minutes discussion.
- Short Case: 2 minutes reading time, 15 minutes observed patient review.
- Whole day: expect alternating Long and Short Case blocks, with variable breaks.

> Pro Tip: Do not prepare as if this is a knowledge viva. Prepare as if examiners are asking, “Can I trust this trainee with my paediatric ward tomorrow?”

Build a Long Case System You Can Reproduce
------------------------------------------

Your Long Case should produce a prioritised problem list, not a transcript of the history. Use the first 10 minutes to identify the child, diagnosis, current trajectory, family context, and the parent’s main concern. Then examine selectively to confirm function, complications, and treatment effects.

During the 10-minute preparation period, structure your notes into four blocks:

1. One-sentence summary: age, condition, severity, current issue.
2. Prioritised problems: acute, chronic, developmental, psychosocial.
3. Examination findings: only findings that change interpretation.
4. Management plan: immediate, medium-term, multidisciplinary, family-centred.

Practise presenting in 6–8 minutes. If you exceed this, examiners may interrupt, and you lose control of your narrative.

Make Short Cases Automatic
--------------------------

Short Cases expose weak examination technique quickly. You need clean introductions, consent, positioning, hand hygiene, and a system-specific examination that looks practised but not robotic.

Create a weekly Short Case circuit covering:

- Cardiovascular: murmurs, cyanosis, heart failure signs.
- Respiratory: chronic lung disease, asthma signs, chest deformity.
- Neurology: gait, tone, coordination, cranial nerves, development.
- Growth and endocrine: short stature, puberty, obesity complications.
- Dysmorphology and genetics: describe before diagnosing.
- Abdomen: organomegaly, chronic liver disease, renal findings.

After each case, ask your observer for one technique correction and one synthesis correction. Record these in a “never again” log and review it before the next session.

Study Schedule Template
-----------------------

Use a 10-week clinical preparation block after the written exam. If you have less time, compress the weeks but keep the same sequence.

WeeksMain taskMinimum weekly target1–2Baseline assessment2 Long Cases, 6 Short Cases, DPE feedback3–5Technique repair2 Long Cases, 10 Short Cases, one recorded presentation6–8Exam simulation3 timed Long Cases, 12 Short Cases, mixed systems9Full mock weekOne full-day mock, equipment rehearsal, feedback review10ConsolidationLight cases, problem-list drills, final logistics check

Do not spend the final fortnight reading broadly. Use it to polish timed presentations, paediatric examination flow, and management language.

Use Resources the Right Way
---------------------------

Textbooks and guidelines are support tools, not the main event. Use them after a patient encounter to close a specific gap, such as “management of chronic kidney disease complications” or “approach to developmental regression.”

High-yield resources include:

- Official RACP DCE pages and criteria documents: align your practice with the marking domains.
- DPE-led teaching: request targeted feedback, not general encouragement.
- Study groups: rotate roles as candidate, examiner, parent, and timekeeper.
- Hospital patients: practise with consent, confidentiality, and consultant supervision.
- Flashcards: use for frameworks, red flags, and management priorities—not rare facts.

> Pro Tip: A good study group is not a lecture club. Every session should include timed performance, examiner questioning, and written feedback.

Common Pitfalls to Avoid
------------------------

The commonest failing pattern is not lack of knowledge; it is disorganised clinical reasoning under time pressure. If your presentation sounds like a ward round note, rebuild it around prioritisation.

Avoid these traps:

- Listing every diagnosis without ranking what matters today.
- Missing family impact, school function, development, culture, or whānau context.
- Performing a Short Case examination silently, awkwardly, or without consent.
- Over-reading rare syndromes while under-practising common paediatric signs.
- Ignoring examiner cues and continuing a memorised presentation.
- Bringing prohibited templates, notes, smart devices, or unauthorised materials.

Key Takeaways
-------------

This week, make your preparation visible and measurable.

- Book a meeting with your DPE or mentor and ask for a frank baseline assessment.
- Schedule two Long Cases and six Short Cases with named observers.
- Create a one-page feedback log mapped to Long Case and Short Case domains.
- Rehearse your equipment setup, timer use, and hand hygiene sequence.
- Record one Long Case presentation, then cut it to under eight minutes.

The Paediatrics &amp; Child Health DCE is demanding because it tests real clinical behaviour. If you practise in the exact format, seek specific feedback, and refine your reasoning aloud, you give examiners what they are looking for: a safe, thoughtful, family-centred paediatric clinician ready for Advanced Training.

 Frequently Asked Questions 
----------------------------

###     How should I split practice between Long Cases and Short Cases?             

Most candidates need both every week. Use Long Cases for synthesis and management planning, and Short Cases for examination technique, signs, and concise interpretation.

###     What should I do if my Long Case presentations are too long?             

Use a fixed structure: summary, prioritised problems, key findings, and management plan. Practise delivering it in 6–8 minutes before inviting examiner questions.

###     Are commercial courses necessary for the RACP Paediatrics DCE?             

No course is essential. Prioritise official RACP criteria, DPE feedback, real patient practice, and timed mock examinations with experienced paediatricians.

###     How can I prepare if I am on interruption of training?             

Meet a mentor early, arrange supervised hospital-based practice where possible, and use previous feedback to create a focused action plan before increasing case volume.

 References  (3)  
------------------

 1. 1.  [ RACP. Paediatrics &amp; Child Health Divisional Clinical Examination.     ](https://www.racp.edu.au/trainees/examinations/divisional-clinical-examination/paediatrics-child-health-dce)
2. 2.  [ RACP. Divisional Clinical Examination Frequently Asked Questions.     ](https://www.racp.edu.au/trainees/examinations/divisional-clinical-examination/dce-faqs)
3. 3.  [ RACP. Paediatrics &amp; Child Health Basic Training.     ](https://www.racp.edu.au/trainees/basic-training/paediatrics-child-health)

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