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100 Grey Cases in Paediatrics.
  1. G Clayden
  1. Reader/Honorary Consultant Paediatrician, Guy’s, King’s and St Thomas’ School of Medicine, Kings College London, UK;

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    Nagi G Barakat. (Pp 197; £15.95.) Royal Society of Medicine Press, 2003. ISBN 1-85315-524-1.

    Although wading through examination questions is a tedious and often superficial learning method, this book is a useful resource for pre-exam practice. The “grey case” type of question comprises of a fairly wordy clinical case description, together with a range of investigation results, is followed by a choice of one or more relevant options from a list. The candidate must choose the best one or more (as defined by the question) for the most appropriate further investigation or treatment. Many paediatric postgraduate trainees are unfamiliar with this method of assessment, although many undergraduate medical schools are moving to a similar format but usually using more abbreviated summaries to describe the clinical scenarios. Questions like this are not easy to construct without falling into the trap of cueing the answer to one question when a subsequent question is asked on the same case. The author effectively avoids this error. The cases are well written and feasible, although the use of some colloquialisms and occasional grammatical inaccuracy would be unusual in professional examinations.

    One of the greatest challenges for authors writing preparatory material for specific examinations is guessing the appropriate level of difficulty. As this book is specifically aimed at the MRCPCH, a check with the examination questions made available freely by the Royal College of Paediatrics and Child Health allows a favourable comparison. This website link is

    A number of the grey cases in Dr Barakat’s book are aimed at a rather more complex level, however this provides the link with the expanded answers in the sections that follow each series of questions. These are admirably concise. If readers attempt the question, commit themselves to giving an answer, and only then read the material that supports the correct answer, a great deal could be learnt in this active learning process.

    Overall this book is well structured, carefully written, and a likely to be a helpful resource for those preparing for this examination as well as useful discussion material for their teachers and trainers.