OSCEs are Objective Structured Clinical Exams. They are exams that involve simulated scenarios with patients (i.e. role-play) and aim to prepare you for the clinical and communication aspects of becoming a doctor. They can be quite stressful and you may feel like you're playing 'dress up' because you're not an actual doctor yet. But, with plenty of practice, you will start to feel like you are and this is key to passing the OSCEs with great marks. In this blog post, I have written down some of the methods and resources that helped me score > 90 in my OSCEs.
Books
The 2 best books I have come across for patient scenarios are OSCE Cases with Mark Schemes: A Revision Aid for Medical Finals and The OSCE Revision Guide for Medical Students.
You can't practice without plenty of scenarios (of varying difficulty) to truly test your ability to respond well to any patient they may throw at you. Both books provide OSCE mark schemes and test a range of communication skills from medical ethics to explanation stations. Some of the scenarios are from stations previously examined. If you're thinking about getting one or the other, buy the OSCE Cases with Mark Schemes book.
Finally, to help with your physical examinations, a must-purchase is the Essential Examination guide. It's a great book that has key facts and tips with plenty of space for you to take notes and highlight.
Websites & apps
There are many websites available providing fantastic content that you can use to practice. Less is more so I'm going to list the only 3 websites I used.
Most students swear by Geeky Medics - an app and website that has helpful checklists of the things you have to do for a range of OSCE stations. Particularly helpful for physical examinations and procedure stations. Their articles and videos not only help you memorise what you have to do but give you some tips for passing the stations with high marks. I recommend playing the videos regularly. Pause them and conduct the physical exam yourself or on a friend. Play the video again to see what you missed. Keep doing that until you're perfect and miss no steps!
OSCE Stop - Clear, concise notes on history taking, examinations, procedures, prescribing, and interpretation stations. I particularly used it for explanations of procedures and interpretation of results e.g. you may be asked to explain an X-ray or a nasogastric tube to a patient or interpret their blood results and discuss it with them.
OSCE Stations - Great bank of OSCE scenarios (of different difficulty levels). I used this to mainly practice history taking. The mark schemes are amazing - you can see what you did and didn't do and if you got your differentials correct.
Information provided by your university
Locate the information about your OSCEs EARLY and make notes of everything they could possibly examine you. This is the best way to figure out what you need to study and devise a schedule to ensure you cover all necessary content.
For example, for the Year 3 OSCE at King's College London, I created a google doc of everything that could come up, based on the 'purple guide' that is downloadable from our online portal KEATS. You can then tick off stations you're confident with as you go along.
Practice
Attend the Mock OSCEs that the medical societies at your university will run - they may cost a small fee but are worth going to. Older students give great feedback and can give you more guidance about how the OSCE works. You should search your student union societies and follow them on social media to keep up with their events.
Create your own Mock OSCEs - some of the best practice OSCEs I did were with 3-4 friends in a spare room we booked. Come up with stations or find some online / use your books. You need a minimum of 3 people: one to act as the patient, one to examine and one to be the medical student. Be open and honest with your feedback (the more brutal the better - we often overestimate how good we are and how much we know).
Practice regularly (at least 4x a week) in the month leading up to your OSCE - Learning the theory is one thing but it takes time and skill to apply your knowledge to a patient scenario under timed conditions.
Make sure you're clued up on what follow-up questions you could be asked after your OSCE station finishes. E.g. 'how would you manage this patient?' 'what tests would you do?'
I was given the helpful structure as follows:
Immediate: Who will I tell? What will I tell/ask them? What will I do?
Tests: Structure - Bedside (e.g., blood tests, other fluids) > Specialised (specific tests to rule out or in certain conditions) > Imaging
Treatment: Structure - Conservative/self-care > Medical (e.g. medications such as anti-coagulants, anti-hypertensives), Surgical (if necessary e.g. in haemorrhagic stroke management, surgical decompression is indicated)
Take it seriously but do not stress if you do not know everything
A sure way to fail the OSCE (or anything in medicine) is by being over-confident. Although it is known that fewer students fail an OSCE compared to written exams, do not underestimate the practice it takes to perform well and how difficult it can be to role-play with a 'fake patient'.
You just have to take yourself back to your MMI days and treat it as a real consultation. The OSCEs are actually quite enjoyable to do and you will find yourself becoming more confident in your abilities and feeling more like a 'real doctor' when you do them.
The most important part of any station you go into is the patient. So, you may have a cardiovascular examination down to a tee, but what if your patient can't lift their arms or sit forward. You'll be marked on your patient interaction, not just whether you could hear a flutter that had less than a 10% chance of being there!
Be caring, be confident, be competent (and never forget to use your common sense)!
And most importantly, good luck!
Check out some more OSCE resources in the resource bank
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