Mr Moore’s Year 3 and Year 5 OSCE Exams hints and tips

Mr Moore is a regular OSCE surgery examiner and BSMS students can find his hints and tips for success here

I regularly examine at the BSMS year 3 and year 5 surgery station OSCEs and the same mistakes by some BSMS students crop up again and again.  Here are my hints and tips for surgery OSCE station success:

Only do what the instructions ask you to do
This is my biggest hint.  You get a sheet of simple instructions before each OSCE station.  The exam is quick, pressurised and stressful and you must have the discipline to read and re-read the instructions.  It is such a shame when students go off on a tangent away from their brief.  Remember that an examiner has a dedicated mark sheet for the station and they can only give marks for mark sheet items.  Sometimes excellent students are very impressive doing something else but if it is not what the instructions asked for then no matter how impressive, the examiner cannot give that student the marks.  It is a good idea to re-read the instructions if you think that you have finished before the station end bell and think seriously whether or not you have done everything that the instructions asked for.  This is the only way to gain full marks.

Don’t look for feedback from the examiner and don’t read anything in to their facial expressions

Examiners are told to keep neutral and not to offer leading hints or facial expressions during OSCE stations to be fair to all students.  Follow the instructions and do not look for cues from the examiner’s face as to whether you are doing well or not.  Examiners in OSCE stations are observers deciding if you get the marks on their pre-prepared mark sheet.  They are not meant to interact with you apart from asking specific questions.  Examiners are told on their mark sheet when to ask specific questions, eg at the one-minute-to-go bell.  If an examiner is frowning please do not worry that this means that you are doing really badly.  You may have actually done very well.  The examiner does give a global impression mark for you so be polite and if there is a patient or actor at the station, be nice to them too because they are often asked to give a global impression mark for you as well.

Be safe and polite

Examiners need to decide if it will be safe to allow you to go forward and become a qualified doctor so be careful not to do anything that might endanger a patient.  Think the worst, eg that a patient might have cancer from the symptoms that they have described to you during a history taking station, and say that you would need to investigate appropriately.  Do not lie and remember that you are not expected to know absolutely everything.  Nobody does!  It is fine to say that you might like to talk to a colleague about further medical management or to say that you would like to refer to the BNF.  Remember that there are nearly always marks for introducing yourself and for washing your hands at the start and finish of any examination station.

You do not have to use everything provided at the OSCE station

Not everything provided at the OSCE station is essential for you to use.  For instance, if you are at an examination station then using the alcohol gel before and after examination should suffice.  Some nervous students with sweaty hands waste innordinate amounts of time trying to put sticky rubber gloves on when they really do not need to.  The flip side of this is that you should quickly scan what has been provided at the OSCE station and this might jog your memory to do something that you might have forgotten.

Exposure and groins!!!

I hope that you use your surgery attachment time wisely and get stuck in on the wards meeting patients and asking permission to examine them.  It is really obvious to examiners if a student is not experienced or comfortable in examining patients.  No matter how much knowledge you may have gained from books in a library, it will really stand out if you are not proficient in putting your hands on patients in a professional manner.  Remember that patients brought to OSCE exams know what they are getting themselves in to and they are usually very happy at being examined and at exposing themselves.  Always ask for permission from a patient before exposing them but then you must gain full exposure in an examination station.  Please remember that the groin area is part of the abdominal examination.  Unfortunately some students do badly because they have not established confidence in examining the groins and they completely miss the pathology, such as a hernia, that all the station marks are associated with.  If you do not feel confident examining patients’ groins then please make sure that you let a firm doctor know this and ask for teaching on the wards or in the out-patients clinic during your surgical attachment.