Friday, July 16, 2010


I finished the last of our exams for this rotation today!

They went okay and I think I passed all of them. I know I did well on the last OSCE, as the examiner told me so (the patient ovarian torsion due to a dermoid), and I looked over the first case and worked out that I covered what I needed to cover (discovering a twin pregnancy that then goes into early labour).

For those of you who haven't done a medical school OSCE, it goes like this:

You walk into the room and meet the examiner. They are a consultant (i.e. attending doctor if you are in the USA) and they are sitting in the room looking at notes that you can't see. They say hello, introduce themselves and you exchange pleasantries until the bell/buzzer/knock on the door tells you that it is time to start.

They introduce the case with a simple statement (e.g. Jane Doe comes into your GP office complaining of X) and you have to take a history from them, say what you want to examine, organise texts and talk to the patient as if it were a real situation, except you are being examined and drilled at the same time and have nothing to refer to in front of you.

There are generally multiple patient encounters, so after you are finished with the first encounter (and the examiner has finished prompting you, mostly to help or sometimes the occasional examiner will mess with you a little), they lead into the next encounter which follows on in time from the first. This might continue on in a different location, at a different time, for example, "Jane Doe comes into the emergency department and you are a resident there, her results from her GP read as follows" and you then have to continue care of the patient. And so on and so forth.

It is challenging because it is a foreign situation, sitting in a room talking with an examiner rather than being in a hospital/office with a patient in front of you. It is harder to remember to do the basic things that you would do out of habit, such as get a drip running or call for help from the registrars of the other disciplines if it isn't immediately apparent that they are needed.

If you get a helpful examiner, they can help you along by describing the situation in more detail for you, and leading you to answer things rather than forget them, because if they describe the situation more and you know the answer then you are familiar with what you have to do but have just been put off by the format.

You should still be able to pass without that help, but I won't ever knock back a couple of extra marks for things that I actually know but would have otherwise forgotten to mention due to nerves and the strangeness of the situation. ;)

It is actually kind of fun if you can relax enough to enjoy it. That said, I'm glad I'm done with this lot. Now I only have two big exams, both of them multiple-station exams, and I'm done with medical school. It is very exciting.

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