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MRCEM OSCE (Objective Structured Clinical Examination)

 

See the RCEM Website for the breakdown of stations

 

Personal Experience:

 

I sat this exam in January 2020, just before the pandemic came to Europe. I remember reading the papers the morning after, which were reporting high numbers of deaths from this terrible disease in Wuhan, China and I was worried that we would be dealing it with it soon after. Lo and behold here we are still trying to manage this pandemic in 2022! However, I digress.

I started to prepare for this exam in late October 2019. I used the MRCEM OSCE book and started ticking them off as I went along. From Day 1 I started practicing my answers and my exams aloud and I think this was a huge help to me on the day as I had so much practice in. I decided to use the contents of the book to guide my study and thus studied each in chronological order. I would bulk up any deficits in the book either with my trusty Tally & O’ Connor (still going strong ten years later) and my Oxford Handbook. For my resuscitation stations I used the ALS guides/algorithms and my ‘Revision Notes FRCEM Intermediate SAQ Paper’. I found the equipment stations such as a Thomas splint or the slit-lamp the hardest to prepare for. I found helpful colleagues to go through them with me in advance which gave me the confidence to know I could at least recognise the item if it were presented to me. Could I operate them both perfectly? Absolutely not, but I was optimistic that those two stations were unlikely to come up on the day. Or at least not both of them and I could hopefully afford to do poorly in one of them. Strategy is key for this one as some of the stations won’t be your forte and you can’t let it knock your confidence as you go into the next room and start all over again. I made peace in my head that I needed to pass the majority of the stations, not all of them. So when a station went poorly, and there were at least two that really shook me up, I just had to suck it up and persevere onto the next. If I were to offer one piece of advice it would be you’re not looking for perfection you’re looking to be good enough, that made it easier for me to get myself into gear on the day.

 

Recommendations:

 

Time-frame: 3-4 months

 

Study Plan:

1.      Buy the MRCEM OSCE book – use it to guide your study

2.      Start practising aloud from day one. I really mean it. There are so many stations to get through, all extremely varied, and it’s hard to switch between your best psych history to running your best PEM resuscitation and then on to crisis counselling a distressed patient.

3.      Write out each OSCE as you intend to do it – almost word for word. Bulk up the details using other references such as Tally & O’ Connor, the Oxford Handbook and the FRCEM Revision Notes for the SAQ. Stick to your same script every time.

4.      Know your ALS algorithms by heart – if you can do an ALS course before your exam that will be a great help.

5.      Find a friend or colleague and practice on them. On the day all of the patients will be actors so the stations will be much quicker than if you were assessing a real patient. I felt it wasn’t of benefit to me during the exam prep to practice on patients (which I was assessing anyway at work) as those interactions are usually much longer. Time your OSCE practice on a friend and colleague and get them to mark you as you go along, using the MRCEM OSCE book.

6.   Look at how each topic is weighted – This should guide your revision. Don’t neglect your communication stations for resuscitation!






(Some)Stations that came up on the day of the exam in 2020:

- Vascular exam
- ATLS - Cyclist hit by a car
- Counsel a pregnant woman about chickenpox (her child has it and she has never had it)
- Psych history (Man presenting with low mood, has taken an overdose of paracetamol 24 hours ago - ensure to ask 'have you ever harmed yourself?')
- PEM - status epilepticus
- Communication - Irretrievable brain injury, inform relatives
- MSK shoulder exam


*That's all I can recall at the moment, if I remember any more I will add them subsequently.



If these posts are helpful to you and you would like to make a contribution for its use, please feel free to visit my Patreon Page. Wishing you the best of luck with your study!


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