Last Years OSCE

Through the eyes of Jonny Grek

Just so you know...

We had 16 stations:

8 Day 1

12 minute stations Reasoning / Explanations etc. History Taking

8 Day 2

8 minute stations Examinations Clinical Skills

Yours will be 7+7 stations over 2 days, and likely more integrated than ours! (i.e. Not as clear cut with exams / clin skills etc.)

Day 1
12 minute stations

1. Capacity Assessment

Assess this persons capacity to undergo an operation Patient definitely lacked capacity

Discuss what to do if someone lacked capacity, e.g. IMCAs etc.

2. COPD History & Management

Acute exacerbation of asthma Emergency management (spoken) Interpret ABG:

T2RF Eventually requiring NIV

3. Hypertension reasoning

Patient was not taking anti-hypertensive medications

Station needed you to explain medications, explanation of hypertension, and discuss LIFESTYLE FACTORS!

4. History of frequency & back pain

70 year old man

History was of urinary outflow obstruction

Given blood results needed to identify AKI Discuss causes of AKI

5. Video about meningitis

Watch a video of patient with meningitis

Explain how you would manage meningitis

Write various bits on drug charts / fluid charts etc.

6. Anaphylaxis Management & BLS

Accepted as the best station

Video How would you manage anaphylaxis? Causes? (penicillin allergy given co-amoxiclav)
Patient crashed initiate BLS on dummy

7. AAA

History from man with AAA Interpret results of an ultrasound abdo

5.5cm AAA Needs referral to vascular surgeon

Explanation of possible operations & risks Really awkward patient

8. History of fatigue

Take a history What investigations? Interpret results Bloods showed iron deficiency anaemia What were the causes?

E.g. red flag symptoms of malignancy

Day 2
8 minute stations

1. Cremation form

Read passage of information, and fill out the form...

Hard to predict mark scheme

Lots of the form filled out already!

2. Aseptic cannulation

... & prescribe IV fluids

3. Venepuncture

I couldnt get any blood out of the arm, after 4 attempts! Interpret blood results...

Hyponatraemia, hyperkalaemia, hypoglycaemia...

ANSWER?

3. Venepuncture

I couldnt get any blood out of the arm, after 4 attempts! Interpret blood results...

Hyponatraemia, hyperkalaemia, hypoglycaemia....

ADDISONS DISEASE!!!!

4. Management of AKI....

Again!!!

Interpret blood results = AKI

What drugs will you stop & why? A med school classic

5. Cardiology exam

Differential diagnosis = Aortic Stenosis / Mitral Regurgitation (I said both!)

ECG intepretation LVH

6. Respiratory exam

Differential diagnosis pulmonary fibrosis

I didnt get time to offer a differential

Apparently showed spirometry results?!

7. GI exam

Renal transplant patient

Interpret blood results AKI !!!!

8. Fundoscopy

On a real patient, who may or may not have had pathology... Then find 5 words on a fake eye

In Summary

All stuff that you can do