OSCEs (Objective Structured Clinical Examinations) are basically a test of your clinical skills. Some schools call them different things, but essentially they are exams where you go see a standardized patient, take a history, do a physical exam, and diagnose your patient.
At my school, they worked us up to a full OSCE. We started with just going in (practicing proper hand-washing skills), introducing ourselves to the patient, and taking an incomplete history. Eventually, as we learned more aspects of history taking and more physical exams, we were able to go in and do a complete history and physical exam to be able to diagnose our patient. The key: it’s timed and a little nerve-racking. It is timed because the Level 2-PE portion of your boards consists of a bunch of timed clinical encounters, so you need to be able to do everything quickly and efficiently.
How to Do Well:
- Practice. Practice. Practice. Honestly, muscle memory really is key. Practice what you are going to say and how you are going to do your physical exams. You’d be surprised how awkward it can be to do a physical exam without looking like you have no idea what you’re doing (because really, you don’t yet) and transitioning to the next physical exam.
- Write out a script. It sounds cheesy, but honestly, it helps. Jot down a few phrases you will say if a patient tells you something personal. You have to get used to people telling you a lot of information about themselves. Sometimes it is hard to know how to respond, so thinking about it ahead of time and writing down some phrases will help when your nerves are already on edge from being timed. At first, it will feel very mechanical and not genuine. Eventually, you will get more comfortable being timed and won’t have to use your script. But trust me, the script helps when you are under pressure.
- Make a shorthand script for note-taking. Everyone has their own method, but jotting down CC (chief complaint), vitals, OPPQRST, etc. on your paper will remind you to ask specific questions and not forget vital information.
- Have a memorized set of ‘review of symptoms’ questions to ask about. Eventually, as you go through systems, you will learn more about what other symptoms you should be asking about. But until you feel comfortable, have a set memorized.
- Be prepared to lead the encounter. Some patients really like to talk. You have to learn how to lead the conversation without being rude and cutting people off when you are talking.
- Enjoy them! These are your chances to feel like a real doctor during the horrible pre-clinical years. Put all of your studying into practical use!