MRCPsych OCSE exam: What happens in the actual exam?
There are twelve stations and a rest station. In each
station there will be a patient and an examiner. An observer might by present
in some of the stations. You will be given a minute to read the instructions posted outside the station. A copy of the instructions will also be present in the station and you can check them should you need to. Its best not to do so as it will not only waste valuable time but will also interfere
with developing rapport with the patient. Before you start the OSCEs you will
be given a writing pad and a pen and you can take down name of the patient or any other important information.
After a minute a bell will ring and you can then enter the station. Acknowledge the examiner. S/he will check your roll number. After this you are not expected to interact with the examiner, unless the instructions
say otherwise. Proceed with the task and focus all your attention on the patient
but make sure that you speak loudly so that the examiner can hear you. A bell
will ring after six minutes indicating that you have only one minute left. It’s
best to summarize in the last minute and ask the patient if he would like to ask any questions. Another bell will ring after a minute. You must then leave
the station and proceed to the next task. If you have not done well in the last
station try not to think about it and get in the habit of changing your mind set quickly. You will have three weeks after
the exam to analyse your performance minutely and shred yourself to pieces about real and perceived failings.
Sometimes a station is followed by a post encounter or tag station and you are expected to answer
question about the encounter in the previous station. The instructions outside
the first link station will tell you that it will be followed by a tag station. In my OSCE exam we had to assess risk of self
harm in a lady who had presented after taking an overdose and in the tag station had to discuss the risk and management plan with the on call consultant.
Remember the Royal College
has already assessed your theoretical knowledge. OSCES check your skills as a
Do’s and Don’ts
the exam, practice with as many patients as you can.
- It helps to practice in groups. Observe your colleagues and seniors. You
might pick up useful interviewing techniques.
- Dress professionally
- Greet the
- Shake hands
your self by name. My name is Dr. Alex Martin.
Don’t say that you are an SHO. To most people it means nothing. It is best to introduce yourself as a psychiatrist.
- Ask the
patient’s name if not given in the instructions
- Adopt an
open posture. Sit with feet resting on the floor.
Lean forward slightly if the situation demands but don’t invade patient’s personal space.
your task to the patient
- Make and
maintain appropriate eye contact
- Ask clear
questions. Don’t use medical jargon.
If you have to use technical terms explain yourself
- Begin with
broad open questions and then move to close questions
ask multiple questions
- Ask follow
- Use non-verbal
and verbal encouragements (head nods)
- Give pauses
and let patient talk freely for the initial 30 seconds or so
- If you
don’t know the answer to a patient’s question, say so
- Be honest
- Use all
the allotted time.
- End by
thanking the patient. Never leave the station abruptly.
- Use the
rest station to calm your self down and to think about the next station. Remain
positive and confident.
- In physical
examination stations describe the manoeuvres and explain what parts of body you would need to expose and touch. If it’s an opposite sex patient ask for a chaperone.
- Help the
patient get on and off the couch.
patient’s dignity and comfort