# OSCE's - med students anyone? or any other degree that has OSCE's?



## JAkDy

Finished my 3rd year OSCE's at med school. They are probably the ultimate victory over anxiety. No matter how good you are, they stress you the f**k out. And it's the most high pressure situation.

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OSCE's (Objective, Subjective, Clinical Examination) are basically role plays/acting out cases often.

So you sit outside a door to a room. You are holding a clipboard which has a piece of paper saying what your task is once you enter the room. You have a STRICT few minutes to read (varies on the school) your task and prepare in your head.

Once you go on, the situation is yourself, the patient, and the examiner. You are in there for 8 minutes and you have to do all the things on the task and think throughout. The difference to a normal exam is, 1. the ABSOLUTE time limit (no exception, iron wall solid). 2. If you think/say anything 'wrong' you can't take it back. You can't save it, so you must be as perfect as possible from the very beginning.
3. The examiner is 1 metre away watching your every move, with his/her scorecard judging how well you do what you're told based on criteria that you don't actually know 100% (i.e. you're simultaneously trying to do what you think is on the scoresheet). If you stumble your words, they see it, if you say something stupid they hear it and mark it.

4. There are "critical fails", so if you say some things, they may be a 'critical fail' which means no matter what else you said in the 8 minutes, your score becomes 0. 
5. Timing, you have 8 minutes. At the end of the 8 minutes you MUST leave the room and move to the next room. The examiner doesn't tell you how to divide your time so you must have an eye on the time or you WILL miss out parts and fail.
6. I had 6 stations (i.e. 6 of these exams i describe) and they are all done in a row regulated by a bell that rings every 8 minutes (8 minute read, 8 minute task, 8 minute read, 8 minute task). I also had 6 in 1st semester this year. For a 3rd year medical student, of the 12 stations total in the year you must pass 9 of them. Which is harder than it sounds. I was fortunate to have passed all 6 of my first 6 OSCE's in 1st semester, so I only needed 3 today.

It is the most stressful thing I think you can experience as a student. 
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Example (i had it today, well similar to it):

You are about to see Jack Smith, 45year old male presenting with a history of funny turns. Tasks are:

1. Take a history from Jack regarding his presenting complaint (6min).
2. Present a differential diagnosis to the examiner (1min).
3. Name the investigations you would like to order (1min).

So you must create an idea in your mind of what questions you need to ask in order to diagnose him. You need to have a very extensive differential list in your mind for 'funny turns'. Thus your must understand every disease/possible presentation of "funny turns" to be able to target your questions cause you only have 6 minutes.


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## JAkDy

Arials said:


> Congrats! WHat is an OSCE? I plan to do nursing or paramedics later, and medicine eventually. The thought of having the responsibility of patients and not making mistakes is scary. I guess you would get used to it though. How is med school?


Okay so imagine your average exam, you stress because it can decide your future (well in uni/big exams, normal reasons why exams stress you out). 
During the exam, you write answers probably in pencil. You stuff up, you can erase your answer and try again.

OSCE's (Objective, Subjective, Clinical Examination) are basically role plays/acting out cases often.

So you sit outside a door to a room. You are holding a clipboard which has a piece of paper saying what your task is once you enter the room. You have a STRICT few minutes to read (varies on the school) your task and prepare in your head.

Once you go on, the situation is yourself, the patient, and the examiner. You are in there for 8 minutes and you have to do all the things on the task and think throughout. The difference to a normal exam is, 1. the ABSOLUTE time limit (no exception, iron wall solid). 2. If you think/say anything 'wrong' you can't take it back. You can't save it, so you must be as perfect as possible from the very beginning.
3. The examiner is 1 metre away watching your every move, with his/her scorecard judging how well you do what you're told based on criteria that you don't actually know 100% (i.e. you're simultaneously trying to do what you think is on the scoresheet). If you stumble your words, they see it, if you say something stupid they hear it and mark it.

4. There are "critical fails", so if you say some things, they may be a 'critical fail' which means no matter what else you said in the 8 minutes, your score becomes 0. 
5. Timing, you have 8 minutes. At the end of the 8 minutes you MUST leave the room and move to the next room. The examiner doesn't tell you how to divide your time so you must have an eye on the time or you WILL miss out parts and fail.
6. I had 6 stations (i.e. 6 of these exams i describe) and they are all done in a row regulated by a bell that rings every 8 minutes (8 minute read, 8 minute task, 8 minute read, 8 minute task). I also had 6 in 1st semester this year. For a 3rd year medical student, of the 12 stations total in the year you must pass 9 of them. Which is harder than it sounds. I was fortunate to have passed all 6 of my first 6 OSCE's in 1st semester, so I only needed 3 today.

It is the most stressful thing I think you can experience as a student. 
------------------
Example (i had it today, well similar to it):

You are about to see Jack Smith, 45year old male presenting with a history of funny turns. Tasks are:

1. Take a history from Jack regarding his presenting complaint (6min).
2. Present a differential diagnosis to the examiner (1min).
3. Name the investigations you would like to order (1min).

So you must create an idea in your mind of what questions you need to ask in order to diagnose him. You need to have a very extensive differential list in your mind for 'funny turns'. Thus your must understand every disease/possible presentation of "funny turns" to be able to target your questions cause you only have 6 minutes.


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## CAmed

Great job! I'm a second year med student so this is my future. Today I finally got up the courage to watch the video from my most recent OSCE. Of course I built up the whole thing assuming that I'd look like a total fool but actually watching the video was very helpful and I realized I should have more confidence in my abilities. It keeps getting easier. I look back on my first year and think how nervous I was. I've gotten a lot less critical about my mistakes. I just joined this website actually because I thought it'd be helpful to share thoughts about overcoming social anxiety with other med students. I should get back to studying now though...oh the joys of med school.


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## Misskittycat

Since your a med student, I'm curious. What really is the difference between a nurse practitioner and a doctor? I know practitioner is an "upper level" nurse in which you can diagnose and treat patients. Aren't they the same thing though? Do you think it's easier to become a nurse practioner or a doctor? 

PS: Sorry for all the questioning. When I graduate high school, I hope to be a nurse practioner or a doctor. I still am indecisive.


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## JAkDy

Misskittycat said:


> Since your a med student, I'm curious. What really is the difference between a nurse practitioner and a doctor? I know practitioner is an "upper level" nurse in which you can diagnose and treat patients. Aren't they the same thing though? Do you think it's easier to become a nurse practioner or a doctor?
> 
> PS: Sorry for all the questioning. When I graduate high school, I hope to be a nurse practioner or a doctor. I still am indecisive.


Doctor is someone who does a medicine degree (MBBS/MD) which is 5-6 years undergraduate. Often leads to more training (while being paid) to become a consultant or GP etc. Start of your degree to GP level would take 8 years, start of degree to specialist level would take 12 years (of course all yrs after the 1st 5 in your degree you are a doctor and have a salary). Btw this is all information relevant to Australia (and to a degree the UK).

Nurse practitioner is a nursing degree (2-3yrs in Aus) with a little extra training to be able to give prescriptions. They're not supposed to do anything without Doctor supervision at a practice (in reality there are some situations where they're unsupervised). They don't have the same freedoms/privileges as doctors cause they simply haven't had nearly the same amount of training so can't do as much.

Easier to become a nurse practitioner, less you can do with that job. Nurse practitioners are becoming less popular iirc and you tend to see them best utilised in really rural areas where they don't have a doctor. There's no need for them in the cities really outside their nursing skills (thus being a nurse is adequate).


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## ew4055

That is awesome. World could definitely use more doctors. Thank you for wanting to help the world! And great job on your exams!


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## arao6

Ugh I hate critical fails. I'm going to apply for med school next year (after I take the MCATs). When I became an EMT, critical fails were my worst nightmare.


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## JAkDy

Arials said:


> That sounds really intense. I would guess all of med school would be stressful. I heard nursing practitioner is kind of like a GP and takes 4 years postgraduate study. Lots of years for education.


Yeah they're very useful in the right setting and really do great work, however they're not as specialised as GPs are. Gotta remember that the undergrad nursing degree obviously has hardly any relevance to the role of a GP/doctor at all cause they have to learn different nursing things/responsibilities. So their only training relevant would be the 4 years post-grad work. Which certainly is a long time but compare that with 8-9 years it takes to be a GP.

Med school is certainly stressful, depends partly how you approach it. But I will say that OSCE's and exam periods in general (lasting around a month each semester) tend to be the most stressful times of my life.


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## Misskittycat

JAkDy said:


> Doctor is someone who does a medicine degree (MBBS/MD) which is 5-6 years undergraduate. Often leads to more training (while being paid) to become a consultant or GP etc. Start of your degree to GP level would take 8 years, start of degree to specialist level would take 12 years (of course all yrs after the 1st 5 in your degree you are a doctor and have a salary). Btw this is all information relevant to Australia (and to a degree the UK).
> 
> Nurse practitioner is a nursing degree (2-3yrs in Aus) with a little extra training to be able to give prescriptions. They're not supposed to do anything without Doctor supervision at a practice (in reality there are some situations where they're unsupervised). They don't have the same freedoms/privileges as doctors cause they simply haven't had nearly the same amount of training so can't do as much.
> 
> Easier to become a nurse practitioner, less you can do with that job. Nurse practitioners are becoming less popular iirc and you tend to see them best utilised in really rural areas where they don't have a doctor. There's no need for them in the cities really outside their nursing skills (thus being a nurse is adequate).


Alright, thanks for info  I'm more on the doctor side, just hope I can afford med school.


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## CAmed

Oh man, that part about affording med school...I hope you're not American like me because its absolutely insane! I go to a public in-state school which is marginally cheaper than private and plan to go into primary care. I'll be paying off my loans for decades. It's worth it to me but I do think the system is pretty broken!


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## zenislev

hi , fellow students


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## zenislev

good for me , 
i don't have to work and i live like 10 min away from medicine university and 5 min away from the hospital where i get internships ( on foot ) 

couldn't be better


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## Tonberry

Yeah, the OSCEs stress the hell out of me. The palpitations I get while waiting in the waiting area, til standing outside the door during reading time, having my mind go completely blank from anxiety. I've managed to survive so far, I have one more exam with around 8 stations and then I'll graduate. Just noticed you're from Australia too, we're kinda on the same boat ey


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## zenislev

Tonberry said:


> Yeah, the OSCEs stress the hell out of me. The palpitations I get while waiting in the waiting area, til standing outside the door during reading time, having my mind go completely blank from anxiety. I've managed to survive so far, I have one more exam with around 8 stations and then I'll graduate. Just noticed you're from Australia too, we're kinda on the same boat ey


what stress me out is oral exam for anatomy 
i am very likely to be the worst student ever in my 3 years studying anatomy ( i repeated my second year in med school ) terrible tests results , that's why i am stressed , because frankly i haven't revised **** each time


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## CAmed

*what's worked for you?*

All of you med students (and nursing and everything else of course). I'm curious what solutions you've found for OSCEs, etc? For me, taking 20 mg of propranolol before I do something anxiety provoking has really really helped. The worst part for me is getting tremors in my hands and having a shaky voice and those things are nonexistent when I take the propranolol. The downside is that propranolol makes it nearly impossible for me to exercise even as much as 10 hours after I've taken it which is a problem for someone like me who loves to run (i'd say running is also therapy for me!) so I only take it when it really seems necessary. Therapy has also been helping me- i'm lucky that its offered free by the counseling center at my university. And I stopped drinking coffee which has also helped tremendously. Maybe its a personal thing but I get very shaky with even the slightest amount of caffeine even after drinking several cups a day for several years- I finally realized I needed to stop with the coffee! I'm wondering how that will play out when I'm a sleep deprived resident...
Next year I'll be starting my clinical rotations so I'm thinking I may be taking the propranolol more often...I'd love to not take medication at all but I'm terrified of trying to do procedures without it. Any thoughts on the surgery rotation? I've always found it difficult to do things with my hands when I'm being observed because my hands shake unless I take the propranolol.


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## JAkDy

CAmed said:


> All of you med students (and nursing and everything else of course). I'm curious what solutions you've found for OSCEs, etc? For me, taking 20 mg of propranolol before I do something anxiety provoking has really really helped. The worst part for me is getting tremors in my hands and having a shaky voice and those things are nonexistent when I take the propranolol. The downside is that propranolol makes it nearly impossible for me to exercise even as much as 10 hours after I've taken it which is a problem for someone like me who loves to run (i'd say running is also therapy for me!) so I only take it when it really seems necessary. Therapy has also been helping me- i'm lucky that its offered free by the counseling center at my university. And I stopped drinking coffee which has also helped tremendously. Maybe its a personal thing but I get very shaky with even the slightest amount of caffeine even after drinking several cups a day for several years- I finally realized I needed to stop with the coffee! I'm wondering how that will play out when I'm a sleep deprived resident&#8230;
> 
> Next year I'll be starting my clinical rotations so I'm thinking I may be taking the propranolol more often...I'd love to not take medication at all but I'm terrified of trying to do procedures without it. Any thoughts on the surgery rotation? I've always found it difficult to do things with my hands when I'm being observed because my hands shake unless I take the propranolol.


My opinion on taking beta blockers for osces is that it's okay if you would actually fail the year without them. If it's just to gain an extra 3 marks in an exam where you'd pass either way then I don't think it's really a valid reason. Even if it's incredibly uncomfortable if one can make it through OSCE's without them then they should try. Cause it may otherwise make you feel like you can't do anything even a tiny bit stressful without them.

I don't take anything really medical for OSCE's, I had a cup of green tea lol.

On surgery rotation obviously being a 3rd year, didn't actually get involved as much other than some people got to assist in surgeries. I didn't get that chance but just watched a few times and so on.


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## Tonberry

I know some surgeons take beta blockers too and I reckon they are fine as long as they dont become a psychological crutch. 

I also get a really bad tremour when I'm anxious but for me they were a bit counterproductive because they made me extremely drowsy/lethargic and my tremour didn't really go away all that much.


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## JAkDy

Guys I know the thread's a bit old, just wanted to say as update:

I PASSED 3rd YEAR MEDICINE!!!!! :yay :yay

I don't know the details like marks etc, or how many stations I passed. I'll hear about that in a few weeks, but they just tell you if you pass or fail at this stage or as they call it an "Ungraded Pass".

Yiew!!!
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On another note, it seems there's a fair few medical students/nursing/etc, or people interested in doing medicine.
We should totally make a group on SAS.


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## dine

hi,im second year medical student..in india.i dont know what osce is,here in india this term is not used.MY COURSE IS MBBS WHICH IS DURATION OF 5 YEARS.GLAD TO FIND FELLOW MEDICAL STUDENTS HERE.


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## JAkDy

You're 18 and a 2nd year student?!? Do people graduate high-school at 17 in India?


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