Top Tips for OSCEs

OSCEs or Objective Structured Clinical Exams are the ‘practical’ exam of medical school. It aims to prepare you for the clinical and communication aspects of becoming a doctor. They can seem really difficult and stressful, but with enough practice, you are likely to score well. I hope these tips are helpful and make you feel a little less worried!

What do you need to know?

It seems obvious, but make sure you know which examinations, histories and procedures you’re expected to know and what you’re supposed to be doing in them. Check out our OSCE guides if you’re looking for help.

Practice makes perfect

Grab a fellow medic/friend/flatmate and practice regularly until your examinations are fluent and confident. Exam nervousness can affect your performance, so it’s better to be a bit overprepared than under. If your medical school allows you to practice with their equipment, then take advantage of those opportunities. If not, things like reflex hammers, blood pressure cuffs and penlights can be bought off the internet for a decent price. Remember to practice with a timer too as the minutes fly by in the real thing.

Clothes maketh the man

Dress professionally and accordingly to NHS dress code. Looking neat might not give you extra marks, but it does help you make a good first impression. Remember to tie up long hair, roll sleeves up above the elbows and take off your wristwatch.

Devil’s in the detail

Read the instructions carefully before you enter the station. It sounds silly, but people have been known to do the wrong examination in OSCEs (e.g. upper limb instead of lower limb neurological examination). If you don’t do what you’ve been asked, you just won’t get the marks.

Did you wash them?

Always begin and end a station with washing your hands! Not only is it just good clinical practice, this gives you vital and easy marks.

And so it begins…

Memorise your opening patter until it becomes second nature. This should consist of greeting the patient, introducing yourself, checking their identity, describing the procedure/examination and gaining their permission to continue. Easy marks, but important stuff.

Structure is everything

For examinations, develop an order that you are comfortable with and can remember. For details check out our OSCE clinical skills guides.

For history taking, a general structure applies:

• Presenting complaint
• History of presenting complaint
• Past medical history
• Drug history
• Family history
• Social history
• Systemic enquiry

This may change during a consultation as patients don’t necessarily follow your rules – but having a structure in place makes it easier to keep track of what you have and haven’t asked and helps you with the flow of questioning.

Take a look at our more specific communication skills guides for more details.

Fake it ‘til you make it

You may not be feeling very confident during your OSCE, but pretend you are! Stand up straight, smile when appropriate and speak loudly and clearly – being too apprehensive can give the impression you don’t really know what you’re doing and make the patient nervous too.

Manners cost nothing

Always be polite, empathetic and honest to your patient. Listen to them carefully and let them speak. Thank them and the examiner at the end of the station. After all, they’ve given up their free time to help you. A significant amount of marks are often awarded just for demonstrating these generic communication skills, so don’t neglect them!

Keep calm and carry on

Don’t worry about making mistakes during the OSCE – you haven’t got time to panic. Stay calm, take a deep breath and continue as you were.

Think again

Once you finish your examination you may have some spare time; don’t let this go to waste. Look around to see if there’s any equipment in the room you’ve not used.

If you remember something you’ve missed, then feel free to go back and do it – you’ve only got marks to gain.

Don’t waste a good mistake…

It can be easy to just wipe all memories of a bad OSCE out of your brain. However, if you write those errors down you can review them for your next exam and ensure you don’t make the same mistakes again. Talking to your coursemates about their experience can help too – no one said that you can only learn from your own mistakes.

Good luck!