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In Focus - Yasmin Tyson

Yasmin Tyson

Year of Study: Year 4

Year 4 student, Yasmin Tyson, talks to us about exams at medical school. Find out how medical students prepare, what to expect on the day, and what happens after the exam.

What is an OSCE?

“OSCE” stands for Objective Structured Clinical Examination and is an assessment of clinical competence in a simulated clinical environment. At BSMS, we do OSCEs as part of our end of year assessments starting from Year 2 all the way to finals in Year 5. The finer details change slightly as you go through the degree, but the general format stays the same – you complete a set number of stations simulating various clinical scenarios aimed at assessing one or multiple different skills. These include history taking, clinical examination, initial assessment, data interpretation and clinical skills (e.g. venepuncture).

How do you prepare for an OSCE?

Practice! The absolute best way to revise is by doing it. These are practical exams, so revising by reading and writing will only help so much. The clinical knowledge the OSCE stations are based on will be learnt during lectures and placement, and mainly revised as part of your Knowledge Test (KT) revision. To make sure you perform to the best of your ability in the OSCE, you need to practice the various skills tested out-loud, as you would in the exam. It’s good to know early in the year what skills you may be tested on, so you can take opportunities to practice them on placement.

During the revision period, my friends and I would set aside dedicated time each day to take a break from KT revision and do OSCE practice together. Many people set up dedicated OSCE practice study groups, but you can also practice on non-medical friends, family and housemates. I’ve definitely practised some clinical examinations on sofa cushions too! There are various websites providing practice stations that you can use, and the BSMS clinical skills team will run OSCE revision sessions during the exam period.

What is the experience like on the day?

BSMS runs multiple cycles of OSCEs on the same day, so prior to the exam day you will be allocated a site and reporting time for your specific cycle. Like any exam day, nerves will be high and it can be daunting walking into the building, but you are not on your own – you’ll be with a group of other students from your year going through the cycle with you.

Outside each room will be a short brief of written instructions, which you have a set amount of time to read and make any notes on before you enter the station. In the room will be an examiner and a patient actor and/or mannequin. After the set amount of time you are allocated to complete the task, the examiner may ask you questions about the case or topic. As you progress through each year of your medical degree, there will be more emphasis placed on your diagnosis and management plan. The full cycle usually takes a couple of hours, but I was surprised after my first OSCE how quick it felt.

The OSCE is definitely an abstract concept – you walk into a room with an actor and pretend you’re not being watched by an examiner whilst you treat them as a real patient. The best thing you can do is commit to it completely, and the more you do the easier it is to suspend disbelief!

The OSCE is not a real clinical situation, so it’s not the end of the world if you make mistakes – you will make mistakes throughout your various OSCEs, and you won’t be the only one who does so. It’s a safe situation, and the primary goal is to assess your overall safety to work as a newly graduated doctor. It’s hard to perform under pressure, but your overall impression is the most important factor. I’m sure watching medical students complete OSCEs would make a very entertaining reality show.

Because multiple cycles of OSCEs take place on the same day, you may have to quarantine before and/or after your exam. This isn’t as intense as it sounds – you’ll stay in a room with the other students from your cycle to ensure you can’t contact students who haven’t completed the exam yet or vice versa. You’ll hand in your phone/electronic devices before you start and get them back once you’re finished. People will bring all sorts to stay entertained during quarantine – books, colouring, crafts, card games, snacks.

What happens after an OSCE?

BSMS uses sequential OSCEs, so there are two OSCEs at the end of each year, but not every student will have to do the second one. The second OSCE is not a resit and sitting it doesn’t mean you’ve failed the first one, it just gives students the opportunity to increase their overall grade. You should go into the exam period assuming that you’ll being doing both examinations.

About a week after the first OSCE, you’ll be told whether you’re required to return for sequence 2. At this point all students will also receive their feedback for the first OSCE. Whether you’re doing sequence 2 or not, this is a great opportunity to reflect on what you think went well and what didn’t, and whether your feedback highlights any areas for improvement. The final results for the OSCE come out on the main results day, with the KT results and results for the year overall.

How do OSCEs help your learning at medical school?

OSCEs are primarily for the medical school to assess your competency and safety, but they are also a great opportunity for students to practice being a more autonomous clinician. For example, one of the stations will often be an initial assessment of an acutely unwell patient. On placement, situations like these will be managed by a senior clinician and students will most likely observe. During the OSCE, however, you’ll be assessed on how you would manage the patient in this scenario before the senior clinician arrives – an intimidating situation, but hugely important to practice.