MRCEM OSCE preparation and resources

Hello people

Since I have cleared my OSCE in one go, I feel it's my duty to journal what all I have done to make it work.(humble brag).Thanks to ChatGPT for helping me pile up some humble generic sentence to make this blog wholesome.(Just kidding).

The MRCEM OSCE exam is an integral part of the qualification which tests the clinical and communication skills of candidates. For Indian students pursuing this qualification, preparing for the MRCEM OSCE exam may seem daunting. However, with a few tips that helped me sail through fine.

The thing that helped me the most is acclimatizing myself to the UK Clinical Setting Before appearing for the MRCEM OSCE exam, it is imperative for Indian students to understand the clinical setting in the UK. Sometimes , all they want to see is how you behave , your body language, your tone , and your organising skills. Diagnosis is not a critical thing here. You will not fail if you get a wrong diagnosis provided that you have done it systematically. So don't focus on the destination, just see that you don't take a bumpy road.

The clinical environment and protocol in the UK may differ significantly from India. So, YouTube videos would help if you familiarize yourself with the clinical culture, protocol, and language in the UK. While preparing, try to make your self aware British guidelines and protocols which you already do while preparing for Part B.

OSCE Format :

Familiarize Yourself with the Exam Format The MRCEM OSCE exam is an 16-station assessment of a candidate's clinical and communication skills. Plus 4 rest stations, these are meant for you to have a sip of water and use restroom . Each is 8 minutes.It assesses the candidate's proficiency in history-taking, examination, interpretation of investigations, and management planning domain wise. The candidate has

eight minutes to complete the station. It's important to familiarize yourself with the format of the exam and its nuances, such as knowing the minimum requirements for passing.

To Avail the Resources that Help Preparing for the MRCEM OSCE exam in India can be an enormous challenge. It's a tad bit easier for people in corporate sector over the ones who are in peripheries or government setup.Preparation courses provide candidates with expert advice, guidance, and extensive practice sessions to help them succeed. They also offer much-needed support and group interaction to help boost confidence and reduce anxiety about the exam.

 A smart approach to study systematically should be planned with a priority given to topics that are more challenging or need more practice. Start by revising the

common clinical scenarios encountered in the UK, and understand the differences in language or presentation styles compared to India.

Speed :

Practice Practice, practice, practice! Its absolute waste of time if you cannot reach the pinnacle (end) and conclude what you think needs to be done next. It's crucial for Indian students to allocate sufficient time for practicing clinical scenarios similar to those in the exam. Allocate time for practice sessions for each topic, taking into account the eight-minute time frame available per station. Increase flow and quickness while practicing your communication skills to manage the time effectively.

Simulate with your friends

Collaborate and Simulate with Others Collaborating with colleagues and fellow MRCEM aspirants is an excellent way to gain insight and understanding. Working together on a clinical scenario can help candidates pool their knowledge and address any shortcomings. Several MRCEM OSCE preparation groups are available online, which could be helpful.

Participate in Mock OSCEs

 It's important for Indian students to participate in mock OSCEs to gain experience and get a real taste of the exam's environment. Mock OSCEs simulate the environment of the actual exam and help candidates identify areas that need improvement. Moreover, by participating in mock OSCEs, you can better understand how to manage your time during the exam, improve your confidence, learn communication skills, and understand the expectations of the examiner.

Let me now talk about my experience.

When do you start preparing?

I had my MRCEM sitting in November first week, I started planning in August, preparation in September .

When do you start mocks?

 By October I started my mock exams. I gave 2 proper mock exams before going to the exam. People will tell you , they sleepwalk the exam . Don't buy B.S.

Eg: My seniors had told me that the actors (patients) would just be quiet and not participate much and the exam is a cake walk. These days the actors are trained.

They will pick a weak point and question you. Many are either smart nurses or junior doctors simulating the scene. Don't take chances , prepare well.

Do mock exams help?

Osce is a subjective exam. Atleast the current one as it is domain based , there is no official check list. Now the examiners mental checklist may vary from person to person like grocery list. The more opinions, the more confusion. I would not recommend more than 2 mock exams before the OSCE. You will be confused. Also try seeking feedback from them.Some might come out as harsh but it's all a part and parcel of the game.

If you have an institute that helps you prepare the whole scene that also works.

Benefit of mock exam?

The situation is designed like you are in your emergency room with 16 patient and everybody has a problem. Some are conflicts , performing procedures , sometimes you are teaching or breaking

bad news , talking to patients examining them etc like running around in the limited time. Its likely that you face performance anxiety as examiners from UK also will be there. You will realise you can potentially go in different tangents and run out of time.You will learn to manage time and cut the medical jargon.

1 pediatric- could be resus or safeguarding

Resources 

1. MRCEM 125 OSCE questions by K. Somani , N. Jain.

Questions will be more or less the same. Practise well.

2. Geeky medics.

3. Bromley

4. If you can get recalls of your immediate senior batch , that will be useful.

Useful content 

1.https://youtu.be/OYTXSBaMQlI

Osce chest tube insertion video

2.https://youtu.be/ZZMAVZhrDHE

Intra osseous route

3.https://youtu.be/TSJTOaOVcQM

Knee aspiration

4.https://youtu.be/7tcrSd5lLoc

Lumbar puncture

5.https://youtu.be/9i8qIZ-G1GM

Nasal packing

6.https://youtu.be/17ZKya9yR2Y

Knee joint examination

7.https://youtube.com/shorts/EkhpxCMyDmA?feature=share

Lachman test

8.https://youtu.be/Ko_qalMOpN8

Femoral Nerve Block

9.https://youtu.be/i-QTRoJiR5E

Learning the opthalmoscope

10.https://youtu.be/FE0sot4OoAE

Otoscopy

11.https://youtu.be/cjyf7lWnEBI

How to use metered dose inhaler

12. https://youtu.be/ue2VT-IfGro

Shoulder exam

13.https://youtu.be/FaCZxrvxJaE

Spine exam

14.https://youtu.be/Hkqr3mg6IWQ

Hip exam

15.https://youtu.be/fNRDWN2OdpY

Needle cricothyrodotomy

16. https://youtu.be/bRfQeHtv7pM

Surgical cricothyrodotomy

17.https://youtu.be/sypBEG9F6uU

https://youtu.be/sfkOEteIZFY

Hand exam

18.https://youtu.be/_Hy3t2Y9HUM

Elbow exam

19. https://youtu.be/sJBpai74tlU

Cranial nerves exam

20. I have a PowerPoint I had prepared for joint exam for quick revision. Interested people can reach out to me in comments or LinkedIn.

Important topics to study

1.ECG Potential questions- Learn systematically as if you are teaching a first year resident.

STEMI , Brugada , WPW, Complete heart block , HOCM. LAFB

2.Follow SPIKES method for breaking bad news

Potential Breaking Bad news scenarios : pediatric drowning case, denovo diabetes, huge IC bleed(brain dead ) patient,

miscarriage, IVF abortion,

3. ABCSMITH for psychiatry cases

4 .Counseling cases : you will have people asking your advice in these scenarios post exposure prophylaxis in HIV , HIV/HBSAg blood splash , Febrile seizure patients mother , Needle stick injury( be prepared patient can have Hbsag positive, hiv positive) ,newly diagnosed type 1 diabetic or asthma

5. Breaking bad news video for pediatrics

 https://youtu.be/pRDFXTvBAx0

 No organ donation for kids

6. Resus Passing resus is mandatory as ER Physician, you are likely to flunk the entire OSCE sitting if you spoil your resus scene. Therefore , get your manekins, understand the ergonomics and start

practising.

7. Commonly asked resus questions : ALS, Pregnant trauma ,adult peri arrest , major trauma , septic shock.

8.Donot forget things like introducing yourself , taking handovers , connecting monitor ASAP , oxygen, IV line , sugars .

9. Read about" Respect "process.

10.Procedures- to have consent, monitor , equipment check , verbalising and doing steps , post procedure disposal of things and vitals and xrays.

11.Commonly asked procedures: Airway skills, vaginal exam , looking for lost condom, suturing, catheterization, ECG , POP, otoscopy , inhaler technique,nerve blocks .

12. Commonly asked conflict topics : difficult conversation with a colleague , difficult referal, angry patient over a missed diagnosis, patient refusing treatment

13. Laws non UK people should be aware of caldicott report, mental health act , mental capacity act , childrens act , advance directive,DNAR , organ and tissue donation

14.DVLA for epilepsy , syncope , ACS, stroke for group 1 and 2 cars

15.Learn when to give these Referals Burns clinic, GuM clinic, fall clinic , safeguarding children.

16. Read about Blood transfusion for Jehovah witness- Difficult situation.

17.https://frcemprep.com/all-about-mrcem-osce-exam/

18 . Read about Pacing- Demand or fixed pacing

Electrical capture, Mechanical capture, Increase pacer output, Count number of boxes, Pain during pacing

19 . Donot carry the mess or celebrationof one station to the next. Thats the perfect receipe of disaster.

20. Be polite . Good morning, thank you, so sorry to hear , can I do anything to make you feel better , you want your family around while I break the bad news , thank you, never interrupt the patient.

 In conclusion, the MRCEM OSCE exam can be challenging for Indian students, but with a well-planned approach, ample practice, and utilizing available resources,one can aim to achieve success. Preparing for the MRCEM OSCE exam is a process, and Indian students must remain consistent in their efforts and maintain a positive attitude throughout.

So far so much

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