Revalidation: the real life OSCE

Consultants love a good OSCE, and if objective structured clinical examinations are good enough for assessing medical students then they should be good enough for assessing consultants, although they must reflect a typical working day. The OSCE outlined here is designed for the revalidation of middle aged, male doctors, but it can easily be adjusted for age, sex, and specialty.

Not unreasonably you ask for an ophthalmoscope to examine the retina of a young man with sudden unilateral visual failure. Sister goes off and returns with one from the urology ward. There is no light and it rattles. Sister goes off again and finds you two batteries. There is still no light. Sister goes off again. She does not return. Examine the other cranial nerves.

The teacher with an early term dizzy turn, nausea, and headache who underwent computed tomography of her head on the medical admission unit two days ago is agitating for the result, in a fierce sort of way—as is her solicitor husband, in a medicolegal sort of way. With an air of calm authority garnered from years at the top you take control, promising to see the scans immediately and “sort everything out.” Your senior house officer (she looks vaguely familiar and you're pretty sure that's who …