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How to pass the emergency OSCE station

BMJ 2019; 367 doi: (Published 01 October 2019) Cite this as: BMJ 2019;367:l2414
  1. Peter J Edwards, GP academic clinical fellow specialty trainee year one1,
  2. Michael J Stechman, consultant general surgeon2 3,
  3. John T Green, clinical senior lecturer2 3
  1. 1Bristol Medical School, UK
  2. 2Cardiff and Vale University Health Board, UK
  3. 3Cardiff University School of Medicine, UK
  1. peter.edwards{at}

Staying safe and systematic

An emergency station is often included in objective structured clinical examinations (OSCEs) at UK medical schools because the General Medical Council requires that junior doctors are competent in the recognition and initial management of acutely ill patients.1 This type of assessment is also common in academic foundation programmes and postgraduate interviews.23 In medical school finals the aim of the OSCE is to assess students’ abilities to manage patients safely and effectively at the level that would be expected of a foundation doctor.

The emergency station often worries medical students because it is perceived to be unpredictable and demands on-the-spot decision making. You can, however, pass any station by taking a systematic approach. This article aims to provide you with the tools to help you maximise your marks and highlights the common errors to avoid.

Station variation

The design of OSCEs varies between medical schools. In some examinations you might be asked to undertake all the steps shown in figure 1, whereas in others you may be given a specific clinical scenario and asked about only certain parts of the process. Some medical schools use high fidelity simulation manikins. These manikins are used to test your ability to examine patients, recognise specific clinical signs such as tachycardias, altered breath and heart sounds, and provide immediate life support. In any station, you may be expected to provide immediate lifesaving support by following the systematic Airways, Breathing, Circulation, Disability, Exposure (ABCDE) approach to managing acutely unwell patients (fig 2).45

Fig 1

Example of an emergency OSCE station set in the medical assessment unit. Observation results are provided in parentheses. BOXES mnemonic used with permission.7 Wells’ scoring and treatment with low molecular weight heparin (enoxaparin) based on NICE guideline for venous thromboembolic disease.15

Fig 2

Example of …

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