Does not having OSCEs in residency matter?

[Please_Stand_By]

Just wondering if those are considered valuable in the residency experience as one program I really enjoy does not do them apparently.

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[gutonc]

I would actively avoid any residency program that had required OSCEs as part of the curriculum.

 

[Please_Stand_By]

I would actively avoid any residency program that had required OSCEs as part of the curriculum.

Really!? Why so? A few I may rank high have them...

 

[gutonc]

Really!? Why so? A few I may rank high have them...

F*** that noise. You know what an OSCE is in residency? Bedside rounds in the ICU. Presenting new admits to your senior/attending.

The time for that fake patient crap should end when you pass Step 2CS. If your attendings aren't watching, critiquing and correcting you in near real time, no amount of made up patient encounters is going to fix what's wrong with (the generic) you.

It angers me that programs are doing this. I'm sure it's to check some asinine ACGME "core competency" checkbox. But there are better (but harder, for the programs) ways to do that.

 

[Please_Stand_By]

F*** that noise. You know what an OSCE is in residency? Bedside rounds in the ICU. Presenting new admits to you senior/attending.

The time for that fake patient crap should end when you pass Step 2CS. If your attending aren't watching, critiquing and correcting you in near real time, no amount of made up patient encounters is going to fix what's wrong with (the generic) you.

It angers me that programs are doing this. I'm sure it's to check some asinine ACGME "core competency" checkbox. But there are better (but harder, for the programs) ways to do that.

Understandably so. I've heard of other programs using the standardized patient method too for a given topic that you have to demonstrate the ability to do, such as delivering bad news.

 

[obiwan]

The time for that fake patient crap should end when you pass Step 2CS. If your attending aren't watching, critiquing and correcting you in near real time, no amount of made up patient encounters is going to fix what's wrong with (the generic) you.

Good God, I didn't realize programs were instituting this....

 

[gutonc]

Understandably so. I've heard of other programs using the standardized patient method too for a given topic that you have to demonstrate the ability to do, such as delivering bad news.

Again...work in the ICU for a week as an intern.

My very first day as an IM intern was a 30h overnight ICU shift (back in the bad old days) where I got to tell 2 families that their loved one had died and a 3rd family that the whole "bottle of vodka chased with a bottle of bleach", first psychotic break of their otherwise smart, talented and beautiful 22yo daughter wasn't going all that well and they shouldn't leave the hospital for the next 24 hours if they could avoid it.

Strap a GoPro to the average resident and they could take care of all this core competency crap in about a month.

 

[gutonc]

Good God, I didn't realize programs were instituting this....

Apparently so. I'm sure my old program is.

 

[dfib slim]

According to Freida, only 2 of the places I interviewed at state "No" for offering OSCEs. Wasn't even something that crossed my mind.

 

[gutonc]

According to Freida, only 2 of the places I interviewed at state "No" for offering OSCEs. Wasn't even something that crossed my mind.

"Offering" or "requiring"?

 

[dfib slim]

"Offering" or "requiring"?

Doesn't specify. Under Educational Environment, for Resident Evaluation, it just says "Yes" for Objective structured clinical examinations.

 

[Please_Stand_By]

According to Freida, only 2 of the places I interviewed at state "No" for offering OSCEs. Wasn't even something that crossed my mind.

Got yo back bro.

 

[Please_Stand_By]

Are there any other important little things that differ between residencies that may be overlooked?

 

[Raryn]

I would actively avoid any residency program that had required OSCEs as part of the curriculum.

My *fellowship program* is requiring us all to do a yearly MiniCEX. That is, an observed history and physical.

I'm a board certified internist.

(To defend the fellowship program a little tiny bit, the requirement comes from the GME office and doesn't differentiate between residents and fellows... but is still absolutely absurd)

 

[gutonc]

Are there any other important little things that differ between residencies that may be overlooked?

Hundreds of them.

 

[rokshana]

My *fellowship program* is requiring us all to do a yearly MiniCEX. That is, an observed history and physical.

I'm a board certified internist.

(To defend the fellowship program a little tiny bit, the requirement comes from the GME office and doesn't differentiate between residents and fellows... but is still absolutely absurd)

lol, my fellowship did the same thing (my residency did not).

 

[Gastrapathy]

My *fellowship program* is requiring us all to do a yearly MiniCEX. That is, an observed history and physical.

I'm a board certified internist.

(To defend the fellowship program a little tiny bit, the requirement comes from the GME office and doesn't differentiate between residents and fellows... but is still absolutely absurd)

Fake patients for senior learners are stupid. Requiring your attendings to watch you do an H&P 3x total on real patients in your fellowship is not stupid. Board certified means you passed a written test in IM, nothing more.

This seems like a very reasonable requirement and the fact that there are IM residencies that don't require this is not good. You haven't seen a fellow that can't take a hx because you aren't one. When you're on the other side, prepare to be surprised.

 

[gutonc]

Fake patients for senior learners are stupid. Requiring your attendings to watch you do an H&P 3x total on real patients in your fellowship is not stupid. Board certified means you passed a written test in IM, nothing more.

Completely agree, and have no problem with this. But the fake patient OSCE BS needs to die on June 30th of the M4 year.

 

[Gastrapathy]

Completely agree, and have no problem with this. But the fake patient OSCE BS needs to die on June 30th of the M4 year.

I'm not convinced there is any value after MS2.

The OSCE debrief where the fake patient gets to tell the doctor how to do it right makes my head explode. I refused to proctor this crap for the last several years.

 

[gutonc]

I'm not convinced there is any value after MS2.

Probably not. But continuing that BS into residency and fellowship is just ridiculous.

 

[Raryn]

Fake patients for senior learners are stupid. Requiring your attendings to watch you do an H&P 3x total on real patients in your fellowship is not stupid. Board certified means you passed a written test in IM, nothing more.

This seems like a very reasonable requirement and the fact that there are IM residencies that don't require this is not good. You haven't seen a fellow that can't take a hx because you aren't one. When you're on the other side, prepare to be surprised.

Board certified means that I passed a written test in IM... after three years of residency training where (in order to sit for the boards) they certified my competency to graduate. I can think of zero actual utility to my program director watching me do an H&P 2-3x, whether on a fake or real patient. If I hadn't gotten it by this point, I never would.

Regardless, it's an easy requirement to fulfill. Just a silly one IMO.

 

[sluggs]

My entire IM residency, I never had an attending (or even a senior when I was an intern) observe me do an H&P... this is something I would occasionally sit through and supervise for med students on my service when I was an intern. You should have more than 100 H&Ps under your belt before you start residency.... never heard of a resident doing an OSCE...