Having really hard time with OSCEs, any advice

[KettleWhistle]

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I'm having really really hard time with the OSCEs. Are there any good books or web sites to practice? I only found osceprep.com, but not sure if it's a legit outfit... seems like there is a lot of spam about them on various medical forum and nothing else.

 

[smq123]

I'm having really really hard time with the OSCEs. Are there any good books or web sites to practice? I only found osceprep.com, but not sure if it's a legit outfit... seems like there is a lot of spam about them on various medical forum and nothing else.

What kind of troubles are you having? Running out of time? Not being thorough enough?

 

[KettleWhistle]

I don't really know--we don't get to review the results/grading sheets.

I don't run out of time, but it is more that it seems the cases we get are just too simple--they pretty much give you the diagnosis. Also, we are asked to do 10 minutes focused physicals, and there isn't much in a focused exam that you'd need 10 minutes. I think I'm missing something, but when I compare notes with my classmates, it seems that we all have same ideas... yet I'm having problems.

 

[smq123]

I don't really know--we don't get to review the results/grading sheets.

I don't run out of time, but it is more that it seems the cases we get are just too simple--they pretty much give you the diagnosis. Also, we are asked to do 10 minutes focused physicals, and there isn't much in a focused exam that you'd need 10 minutes. I think I'm missing something, but when I compare notes with my classmates, it seems that we all have same ideas... yet I'm having problems.

I agree that the OSCEs are often over-simplified presentations of diseases. But the thing with OSCEs is that, even though they ask for a "focused" physical, and the diagnoses are so obvious that anyone could figure it out in a second, they still want you to think of a differential dx and do the physical exam parts that would rule out some of the less-likely diagnoses. That will help fill out the ten minutes.

Step 2 CS requires that you do the same thing, except they actually ask that you LIST the differential dx - a hard exercise to do when the diagnosis is practically staring you in the face.

 

[QofQuimica]

I agree that the OSCEs are often over-simplified presentations of diseases. But the thing with OSCEs is that, even though they ask for a "focused" physical, and the diagnoses are so obvious that anyone could figure it out in a second, they still want you to think of a differential dx and do the physical exam parts that would rule out some of the less-likely diagnoses. That will help fill out the ten minutes.

Step 2 CS requires that you do the same thing, except they actually ask that you LIST the differential dx - a hard exercise to do when the diagnosis is practically staring you in the face.

How helpful did you think that FA for CS was? I've heard good things about it, but I figured I'd get another opinion anyway before I go out and buy it.

OP, the best advice I ever got was to focus on the most likely thing and also the worst possible thing. So in other words, if someone comes in complaining of chest pain after eating a spicy, greasy meal and then going to bed, they probably have heartburn. But of course you also want to rule out MI. So you should ask questions for both, do an exam for both, and include both in your differential. If you've never seen these before, there are mnemonics that you can use to help think about different causes for a set of symptoms. Here is someone's blog post that lists several of them. I think they really help.

 

[smq123]

How helpful did you think that FA for CS was? I've heard good things about it, but I figured I'd get another opinion anyway before I go out and buy it.

FA for CS was very, very helpful, and I would definitely recommend reading it through all the way once or twice before taking the exam. Everything you need to know to pass the exam (provided that you're a native English speaker) is in that book.

But don't buy it - you'll never need it again, and you'll only need it for a few days. Does your library have a copy you can borrow? Or bum a copy from someone in the class of 09?

 

[QofQuimica]

FA for CS was very, very helpful, and I would definitely recommend reading it through all the way once or twice before taking the exam. Everything you need to know to pass the exam (provided that you're a native English speaker) is in that book.

Yes, I'm a native speaker.

But don't buy it - you'll never need it again, and you'll only need it for a few days. Does your library have a copy you can borrow? Or bum a copy from someone in the class of 09?

They probably do. But I like to write notes in books, so I was planning to get a used copy off Amazon or something. Considering that registration + travel + lodging is going to be around $1500, I'm not too overly concerned about an extra $20 or $30 for a prep book. I will definitely read it over before the test. May the deity of your choice help me if I have to cough up the cash for this idiocy twice. 😱

 

[Jesus DO]

I'm having really really hard time with the OSCEs. Are there any good books or web sites to practice? I only found osceprep.com, but not sure if it's a legit outfit... seems like there is a lot of spam about them on various medical forum and nothing else.

A good place to start is the First Aid Step 2 CS book. It's not a cure all, but still a good place to start. Also, find a friend to work with too. Use a timer or stop watch to see how much time it is taking you to get through cases.

The FA book has about 31 scenarios that are commonly seen on the CS and then you can give your friend the book and let him or her act as the patient. So you can ask: "What brings you in today?"

And your friend with the book can read it and respond "I'm feel cold and tired all day long"

And you keep asking question like duration, location, characterizes, alleviating symptoms and aggravating symptoms - and eventually when you write out your note at the end, you will have to make a DDX.

Just photo copy the blank page they give you and then write what your note will look like. Make sure you time yourself as well. Then, when you are all done, you and your buddy can turn the page again and see what an ideal note will look like. The book provides you with what would be considered the essential items that should go into the notes of the patient encounter you just did.

Don't forget to also pay attention to your physical examination of the patient as well. Sometimes when you start to perform some examination, the standardize patient will hand you a form and it will have a picture that shows you what you are seeing, such as a picture of an inflamed TM or red ear canal. You'll then have to note that on your paper.

 

[Jesus DO]

Yes, I'm a native speaker.


They probably do. But I like to write notes in books, so I was planning to get a used copy off Amazon or something. Considering that registration + travel + lodging is going to be around $1500, I'm not too overly concerned about an extra $20 or $30 for a prep book. I will definitely read it over before the test. May the deity of your choice help me if I have to cough up the cash for this idiocy twice. 😱

Yes. You can certaintly find it at the library or find some used copy of it on Amazon. No need to go out and spend $39 on a new one.

And I hope you do VERY WELL!!! A++

 

[JenHeart]

I use First Aid USMLE CS for the OSCE and it's really all inclusive on what should be done for each complaint. I would recommend start using it a couple of weeks in advance. And have a mnemonic for the history taking so that you don't forget to ask anything (PAM HUGS FOSS or any variation of that).

 

[KettleWhistle]

Thanks all for the advice and feedback.

I have FA CS, and it seems ok. Also bough OSCEprep.com It's only somewhat useful. Looks like a lot of powerpoints put together by a bunch of different people. There are even quite a few spelling errors in these. Some things are helpful, and it may be ok to complement the FA CS, but overall that site's material just isn't professionally made or presented.