Studying Medicine

First OSCE: done and dusted?

Today I had my first ever OSCE. That stands for “Objective Structured Clinical Examination” and is basically a practical exam for medical students. I don’t think I was this nervous for my final Matric exams. Of course I wasn’t, back then I was an A+ student.

As our first OSCE, we didn’t have real patients and it was probably the easiest OSCE we will ever encounter. Each student does eight stations in the Clinical Skills Lab. I did:

  1. Sterile hand washing technique and urine dipstick analysis: this would not have been bad if I had dried my hands properly. I then struggled for probably a minute to put on the gloves for the urine analysis – did I mention we only get five minutes per station?
  2. Emergency medical care of a child: with no ambu-bag, i.e. the breaths were mouth-to-mouth; something we hadn’t actually practised and so I don’t think the dummy’s chest actually rose – in which case I don’t get the mark for rescue breaths.
  3. Apex beat auscultation: The examiner wouldn’t let me go after I answered all the questions and demonstrated how to palpate for the apex beat and parasternal heave. I finally realised I had forgotten to mention that in the case of apex displacement I would check if the trachea was central. Oops. I also didn’t mention that I could feel the apex beat more strongly if I had the patient do some mild exercise. Truth be told I didn’t study that part.
  4. Abdominal examination for ascites and palpation for the kidneys: I did well in this one, but I forgot to sanitize my hands. Hopefully the rubric didn’t mention it – sometimes they don’t, I’ve seen examples. Afterthought: CRAP. Why do I suddenly think the lady asked me to feel for the SPLEEN?
  5. Integrated Management of Childhood Illness (IMCI) Assessment: This is an approach I actually get, and a lot of the friends I have spoken to don’t. I think I may have made a stupid mistake though. I blame it on a poorly re-reproduced growth chart.
  6. Clinical identification of slides: my pictures were moderate, I think I got all of them right.
  7. Consultation with a patient who has severe chest pain.
  8. Questions about aforementioned patient: I knew we would be asked a genogram, and yet I forgot to ask the ages and genders of the patient’s children. Damnit!

I felt good about the OSCE, but the later it gets the more scared I get. This year has been terrible for me academically. Truth be told I can deal with poor marks for theoretical assessments, but I want my clinical skills to be impeccable. I couldn’t live with myself if I were a doctor of poor clinical skills. Then I might as well not be studying this course.

So now onto further studying. I hope that I can somehow remain focussed enough to continue studying properly till the end of exams.

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2 thoughts on “First OSCE: done and dusted?”

  1. Well done met die eerste osce! My dummy se borskas het ook nie gestyg nie – toe vind ek later uit ekt soos 2/10 gekry :/ then again, hulle het gese hule gaan die CPR kriteria verander vir hierdie jaar… En dis nie net die maklikste osce wat jy gaan he nie, dis ook die enigste een 😉 Subjective Unstrutructured Clinical Circus (SUCC?) van volgende jaar af…

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