Read ALL the information on the ACEM website (Fellowship Exam Resources page) relating to the OSCE. Ensure you are familiar with the exam process, the ACEM Curriculum Framework and, especially, the OSCE Domain Criteria. Watch the example OSCE videos, and read the examiner marking sheets and the released past OSCE stations. The College releases all materials from two OSCE stations every year. The published OSCE Reports from past examinations contain valuable information about the types and format of stations that typically make up an OSCE. These are essential reading. They include examples from examiners of how high performing candidates responded to particular stations and the errors that were made by candidates who did not perform as well in certain stations. Understanding the OSCE process and how they are marked will make a big difference to how you prepare as well as your performance.
Join a study group. In my opinion, this is ESSENTIAL. Forming a study group of 2-4 people and regularly getting together to practise and critique each other will make a big difference to your preparation. Unlike the written exam, you must now become proficient at verbally displaying your knowledge and this is difficult to practise on your own.
Be familiar with the OSCE examination format. You should be well versed in the essential components of the OSCE format including what is required during reading time and within the OSCE stations. Consider the role of the examiners, the interactions you will have with others participating in the OSCE, the time limitations and the various types of OSCE station. The ACEM document “About the Fellowship Clinical Examination” on the Fellowship Examination Resources page is essential reading.
Develop specific OSCE skills. Some of the keys to exam success are:
Using reading time effectively
Understanding how the domains guide your performance
Effective and efficient communication
Keep up your knowledge and learn it in a different way. The knowledge that you have gained whilst studying for the written exam will not be enough to pass this exam. This exam tests the application of that knowledge in a different way, as well as other skills such as communication. When you are revising, do so in a way that will be helpful for the OSCE. For every topic think of how you would run a resus, how you would explain that ECG and what the management of it would be, how you would explain that concept to a junior or how you would teach that procedure etc.
Predict what will be tested.
Core curriculum – common, important stuff not tested in the written.
Think of the challenging “wet your pants” moments in ED and have an approach to managing them.
Write a list of procedures from the ACEM Curriculum Framework, in order of importance. Start with those of which you are expected to have "expert" knowledge.
Practise, practise, practise. The more you practise, the better you will become and the more comfortable you will be on the day.
Practise your OSCE skills at work. When you receive an ECG/blood gas or other investigation from the nursing staff or junior medical staff, you could practise describing and interpreting it to your junior colleague. Ask a FACEM colleague to quiz you about your patients - practise clear and concise descriptions of assessment or management plans.
Meet and practise with your study group regularly. You should practise the same OSCE station multiple times to become competent.
Ask any FACEMs you know for practise sessions, especially any college examiners.
Are you ready to sit? Passing the written examination should not be considered as an indicator of your readiness to sit the OSCE, as the OSCE assesses a broader range of skills and knowledge. Seek objective feedback from your tutors based on their observation of your performance,in a range of trial OSCE stations, to determine if you are consistently reaching the ‘Above’ or ‘Well Above Standard’ in most OSCEs. Attempting the OSCE without evidence that you are meeting this standard is likely to result in disappointment. Experience has shown that being unsuccessful in the OSCE can have a significant impact for you personally and on your confidence in preparing for subsequent attempts.