Preparing for the Exam
Read ALL the information on the ACEM website (Fellowship Exam Resources page) relating to the OSCE. Ensure you are familiar with all college requirements and processes, the ACEM Curriculum Framework and especially the OSCE Domain Criteria. Watch all 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 reports also provide 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 and your performance.
Commit to an exam and work towards that. You will only have 4 chances to pass the exam and then you are out of the training program. Give yourself the best chance to do this exam only once. Attend all organised sessions of the OSCE course so you do not miss out on practise in any one OSCE type. We recommend that when preparing for this exam, you should ideally be working in one of the three Emergency Departments, as this is the best way of ensuring you are in the right head space. It allows you to practice your OSCE skills every time you come to work.
Join a study group. 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. You will cover lots of OSCEs in this way and learn a lot from each other. 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.
Aim to develop your skills in the OSCE format. This is what we mean when we say exam success is partly “learning to play the game”. Practise the skills you will need during reading time, such as comprehension, picking out the key points, being familiar with the ACEM Curriculum Domains and determining the first action you will need to take on entering the station. Synthesising all the information contained in the OSCE stem (e.g. clinical context, the tasks and the domains assessed) is needed to allow you to plan and anticipate your approach during each station. Be prepared for additional information that is given and/or unexpected issues that arise during the OSCE which will also need to be addressed within the time frame. These skills need to be practised over many and varied OSCE stations.
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 each day at work. Get a FACEM to critique you whilst you run a resus, take a history or examine a patient. Practise your teaching skills whenever a resident presents to you. When you receive an ECG/blood gas or other investigation from the nursing staff or junior medical staff, you should practise describing and interpreting it to your junior colleague. You should use every patient interaction to practice your communication skills.
Meet and practise with your study group regularly. You should practise the same OSCE station multiple times to become competent.
Our weekly OSCE course sessions are only one part of your preparation. You will need to do additional practice with other FACEMs, ideally with the many college examiners we have at Monash Health. It will be your responsibility to arrange time with these SMS – most of us will gladly make time for you, but the organisation is up to you. As a start, the SMS on this list are usually happy to help.
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.