Congratulations on making it this far through your MRCEM qualification and now you have just one more step to go. This article will outline the structure and content of the exam, how the exam will be marked and Remediums top tips to making sure you pass your MRCEM OSCE and accelerate your career in Emergency Medicine Career.
Structure and Content of the MRCEM Final Examinations
The MRCEM OSCE consists of an Objective Structure Clinical Examination of 18 stations and you will be at each station for seven minutes. You will be given an additional one minute of reading time in between each OSCE station to prepare yourself for that station.
Of the 18 stations, 16 of these stations will be patient encounters and the other 2 will be rest stations.
The MRCEM OSCE assesses the common competences and clinical competences required for the evaluation and immediate management of common clinical conditions seen in the Emergency Department in adults and children.
The full breadth of the major and acute presentations listed in the ACCS curriculum will be tested. Additional presentations in the higher training curriculum will not be tested in the examination. Competence in children’s emergencies is expected at a level delivered in a general Emergency Department and focuses mainly on the seriously ill and injured child, or the management of common childhood emergencies.
The difficulty that many doctors have is that the MRCEM OSCE does not only challenge your theoretical knowledge but also your communication skills and your resus skills. With this, preparation is always vital, this page will outline the best tips to pass your exam.
How will I be marked?
It is very important to understand what the examiners are looking for when it comes to the MRCEM OSCE. To get to this stage you are obviously very competent doctors but the OSCE is here to challenge your ability to think in a pressure situation and extract as much information as possible from a patient.
Quite simply the examiners want to see that you have left no stone unturned and that you have ruled out potentially life threatening diseases or scenarios and that you are managing the patient with great clinical competencies but also with compassion and care.
Here you can see that on a standard scenario the distribution of marks is massively weighted towards history taking. You need to make sure that you are taking as many notes as possible, below is an example to showcase how detailed you have to be when evaluating each scenario. It is always better to know too much than not enough.
This is why it is so important to use your 1 minute at the start of each station and think about what exactly you want to know about the patient and the build up to the patient’s incident.
Mr Parsons is a 76 – year – old retired bus driver. He fell over at home and called an ambulance. His only injury is to his left wrist. His wrist X -ray does not demonstrate a fracture. Take a history from him and then explain your management plan to him.
As you can see a lot of the marks from this scenario are all about reassuring the patient and making sure that you extract as much information from the patient as possible.
How do you prepare?
Failure to prepare is preparing to fail, so here is how we suggest you prepare.
Obviously, it is important to understand the full range of knowledge that you may need to know when it comes to the OSCE. The Royal College of Emergency Medicine encourages you to get to know the 2015 Curriculum as the examination will test the competencies of the first 3 years.
However, the best way to make sure that you are prepared for your MRCEM OSCE is to practice as many clinical scenarios as possible and make sure you are confident in delivering them to the examiners.
Below is a book with 125 clinical scenarios and the answers, however, more examples can be found online.
A good idea is to work with a friend or maybe a colleague who has passed his MRCEM. If you take in turns to be the examiner and the doctor then you can critique each other and see where you may need improvement.
Not everyone can practice with a friend so here are some other resources that you can take advantage of.
Stay posted on the Remedium facebook page for information about online courses.
https://www.facebook.com/groups/681598885271299 – MRCEM preparation courses
TOP TIPS for Exam Day
1) Be confident
2) Be friendly, keep your posture open
3) Make sure you utilize the time before the station to prepare your answers
4) Remember the importance of history taking when you answer
And good luck everyone with their exam.