HOT TIPS



  

Hot Tips by Dr Miles Meyrick


The way to pass the OSCE  is to be absolutely safe.  Competency comes a very close second.  After all, you are going to be allowed to practice completely unsupervised, anywhere in Australia, across the entire spectrum of the 5 domains of General Practice.

Domain 1 – Communication skills and the patient-doctor relationship (eg. communication skills, 
patient centredness, health promotion, whole person care) 

Domain 2 – Applied professional knowledge and skills (eg. physical examination and procedural 
skills, medical conditions, decision making) 

Domain 3 – Population health and the context of general practice (eg. epidemiology, public 
health, prevention, family influence on health, resources)

Domain 4 – Professional and ethical role (eg. duty of care, standards, self appraisal, teacher 
role, research, self care, networks)

Domain 5 – Organisational and legal dimensions (eg. information technology, records, 
reporting, confidentiality, practice management). 

The examiners score sheet will have these domains as headings:

These headings are weighted according to their importance in that particular case.  Your safety and competency is reflected, as in the real job, in your ability to identify what part of the patient's presentation is important and what's not - always have these domains in the forefront of your mind. Keep to the point and on track for the task in hand - make sure you don't waste time giving the examiners what they can't give you marks for.  If you go off track the examiner will give you a cue - listen for it and take it.

I don't mean to sound patronising, but I think it worth remembering that the specialty of General Practice is an enormous and privileged responsibility, if you haven't figured that out yet.  Just because you have turned up for all the training and speak perfect Australian, doesn't mean you will sail through this part of the exam!!  

Read and re read the case outside the room - If it asks for management, give them that - no points at all are awarded for a really thorough history if it's not required - None!!!

It's all about communication, communication and communication, even down to the non verbal type - there's a box on the examiner's sheet for that too!!  You need to 'rehearse your lines', the way you say things, the way you do things - let the examiner know this is second nature to you.

It's not just your knowledge either that you are being tested on here remember.  You've done a lot of that already in your AKTs and KFPs.  It's what sort of a doctor you are - your skills of building rapport in just a few minutes, your ability to apply your skills, the establishment of trust with someone you have never met before, your ability to filter information correctly and accurately, time management, correct use of the MBS, state and territory laws - it's the stuff you don't get taught at medical school or grand rounds or on a Wednesday afternoon at your training consortium; you may need to draw on your own life experiences including the morbidities of friends, family and loved ones.  Use it all where appropriate - that's what being a good GP is all about.

Don't forget the importance of a good focused history if asked for.  Empathy and compassion are required - but you are first and foremost a doctor and not a counsellor; you have allied health providers for that.

Make sure your examinations are a pleasure to watch, systematic and focused as the case demands; be slick and have your musculoskeletal examinations as good as a sport's physician, it's not rocket science.

Management is just that - keep it simple - do nothing [unlikely in an OSCE], watchful waiting, be conservative, investigate further, refer - whatever the case requires -  cover the options that the case demands in the time available.  Safety net and get the patient back if you need to.

Have all your emergency algorithms at your finger tips - there is absolutely no excuse for getting these wrong in an OSCE or for in real life!

Stay in role at all times, whatever happens, [except when asking the examiner for details].

Treat the OSCE just like a normal day at work, but with no one to ask if you get stuck!!  If you don't know the answer, don't be afraid to tell the patient/VIVA examiner you don't - I know that sounds strange for an exam, but General Practice is an endless specialty and you can't be expected to know everything - and we don't; it's far safer to make a phone call or ask a specialist than guess, give false reassurance/hope or give incorrect advice.  

If you finish early tell the examiner, but remember you cant come back in if you leave.  If you think you might have failed that last OSCE, don't dwell on it - move on to the next - the stations are all equally scored.

As a long distance runner my philosophy was this:

The OSCE is your first marathon - all the years of training has led up to this moment - visualise the day so nothing is unexpected - you know you can do it, so do it and try to relax and enjoy it - you have put in the hard yards and should pull out a personal best - the weather and conditions are perfect - the day is set up for you to shine - don't just aim to pass -  aim for excellence, be the very best you can be.

If you are not up to this, then you're not ready yet and need to do some more training.

Good luck.
Dr Miles W Meyrick
BSc (Hons) MB BS (London)  FRACGP (College Medal Winner 2009) AMC CERT
Grange Road Medical Services


Hot Tips by Dr Raquel Galman


Relax!

This is the most important thing to do while doing the RACGP OSCE exams.  If you are relaxed, then you can think more properly and deliver what is asked of you.

Practise, practise, practise!- Another important thing to do.

Even if you know a lot, if you don't practise on how to deliver it, then you can end up failing.  Remember, this is an oral exam and you need to practise on how to say things.  You need to use simple words that your patient will be able to understand unless it is a VIVA case wherein you can use medical terms because you are talking to the examiner directly.  Make sure that you tackle all the required tasks.  Example, if your task is to do physical examination only, then you don't need to do history taking.  If your task is to explain how you will manage this case and they are not asking you to do history and physical examination, then don't do history and physical examination.  Just go straight to management.  Therefore, you need to have a clear head to be able to concentrate on the tasks required.  If the task is multiple, time management is very important.  Make sure to tackle all tasks to earn points.  Don't dwell too much on one task not realizing that you don't have time to do other tasks anymore.  Remember, examiners have checklists that they need to tick for you to pass.  Therefore, you need to deliver a lot to be able to get a lot of ticks in the checklist.

Good luck!


Hot Tips by Dr Tricia Qld


1 Treat every patient every day in the way as if you are doing OSCE.

(a) Once open the patient's file, use 3 min to check PMHx, meds, details of last visit, new investigation results, smoking, alcohol, FHX  .....then have a guess, the reason or your task for this visit? (you might be wrong, very interesting!).
(b) Once patients in the room, build rapport, find out your task and patients' expectation.
(c) G
ood communication very important, patients will help you if you listen carefully.
(d) Be aware of patient's safety, red flags, suicidal ideation etc ....
(e) Time management, try to finish in time.
(f) Always do health promotion.
(g) Use your supervisors, run at least a case daily with your supervisors even you are happy with every case you managed, their experience is invaluable.

2. Treat your OSCE as a normal day at work and have fun, the "patients' are good patients, your task are easier than normal day of work. You just need to find out their expectation and show them you can meet their expectation in time.

3. Knowledge and clinic experience are the base, of course.
4. Manage your stress and have a life during the preparation time .



Hot Tips by Dr Fredrick Qld


These are my hot tips:
(1) Go through Murtagh at least twice before the exams.
(2) Go through the previous 5 years CHECK.
(3) If possible participate in the pre-exam courses in Brisbane.
(4) If possible form a study group.
(5) Put into practice what you study at home as it helps you not to forget.
(6) Go through past examinations questions that have explained answers.
(7) Participate in the mock online exams published by the RACGP 1 month before each exam series.


Hot Tips by Dr Philips Qld


Start studying at least six months before exams as there is a lot to cover.
  • Form a study group with like minded people.
  • For the written exam consider working through the RACGP “Check” programs.
  • Ask past candidates if they have any old exams / study material.
  • Attend the RACGP practice clinical exam (well worth it).
  • Use Susan Wearne’s “Clinical cases for general practice exams” to practice clinical cases with your study group.
  • Make sure you time your practice cases. Even try running a few together – it can be exhausting but is what the exam is like.
  • Practice specific systems examination when seeing real patients – try to stick to the exam time limit.
  • In the exam if a station goes poorly, make sure you “shake it off” and don’t let it affect the next station. One bad station will not fail you.


Hot Tips by Dr Lincoln Vu Melbourne


There were 2 long cases and 12 short cases.

Essentially all stations are presented with a health summary sheet and a page of instructions which will all include taking a history, examination, presenting a problem list and/or differential diagnoses, requesting relevant investigations, formulating a management plan.

Essentially every station you will have to go through all these processes. Majority of stations the examination findings are given to you on a sheet of paper when asked. There were 2 stations I encountered where you had to perform the examination yourself and this clue would be given on the instruction sheet.

Joint examination station station example:
Health summary of middle aged man given. Instructions would say to take a history from patient, demonstrate appropriate examination if applicable, when you are finished tell the examiner your differential diagnosis and ask for any relevant investigations. Formulate a management plan for the patient.

Reading the instructions will allow you to plan and allocate time for appropriate phases of the consultation. When practicing OSCE, it should be noted that it does take you a couple of minutes to read and digest the examination findings and interpret investigation reports so aim to wrap everything up in 6 minutes otherwise you will lose points for running out of time and not being able to discuss management and follow-up.