MRCEM OSCE – revision, resources and courses

  • November 05, 2021
 

The MRCEM OSCE exam requires a considerable amount of revision and preparation....

And we are often asked by Emergency Medicine doctors where they should look for MRCEM OSCE resources, online revision materials, mock stations and preparation courses.

Here we compile the best advice, tips, courses and resources available for the Membership of the Royal College of Emergency Medicine (MRCEM) OSCE exam whilst also address some understandable concerns about the effect of COVID-19 on availability of test centres and upcoming exams.

What is the MRCEM OSCE?

The MRCEM OSCE consists of 18 stations (16 patient encounters & 2 rest stations), each one lasting for about 7 minutes. The MRCEM OSCE exam will not only test your theoretical knowledge, but also your resus skills and communication skills. Even candidates who are working in an emergency medicine department (ED or ER) often find these OSCEs difficult. Even if you have strong background knowledge in Emergency Medicine the exams can still be tricky due to a heavy reliance on testing your communication skills and etiquette. 

Preparation is therefore vital for all doctors who intend to take the MRCEM OSCE (part C) exam. This can be broken down into the following: 

  • Practical day-to-day work (colleague observations & feedback, peer groups, study groups) 
  • Online revision resources (subscriptions, reading materials, tutorials, videos)
  • Courses (face to face, online)

In general, emergency medicine course tutors advise setting aside at least 2-3 months preparation in addition to your Emergency Medicine experience.

How has the COVID-19 coronavirus afffected MRCEM exam centres & dates?

The Royal College of Emergency Medicine took the difficult decision to cancel all events for the months of April, May and June following the escalation of the virus. As the UK and most of the world remain in some form of lockdown, the Royal College has not announced when it is expecting to open up it's centres again. Understandably this will be tied into government advice and that of the WHO whilst most examiners involved in the OSCE examinations will be tied into urgent clinical duties.

IMG Connect is keeping a very close eye on the examination schedule and will keep all our IMGs informed as soon as the College publishes some updates. You can find the updated exam schedule here.

However, this does not mean you cannot use the time to prepare for your OSCE!

So how to get started?

The first step is to ensure you are familiar enough with the Royal College of Emergency Medicine Curriculum (2015), and to use this to create your study plan covering the whole curriculum, whilst also identifying areas of weakness to strengthen. 

Take a look through Mastering Emergency Medicine – a practical guide to re-enforce your solid background in Emergency Medicine knowledge before you start approaching the stations. Note that this book was first published in 2009, and some aspects may be slightly outdated. 

Familiarise yourself with the stations, techniques and format by watching online videos and tutorials - you can find both free and paid tutorials online. 

YouTube has many great videos available to get you started, covering basics of examination and OSCE guides through to mock OSCE scenarios: 

  1. Mcleods Examination videos (Basics of examination)
  2. OSCE guides - Geeky Medics  
  3. Bromley webinars and tutorials 

Watching these videos before you start your practice sessions (and then repeatedly throughout your study plan) will give you a huge boost. 

 

Resources for MRCEM OSCE

General advice is to use a variety of resources, including reading materials, online subscriptions to videos and tutorials, podcasts and videos. The following have helped IMGs on their journey to successful completion of the MRCEM OSCE: 

Practical work - peer groups and senior colleague observations

The best way to practice and solidify what you have learnt from your studies is to organise group sessions and observations at work.

Observations at work 

Ask senior colleagues to observe and offer feedback to you on a regular basis on the EM ward. Receiving quality feedback in a formal setting is widely regarded as fundamental to your advances in emergency medicine practice. 

Group sessions

When organising a peer group of Emergency Medicine OSCE aspirants, advice is to have a maximum of three/four persons per group. Three works very well because you can each play a role during role play sessions. 

When conducting role plays, you may want to organise yourselves as follows: 

  1. Patient (use instructions for the actor provided in the textbooks, remember each patient has a backstory and there are many aspects the actor must show, including emotion)
  2. Exam Candidate
  3. Examiner (takes notes, observes, marks the checklist and gives immediate and detailed feedback on all aspects of the marking sheet)

Remember to take turns and swap roles, work as the patient, exam candidate and the examiner. Stick to the exam format, for example set a time limit of about 7 minutes which will allow you to get a clear understanding of how to pace yourself and finish before 7 minutes. Remember not to be too fast, or too slow, helping you to make every second count.

Feedback is crucial to improving your practice. As you practice together, look at the checklists after you perform each station and find out if you are missing anything. 

When taking up the examiner role ensure to give detailed feedback covering all marking criteria (intro, examination, body language and winding up - the four key areas that can improve your score). Once the examiner has delivered their feedback, discuss as a group, considering how to improve in all aspects of the exam criteria. 

Build stamina

Once you have a routine in place for peer group practical OSCE simulations, build up towards completing a full set of stations. This should be done for each member of your group. The exam can be tiring, which can in turn affect your performance on the day of the exam. For example, if exhausted at the final stations, it can be hard to maintain your clear communication and positive body language, so a full run through will help you to understand what it will be like on the day and what you need to do to ensure that you are consistently performing. 

Record sessions

Try recording your group scenarios. IMGs who have done this repeatedly informed us that this was one of the single most important methods for seeing first-hand how to improve. We are after all our own worst critics! Take notes on the way you enter the room, move, talk, express yourself, your non-verbal cues, body language and interactions.

Take a course 

There are various workshops organised by expert course tutors in Emergency Medicine designed to help you pass. You can find these online and anecdotal evidence suggests that taking a face to face course improves your chances of passing the MRCEM OSCE exam. 

Speak to an IMG Consultant to check what courses might be suitable for you, if there is not a course where you live, it may be possible for us to organise one for you and your peers. 

Is a course necessary? 

Many overseas doctors preparing for their FRCEM or MRCEM Emergency Medicine examinations wonder if they should take a course as part of their preparation. In short, we advise that all IMGs should attend as many courses as possible. The knowledge gained on an MRCEM or FRCEM course goes well beyond the exam. 

One issue is of course that courses cost a considerable amount of money, but if you consider that taking a course increases your chances exponentially of passing the examinations first time, the cost is offset by not having to pay to re-sit and all the additional costs that come with it (i.e. flights & accommodation).

Finding courses can be tricky 

So take some time to work out what you specifically need help with and the stage you are at in the process. Search online to find the course that will suit your needs the most. 

Speak to your peers, some may have attended a course that they felt had a positive impact on the learning and preparation. 

Once you think you have found a course that suits your needs, such as an MRCEM OSCE course, check reviews posted by other IMGs to be sure of the quality of the tutoring. 

If you have found a course that suits your needs, has good reviews recommendations from your peers, then it will likely be worth the investment. As a direct result you will likely pass the exams much quicker, helping you to secure the Emergency Medicine job that you want in the NHS.

On the day of exam - tips from IMGs

Passing any exam is not easy, passing the Membership of the Royal College of Emergency Medicine (MRCEM) OSCE examination even more so. In speaking with IMGs about their journey through the MRCEM OSCE exams, we have heard many thoughts about what it takes to pass. To help IMGs preparing to take the test, here we share some tips from past examinees and OSCE course tutors. 

Firstly, it is good to know that every IMG taking the test is in the same position as you, perhaps anxious about how to prepare and worried about the exam day. We are told that the exam is just an ordinary day on the ward, so why then do so many excellent practicing EM physicians struggle to pass at first attempt?

It is perhaps important to say that the advice below is not just from not just those IMGs who passed first time, but from those who had to learn from their mistakes and take the test a second or even third time. 

The most common thing that we hear is that IMGs must adapt their skill set to the requirements of the NHS system as well as changing their mindset to be able to work under intense observation. 

Further reasons they struggle are: 

1. Anxiety

Experiencing anxiety during exams is completely natural and the fact that the OSCE stations are only 7 minutes adds to this in the Part C. The only way to combat exam anxiety is to accept that is both natural and inevitable. The best way to prepare and suppress the adrenergic surge is with practice, practice and more practice. The best way to practice is under exam conditions and if possible, this should be timed and observed by different examiners.

We are not of the opinion that this practice should be done last minute in the week before the exam, instead, your practice should start long before this point. Ask your senior colleagues in the ED to observe and comment upon your history taking and examination skills. If you can get into a routine of doing this with 3 to 5 patients per day you will be able to run through nearly all the most likely scenarios in only 12 shifts. Another great strategy is to teach OSCEs to the more junior doctors within the department. Teaching can be a powerful learning tool and has helped many aspirants with their revision.

2. Lack of practice

Make no mistake – the exam is very tough. Over 50% of candidates failed the 2016 sitting. Unless you are freakishly good at cramming you will need to set aside at least 3 months to prepare. IMGs will all study in different ways. Remember you have been through many exams all on your own. Whatever revision method works for you, stick to it. Once you know that you are going to study, make a revision plan and stick to it. 

Practice in any way that you can. As above, be sure to ask senior colleagues to observe and offer feedback to you on a regular basis on the EM ward. 

To practice out of work, form a small group of colleagues who are also taking the test and run through role plays, taking turns to be patient, doctor or examiner. 

Pay careful attention to time keeping as it is very common for candidates to run out of time, particularly in history taking and communication skills stations.

3. Lack of familiarisation with curriculum

If you don’t know what you could be tested on, you won’t know what to prepare. The MRCEM OSCE is mapped to the competences of Year 1-3 of the Emergency Medicine 2015 Curriculum which is available on the 2015 Curriculum page. You should familiarise yourself with the Year 1-3 competences in preparation for sitting this examination.  

4. Not being able to communicate effectively 

Many IMGs have made the mistake of thinking that communication is only about what you say, not considering how you say it, and what you look like when you are saying it. Of course, you may be anxious, which can make you behave differently and say things in a different way. So, if you have practiced as above, make sure you incorporate practicing communicating not just focusing on what you say, but also your body language when saying it. Remember that between 70% of our communication is non-verbal!

Try to speak audibly and clearly and if at all possible, sit at the same level as the patient with an open posture. Attempt to make a connection with the patient, maintain good eye contact and give them your undivided attention. Treat actors and mannequins as if they are real patients, interact with them in the same way that you would on the EM ward.

Be direct and to the point but deliver any bad news in a sensitive and empathetic manner. Always check whether the patient has understood what you have said and ask if they have any questions.

5. Reading and deciphering the instructions 

It is vitally important to read the instructions very carefully before entering a station. Easy marks are frequently lost by nervous or over-confident candidates that have overlooked key information or made assumptions by misreading. This is a mistake many IMGs have made, so learn from their mistakes and be sure to read everything carefully. Once read, make a plan of how you will approach the scenario. Once your minute is up… deep breath and smile! 

If you have any questions about how to prepare for the MRCEM OSCE exam, including advice on courses, resources, mock scenarios, online materials and revision books, then don’t hesitate to get in touch with an IMG Consultant.


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Don’t hesitate to get in touch using the buttons above (and below) to discuss emergency medicine doctor job options in the NHS, including discussions regarding a typical doctor salary in the UK and the most suitable hospital locations for you.

 

Relevant Jobs

A hospital in Yorkshire is looking for a Consultant in Emergency Medicine with an interest in trauma care and emergency medicine leadership. The Emergency Department comprises a team of consultants and is supported by a large team of middle-grade doctors. This Emergency Medicine job is open to both international applications and UK-based doctors, though those with European Specialist or FRCEM are most encouraged to apply.

Anyone requiring portfolio support (formally known as CESR) can have their required support discussed on a case-by-case basis.

JOB REQUIREMENTS AND DETAILS

Full GMC registration with a licence to practice and at least six months of obtaining a CCT in Emergency Medicine, CESR, or European Specialist Qualifications are required for this role, and anyone with an interest in trauma care and clinical leadership should apply. 

CORE DUTIES OF THIS ROLE

  • Provide high-quality emergency care to patients in the ED, including trauma cases.
  • Lead the clinical team and oversee the Emergency Physician in Charge (EPIC) role.
  • Engage in departmental audits and participate in clinical governance and quality improvement projects.
  • Provide clinical supervision and mentoring to junior doctors and trainees.

LIFE IN YORKSHIRE

The hospital is located in a picturesque region, with local towns offering both urban and rural living options. The area boasts excellent schools, transport links, and a wide range of leisure activities. Yorkshire has historical significance as a former center of the wool industry and offers rich industrial heritage alongside beautiful countryside.

HOW WILL IMG CONNECT SUPPORT YOU?

When applying with IMG Connect you’ll have the full support of an expert recruitment team who will be your recruitment and relocation partners throughout the process. We\'ll support you with:

  • CV Preparation with a bespoke session with one of our specialists
  • Application support with expert knowledge of NHS specialisms & recruitment practice
  • At least two video calling interview preparation sessions
  • Contract and offer negotiations for salary, relocation packages, tenure and more

Once you have accepted your new role, you’ll then be supported and led throughout by one of our dedicated relocation executives who will guide you through all the way to starting your new role including:

  • Document gathering and checking COS and Visa Application support if applicable
  • Support sourcing short- and long-term accommodation
  • Travel Arrangements Family support for finding schools and any other aspects of pastoral care.
110,257 - 164,372

An excellent health service is looking to appoint an Emergency Medicine Consultant. This is a great opportunity to further your medical career in the UK. This NHS job offers CESR Portfolio Pathway support, and international applications from IMGs are welcome.

The Emergency Department sees over 45,000 patients annually, with 25% of attendances being children. As a Trauma Unit and part of the Wessex Trauma Network, the department features a robust clinical governance process and an active audit program. This progressive department actively uses ultrasound in diagnostics and is developing a regional blocks program.

Health Service

Working for this health service is professionally rewarding, offering high-quality, patient-centered care. Their clinicians lead in developing and managing services, supported by strong links with UK specialists. With a generous study leave budget, doctors are encouraged to pursue further education. Exciting developments include a new general hospital and a new mental health inpatient unit. They foster strong relationships between mental health, primary, and secondary care, promoting joint learning and teaching in their modern education center.

The health service, separate from the NHS, is an integrated, taxation-funded system, free at the point of delivery, managed by the Health and Community Services Department. This is a unique opportunity to help shape an integrated care system with closer political engagement than in the UK.

Department & Team

The Emergency Department operates with dedicated consultant presence from 8 am to 10 pm Monday to Friday, and 10 am to 4 pm on weekends, supplemented by on-call service beyond these hours. A team of 24/7 middle-grade physicians supports the department, alongside a rotating roster of 15 junior doctors comprising F2s, GPVTS doctors, and Clinical Fellows.

Comprehensive specialty support is available on-site throughout the day and night, including medicine, anaesthetics, paediatrics, and obs & gynae, with senior orthopaedic and surgical specialists accessible both during regular hours and on-call. The department boasts continuous access to imaging services, including cross-sectional imaging, ensuring prompt diagnostics. Facilities include a 3-bedded resus area with a dedicated paediatric resuscitation cubicle, an 8-bedded Majors area with half of the beds in isolation, designated paediatric and minors examination rooms, and specialized facilities for eye examinations.

Continued Professional Development

The service job offers further training & accreditation within psychiatry, including CESR Portfolio Pathway Support, access to specialty training, and the opportunity to develop sub-specialist interest. The post holder will have ample opportunities to develop knowledge, skills, and experience through attendance at relevant courses, conferences, and locally organized CME events. Health & Community Services supports Continuing Medical Education with time and financial support, offering study leave of 30 days in 3 years, and an annual study leave allowance.

Life in the area

Living in the area presents significant financial benefits. The flat income tax rate is notably advantageous compared to the U.K., and they provide a generous public sector pension scheme that isn\'t constrained by U.K. lifetime or annual contribution limits. The Consultant Contract closely mirrors the U.K. model but offers higher incremental levels. Incremental progression is automatic from points 1 to 17 on the pay scale based on satisfactory performance, while formal applications are necessary for points 18 to 20.

Am I eligible for this role?

UK based candidates:
•    Experience in Emergency Medicine

EEA candidates: 
•    Experience in Stroke Medicine
•    European Specialist Qualification

Non-EEA candidates:
•    MRCP UK 
•    Experience in Stroke Medicine
 

52,530 - 82,400

An excellent opportunity has arisen for Specialty Doctors in Emergency Medicine to join an NHS Foundation Trust that is dynamic and dedicated to providing great service to their patients. The site that is ideally located near stunning blue flag beaches. The Emergency Medicine team boasts extensive experience and expertise in supporting doctors through the CESR programme. The current CESR programme includes a customized professional development plan tailored to meet the individual needs of each doctor, with available placements in Critical Care, Anaesthetics, Acute Medicine, and Paediatrics. 

This is a unique opportunity for Specialty Doctors seeking to advance their careers within the NHS in the UK. Successful candidates will have the option to participate in this CESR support programme, further enhancing their professional growth. Don\'t miss this chance to explore NHS jobs that offer both career progression and an excellent quality of life. Overseas applications from experienced Specialty Doctors and Consultants are welcomed. 

What is the NHS Foundation Trust like?

The NHS Foundation Trust is a district general hospital trust managing three hospitals. The Trust serves the different towns, delivering a broad range of medical services. They are performing at a good level across their services and continuously provides huge opportunities and benefits to the way they deliver patient care. The Trust focuses on delivering excellent general hospital services, serving a population of approximately 750,000 with the help of more than 9,000 staff members. The hospitals have around 1,100 beds in total, offering services including General Medicine, General Surgery, Neurology, Rheumatology, Gastroenterology, Dermatology, Gynaecology, and Paediatrics.

The Trust achieved foundation status in 2005 and, in October 2020, merged two of its hospitals to create a new organization, establishing one of their hospitals as the emergency care site and another as the planned care site. The Trust remains dedicated to continuous improvement, striving to provide high-quality, patient-centered care across all its facilities.

What is the department & team like?

The Emergency Medicine Department is a highly advanced and well-equipped unit, dedicated to providing emergency care. The department is staffed with a robust team of consultants and junior doctors, ensuring round-the-clock expertise and comprehensive patient care. The team is proficient in managing a diverse range of emergency cases, including trauma, cardiac emergencies, respiratory issues, and other urgent medical conditions. With access to advanced diagnostic tools and treatment facilities, they provide immediate and effective care for all patients.

The facilities within the department include modern resuscitation bays, dedicated observation units, and specialized treatment areas for both adults and children. These state-of-the-art resources enable them to handle high patient volumes efficiently and effectively. On average, the Emergency Medicine Department manages a significant number of emergency cases each year, reflecting its critical role in the region\'s healthcare system. Their commitment to delivering high-quality, patient-centered care is unwavering, supported by their experienced team and cutting-edge facilities.

Career Development & Opportunities Available

With an extremely active education/teaching programme supported by the consultant team, there is opportunity to work towards and complete CESR, get involved in active research and many aspects of CPD. Participation in research and educational activities will be encouraged.

  • Attractive salary and relocation package
  • Training and development opportunities
  • CESR support for those eligible
  • Tier 2 Health and Care Visa (sponsorship for the whole family)
  • Guidance regarding the CV and full interview preparation
  • Assistance regarding the GMC registration, visa, accommodation and transportation by an experienced onboarding specialist
  • Complete IMG Relocation service from start to finish of process
Life in the area

Nestled along England\'s picturesque south coast, the area offers a unique blend of urban amenities and coastal charm. Doctors enjoy proximity to both bustling city life and tranquil seaside retreats. Residents indulge in sailing adventures around harbour or stroll along its sandy beaches. The area boasts reputable schools and universities, nurturing young minds for future success. Transportation links are robust, with easy access to neighboring cities like Bournemouth and Southampton, as well as major airports. Housing options range from waterfront apartments to quaint cottages, catering to varied tastes and lifestyles. Poole epitomizes the quintessential coastal living experience.

Am I eligible for this role?

UK based candidates:

  • Experience in Emergency Medicine
EEA candidates: 
  • Experience in Emergency Medicine
  • MRCP
Non-EEA candidates:
  • MRCP
  • Experience in Emergency Medicine
88,364 - 119,133

An outstanding opportunity for experienced Consultant in Emergency Medicine to join an NHS Trust that is committed to providing the best quality care to the people of East Sussex by attracting and recruiting passionate people who share this commitment. This Trust is one of the largest employers in the region and their members and staff are dedicated professionals whose work is varied, challenging and makes a real difference to people’s health and well-being.

The post is suitable for candidates holding specialisation in the EEA, or for experienced IMGs looking to complete CESR.

WHAT IS THE NHS TRUST LIKE? 

The Trust is one of the largest organisations in the country and they employ over 6,000 dedicated staff with an annual turnover of £380 million who provides service to 525,000 people that live within the area. Their services are mainly provided from two district general hospitals, both have Emergency Departments and provide care 24 hours a day. They offer a comprehensive range of surgical, medical and maternity services supported by a full range of diagnostic and therapy services.

The role of the NHS Trust is to provide the best possible healthcare service to patients, who come first in everything the organisation does. Safe patient care is the Trust's highest priority. They will provide high quality clinical services that achieve and demonstrate optimum clinical outcomes and provide an excellent care experience for patients. The employees will be valued and respected. They will be involved in decisions about the services they provide and offered the training and development that they need to fulfill their roles.

They will operate efficiently and effectively, diagnosing and treating patients in timely fashion and expediting their return to health. They will use their resources efficiently and effectively for the benefit of their patients and their care to ensure our services are clinically, operationally, and financially sustainable.


WHAT IS THE DEPARTMENT & TEAM LIKE? 

The Emergency Department is a team of consultant that focuses on being on top of taking care of their patients. The department is open for hours a day, seven days a week for those seeking treatment for an urgent problem that may be caused by an accident or an illness. In the last year, there were 130,000 visits in their department. 

Urgent Treatment Centres are being in developed nationally with the aim to provide same day ‘urgent treatment’ operating in a fully integrated way with the local community. The department has a vision is to provide an urgent care stream from the front door of the Emergency Department and develop innovative interoperable ways to ensure that the patients receive the right care at the right time and in the right place. 

WHAT IS LIFE LIKE IN THE REGION?

The region has a natural beauty. Sussex has some fantastic natural features such as the Seven Sisters National Park, and many areas of outstanding natural beauty that include the medieval heathland and forests of the High Weald. It also has beaches and harbours where people can go to during their dayoffs.

Besides its natural beauty, there's a rich array of accommodation options, ranging from the five star Grand Hotel on Eastbourne seafront to quaint B&Bs set amid beautiful Sussex countryside. East Sussex offers a rich array of culture, with art galleries such as the Jerwood Gallery in Hastings and the Towner Gallery in Eastbourne and an array of theatre and entertainment venues such as the De La Warr Pavillion in Bexhill, Congress and Deveonshire Park Theatres in Eastbourne and the White Rock Theatre in Hastings.

WHAT OPPORTUNITIES ARE AVAILABLE TO YOU?

The combination of clinical practice and first-class academic connections means that medical professionals have a wide range of opportunities to develop their careers and achieve their aspirations. You will have access to leadership, teaching, educational and research opportunities for Continued Professional Develop (CPD).

If you are a new consultant you will receive mentoring and support from medical leads as well as access to a large peer group of enthusiastic and high-caliber Consultants.

ARE YOU ELIGIBLE FOR THIS ROLE?

EEA Candidates:

  • Experience of working in Emergency Medicine
  • European Specialist Qualification in Emergency Medicine

Non-EEA Candidates:

  • FRCEM
  • Experience of working in Emergency Medicine

UK based applicants

  • Experience of working in Emergency Medicine
  • Within 6 - 12 months of completing CCT
88,364 - 119,133

A fantastic opportunity for specialist in geriatric or elderly care medicine to settle into their first consultant post and work towards their CESR application, if that is the intention.

The hospital will consider senior consultants with no UK experience who are not on the UK specialist register for geriatric medicine.

The Geriatrics department is a small and manageable size with a 28 bedded inpatient ward and various other outlier beds.

Currently no formal geriatric outpatient services are offered with the exception of a Parkinson's / Movement clinic. The department will be looking to develop these in conjunction with skill set of a successful applicant.

The Geriatrics department comprises 3 consultants in elderly care medicine supported by 15 specialty registrars, 9 core medical trainees and FY2's and 9 FY1's working full shifts for GIM on call.

Each consultant will be offered a budget and 30 days of study and professional leave over each 3  year period to pursue their career development activities. Furthermore there is an active Postgraduate Medical Centre which acts as a focus for contract between doctors at all levels an in all disciplines.

Consultants will be encouraged to actively participate in teaching and training of juniors throughout their tenure.

Requirements of this position are:

  • MRCP 
  • IELTS or OET
  • Experience working at consultant grade in elderly care

Senior geriatric medicine specialists looking to work towards their CESR application or secure their first consultant role in the NHS are encouraged to apply

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