Passing the MRCEM OSCE – tips from IMGs
- November 05, 2021
Passing any exam is not easy, passing the 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 we felt it was important to give advice 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.
In this article we take a broad look at some of the main reasons that good candidates have cited as contributing to their failure to pass.
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.
IMGs have told us that the main reasons they struggle are:
- Nerves
- Lack of practice
- Lack of familiarisation with the test
- Lack of understanding of the curriculum
- Not being able to communicate effectively
- Reading and deciphering the instructions
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.
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.
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.
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 differently. 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.
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!
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Relevant Jobs
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
An excellent opportunity for a consultant in emergency medicine to join a large integrated care provider in North East England. The trust is high performing with a strong track record of supporting new appointees with career development.
Applications are welcomed from international candidates.
Trust overview:
The Trust is based on two acute sites with most acute medical services and specialties duplicated on each site.
The new appointee could be based at either site, preferences will be accommodated.
Service overview:
The Urgent and Emergency Care team encompasses five Urgent Treatment Centres, two Acute Medical Units including Same Day Emergency Care services and two Emergency Departments (ED).
With over 129000 ED attendances every year, the Trust is one of the largest services in the North East.
Local area:
You can be in the countryside in less than ten minutes from all major towns and cities in the area, with some of the most stunning scenery and outdoor space in the country.
There is a strong sporting and cultural heritage in the north east, so no matter what your interests are, there is something here for you to explore. For families, you will have access to fantastic school and academic institutions as well as very affordable properties.
The region is also known to be friendly, relaxed and welcoming.
Requirements for the post:
UK based applicants:
- Hold CCT, or within 6 months of completing CESR
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- MRCEM
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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
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- 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
Overseas doctors with aspirations to work as NHS Consultants in Emergency Medicine (A&E) - doctors aspiring via the CESR route and particularly urged to apply. Doctors keen to enter Specialty Training at ST4 grade or those wishing to make direct CESR applications are welcome.
Total salaries offered a much higher than other hospitals based in the UK due to a total of 13 sessions available in ED.
These are flexible Specialty Doctor & Senior Clinical Fellow posts within in a busy and supportive Emergency Department in one of the more beautiful parts of the UK, but located within 30 minutes to the second largest city in Wales, Swansea.
The hospital is a District General Hospital with roughly 350 inpatient beds with a full set of ED equipment and facilities.
The hospitals facilities and equipment in the ED consist of resuscitation bays, X-ray, plaster rooms and treatment rooms giving immediate access to primary medical and surgical assessment treatment and care.
The Health Board serves a population of 389,000 and is leading the way for established CESR support and training for international doctors.
An established and successful CESR programme offered for MRCEM qualified doctors in Emergency Medicine.
Contrary to some popular myths - understanding of the Welsh language is not required to work in Wales and everyone speaks English as a first language!
Requirements to join are:
- MRCEM
- IELTS or OET (exemptions can be given)
- At least four years experience in Emergency Medicine
The Health Board offers support for both Tier 2 visa and is particularly welcoming of international candidates.
If you ar looking to start your career in the NHS and attain Specialist Registration and a Substantive Emergency Medicine Consultant positions - these really are fantastic opportunities.