By Rashid Elhawli

Ask any medical student about exams and two things should pop up; written exams and OSCEs. Most are familiar with the drill behind written exams, but less are aware of the awkward OSCE experience.

OSCE is short for Objective Structured Clinical Examination, which is a fancy way of saying that you are simulating a real-life doctor-patient encounter. The first official experience with this kind of examination was at the end of our first semester, when we had a practice run. The day was set-out so that it would be as similar as possible to the real thing.

Divided into groups and waiting to be escorted out to our respective stations, I realised that in our group, I was the first guinea pig. An overactive nervous system kicked in right about now, with knots in my stomach, profuse sweating being under those bright lights and not to mention the coffee I’d had just 10 minutes ago beating my heart almost out of my chest!

The time had come, the bell rang and reading of the instructions began. Two minutes were allocated to reading the scenario, figuring out what we had to do and calming my nerves. It’s hard to imagine why the experience would be so nerve wracking, but a consensus of medical students agree that OSCE proceedings at first, can be very strange.

The OSCE’s can be described as scenes of a film that in the end will constitute your medical training. Each station is a different scene from the film that you yourself put together, in no particular order. After that slight digression, let’s head back to sweaty old me.

The second bell rings and with it, comes the moment of truth. Time to go in and execute my well thought out plan. Swing the door open to see my classmates sitting there with the assessor all waiting for the theatre to begin. So off I go, trying to work out what vital signs are so I can explain them to this acting patient and then remembering how to take them.

In terms of actual performance, my feedback was better than expected. However, there was one interesting thing that I didn’t mention and that was concerning the simulator patient. He happened to be a healthy older gentleman, who when I took his blood pressure it was much higher than normal with a weird feeling pulse. During the exam, I didn’t say anything because these guys are meant to be actors, such is the well known mantra of ‘normal presentation’.

I went quiet when he asked me during the exam, but afterwards I explained to the assessor that something is not quite right. So after all was said and done, I get a tap on the shoulder from the assessor telling me to speak to her in private. My peers tried to make it into a football match, leading on that I was in trouble but I had a hunch it might have been related to the OSCE earlier in the day.

After moving away from the crowd, she confirmed my suspicions and told me that indeed he was feeling unwell that day. His blood pressure had been abnormally high and his pulse could not be confined to a ‘normal presentation’. I regained my sanity after being reaffirmed about the patient and in retrospect, that was quite an OSCE debut.

‘OSCE Debut’ was originally published on Rashid’s personal blog.