Following each of its fellowship exams after results are released, the Royal Australian College of General Practitioners (RACGP) releases a report outlining the exam psychometrics (e.g., mean and standard deviation of the candidate cohort) as well as providing feedback to candidates regarding common errors made. But what has this got to do with your exam preparation, I hear you ask? Hasn’t the OSCE changed this year?
Even though the Remote Clinical exam (RCE) has changed (not only by name), understanding exam requirements and common mistakes made in the past gives you the opportunity to learn from others’ mistakes and avoid making the same ones yourself, for exam success.
According to the RACGP, the top 4 mistakes made in the last OSCE Fellowship exam as documented in the Exam 2019.2 report were:
1. Candidates did not practice.
RACGP’s feedback in relation to the last OSCE was basically if you want to pass, you need to practice! This will be no different for the coming Remote Clinical exam (RCE). Ideal practice is being observed and then being provided with feedback on your performance. Physically role-playing and answering potential RCE-type questions makes it easier to translate and perfect your practice performances into the exam situation. Paraphrasing the RACGP’s OSCE report, practice exams can give an indication of whether a candidate is likely to pass or not, and they highly recommend attendance at exam preparation workshops and completion of practice exams.
2. Candidates didn’t read the instructions properly.
Similarly, as in past OSCE exam stations, RCE stations will likely have individualised rating criteria that will correspond to the tasks outlined in the candidate instructions. Examiners will rate candidates on specific competencies. It is easy when stressed or anxious to skim read and/or make assumptions about what is required in a station. However, feedback from past OSCE examiners to candidates was to read the instructions carefully and understand the tasks in each case. The importance of reading carefully what is required in each station cannot be emphasised enough.
3. Candidates underperformed in key general practice competencies.
In last year’s OSCE, the RACGP reported that a number of candidates underperformed in key general practice competencies, such as those of history-taking and management. This is important to consider in this year’s RCE as well. Underperformance in key competencies can lead to errors in the selection of initial investigations as well as formulation of provisional and differential diagnoses, likely resulting in sub-optimal rating for that station. Remember, these competencies assist you to piece together a puzzle that you are trying to decipher. The questions you ask in your history-taking can lead you down the wrong path if you don’t carefully consider what you are asking and why.
4. Candidates didn’t exhibit a ‘whole-of-patient’ approach.
Although the tasks within each case will likely be specific for each station, candidates will be expected to exhibit a ‘whole-of-patient’ approach by demonstrating core general practice skills, as found in the RACGP’s Curriculum for Australian General Practice. Familiarisation with the curriculum as well as the Domains of General Practice, will help you understand this ‘whole-of-patient’ approach and how to demonstrate it to the examiners. This is key in optimising your marks at each station.
The RCE, like the OSCE previously, is designed to assess how a candidate integrates their applied knowledge and clinical reasoning, when presented with a range of clinical scenarios, through demonstration of their clinical and communication skills, and professional attitudes. Hence its important, if you want to avoid repeating the errors of those that have gone before you, be clear of the exam expectations, what they are examining, and practice, practice, practice! Hence, the use of practice exams, such as ModMed Institute’s Dr OSCE therefore comes “highly recommended”. If you would like more intensive training in the RCE technique with one-on-one coaching, consider enrolling in Dr OSCE Plus or Premium. So, to boost your marks or to get a higher pass rate that before, learn from other’s mistakes and follow these four tips.
- The Royal Australian College of General Practitioners. RACGP Education: Exam report 2019.2
- OSCE. East Melbourne, Vic: RACGP, 2019.