That Time of Year Again

The bluebells are out and with them come the OSCEs.

An Objective Structured Clinical Examination, known as an OSCE, pronounced Oskey, is an exam for medical students, or other healthcare students.

They travel round a series of little rooms doing a different task in each: things such as testing a patient's reflexes or taking a medical history of their problem.

Each "station" is usually either six minutes or twelve minutes, depending upon the length and complexity of the task.

At this time of year I, and other simulated patients, work in OSCEs in different parts of the country for the different year groups' exams.

Student doctors train for five years and today I was working on an exam for 5th year students - so it's their final exam before they qualify as doctors.

There's a lot riding on this exam, as you can imagine. Some students from the second year had come along to help, with the cunning plan of also finding out how OSCEs work, because they haven't had one yet.

I knew some of them and they were marvelling to me at the level of nerves involved. "It's making me terrified just looking at the candidates," said one. I comforted them by pointing out that, at fifth year level, the students are of course particularly nervous - - but also that most of them pass.

In some "stations" the students are really rushed but in mine they weren't - good candidates could complete it in less than the allotted time.

As the Simulated Patient, I would then just keep quiet and stare at the floor - it's really important to stay neutral, in role, and not to be drawn into any conversation or you can find yourself faced with a student saying "How did I do?"

But there is also an examiner in each room: and the examiner, once he'd made it clear that he had finished examining, often asked them how they were finding the exam. The students mostly said something like "Really scary" or "You just can't tell how you're doing" or "If you think you've messed up one station you just have to move on quickly and put it out of your head, don't you?"

One, however, went into a little monologue which I found very entertaining.

"Well, this is my third station in this OSCE and I'm from Liverpool. Usually I don't have a strong Liverpool accent but when I'm nervous I talk more loudly and much faster and more Scouse. So if you talk to the examiner from the first station he'll remember me as a Liverpudlian maniac who seemed to be trying to break the British speed-talking record whilst shouting all the time in a thick Scouse accent.

Then if you talk to the examiner from the second station she'll think I was far too loud and too fast and too Scouse but she probably won't think I'm actually insane.

Now then, by the time I've got to you I've calmed down a bit and you'll think I'm just a bit manic but I hope I've done well enough to pass.

And by the time I get to the eighth station which is the last one for this OSCE, I hope I'll be beginning to sound like a junior doctor and I hope they'll pass me so I can become one. - - Ohhh, there's the bell for the next station."

And off he hurtled to shake his clammy hand with the next Simulated Patient.

I love my work.