1.

Pneumothorax, PE
2. Asthma, pneumonia
3. COPD, interstitial lung disease (fibrotic), sarcoidosis, bronchiectasis
4. Congestive heart failure, endocarditis, aortic regurgitation, aortic stenosis, cardiac synope
5. MI, aortic dissection
6. Lung cancer, metastases, epithelium mesothelioma
7. Sinus arrhythmia, atrial fibrillation, stroke, coagulation/bleeding
8. AKI, sepsis/shock, gastric ulcer
9. Biliary colic, gallstones, acute pancreatitis10. acute pancreatitis secondary to alcohol,
GORD, adenocarcinoma, perforated PUD, peptic ulcer
11. Appendicitis, IBS
12. Obesity, Cushings, addisons, small cell lung cancer, membranous nephropathy
13. Diverticulitis, colon cancer
14. IBD, perianal abcess, diabetes, haemorrhoids, anal fissure

Write patient assessment summary based on this information ‘ ‘

Using this as a structural guideline-

“one sentence describing how old the patient is and what is wrong with them”
“What is diagnosis and what re key differentials considered”

[11:51, 21/03/2024] +44 7468 480918: Data interpretation :

- Quesmed: have a section of data interpretation questions.
- TCDs: from my TCDs I collected all the ECGs & CXRs, etc from cases & put them all in 1 file /
toggle out of context with captions of the answer to each. Then I test myself on them for
revision.
- Examiners Questions: the examiner may as you to say a summary of your findings from the
data, your differentials, & further investigations that you want to do. After this they may
present more data e.g. you just analysed a chest x-ray then they later show you the blood
results, then ask you again for differentials.
- acronym: Learn core acronyms for each condition e.g. HASBLED, CURB65, CRUSADE,
GRACE, Wells, glasgow-blatchford etc.
- books: in the osce books that I have mentioned they have data interpretation advice for
each type of data, which is very helpful.
- Speak OUT LOUD: as you are going through it & then they will ask additionally to
summarise what your interpretation is
- Script: have a script ready for how you will present your findings e.g. 1. Say patient name,
age, ID No, 2. go through your findings/the acronyms e.g RICE & DRSABCDE for CXRs or rate,
rhythm, P waves etc of ECGs,, and 3. differentials. I can write a script for you guy if you want
- combination stations: They like to combine data interpretation with any other station.
- data interpretation + history / explanation: If a patient is there you should introduce
yourself to the patient first, & ask them why they have come in today (e.g. most likely they
will say they have come for some results) and then say politely e.g. 'I have your notes here,
please may I have a read of them first before we discuss xyz?'
- data + examination: sometimes they might tell you to examine first then look at the data. It
is easy to forget to look at the data if you have 2 tasks, so its up to you to remember.
- station brief: midway through the station, read the station brief again (it is written inside
the room), to check if you have missed anything e.g. BNF, data interpretation, state
investigations etc. You could even pick up the brief & keep it next to you with your clipboard
so you can glance at it when you are stuck
- differentials & investigations: if you realised you said the wrong test or investigation, it is
absolutely okay to say to the examiner ‘I’m sorry but please may I change x to z‘
- types of data: Onemed Info says you could be tested on "blood, urine, microbiology, ECGs,
ABGS, radiological images" & that there will be 2 sets
- acute: Don't ever forget to say you will do ABCDE if there is an acute data interpretation
station For your investigations. dont forget your classic investigations & management e.g.
Fever = sepsis 6 etc
- investigations: They want scoring systems, tests & investigations etc. (beside test, bloods,
imaging, special tests) - you are unlikely to be asked for the management of a condition such
as drug treatment etc as this is more year 4.
[11:51, 21/03/2024] +44 7468 480918: BOOKS: I always use:
1. OSCE cases with mark schemes (Schelmerdine)
2. OSCEs for PLAB and medical students (Pip Fisher)
3. The OSCE revision guide for medical students (OSCE STOP)

Patient assessments:
- presentations: Write a list of all the different presentations for each speciality & a list
differentials & investigations for each (E.g. chest pain). As soon as you have seen the brief
outside the station, you already have a list of differentials ready & hence questions to ask.
2. mark scheme: Read through the mark schemes (onemed info), there are easy marks e.g.
ICE, summarising, washing hands at every station, etc - very important
3. ROS: If unsure of diagnosis, with vague symptoms, then do the review of systems! To help
you get out of a rut. E.g. tiredness, lack of sleep, malaise, etc - very general symptoms that
could be any system.
4. summaries: Write a short summary for conditions to quickly revise from. E.g. 1 Sentence
for the condition, 1 for the signs and symptoms, 1 sentence of investigations, etc (can read
this before the exam when you are waiting before you go in). I saw a friend do this & it made
it easier to learn because TCD notes are good for progress but sometimes too much for CCA
5. paper: You get given a piece of paper in the exam. Write down the framework (PC, HPC,
PMHx, SHx etc) & anything that you forget so that you can ask all the required Qs & can give
a summary. Be engaged with the patient though!
[11:51, 21/03/2024] +44 7468 480918: Sharing info/explanation stations:
- ICE: If you forget to do ICE, you may miss the point of the whole station! do it at the start if
you are likely to forget.
- Youtube: https://www.youtube.com/@mattandhazelsmith have really good short videos on
how to explain common conditions.
- next steps: Explain the next steps after a diagnosis e.g. diabetes checks on HbA1C & U&Es
etc
- SPIKES framework: useful for bad news
- Motivational Interviewing
- topics: Could be explaining a Medication e.g. inhaler technique, condition, procedure,
recent diagnosis. Any lifestyle changes? Complications? Monitoring?
- history: Have to take a quick history as you may need to refer to parts of the history in your
explanation
[11:51, 21/03/2024] +44 7468 480918: Prescribing:
- combination: They may combine with data interpretation
- BNF: If the BNF is in the room then you know its a prescribing station. They could either
give you an ipad or a book BNF (need to Learn how to use a book BNF)
- examiners questions: They may ask you specific questions that you will need to look up on
the BNF e.g. Qs on contraindications or monitoring.
- patient questions: Patient may ask questions, you have the BNF to check e.g. if any drugs
they are taking atm will interact, any side effects, etc
- Prescription review: read through it & think out loud. Go through each drug as if you are
about to prescribe it, e.g. check in the BNF for the dose, indication, administration, drug
interactions, hepatic & renal function, times of day (QDS or TDS etc.). Have the drugs been
written in the right place e.g. once only drugs in the once only area, Antibiotics on the right
chart, etc. There will be a bit of the patients notes written on the with the list of drugs, that
you need to check through to help with your review e.g. patient has PMHx of CKD 3 so chekc
if meds are suitable for renal function.
- script: have a script ready for your summary / presentation of the prescription review to
the examiner. When presenting say e.g. patient name, age, patient ID, etc. Say your findings,
go through each drug & say if it is okay or not or if you would change anything
- Prescribing a drug
- explaining a drug
- medication history: learn inside out. Also useful to ask why they are taking each drug e.g.
contraception for acne.
- explaining medication: ATHLETICS (action, time to take, how to take (w/food?), length to
take effect, time to take effect, indications, complications and side effects, miss a dose?
[11:51, 21/03/2024] +44 7468 480918: Ethics and challenging communication:
- history: Always take a short history first, especially ICE as you may miss the point of the
station.
- explanation: Before you start doing an explanation of risks in challenging communication or
start motivational interviewing etc ask the patient their opinion on the topic, what risks are
they already aware of, What have they already tried in The past etc. Compare both sides,
benefits and downsides During your discussion with the patient.
- Negotiate and compromise: during difficult communication, try to find a middle ground
between your agenda & the patient agenda. Try to find alternatives
- understanding: Check they have understood what you have said & ask them to say it back
to you, especially if you have just explained risks.
- diagrams: You have a piece of paper in the exam, use it to draw out diagrams to help you
explain
- support: Tell them what support they have available e.g. stop smoking clinic via the GP or
online. give them all the options & where to get that support should they want to get that
support later. Ask them what support they would like & if they want to learn more about it.
- Scary info: Try to not scare people into lifestyle change, instead frame it as risks & benefits
(ask them what they know about the risks attached, ask if they want to hear about the risks,
use their words, validate their understanding already and explore each of their points
further)
- Alcohol: CAGE questions
- Breaking bad news: learn SPIKES https://www.youtube.com/watch?v=9afuudUCKm4
- Motivational interviewing for behaviour change e.g. OARS framework. Again take a quick
history to find the cause of their diagnosis / drinking/ smoking / etc etc (e.g. poor lifestyle?
Stress? Work? medications?)
- Raising concerns: learn complaint pathway, empathise with them, apologise & explain who
they need to do to submit complaint, & then what will happen about the complaint. Always
offer the complaint pathway but also ask them if there is anything they want us to do for
them now and any action to take immediately before they make a complaint (but always
ensure that they know that they can make the complaint) . e.g. Would they like a meeting
directly with the team to discuss the care of their grandma & why certain decisions were
made, etc.
- Consent: check competency and capacity and ensure you give them a leaflet so that they
can go home and think. Draw diagrams, ask if they want to take notes. Practice consenting
them for different topics e.g. an ECHO, an OGD, etc, you need to explain the procedure, risk
and benefits etc. , how long will they stay in hospital etc.
[11:51, 21/03/2024] +44 7468 480918: I appreciate I have written a lot and it can be a bit
overwhelming - please trial what works for you too, pick and choose from what I have
written. my tips are only suggestions, so you dont need to do any of it tbh. You will learn a
lot from the formative CCAs and I didn’t even revise for my formative CCAs, I went in blind
just to get the vibe of what it was like then I made a plan of how to go about CCAs after I
understood how it worked

[11:51, 21/03/2024] +44 7468 480918: OSCE Day 1

Thyroid examination
History- headaches (migraine)
Medication explanation (rivaroxaban)
Respiratory exam
History- chest tightness and shortness of breath (COPD)
Explaining end of life care (making arrangements for decisions when you no longer have
capacity so DNAR and lasting power of attorney)
Rest
ePrescribing (prescribe hydrocortisone during an acute illness [steroids increased during
acute illness] and prescribe iron tablets)
Data interpretation- abdo x ray showing enlarged large colon (toxic mega colon or LBO) with
blood results and history showing sepsis
OSCE day 2

Difficulty swallowing history- achalasia, pharyngeal pouch, oesophageal cancer, lower

oesophageal sphincter structure
Prescription review
Cardiovascular exam
DVT history
Explain hyperthyroidism
Explain BPH
Abdo exam
Tiredness history- Hodgkin’s lymphoma
[11:51, 21/03/2024] +44 7468 480918: OSCES year 3

My mocks
1. Interpret results and CXR - showed MI with pleural effusion
2. Explain why a man who’s just had an MI should to stay in hospital - he wants
to go home
3. Respiratory examination looking for signs of COPD on a manikin
4. Headache history - tension headache
5. Diabetes explanation, explain ways in which he can reduce his risk from going
from pre-diabetes to t2dm
6. Write prescription - online

Others days:
⁃ biliary colic history
⁃ IDA data interpretation
⁃ Explain heart failure
⁃ Cardiac exam for infective endocarditis
⁃ Ethics station?
⁃ Write prescription - online

Real OSCEs day 1:

1- Chest pain history in GP
2- Abdominal exam (focused on bowel obstruction signs) on a healthy volunteer in ER
3- Leg swelling and pain history (DVT) in ER
4- Migraine counselling and explanation with BNF at a GP
5- Cardiovascular exam on a manikin
6- Data interpretation on a young patient with sudden SOB in the ER. ABGs and CXR +
Questions on management - was pneumothorax
Day 2 stations:
7- explaining hyperthyroidism
8- History of urinary symptoms in GP (BPH?)
9- Discussing end of life care and choices with a patient recently diagnosed with lung
carcinoma
10- Respiratory Exam (non focused)
11- Electronic prescribing for H.pylori / peptic ulcer
12- History + Data interpretation + Questions about AKI
Day 2:
1. Hypothyroid explanation as well as levothyroxine explanation
2. Respiratory exam on manikin for pleural effusion
3. Data interpretation - perforated peptic ulcer (blood and erect cxr)
4. UTI history
5. Abdominal exam on person - had a hernia removal scar and hernia??
6. Migraine history
7. Domestic abuse ethics station
8. CV examination on a manikin
9. Tiredness history, was lymphoma and then data showing biopsy and the
presence of RS cells
10. Prescribe amlodipine for HTN
11. Explain CKD stage 3a and ramipril
12. Breathlessness and cough history - was asthma

Preface.