I failed my 4th year OSCE. Can I ever pass it if I don't know what went wrong?

Hello,

I failed my fourth year OSCE. I failed it because I failed six stations, and the limit is four. Of the stations that I failed, half were almost on the borderline of the passing score (less than 1 to 2 marks below the passing score).

I do not have any extenuating circumstances. I did not expect to fail. I thought that I prepared well and I even felt ready for the exam. I came out of the exam feeling like I passed. Ha!

I looked at my feedback from the examiners, and of the comments I could read, they seemed specific to the station e.g. "Did not ask about xyz". In the stations that I did pass, the comments I received read like I was a great student or something. Someone good enough to pass.

I just don't know what went wrong. I've been thinking about it over and over. I really don't know. Maybe I didn't practice enough, so I've started to practice for the next fourth year OSCE now, 12 months in advance. That's all I can think of.

I have never failed any exams before. I passed my written exam of fourth year (74%). I did rather well in my previous OSCEs (although of course, they are easier by definition).

Could anyone kindly offer me some advice? Can I ever pass this OSCE if I can't think of what went wrong for me?

You need to work on the stations that you failed. I found that I was almost consistently failing multiple communication skills stations in my earlier years so I worked really hard on that and have gotten much better patient global scores since!

Hello,

I failed my fourth year OSCE. I failed it because I failed six stations, and the limit is four. Of the stations that I failed, half were almost on the borderline of the passing score (less than 1 to 2 marks below the passing score).

I do not have any extenuating circumstances. I did not expect to fail. I thought that I prepared well and I even felt ready for the exam. I came out of the exam feeling like I passed. Ha!

I looked at my feedback from the examiners, and of the comments I could read, they seemed specific to the station e.g. "Did not ask about xyz". In the stations that I did pass, the comments I received read like I was a great student or something. Someone good enough to pass.

I just don't know what went wrong. I've been thinking about it over and over. I really don't know. Maybe I didn't practice enough, so I've started to practice for the next fourth year OSCE now, 12 months in advance. That's all I can think of.

I have never failed any exams before. I passed my written exam of fourth year (74%). I did rather well in my previous OSCEs (although of course, they are easier by definition).

Could anyone kindly offer me some advice? Can I ever pass this OSCE if I can't think of what went wrong for me?

Sorry this has happened, must have been a big shock for you.

You have to understand how marking schemes for OSCEs work. They are designed to be objective, rather than based on an overall impression (there may be a few marks available for that, but it's a very small fraction). The examiners have tick boxes for each action you are expected to do/thing you are supposed to say, and if you don't tick the box, no matter how well you come across overall, you will not get the marks, and clearly you were missing out quite a few things or you would have got enough to pass. There may also be one or two "sudden death" boxes which will automatically fail you if you don't do them in a particular station e.g. asking about possible pregnancy in a young woman with abdominal pain. A lot of it is about playing the game and being seen to do things (a bit like checking mirrors in your driving test).

I don't think it's necessary to start practising now, because what you do now is not really likely to have any bearing on what you can do this time next year. I do think you might need to be a bit more focused when you do practise though. Get a friend, or one of the doctors on the firm you're attached to, to watch you examine/take a history and give you honest feedback. Pay attention to it and reflect on it, to see if you can improve next time.

Don't let this get you down; it must suck at the moment but one failed exam does not mean you can't do this, or that you won't be a good doctor. Good luck!

Hi,

Thank you for replying. That is some good advice. How did you work on communication skills, for example?

Sorry this has happened, must have been a big shock for you.

You have to understand how marking schemes for OSCEs work. They are designed to be objective, rather than based on an overall impression (there may be a few marks available for that, but it's a very small fraction). The examiners have tick boxes for each action you are expected to do/thing you are supposed to say, and if you don't tick the box, no matter how well you come across overall, you will not get the marks, and clearly you were missing out quite a few things or you would have got enough to pass. There may also be one or two "sudden death" boxes which will automatically fail you if you don't do them in a particular station e.g. asking about possible pregnancy in a young woman with abdominal pain. A lot of it is about playing the game and being seen to do things (a bit like checking mirrors in your driving test).

I don't think it's necessary to start practising now, because what you do now is not really likely to have any bearing on what you can do this time next year. I do think you might need to be a bit more focused when you do practise though. Get a friend, or one of the doctors on the firm you're attached to, to watch you examine/take a history and give you honest feedback. Pay attention to it and reflect on it, to see if you can improve next time.

Don't let this get you down; it must suck at the moment but one failed exam does not mean you can't do this, or that you won't be a good doctor. Good luck!