silvercloud92
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I consistently perform poorly in OSCEs - I always have a mark that is below the average. I always worry that it will fall dangerously close to a fail mark one day. I'm now in my fourth year and I am aware that the OSCE is much harder this year. I really want to do well but I just don't know what to do to improve. I feel that I do well when I practice with others (on observation, I feel that I am on the same level as my peers) and I also do well when I clerk real patients on the wards. But I still perform worse than my entire cohort.

In the OSCE, I forget important questions during the history taking stations or I can't remember the differentials to ask to right questions to exclude things. I just get this huge thought block all of a sudden in some stations and I panic and sweat all over the place. I wonder if some medical students just don't tend to perform well in OSCEs and I also worry that it's a reflection on how I will practice as a doctor i.e. I will be a below average doctor who might miss something really important.

Can anyone kindly pass along some tips?
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*pitseleh*
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You're probably forgetting these things because you're nervous, rather than because of anything else. I think the only thing to do is practice history-taking (as it sounds like that's where you struggle) to death. You can even do it by yourself to a degree - make checklists of things you would want to ask if a patient came in complaining of X, and then keep testing yourself until you can recite them in your sleep. Obviously that's only part of the station, but perhaps if you can get that part down then the other aspects will seem easier?

Oh, and I don't think you should take your OSCE nerves an omen of how you'll be as a doctor. Don't forget that no-one's going to drop you in at the deep end by yourself the second you qualify - you'll have support in place for those times when you do forget the odd thing. And by the time that support eases off, you'll hopefully be more comfortable in your job and less prone to nerves anyway.

Hope that helps a little bit - nerves are just the worst.
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Okorange
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I think the more prepared you are the better you do. I feel like when you aren't prepared enough, basically you barely know what to do but are at risk of forgetting, you get really nervous. This happens to me. But if you practice to the point that it becomes second nature, then you are really ready to tackle the OSCE.
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pgreg1
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try to portray confidence
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seaholme
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It's good to have a strong & easy system (that isn't just memory) to base your histories on and then you won't feel so anxious - personally I find it easiest to just think about the anatomy because the patient is sat there right in front of you and you can remind yourself of what to ask literally just by staring at them! Then the stress of trying to remember lists of questions evaporates away. Also a LOT of your history can come from just asking the good basic questions. What makes it better? What makes it worse? Can elucidate a lot of details versus you asking specifically.
An example of the 'anatomical' thing would be chest pain... just ask yourself what is in the chest? Heart. Lungs. Oesophagus. So cardiac causes, pulmonary causes, oesophageal causes. That's literally almost all of the important Qs done! Falls... why do we fall? Brain, heart, veins, ears (balance), eyes (vision).

If you can come up with those things just by looking at somebody and thinking from the very very basics, then you'll find that they remind you of your questions - which deep down inside, you do know! It eliminates a lot of stress and anxiety to feel like you've got the answers (in a very loose form!) within seconds, and allows you to concentrate on thinking exactly what to ask after that. It works for me anyway, I find myself able to perform a lot better when I think this way.
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