Possibly failed resit OSCE Watch

Anonymous #1
#1
Report Thread starter 10 months ago
#1
Hi everyone

I need a bit of advice. I resat my 4th year osce and I'll be completely honest when I say I think it went better than the first time (I was expecting to fail the first time). However, I can't help but feel like I could still be failed on a few stations because of missing some things out. Logic tells me if I've covered most things and the passmark is set to 49-52% as it tends to be, surely missing one or two things out should not mean a fail if I'm safe overall. However, I've already been failed on a couple of stations I was expecting to pass in the main exam. Ultimately this all resulted in my gut feeling of not having scraped through being a correct feeling...but for different reasons than I expected. You can fail 5 stations, I failed 6. But I wasn't expecting a few out of the 6 I did fail. For example, my feedback for one was that I was too quiet and hard to hear from the patient who then gave me a very low patient mark. I wasn't expecting this at all if I'm completely honest because he was answering my questions properly and I honestly didn't see any indications that he couldn't hear me. I am soft spoken so this is something I could work on. However I feel like I don't need to repeat this particular year to achieve that :( I'm a bit upset because this year is our longest and most gruelling year. I would not mind repeating any other year but this one.

It's probably worth describing what happened in the main osce. Our osce is set up to have 5 longer stations in one day and 9 shorter stations in another. I was one of the first groups to go in the morning and felt like it went well. I had actually done really well apart from marginally failing one station (I was expecting this). Got scores of 90%, 97% and a couple in the 70s. I went into the second exam calmer. I was the last group to do the second set of the stations a few days later and for whatever reason, it was just catastrophic. I almost got the sense that the examiners and patients were much nicer the first time and pretty horrible the second. I'm sure I've just imagined that but regardless I just ended up having a pretty catastrophic second day. This ultimately resulted in me marginally failing. I met with an academic who saw the difference between the 2 days and said I should resit. I agreed because what did I have to lose?

For the resit, we had all the stations in one day. We did have a break in the middle. But we had the shorter stations first then the longer stations. It was a tiring day. The first half went alright I thought but I'm a bit traumatised after failing things I thought I passed the first time. All the stations were different from the main exam except for one station which was a long sepsis station with the works - history, differential, results interpretation, management. This happens to be the station I somehow scored 97% on the first time. Unfortunately, perhaps due to being tired after a long day, I read the blood gas wrong twice the second time. I apologised to the examiner and corrected myself the third time. It was definitely correctly interpreted the third time and within a minute or two. Everything else I did exactly the same as the first time. Even the actor was the same. I feel like I've failed this station however because I accidentally saw the iPad and she'd marked me very low for the results bit and kind of average/low overall. There's a part of me that actually feels pretty angry about this station if I'm completely honest. Because I'll find it completely unfair if I've failed it. I actually missed a few things out in the history the first time (medication history and allergies) which I was sure to cover this time. Everything else I did exactly the same. So how on earth could I have done so well the first time and possibly failed the second? I will be absolutely broken if this station is the reason I don't pass overall.

I think my issue is I can understand my feedback for all the other stations. But frankly if I've failed this sepsis station the second time, I really will not agree with the feedback. What I had said in the main exam was all very fresh in my head and I covered it all and more the second time. The only thing I messed up on was the blood gas which I read correctly in the end. What can I do in specific situations like this in term of appealing if I've failed it? I realise probably not much but surely there would be somebody I could turn to. If I fail this station, there is absolutely no objectivity. I wish I could sit here and say I did anything else differently apart from that blood gas fiasco. Unless the blood gas alone is somehow worth 50% of my marks, I don't think messing one thing up (and ultimately correcting it) should warrant a fail. Perhaps there's a safety aspect there that resulted in sudden death situation but I didn't ask about allergies the first time and there was no sudden death system that time...And I did correct my mistakes very quickly so I didn't just leave it incorrect

As you can see I've been pretty stressed about this all. I want to reiterate that I do agree with most of the feedback I've been given. There are lots of things I can work on. But I'm so broken up by it all because I don't want to redo this year. I've worked the hardest I ever have this year and it really showed in the written exam as I did extremely well in it. I guess I don't see how redoing this particular year will help me with some of the issues I've specifically outlined.

Hopefully I haven't failed that sepsis station. I get my results in a few days. I'm hoping somebody that's reading this can see why I'd be absolutely crushed if that sepsis station ends up being the difference between passing and having to retake the year.

In terms of what happens if I fail the resit:

I won't get kicked out if I fail thankfully. You get one third attempt over the 5 years at my uni. Since I'm in 4th year and felt like I had a bad day in the main exam, I opted to resit. You also get to retake the year twice over the 5 years. I'm stressed because I really don't want to redo this particular year. It's been a very long and hard year

Anyway sorry for the long message. Thanks so much for reading
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Anonymous #1
#2
Report Thread starter 10 months ago
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(Original post by Anonymous)
Hi everyone

I need a bit of advice. I resat my 4th year osce and I'll be completely honest when I say I think it went better than the first time (I was expecting to fail the first time). However, I can't help but feel like I could still be failed on a few stations because of missing some things out. Logic tells me if I've covered most things and the passmark is set to 49-52% as it tends to be, surely missing one or two things out should not mean a fail if I'm safe overall. However, I've already been failed on a couple of stations I was expecting to pass in the main exam. Ultimately this all resulted in my gut feeling of not having scraped through being a correct feeling...but for different reasons than I expected. You can fail 5 stations, I failed 6. But I wasn't expecting a few out of the 6 I did fail. For example, my feedback for one was that I was too quiet and hard to hear from the patient who then gave me a very low patient mark. I wasn't expecting this at all if I'm completely honest because he was answering my questions properly and I honestly didn't see any indications that he couldn't hear me. I am soft spoken so this is something I could work on. However I feel like I don't need to repeat this particular year to achieve that I'm a bit upset because this year is our longest and most gruelling year. I would not mind repeating any other year but this one.

It's probably worth describing what happened in the main osce. Our osce is set up to have 5 longer stations in one day and 9 shorter stations in another. I was one of the first groups to go in the morning and felt like it went well. I had actually done really well apart from marginally failing one station (I was expecting this). Got scores of 90%, 97% and a couple in the 70s. I went into the second exam calmer. I was the last group to do the second set of the stations a few days later and for whatever reason, it was just catastrophic. I almost got the sense that the examiners and patients were much nicer the first time and pretty horrible the second. I'm sure I've just imagined that but regardless I just ended up having a pretty catastrophic second day. This ultimately resulted in me marginally failing. I met with an academic who saw the difference between the 2 days and said I should resit. I agreed because what did I have to lose?

For the resit, we had all the stations in one day. We did have a break in the middle. But we had the shorter stations first then the longer stations. It was a tiring day. The first half went alright I thought but I'm a bit traumatised after failing things I thought I passed the first time. All the stations were different from the main exam except for one station which was a long sepsis station with the works - history, differential, results interpretation, management. This happens to be the station I somehow scored 97% on the first time. Unfortunately, perhaps due to being tired after a long day, I read the blood gas wrong twice the second time. I apologised to the examiner and corrected myself the third time. It was definitely correctly interpreted the third time and within a minute or two. Everything else I did exactly the same as the first time. Even the actor was the same. I feel like I've failed this station however because I accidentally saw the iPad and she'd marked me very low for the results bit and kind of average/low overall. There's a part of me that actually feels pretty angry about this station if I'm completely honest. Because I'll find it completely unfair if I've failed it. I actually missed a few things out in the history the first time (medication history and allergies) which I was sure to cover this time. Everything else I did exactly the same. So how on earth could I have done so well the first time and possibly failed the second? I will be absolutely broken if this station is the reason I don't pass overall.

I think my issue is I can understand my feedback for all the other stations. But frankly if I've failed this sepsis station the second time, I really will not agree with the feedback. What I had said in the main exam was all very fresh in my head and I covered it all and more the second time. The only thing I messed up on was the blood gas which I read correctly in the end. What can I do in specific situations like this in term of appealing if I've failed it? I realise probably not much but surely there would be somebody I could turn to. If I fail this station, there is absolutely no objectivity. I wish I could sit here and say I did anything else differently apart from that blood gas fiasco. Unless the blood gas alone is somehow worth 50% of my marks, I don't think messing one thing up (and ultimately correcting it) should warrant a fail. Perhaps there's a safety aspect there that resulted in sudden death situation but I didn't ask about allergies the first time and there was no sudden death system that time...And I did correct my mistakes very quickly so I didn't just leave it incorrect

As you can see I've been pretty stressed about this all. I want to reiterate that I do agree with most of the feedback I've been given. There are lots of things I can work on. But I'm so broken up by it all because I don't want to redo this year. I've worked the hardest I ever have this year and it really showed in the written exam as I did extremely well in it. I guess I don't see how redoing this particular year will help me with some of the issues I've specifically outlined.

Hopefully I haven't failed that sepsis station. I get my results in a few days. I'm hoping somebody that's reading this can see why I'd be absolutely crushed if that sepsis station ends up being the difference between passing and having to retake the year.

In terms of what happens if I fail the resit:

I won't get kicked out if I fail thankfully. You get one third attempt over the 5 years at my uni. Since I'm in 4th year and felt like I had a bad day in the main exam, I opted to resit. You also get to retake the year twice over the 5 years. I'm stressed because I really don't want to redo this particular year. It's been a very long and hard year

Anyway sorry for the long message. Thanks so much for reading
Sorry for the resit I meant we had the longer stations first and then the shorter stations. Not that it matters too much but thought I'd correct myself
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junior.doctor
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#3
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Sorry your resit felt hard. This no-man’s land of waiting for results is really hard.

Remember, you’ll always remember your screw ups much more clearly than the things that went well. I am terrible at exam post-mortems, even though I always try really hard not to. Recently did a postgrad OSCE and kept reliving the screw up of a certain station over and over for the whole 4 weeks we waited for results. Sure enough I got a bare fail in that station, but whilst I was busy remembering all the screw ups, I forgot all the things that I actually did ok / well. Which were actually quite a few. It’s so frustrating when you know where you went wrong and you think you could have done it differently and it doesn’t reflect your ability (I came out of my screw up station completely flustered after the examiner had been awful to me and I’d been unable to give the diagnosis, stepped outside the door and within ten seconds went “ohhhhh it’s xyz diagnosis” but it was ten seconds too late and I really kicked myself for it as I thought it would make the difference between pass and fail and I could have so easily improved my mark because I did actually know it. I think that’s when it’s most frustrating. But having an awareness of your mistakes is a good thing, even if it feels painful at the time.

Try to relax as much as you can now and don’t write it off as failed until you get the results. You can’t second guess no matter how much you keep doing an exam post-mortem in your head, and what’s done is done. Best of luck.
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lc16079
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From your description it sounds like we're at the same uni. It seems you only just failed first time, and got great marks in the stations you passed, and if you thought the resit felt better then that's probably a good sign. As has been said before, we preferentially remember the things we got wrong, so try to put it out of your mind as much as possible (difficult I know!) and good luck!
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Anonymous #1
#5
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(Original post by junior.doctor)
Sorry your resit felt hard. This no-man’s land of waiting for results is really hard.

Remember, you’ll always remember your screw ups much more clearly than the things that went well. I am terrible at exam post-mortems, even though I always try really hard not to. Recently did a postgrad OSCE and kept reliving the screw up of a certain station over and over for the whole 4 weeks we waited for results. Sure enough I got a bare fail in that station, but whilst I was busy remembering all the screw ups, I forgot all the things that I actually did ok / well. Which were actually quite a few. It’s so frustrating when you know where you went wrong and you think you could have done it differently and it doesn’t reflect your ability (I came out of my screw up station completely flustered after the examiner had been awful to me and I’d been unable to give the diagnosis, stepped outside the door and within ten seconds went “ohhhhh it’s xyz diagnosis” but it was ten seconds too late and I really kicked myself for it as I thought it would make the difference between pass and fail and I could have so easily improved my mark because I did actually know it. I think that’s when it’s most frustrating. But having an awareness of your mistakes is a good thing, even if it feels painful at the time.

Try to relax as much as you can now and don’t write it off as failed until you get the results. You can’t second guess no matter how much you keep doing an exam post-mortem in your head, and what’s done is done. Best of luck.
Hi thanks so much for your reply. You're absolutely right about the exam post-mortem. I think what I'm actually scared of is failing marginally again but that one station being the difference between passing and failing the year. I think if I passed that but failed something else I'd actually feel better because at least then I know the exam is objective. I guess I don't know what I'd do differently if my feedback was so vastly different. Because the actor was the same and the station was largely the same and what I said was the same, I guess it scares me that examiners could potentially mark you in such a subjective way. I am always happy to work harder and will take all feedback on board. But I guess it petrifies me because issues like this one won't really change come next year if I redo the year If my best which was enough once ends up not being enough a second time, what do I do?

I have done nothing but beat myself up to a pulp. There is a lot I probably need to work on to improve my confidence. Those are all objective things I can do. I just don't want to have failed that sepsis station because then I don't really know what they want from me. I guess what I'm saying is if I've failed the year, I want solid and objective things I can work on.

You're right though, it's all done and I guess there's no point dwelling over it. Just have to brace myself and hope I've done enough

Thanks again for replying, your story really resonated with me
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Anonymous #1
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(Original post by lc16079)
From your description it sounds like we're at the same uni. It seems you only just failed first time, and got great marks in the stations you passed, and if you thought the resit felt better then that's probably a good sign. As has been said before, we preferentially remember the things we got wrong, so try to put it out of your mind as much as possible (difficult I know!) and good luck!
Hey thanks for the reply. We probably are, yeah I hope it is a good sign. I'm not really sure what to believe I think is the problem. I failed two stations I thought I passed and one station I thought I failed the first time so I'm almost not even sure what I'm doing right or wrong anymore. My gut feeling of barely failing was right though and despite thinking it went better this time round, I still can't shake that off. Just this awful feeling in my gut that I'm about to get some awful news.

Anyway I think the issue I have is if I'm going to fail this year, I need to know exactly why so I can see what I can change the second time round. But if I've failed that sepsis station for example, how am I supposed to know what to work on? There were only two solid variables there - the blood gas that I read wrong twice and the examiner. I can't think of why that blood gas alone would cause me to fail if I corrected it in the end. And I don't think the content should either, mainly because of the score I got the first time. I guess that's the issue If the score wasn't near perfect and if I hadn't done exactly the same thing, I wouldn't be so stressed by it all. That's something I have no idea how to work on if I'm honest. I said all the right things the first time and unless the examiner wasn't listening, something I did made him happy enough to score me so highly. So if using the same approach failed the second time, what can I do?

I'm overthinking this because I saw a few average/low-ish rankings and one really for ranking on her iPad. It honestly baffles me that the approach can go so wrong the second time. Either the first examiner was wrong in giving me my score or the second examiner did not objectively mark me. I need to know which it is otherwise I'll be right back in this position next July.

I'm hoping I've passed despite this terrible feeling in my gut that something bad is coming. I feel like I've done enough at the same time though, it's so strange. It shakes up your confidence massively when you think you've done enough but you fail anyway. I don't want to redo this year without solid feedback. Or over that sepsis station.

Anyway that's enough ranting. Thank you so much for taking the time to reply
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Anonymous #1
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Does anyone know if it would be possible to appeal a station? I know I must sound unreasonable. I'd never normally do it because I always agree with feedback. However this particular situation is quite unique because of the high score I got the first time. I would hate to fail the year over failing that station
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Rainy Times
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I would imagine that examiners are starting off with a more negative opinion of you when it's a resit, which will influence everything they judge you on. It is incredibly subjective and I personally think of OSCEs as interviews, not examinations. This might go some way to explaining how your mark in a station where the actual medical knowledge you demonstrated was identical could vary significantly.

At my uni we call the ability to appeal a "procedural irregularity" - so if you think the station did not run correctly you can appeal, and appeals are then investigated and if upheld that station is removed from the examination for the entire cohort. This did happen in our end of year OSCE - just 2 students submitted procedural irregularities about a station and it was taken out of the exam for all 170 or so students. Do you think there was an error with the actual running of the station, or was it more that you felt you were marked unfairly?

I really do feel for you - personally I think OSCEs are awful. I'm pretty good at 'playing the game' so they suit me fine, but they are a terrible way of demonstrating objective competence in practical skills and it's archaic that they still form a significant part of gaining a medical registration.
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Anonymous #1
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(Original post by Rainy Times)
I would imagine that examiners are starting off with a more negative opinion of you when it's a resit, which will influence everything they judge you on. It is incredibly subjective and I personally think of OSCEs as interviews, not examinations. This might go some way to explaining how your mark in a station where the actual medical knowledge you demonstrated was identical could vary significantly.

At my uni we call the ability to appeal a "procedural irregularity" - so if you think the station did not run correctly you can appeal, and appeals are then investigated and if upheld that station is removed from the examination for the entire cohort. This did happen in our end of year OSCE - just 2 students submitted procedural irregularities about a station and it was taken out of the exam for all 170 or so students. Do you think there was an error with the actual running of the station, or was it more that you felt you were marked unfairly?

I really do feel for you - personally I think OSCEs are awful. I'm pretty good at 'playing the game' so they suit me fine, but they are a terrible way of demonstrating objective competence in practical skills and it's archaic that they still form a significant part of gaining a medical registration.

Hi, thanks so much for your post. I honestly do agree with everything you've said. It's hard to say out loud because I guess I am a bit biased. So it is nice to hear it from others. I have also noticed that they're more lenient on you if you go in 'blind'. At my uni people tell each other stations all the time and I find the examiners to be very strict if you're in a later group. They were very, very forgiving of my mistakes on Monday morning, of which there were plenty. I made less mistakes on Thursday afternoon and felt I got completely crucified for them in the stations I thought I'd passed. I'm sure the other half is I probably come across a bit timid which I know some examiners hate. I've been trying to reflect and see what's happened. My friend was in the first group the day before me for the second set of stations and she had the same patient I did. She missed out loads of stuff - didn't auscultate the back, didn't pick up on irregular pulse, didn't realise she had had a lobectomy. But yet she passed and I failed. My feedback said I did not do capillary refill for long enough and my percussion technique was not that good. Fair enough but a bit harsh to fail me for that and pass my friend who missed out a load more. So either there is a leniency issue or she came across as more confident and my soft-spokenness let me down. I wish there was a way to find out if I'm honest. I think that's why I sit here comparing myself to people. I'd like something to work on if I have to retake the year. I think I will ask to be put in the earlier groups if possible in my future OSCEs regardless of the outcome.

Thank you for the advice on procedural irregularity. I can try and look into that. The truth is I just found it a bit unfair I think so probably won't hold much weight. I even said things in the same order as I did the first time. I was pretty nervous the first time I sat it but it did not count against me. I wish there was a bit more consistency.

The only hope I have is perhaps if there is a leniency issue, maybe they'll be a bit nicer to us because we all went in blind and sat them all in one go. I also think it's a bit harsh to make us sit it all in one day when the passmark for all those stations is set from people who sat them on different days. Here's hoping they've accounted for that.

I think I'm just looking for something to blame. The truth is there is stuff I need to work on. But my worst nightmare would be to fail the year on the basis of not passing that sepsis station if I was one station away from passing. I would not be able to help blaming the university if I'm honest. Because there is an inconsistency somewhere. The issue is it ends up being my word against the examiner's How can I prove I said the things I said. I hate how subjective this can be. I don't want to redo the year over something like this. Or if I do redo the year, I feel like I deserve to know what I can work on. I can't work on their subjectivity It's all so stressful. I had the same examiner marking my hip exam station. I did it in a slightly different order than I should have but did everything. My personal tutor who examines OSCEs said I should not fail over that. But I was also a bit nervous so if she's an examiner that hates that, perhaps I have failed that too. It's hard not to be nervous in a resit situation though

So sorry for the rant. Thanks so much for replying. I think regardless of the outcome I need to practice playing their game. Probably worth doing as many proper mock osces as possible instead of just practising with my friends
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Anonymous #1
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Probably worth mentioning that I can obviously practice things like percussing better and not messing up capillary refill. I think my issue is not that I didn't deserve to fail. I should probably be better at doing those things. I think my issue is the inconsistency. If me making X mistakes and missing Y out made me fail, that standard should surely be applied across the board The same friend actually read the blood gas wrong too in the main exam. It seems the gravity of your mistakes is in the hands of your examiner. I hate the thought of that because it's down to luck. Anyway all I can do to be safe is to be as perfect as I can be no matter who I end up with. But the lack of consistency has really surprised me
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Anonymous #1
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Hi guys, just wanted to update and say I passed the resit Feel a bit embarrassed about the meltdown now. I should get some help for anxiety I think. I am so glad it worked out! Thanks everyone for your kind words and advice
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junior.doctor
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(Original post by Anonymous)
Hi guys, just wanted to update and say I passed the resit Feel a bit embarrassed about the meltdown now. I should get some help for anxiety I think. I am so glad it worked out! Thanks everyone for your kind words and advice
Yay, well done you, congratulations! Onwards to good things 😊 Enjoy celebrating!
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