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Respiratory OSCEs
Prepare yourself for these common respiratory topics in Objective Structured Clinical Examinations
The common topics that have been tested in
OSCE exams during USMLE Step 2 CS, MCCQE
Part II, PLAB 2, OSCEs for medical students
and medical school clinical finals, Clinical
Skills Assessment for International Medical
Graduates are:
Asthma: in all scenarios: Acute ER setting management, Worsening
follow up, After attack follow up, Consult.
Wheezes.
Pneumonia, typical and atypical.
Chest pain.
Cough.
Coughing up blood (Haemoptysis).
COPD: in all scenarios: Acute ER setting management, Worsening
follow up, After attack follow up, Consult.
Shortness of breath.
Chronic shortness of breath.
Pulmonary embolism in ER setting.
Anticoagulant counseling for pulmonary embolism.
Bronchiectasis.
Pleural effusion.
Interstitial lung disease, occupational cough/SOB.
Solitary pulmonary nodule on X-ray.
Pneumothorax in ER setting.
Rhinorrhea / Sore throat.
Sinusitis.
Chest X-ray interpretation.
Pulmonary Function Tests interpretation.
Arterial blood gases interpretation.
Smoking consult.
Respiratory system examination.
Common respiratory OSCEs
Common OSCE exam cases that have been seen in
USMLE Step 2 CS, MCCQE II, PLAB 2, OSCEs for
medical students and medical school clinical
finals, Clinical Skills Assessment for
International Medical Graduates are:
(Please note: For USMLE Step 2 CS, there is no
examiner in the room. The encounter is video monitored and taped. Thus,
there will be no questions asked in the room other than the patient's
questions. However, during physical examination, you are still required to
explain what are you going to do to the patient before physically touching
him/her. All USMLE Step 2 CS stations are of 15 minutes long and require
focused history taking, physical examination, and counseling as needed.
Thus, ignore the last statement in the following sample stations about the
available time and required tasks to do).
1. Ronald Davidson is a 43 year old man who comes to your office
complaining of shortness of breath. In the next 5/10/15 minutes take
focused history. (SOB).
2. Jeffrey Hanson is a 52 year old man who has come to your office
because of frequent episodes of shortness of breath. In the next
5/10/15 minutes take focused history. (SOB).
3. James Fairman is a 57 year man who comes to your office because
during an employment routine check up he was found to have a
nodule in his lung. In the next 5/10/15 minutes take focused history.
(Lung nodule).
4. Julian Cameron is a known case of chronic bronchitis who has come
to your office for a regular check up. In the next 5/10/15 minutes
perform focused physical exam. (Exam).
5. Albert Henderson is a 62 year old man who comes to your office with
cough for three months. In the next 5/10/15 minutes take focused
history. In the last minute the examiner will stop you to ask
questions, (Cough).
6. John Hunter is 54 year old man who comes to the emergency
because of cough and recurrent lung infections. In the next 5/10/15
minutes take focused history. (COPD).
7. George Camay is a 32 year old man and an asthmatic patient of your
colleague Dr. Eric Goodson. He comes to your office for a follow up
visit as your covering Dr Goodson while he is away. In the next
5/10/15 minutes talk to him (Asthma).
8. Nikkei Johnson is a 29 year old woman who has been diagnosed with
asthma recently. In the next 5/10/15 minutes talk to her. (Asthma).
9. Steven Copper is 19 year old man who came to emergency with
sudden right sided pain. In the next 5/10/15 minutes take focused
history and focused physical examination. (chest pain/
Spontaneous Pneumothorax).
10. Norman Pearson is a 77 year old man who came to your office
complaining of hoarseness for three months. In the next 5/10/15
minutes take focused history.(Cough).
11. James Timothy is a 66 year old man who comes to your office
complaining of coughing up blood. In the next 5/10/15 minutes take
focused history. (Hemoptasis).
12. Nick Camberley is 65 year old man known case of COPD who comes
to the emergency complaining of shortness of breath for two days. In
the next 5/10/15 minutes, mange him. (COPD exacerbation).
13. Julie Osler is 67 year old woman who came to your office because of
a bothersome dry cough for two months. In the next 5/10/15 minutes
take focused history and answer her concerns. (Cough/ Atypical
pneumonia).
14. Sandy Homer is 22 year old asthmatic woman who comes to the
emergency because of worsening shortness of breathing. In the next
5/10/15 minutes manage her. (Asthma exacerbation).
15. Sandy Homer is 22 year old asthmatic woman who comes to the
emergency because of worsening shortness of breathing. You
managed her and she is stable now. In the next 5/10/15 minutes talk
to her before discharge. (Asthma exacerbation).
Cardiovascular OSCEs
Prepare yourself for these common cardiovascular topics in Objective Structured Clinical ExaminationsThe common topics that have been tested in OSCE exams during USMLE Step 2 CS, MCCQE Part II, PLAB 2, OSCEs for medical students and medical school clinical finals, Clinical Skills Assessment for International Medical Graduates are:
Chest pain.
Myocardial ischemia/infarction: ER management.
Cardiac arrest.
Palpitation.
Atrial fibrillation.
Syncope.
Hypertension.
Hypotensive shock: ER management.
Digoxin toxicity, ER management, and counselling setting.
Pericarditis.
Infective endocarditis.
Heart failure/ generalized edema/ ankle swelling.
Intermittent claudication.
Acute/ chronic leg pain.
Deep venous thrombosis.
Complete cardiovascular examination.
ECG interpretation.
Cardiopulmonary Resuscitation (CPR).
Common cardiovascular OSCEs
Common OSCE exam cases that have been seen in USMLE Step 2 CS, MCCQE II, PLAB 2, OSCEs for medical students and medical school clinical finals, Clinical Skills Assessment for International Medical Graduates are:
(Please note: For USMLE Step 2 CS, there is no examiner
in the room. The encounter is video monitored and taped. Thus, there will be no questions asked in the room other than the patient's questions. However, during physical examination, you are still required to explain what are you going to do to the patient before physically touching him/her. All USMLE Step 2 CS stations are of 15 minutes long and require focused history taking, physical examination, and counselling as needed. Thus, ignore the last statement in the following sample stations about the available time and required tasks to do.).
1. William Hartman is a 46 year old man who comes to your office with chest pain. In
the next 5/10/15 minutes take focused history and address his concerns. (Chest pain).
2. Michael McCarthy is 52 year old man, who is a known case of hypertension. He came
to your office for his annual check up. In the next 5/10/15 minutes perform a complete
physical examination. On the last minute the examiner will stop you and ask you
questions. (Hypertension).
3. Melissa Pilgrim is a 27 year old woman who has come to your office because oh heart
racing. In the next 5/10/15 minutes take focused history and talk to her about a
possible management plan. (Palpitation).
4. Dan Greenspan is a 68 year old man who had brought to the emergency because he
passed out earlier today at home. In the next 5/10/15 minutes perform a complete
physical examination. (Syncope).
5. Jenny Davidson is a 23 year old girl who suddenly lost her consciousness today and
fainted. In the next 5/10/15 minutes take focused history and address her concerns.
(Syncope).
6. Lenny Sullivan is a 56 year old man who got a sudden bad chest pain when he was
having lunch with his family. He was brought to emergency few minutes ago. In the
next 5/10/15 minutes manage him. (MI).
7. Alfred Sabitto is a 53 year old man who comes to your office because ho got swelling
of his legs. In the next ten minutes take focused history and address his concerns.
(Heart failure).
8. David Perry is a 54 year old diabetic man who came to your office because of leg pain
after walking. In the next 5/10/15 minutes take focused history and perform a focused
physical examination. (Claudication).
9. Eric O'Malley is a 51 year old man who came to emergency because of chest pain and
palpitation. In the next 5/10/15 minutes take focused history and address his concerns.
(Chest pain/ Atrial Fibrillation).
10. Sandra Anderson is 81 year old woman who was brought to emergency by ambulance
semiconscious, hypotensive and bradycardia. In the next 5/10/15 minutes manage
him. (Digoxin intoxication).
11. Andrew McDonald is 60 year old man who has a cardiac arrest while the ambulance is
rolling into the emergency. He is quickly brought into the resuscitation room. In the
next 5/10/15 minutes run code blue and manage him. (Cardiac arrest).
12. Tina White is a 22 year old woman who was referred to you by a community nurse
because of high blood pressure. In the next 5/10/15 minutes take focused history and
talk to her about a possible management plan. (Hypertension/ Pheochromocytoma).
13. Tim Brown is a 39 year old male who came to emergency because of sharp chest pain.
He feels unwell and trouble breathing. In the next 5/10/15 minutes take focused
history and perform a focused physical examination. (Pericarditis).
Gastrointestinal OSCEs
Prepare yourself for these common gastrointestinal topics in Objective Structured Clinical Examinations
The common topics that have been tested in
OSCE exams during USMLE Step 2 CS, MCCQE
Part II, PLAB 2, OSCEs for medical students
and medical school clinical finals, Clinical Skills Assessment for
International Medical Graduates are:
Difficulty swallowing (Dysphagia).
Nausea / vomiting.
Heartburn/ Gastroesophageal Reflex Disease.
Peptic ulcer disease.
Upper GI bleeding.
Lower GI bleeding.
Diarrhea, acute & chronic.
Constipation.
Steatorrhea.
Irritable bowel syndrome.
Inflammatory bowel disease, Crohn's & ulcerative colitis.
Diverticulosis/ Diverticulitis.
Abdominal pain, acute & chronic.
Jaundice.
Biliary colic.
Hepatomegally/ hepatitis..
Splenomegally.
Abdominal distension.
Abdominal mass.
Complete abdominal examination.
Liver function tests interpretation.
Common gastrointestinal OSCEs
Common OSCE exam cases that have been seen in USMLE Step 2 CS,
MCCQE II, PLAB 2, OSCEs for medical students and medical school
clinical finals, Clinical Skills Assessment for International Medical
Graduates are:
(Please note: For USMLE Step 2 CS, there is no examiner in the room. The encounter is video monitored and taped. Thus, there will be no questions asked in the room other than the patient's questions. However, during physical examination, you are still required to explain what are you going to do to the patient before physically touching him/her. All USMLE Step 2 CS stations are of 15 minutes long and require focused history taking, physical examination, and counselling as needed. Thus, ignore the last statement in the following sample stations about the available time and required tasks to do.).
1. Anthony Smith is a 73 year old man presents to your office
complaining of trouble swallowing. In the next 5/10/15 minutes take
focused history. (Dysphagia).
2. Natasha Husinoff is a 36 year old woman presents to your office
complaining from diarrhea for six months. In the next 5/10/15
minutes take focused history. (Diarrhea).
3. Mark Joe is a 52 year old man who was brought to emergency with
abdominal pain and vomiting. His vitals are: BP 80/40 mmHg, HR
120 bpm, RR 18 bpm, Temp 37.5 C. In the next 5/10/15 minutes
mange him. (Upper GI bleeding).
4. Catherine Roberson is 81 year old who was brought to emergency by
her daughter because of blood with bowel motion. Her vitals are: BP
140/90 mmHg, HR 70 bpm, RR 17 bpm, Temp 37.5 C. In the next
10/15 minutes take focused history and perform focused physical
examination. (Lower GI bleeding).
5. Michael Johnson is a 62 year old man who came to emergency
complaining of LLQ pain and fever. In the next 5/10/15 minutes take
focused history and perform focused physical examination.
(Diverticulitis).
6. Michael Johnson is a 62 year old man who came to emergency
complaining of LLQ pain. In the next 10/15 minutes take focused
history and perform focused physical examination. (Ischemic
colitis).
7. Leo Alfonso is 19 year old male who was brought to emergency
because of abdominal pain. His vitals are BP 90/50 mmHg, HR 120
bpm. In the next 5/10/15 minutes mange him. (Appendicitis).
8. Lorry Samuel is 25 year old female who came to emergency
complaining of recurrent RLQ pain. In the next 10/15 minutes take
focused history and perform focused physical examination. (Crohn).
9. Kim Ho is 27 year old man who came to emergency because he
turned yellow. In the next 10/15 minutes take focused history and
perform focused physical examination. (Jaundice).
10. Lora Timber is 40 year old woman who came to emergency
complaining of recurrent RUQ pain. In the next 5/10/15 minutes take
focused history and perform focused physical examination.
(Cholecystitis).
11. Jessica Smith is 22 year old woman who came to your office
complaining of greasy foul smelling stool and weight loss. In the next
5/10/15 minutes take focused history. (Steatorrhea).
12. George Wilson is 64 year old man who comes to your office
requesting a laxative because he is always 'blocked up'. In the next
5/10/15 minutes take focused history. (Constipation).
13. Steve Gomella was brought to the emergency by his friends after
vomiting blood. In the next 5/10/15 minutes take focused history and
talk to him about your possible plan of management.
(Hematamesis).
Endocrine OSCEs
Prepare yourself for these common endocrine topics in Objective Structured Clinical Examinations
The common topics that have been tested in
OSCE exams during USMLE Step 2 CS,
MCCQE Part II, PLAB 2, OSCEs for medical
students and medical school clinical finals,
Clinical Skills Assessment for International
Medical Graduates are:
Diabetes, all scenarios including ER for
DKA and consult.
Hypoglycemia.
Hypercalcemia.
Abnormal lipid profile / Hypercholestrolemia
Obesity / Weight gain counselling.
Weight Loss.
Hirsutism/ Virilization.
Galactorhea.
Gynecomastia.
Neck mass.
Thyroid nodule/ Enlarged thyroid/ Hyperthyroidism/ Hypothyroidism.
Pituitary adenoma.
Polydipsia.
Adrenal insufficiency/ excess.
Failure to mature.
Failure to thrive.
Common endocrine OSCEs
Common OSCE exam cases that have been seen
in USMLE Step 2 CS
for medical students
clinical finals
International Medical Graduates
(Please note: For USMLE Step 2 CS, there is no examiner in the room. The encounter is video monitored and taped. Thus, there will be no questions asked in the room other than the patient's questions. However, during physical examination, you are still required to explain what are you going to do to the patient before physically touching him/her. All USMLE Step 2 CS stations are of 15 minutes long and require focused history taking, physical examination, and counselling as needed. Thus, ignore the last statement in the following sample stations about the available time and required tasks to do.).
1. Dick Homer is an 21 year old man came to the emergency
complaining of nausea, vomiting and diarrhea. In the next ten
minutes take focused history. At the eighth minute the examiner will
stop you to ask questions. (Lab results). (
2. Debbie Hamilton is thirty year old woman who came to your office
complaining of fatigue for two months. In the next ten minutes take
focused history. (Hypothyroidism).
3. Rochelle Patrick is 58 year old woman who came last week for her
routine annual check up. Her investigations came back with serum
calcium 12 mg/dL. In the next ten minutes take focused history and
perform focused physical examination. At the eighth minute the
examiner will stop you to ask questions. (Hypercalcemia).
4. George Hunter is 51 year old man who came last week for his
routine annual check up. His investigations came back with elevated
serum cholesterol. In the next ten minutes take focused history and
address his concerns. At the eighth minute the examiner will stop
you to ask questions. (Hyperlipidemia).
5. Victoria Atkins is a 31 year old woman who comes to your office with
hoarseness. In the next ten minutes take focused history.
(Hypothyroidism).
6. Patricia Spence is 28 year old woman who was sent by the
community nurse to you because of abnormal thyroid tests. In the
next ten minutes take focused history and perform focused physical
examination. (Hyperthyroidism).
7. Tanya Allison is 48 year old woman who was sent by the community
nurse to you because she thinks she felt a thyroid lump. In the next
ten minutes take focused history and perform focused physical
examination. (Thyroid nodule).
8. Mary Hamilton is a 53 year old woman who is a patient of your
colleague, Dr. Watson, came to your office because you are covering
for Dr. Watson while he is away. Her blood glucose results has come
back 8.7 and 9.1 mmol/L in two fasting tests. She is very anxious to
know what is wrong. In the next ten minutes talk to her and address
her concerns. (DM, initial visit).
9. Mr. Russell Shantini is a 49 year old man who is a known case of
diabetes. He came to your office for his annual follow up bringing his
log book. In the next ten minutes talk to him . (DM, follow up).
10. Sandy Robert is a 23 year old woman who comes to your office
complaining of recurrent headache and abnormal hair growth on her
chin. In the next ten minutes take a focused history. (Pituitary
adenoma).
11. Laura Battler is 26 year old woman who comes to your office
complaining from weakness and weight gain. (Cushing).
12. Sarah Anderson is 18 year old girl who came to your office because
she notice her neck is wide. In the next ten minutes take focused
history and perform focused physical examination. (Goitre).
13. Tony Black is 30 year old man who came to your office complaining
from feeling dizzy and weight loss. In the next ten minutes take
focused history. (Adrenal Insufficiency).
14. Martin O'Malley is 34 year old man who cam the emergency because
of persistent headache and heart racing. In the next ten minutes
take focused history. (Pheochromocytoma).
15. Jim Charles is 12 year old boy, who is know for diabetes type I, was
rushed to the emergency by his parents after falling unconscious.
Please mange him in the next ten minutes. (Hypoglycemia).
Hematology OSCEs
Prepare for these common hematology & Immunology topics in Objective Structured Clinical Examinations
The common topics that have been tested in
OSCE exams during USMLE Step 2 CS,
MCCQE Part II, PLAB 2, OSCEs for medical
students and medical school clinical finals, Clinical Skills
Assessment for International Medical Graduates are:
Anemia.
Eosinophilia.
Neutropenia.
Thrombocytopenia.
Easy bruising/ Bleeding tendency.
Patechae/ Purpura.
Elevated hemoglobin/ Polycethemia.
Splenomegaly.
Hypercoagulable state.
Urticaria/ Angioedema/ Anaphylaxis.
Allergic reactions/ Atopy/ food allergies.
Lymphadenopathy; Generalized/ localized.
Blood transfusion reactions.
Neck mass.
Mediastinal mass.
Complete hematological examination.
Abnormal Complete Blood Profile, WBC.
Common Hematology & immunology OSCEs
Common OSCE exam cases that have been seen in
USMLE Step 2 CS, MCCQE II, PLAB 2, OSCEs for
medical students and medical school clinical
finals, Clinical Skills Assessment for
International Medical
Graduates are:
(Please note: For USMLE Step 2 CS, there is no examiner in the room. The encounter is video monitored and taped. Thus, there will be no questions asked in the room other than the patient's questions. However, during physical examination, you are still required to explain what are you going to do to the patient before physically touching him/her. All USMLE Step 2 CS stations are of 15 minutes long and require focused history taking, physical examination, and counselling as needed. Thus, ignore the last statement in the following sample stations about the available time and required tasks to do. ).
1. Kim Quang is a 17
year old woman who
presents to your
office with recurrent
episodes of bleeding
from her nose. Please
take focused history in the next 5/10/15 minutes. (
2. Jackie Levis is 22 year old woman who has been booked by the
surgeon to undergo laparoscopic cholecystectomy in two days. She
comes to your office with questions about the risk of blood
transfusions as her friend warned her about the possibility of HIV and
Hepatitis infection. Please talk to her in the next 5/10/15 minutes.
(Blood transfusion).
3. Rajeev Khan is a fifty year old man who is supposed to have his forth
blood transfusion today. He has a hematological disease that he
needs blood transfusion every few weeks. Last time he had a bad
reaction that made him feverish and ill. He refused to go on until he
talks to you because he is afraid it might happen again. Please talk
to him in the next 5/10/15 minutes. (Blood transfusion
4. Scott Fuller is a 47 year old man who comes with fatigue and a
hemoglobin of 95. Please talk to him in the next 5/10/15 minutes and
address his concerns. (Anemia).
5. Lucy Armstrong is 23 year old woman who came to your office after
she felt a lump in her right side of her upper neck. In the next
5/10/15 minutes take a focused history and perform a focused
physical exam. (Note: She keeps her bra and thighs exposed with
gestures of seduction. The case is infectious mononucleosis and she
is sexually active. Take sexual history and safe sex counselling too.)
(Lymphadenopathy/ Seduction/ Safe sex
6. Andres Fallen is a 45 years old man who is a known case of Hodgkin
disease under the care of your colleague Dr, James Brown who is
away and you are covering for him. He came to your office for a
follow up. In the next 5/10/15 minutes take a focused history and
perform a focused physical exam. (Lymphadenopathy
7. Mark Anthony is a 42 year old man comes to your office because he
felt few lumps in his groins. In the next 5/10/15 minutes take a
focused history and perform a focused physical exam.
(Lymphadenopathy).
8. Mary Copper is a 31 year old woman who had delivered a healthy
boy last week came to your office because of bluish dots and areas
over her body. In the next 5/10/15 minutes take a focused history.
(Patechae/ Purpura).
9. Sandra Hunter is 27 year old business woman who had just returned
from Asia in a business trip came to your office because of right calf
pain. In the next 5/10/15 minutes take a focused history and perform
a focused physical exam. (DVT).
Neurology OSCEs
Prepare yourself for these common neurology topics in Objective Structured Clinical Examinations
The common topics that have been tested in OSCE exams during
USMLE Step 2 CS, MCCQE Part II, PLAB 2, OSCEs for
medical students and medical school clinical finals, Clinical
Skills Assessment for International Medical Graduates are:
Head injury: ER management.
Cervical spine trauma.
Bacterial meningitis.
Unsteadiness/ Dizziness/ Ataxia.
Loss of consciousness/ Comatose management.
Tremor/ Parkinsonism.
Stroke/ TIA.
Subarachnoid hemorrhage.
Headache: all types and settings.
Temporal arteritis.
Seizure: attack at ER setting/ Follow up consult.
Memory impairment.
B 12 neuropathy.
Chronic back pain.
Carpal tunnel syndrome.
Sciatica/ leg pain.
Gait disturbances.
Weakness.
Numbness.
Pituitary adenoma.
Complete neurological examination.
Limb neurological examination.
Cranial nerves examination.
Coordination examination.
Glasgow coma scale.
Common Neurology OSCEs
Common OSCE exam cases that have been seen in
USMLE Step 2 CS, MCCQE II, PLAB 2, OSCEs for
medical students and medical school clinical finals,
Clinical Skills Assessment for International Medical
Graduates are:
(Please note: For USMLE Step 2 CS, there is no examiner in the room. The encounter is video
monitored and taped. Thus, there will be no questions asked in the room other than the
patient's questions. However, during physical examination, you are still required to explain
what are you going to do to the patient before physically touching him/her. All USMLE Step 2
CS stations are of 15 minutes long and require focused history taking, physical examination,
and counselling as needed. Thus, ignore the last statement in the following sample stations
about the available time and required tasks to do.).
1. Larry Warren is a 32 year old man who presents to the you in the walk-in clinic
complaining of headache. Please take focused history and address his concerns in the
next 5/10/15 minutes. (Headache).
2. Jerry La point is a 53 year old gentleman who comes to the emergency complaining of
sudden severe headache. Please take focused history and perform a focused physical
examination in the next 10/15 minutes. (Headache).
3. Michael Jones is a 55 year old bus driver who was brought to the emergency by family
members because he had a 'spell'. Please take a focused history in the next 5/10/15
minutes. (Seizure).
4. Albert Russel is 55 year old man who comes to your office for the first time to have
check up examination. Please perform a complete cranial nerves examination in the
5/10/15 ten minutes. (Cranial nerves examination).
5. Steve Barreto is 67 year old man who came to your office because he has been having
frequent falls which made him very concerned. Please talk to him and address his
concerns in the next 5/10/15 minutes. (Fall / Unsteadiness/ Dizziness/ Ataxia.).
6. Frank Sullivan is a 57 year old man who came to the emergency by an ambulance
because of weakness of his right arm and leg. Please take a focused history and
perform a focused neurological exam in the next 10/15 minutes. (Stroke).
7. Javid Ehsani is 58 years old man who had some transient attacks of left eye blindness
and was rushed to the emergency by his family. Please take focused history and
address his concerns in the next 5/10/15 minutes. (Temporal arteritis).
8. David Harrison is a 66 year old businessman who comes to your office because of
unsteady walking pattern. Please take focused history and perform a focused
neurological exam in the next 5/10/15 minutes. (Unsteadiness/ Dizziness/ Ataxia.).
9. A middle aged man was brought by the police to the emergency after being found
unconscious. Please manage the case in the next 5/10/15 minutes. (Loss of
consciousness/ Comatose management.).
10. John Smith is 80 years old man presents to the emergency having sudden onset of
speaking difficulty earlier today. It has now resolved. Please take focused history and
perform a focused neurological exam in the next 5/10/15 minutes. (TIA).
11. Tony Longfield is 16 years old male who is a know case of epilepsy on medication
came to your office referred from the driver licence authority. Please talk to him in the
next ten minutes. (Epilepsy).
12. Maria Lanzonzo is 60 year old woman came to your office complaining of tremor.
Please take a focused history and perform a focused neurological exam in the next
5/10/15 minutes. (Tremor/ Parkinsonism).
13. George Haung is 26 year old man who was brought to the emergency by his partner.
She said that he had the 'flu' for the last two days and has complained of headache and
fever. Please take a focused history and perform a focused neurological exam in the
next 5/10/15 minutes. (Meningitis).
14. Leanne Price is 32 year old who came to your office because of right hand tingling and
numbness. Please take a focused history and perform a focused neurological exam in
the next 5/10/15 minutes. (Carpel Tunnel).
15. Anthony Smitherman is 44 year old man who came to your office because of fatigue
and problems with walking with staggering. Please take a focused history and perform
a focused neurological exam in the next 5/10/15 minutes. (B12 Neuropathy).
16. Eric Brown, a 28 year old male, was brought to the emergency unconscious after
falling from a platform at work this morning. Please perform a complete neurological
exam in the next 5/10/15 minutes. (Head injury/ Cervical spine: ER management.).
17. Bob Jackson, a 46 year old construction man, came to your office because of sudden
back pain for two days. Please take a focused history and perform a focused
neurological exam in the next 10/15 minutes. (Back pain).
18. Leo alfanso is 47 year old man who had leg pain for years getting worse recently.
Please take a focused history and perform a focused neurological exam in the next
5/10/15 minutes. (Sciatica).
19. John Riddle is 26 year old male who had a minor car accident a week ago. He came to
your office because he noticed that he don't see on the sides. Please take a focused
history and perform a focused neurological exam in the next 10/15 minutes.
(Pituitary).
20. Sue Haung is 30 year old woman who had a car accident three days ago. She came to
your office because of neck pain. Please take a focused history and perform a focused
neurological exam in the next 10/15 minutes. (Whip splash C-spine injury).
Renal OSCEs
Prepare yourself for these common renal topics in Objective Structured Clinical Examinations
The common topics that have been tested in
OSCE exams during USMLE Step 2 CS,
MCCQE Part II, PLAB 2, OSCEs for
medical students and medical school
clinical finals, Clinical Skills Assessment
for International Medical Graduates are:
Urinary tract infection/ Dysuria/ Frequency.
Urethral/ penile discharge in males.
Hematuria/ red urine/ blood in urine.
Renal failure, acute and chronic.
Protienurea.
Hyperkalemia/ Hypokalemia
Hypernatremia/ Hyponatremia.
Impotence/ Erectile dysfunction.
Incontinence.
Benign prostatic hypertrophy.
Prostatic cancer.
Scrotal pain.
Scrotal swelling/ mass.
Hernias.
Abnormal serum hydrogen ion concentration.
Common renal OSCEs
Common OSCE exam cases that have been seen
in USMLE Step 2 CS, MCCQE II, PLAB 2,
OSCEs for medical students and medical
school clinical finals, Clinical Skills
Assessment for International Medical
Graduates are:
(Please note: For USMLE Step 2 CS, there is no examiner in the room. The encounter is video monitored and taped. Thus, there will be no questions asked in the room other than the patient's questions. However, during physical examination, you are still required to explain what are you going to do to the patient before physically touching him/her. All USMLE Step 2 CS stations are of 15 minutes long and require focused history taking, physical examination, and counseling as needed. Thus, ignore the last statement in the following sample stations about the available time and required tasks to do.).
1. Jasmine Corel is a 22 year old woman who comes to the emergency
complaining of burning sensation with urination. In the next 10/15
minutes take a focused history and perform a focused physical
examination. (UTI).
2. Jack William is a 70 year old man who comes to the emergency
complaining of difficulty making his urine. In the next 10/15 minutes
take a focused history and perform a focused physical examination.
(UTI/ Prostate).
3. Mick Humper is a 48 year old man who comes to the emergency
complaining of the worst pain he has ever had and at the hospital he
noticed is urine is red.. In the next 10/15 minutes take a focused
history and perform a focused physical examination. (Renal colic/
stone).
4. Sam Longwill is a 69 year old man who comes to your office because
he saw blood in his urine. In the next ten minutes take a focused
history and perform a focused physical examination. (Hematuria).
5. Marie Brono is a 56 year old woman who comes to your office
complaining of urine leaking. In the next 5/10/15 minutes talk to
her. (Incontinence).
6. Andre Heatherford is a 19 year old male who comes to the walk-in
clinic complaining of penile discharge. In the next 5/10/15 minutes
talk to him. (Urethral/ penile discharge).
7. Anthony martin is a 43 year old man who presents to your office
having a problem getting and maintaining erection. In the next
5/10/15 minutes talk to him. (Erectile dysfunction).
8. Eric Smith is a 82 year old man he comes to emergency complaining
of problems with emptying his bladder. In the next 5/10/15 minutes
talk to him. (Prostate).
9. Amy Davidson is a 61 year old woman who is a patient of your
colleague Dr. Wong. She comes to your office complaining of being
unwell. Dr Wong sent for some investigations and she is here for the
results. Her hemoglobin is 100, creatinine 1000, and BUN 22.4. In
the next 5/10/15 minutes talk to her. (Renal failure).
10. David Robert is a 64 year old man who is a patient of your colleague
Dr. Wong. He comes to your office complaining of being unwell. Dr
Wong sent for some investigations and he is here for the results. His
blood pressure is165/ 100, and creatinine 700. In the next 5/10/15
minutes talk to her. (HTN/ Renal failure).
11. Andre Heatherford is a 19 year old male who comes to the walk-in
clinic complaining of scrotal painful swelling. In the next 5/10/15
minutes take a focused history . (Scrotum).
Musculoskeletal OSCEs
Prepare yourself for these common musculoskeletal topics in Objective Structured Clinical Examinations
The common topics that have been tested in OSCE
exams during USMLE Step 2 CS, MCCQE Part II,
PLAB 2, OSCEs for medical students and
medical school clinical finals, Clinical Skills
Assessment for International Medical
Graduates are:
Back pain, acute and chronic.
Siatica.
Neck pain/ trauma.
Ankylosing spondylitis.
Joint pain/ any joint
Osteoarthritis.
Inflammatory arthritis/ Rheumatoid.
Septic arthritis.
Osteoporosis.
Complete joint examination: Cervical and lumbar pain, shoulder,
elbow, wrist, hip, knee, and ankle.
Wound suturing.
Common musculoskeletal OSCEs
Common OSCE exam cases that have been seen in
USMLE Step 2 CS, MCCQE II, PLAB 2, OSCEs for
medical students and medical school clinical
finals, Clinical Skills Assessment for International Medical
Graduates are:
(Please note: For USMLE Step 2 CS, there is no examiner in the room.
The encounter is video monitored and taped. Thus, there will be no
questions asked in the room other than the patient's questions. However,
during physical examination, you are still required to explain what are you
going to do to the patient before physically touching him/her. All USMLE
Step 2 CS stations are of 15 minutes long and require focused history
taking, physical examination, and counselling as needed. Thus, ignore the
last statement in the following sample stations about the available time
and required tasks to do.).
1. Eric Samuel is 43 year old man who came to your office complaining
of lower back pain for two days. Please take a focused history and
perform a focused physical examination in the next 10/15 minutes.
(Back pain).
2. Cathy Smitherman is 62 year old woman who came to your office
complaining of bilateral leg pain for years which getting worse
recently. Please take a focused history and perform a focused
physical examination in the next 10/15 minutes. (Sciatica).
3. John Hamber is a 40 year old man who came to your office
complaining of neck pain after a car accident two months ago.
Please take a focused history and perform a focused physical
examination in the next 10/15 minutes. (Whip splash injury).
4. Michael Turner is 36 year old man who came to emergency because
of a sudden right knee pain during football game. Please take a
focused history and perform a focused physical examination in the
next 10/15 minutes. (Joint pain).
5. Patty Applewood is a 47 year old woman who came to your office
because of right shoulder pain. Please take a focused history and
perform a focused physical examination in the next 10/15 minutes.
(Joint pain).
6. Tony Andreson is 22 years old who came to your office because of
right knee swelling. Please take a focused history and perform a
focused physical examination in the next 10/15 minutes. (Septic).
7. Elizabeth Johnson, a 55 year old woman, came to you office because
of stiffness in her fingers. Please take a focused history in the next
5/10/15 minutes. (Inflammatory).
8. Anthony Smith is a 65 year old man who came to your office
complaining of right hip pain. Please take a focused history and
perform a focused physical examination in the next 5/10/15 minutes.
(Joint pain).
9. Susan Rinker is a 55 year old woman who has been investigated by
your colleague, Dr Mark Brown. She came to see you as you are
covering for Dr. Brown while he is away. The results of the bone
density scan came back as 'Osteoporosis'. Please counsel her and
address her concerns in the next 5/10/15 minutes. (Osteoporosis).
10. Martin Brown is 42 year old man who came to your office
complaining from pain in his right elbow after a playing golf. Please
take a focused history and perform a focused physical examination
in the next 10/15 minutes. (Joint pain).
11. Jonathan Brown is 57 year old man who came to your office
complaining of left ankle pain. Please take a focused history and
perform a focused physical examination in the next 10/15 minutes.
(Joint pain).
12. Please enter the room and perform a wound suturing in the next
5/10/15 minutes.
Pediatric OSCEs
Prepare yourself for these common pediatric topics in Objective Structured Clinical Examinations
The common topics that have been tested
in OSCE exams during USMLE Step 2 CS,
MCCQE Part II, PLAB 2, OSCEs for
medical students and medical school
clinical finals, Clinical Skills
Assessment for International Medical Graduates are:
Fever.
Rash.
Vomiting.
Diarrhea.
Seizure; febrile and epilepsy
Cough: Asthma, viral, cystic fibrosis.
Running nose/ ear pain.
Anemia.
Neonatal jaundice.
Failure to thrive.
Feeding counseling.
Short stature.
Growth chart interpretation.
Speech delay.
Enuresis.
Recurrent abdominal pain.
Acute abdominal pain.
Infant colic.
Hyperactive child.
Urinary tract infection.
Immunization counseling.
Acute poisoning.
Peanut allergy.
Child abuse.
Common pediatric OSCEs
Common OSCE exam cases that have been seen in
USMLE Step 2 CS, MCCQE II, PLAB 2, OSCEs for
medical students and medical school clinical
finals, Clinical Skills Assessment for
International Medical Graduates are:
Note: Usually there is no child in the room and so no physical
examination.
(Please note: For USMLE Step 2 CS, there is no examiner in the room.
The encounter is video monitored and taped. Thus, there will be no
questions asked in the room other than the patient's questions. However,
during physical examination, you are still required to explain what are you
going to do to the patient before physically touching him/her. All USMLE
Step 2 CS stations are of 15 minutes long and require focused history
taking, physical examination, and counseling as needed. Thus, ignore the
last statement in the following sample stations about the available time
and required tasks to do.).
1. Andrew Bold came to your office concerning his six month old Jimmy.
He has some questions about vaccinations. Talk to him in the next
ten minutes. (Immunization).
2. Rochelle Davidson came to your office and want to talk to you about
her one year old son Tom. Her sister noticed that Tom is so small.
Address her concerns in the next 5/10/15 minutes. (Failure to
thrive /or Child abuse /or Single mother/ Feeding).
3. Eric George is 16 year old came to your office asking for a letter to
the transportation authority. Talk to him in the next 5/10/15 minutes.
(Epilepsy).
4. John Smitherman came to your office worried about his three and
half year old daughter, Julie, speech. Talk to him in the next 5/10/15
minutes. (Speech delay).
5. Leanne Goldson brought her two year old daughter, Lisa, to the
emergency because of diarrhea for three days. The ER team
managed Lisa is in the next room and she is stable now. Mrs Goldson
is waiting in this room. You are the physician on duty now. In the
next 5/10/15 minutes enter the room an take a focused history from
the mother. (Diarrhea).
6. Sandra Levis brought her two month old son, Leo, to the emergency
because of vomiting for two weeks. The ER team managed Leo and
he is stable now in the next room. Mrs Levis is waiting in this room
worried and crying. You are the physician on duty now. In the next
5/10/15 minutes enter the room an talk to her. (Infant colic /or
Single mother /or spousal abuse).
7. Luisa Huang brought her three day old son, Kim, to the emergency
because he turned yellow. The ER team managed Kim is in the next
room and he is stable now. Mrs Huang is waiting in this room
worried. You are the physician on duty now. In the next 10/15
minutes enter the room and talk to her. In the last two minutes the
examiner will ask you few questions. (Neonatal Jaundice).
8. Mary Hansfield brought her two and a half year old son, Tony, to the
emergency because he just had a fit. The ER team managed Tony is
in the next room and he is stable now. Mrs Hansfield is waiting in this
room. You are the physician on duty now. In the next 5/10/15
minutes enter the room an talk to her. (Febrile convulsion).
9. Martin Simon came to your office concerned about his 18 month old
son, Patrick. He thinks he looks pale. In the next ten minutes address
his concerns. (Anemia).
10. Barbara Hancocks is the mother of a six month old baby, Jim, who
brings her child to your office because of fever. Jim is in another
room with your nurse. Please enter this room and talk to the mother
in the next 5/10/15 minutes. (Fever).
11. Mary Levis is the mother of a 4 week old baby, Nick. She brought
him to the emergency because of vomiting for two weeks. The ER
team managed Nick and he is stable now in the next room.. Mrs
Levis is waiting in this room. You are the physician on duty now. In
the next 5/10/15 minutes enter the room an talk to her. (Vomiting /
Pyloric).
12. Erin Mayer came to your office concerned about her four year old
daughter, Emmy, who has cough for quiet some time. In the next
5/10/15 minutes take a focused history and initiate counseling.
(Cough).
13. Nicole Bennet came to your office because she thinks her 18 month
old daughter, Jane, is not growing well. Please address her concerns
in the next 5/10/15 minutes. (Failure to thrive /or Child abuse /or
Single mother/ Feeding).
14. Wanda Hung came to your office because she thinks her six year old
son, Kim, is short. Please address her concerns in the next 5/10/15
minutes. (Short stature).
15. Catherine Wellman is in your office to talk about her five year old
Eric who wet his bed at night. Please address her concerns in the
next 5/10/15 minutes. (Enuresis / UTI).
16. Lesia Malanchuk come to your office because her seven year old
daughter, Cathy, is complaining for abdominal pain. Please address
her concerns in the next 5/10/15 minutes. (Recurrent abdominal
pain).
17. Elizabeth Hartman came to your office because she received a letter
from her son's elementary school principle asking her to consult with
a physician about his condition. Please address her concerns in the
next 5/10/15 minutes. (Hyperactive child).
18. Jennifer Black asked you to see her 15 year old daughter, Tracy,
because she refuses to eat and lost over twenty pounds of her
weight. Tracy is now here in your office. Please talk to Tracy in the
next 5/10/15 minutes. (Anorexia).
19. Jeffery Hamilton brings his two year old son, Martin, to the
emergency for a hand injury. When you took X-rays, you found a
spiral fracture of the humerus. You also noticed old fractures of both
the forearm bones. Please talk to Mr. Hamilton in the next 5/10/15
minutes. (Child abuse).
20. Ellen Anderson came to your office complaining that her two year old
son, Tim, cannot sit with the family during dinner and finish his plate.
Please talk to her in the next 5/10/15 minutes. (Feeding /or
Hyperactive child ).
21. Jane Dave is calling concerning her 18 month son, John, who has
swallowed his aunt's blood pressure medications. In the next 5/10/15
minutes enter the room and pick up the telephone and talk to her
about John and advice her. (Poisoning).
22. Julie Copper is calling concerning her 7 year old daughter, Jessica,
who has swallowed 10 birth control pills. She is worried if that will
initiate early puberty. In the next 5/10/15 minutes enter the room
and pick up the telephone and talk to her about Jessica and advice
her. (Poisoning).
23. Andrea Jackson came to the emergency bringing her 18 month old
son, Roy, who has been crying for the last ten hours. Please talk to
her in the next 5/10/15 minutes. (Acute abdomen/
Intussusception).
24. Yee Man Lee came to your office because her 4 year old son, Kim,
has rash. Please talk to her in the next 5/10/15 minutes. (Rash).
25. Susan Coupland came to your office because her 4 year old
daughter, Julie, has recurrent urinary tract infections. Please talk to
her in the next 5/10/15 minutes. (UTI).
Gynaecology & Obstetric OSCEs
Prepare yourself for these common gynaecology & obstetric topics in Objective Structured Clinical
Examinations
The common topics that have been tested in OSCE exams during USMLE
Step 2 CS, MCCQE Part II, PLAB 2, OSCEs for medical students and
medical school clinical finals, Clinical Skills Assessment for
International Medical Graduates are:
Vaginal discharge.
Pelvic inflammatory disease.
Sexually transmitted diseases (STD).
Vaginal bleeding (Gynaecological, post menopausal, 1st trimester,
3rd trimester).
Ectopic pregnancy.
Irregular menses.
Post-menopausal bleeding.
Amenorrhea.
Lower abdominal pain, acute and chronic.
Endometriosis.
Fatigue and nausea (Pregnancy).
Pre-eclampsia/ Pregnancy induced hypertension.
Hormone replacement therapy counselling.
Birth control counselling.
Early pregnancy counselling and routine tests.
Pregnancy planning counselling; teenage, young, and old women.
Coagulation disorders with pregnancy.
IUGR counselling.
Abortion counselling.
Pap smear counselling.
Breast nodule/ Nipple discharge/ Self Breast exam.
Mammogram counselling.
Women abuse.
Common gynaecology & obstetric OSCEs
Common OSCE exam cases that have been seen
in USMLE Step 2 CS, MCCQE II, PLAB 2,
OSCEs for medical students and medical
school clinical finals, Clinical Skills
Assessment for International Medical
Graduates are:
(Please note: For USMLE Step 2 CS, there is no examiner in the room.
The encounter is video monitored and taped. Thus, there will be no
questions asked in the room other than the patient's questions. However,
during physical examination, you are still required to explain what are you
going to do to the patient before physically touching him/her. All USMLE
Step 2 CS stations are of 15 minutes long and require focused history
taking, physical examination, and counselling as needed. Thus, ignore the
last statement in the following sample stations about the available time
and required tasks to do.).
1. Jessica Maul is a 24 year old woman who comes to your office
complaining of vaginal discharge. Please take a focused history in
the next 5/10/15 minutes. (STD/ Pelvic inflammatory disease).
2. Elizabeth Harwal is a 19 year old woman who comes to the office
because her periods are irregular and she missed three periods now.
She is a bit concerned about this. Please talk to her in the next
5/10/15 minutes. (Irregular menses).
3. Janet Nicholas is 25 year old woman who came the emergency
because of lower abdominal pain. You are the physician on duty here
now. Please take a focused history and a focused physical
examination in the next 10/15 minutes. (Ectopic/ or any
gynaecological cause)
4. Cathy Simmons is 35 year old who came to your office because of
irregular vaginal spotting. Please take a focused history in the next
5/10/15 minutes. (Vaginal bleeding).
5. Susan Rinker is a 32 year old woman who has been investigated by
your colleague, Dr Mark Brown. She came to see you as you are
covering for Dr. Brown while he is away. The results of the pathology
came back as 'Endometriosis'. Please counsel her and address her
concerns in the next 5/10/15 minutes. (Endometriosis).
6. Judy Jurkovich is a 68 years old woman who came to your office
because of vaginal bleeding. She is very worried about this. Please
take a focused history and address her concerns in the next 5/10/15
minutes. (Vaginal bleeding).
7. Debrough Collicot is a 26 year old woman who came to your office
complaining of felling sick and tired. Please talk to her in the next
5/10/15 minutes. (happy lady). (Early pregnancy counselling and
routine tests).
8. Helen Bianco is 10 week pregnant woman who came to your office
with vaginal bleeding. This her first pregnancy and she is upset with
what is happening. Please talk to her in the next 5/10/15 minutes.
(Abortion counselling).
9. Helen Bianco is 6 week pregnant college student who came to your
office considering abortion. Please talk to her in the next 5/10/15
minutes. (Abortion counselling).
10. Janice Weigelt a 36 year old pregnant woman at 34 weeks came to
the emergency because of sudden vaginal bleeding. You are the
physician on duty here. Please take a focused history in the next
5/10/15 minutes. The examiner will stop you at the last minute to
ask you questions. (3rd Trimester vaginal bleeding).
11. Sarah Timberlake is 28 years old pregnant woman at 36 weeks came
to your office because she put on 5 kg in the last two weeks and she
feels her legs are so puffy the she cannot put her shoes on. Please
take a focused history in the next 5/10/15 minutes. The examiner
will stop you at the last minute to ask you questions. (Eclampsia).
12. Marie Salem is a 25 years old pregnant woman who came to your
office complaining of petechiae and easy bruising. Please take a
focused history in the next 5/10/15 minutes. The examiner will stop
you at the last minute to ask you questions. (Idiopathic
Thrompocytopnia).
13. Tania Chaw is 18 years old girl came to your office because she
wants to go on the birth control pills. Please talk to her in the next
ten minutes. (Birth control counselling).
14. Chawla Heuang is 36 years old woman came to your office because
she wants to go on the birth control pills. Please talk to her in the
next 5/10/15 minutes. (Birth control counselling).
15. Debbie Johnson is 52 years old woman who came to your office
asking for your opinion about hormone replacement therapy. Please
talk to her in the next 5/10/15 minutes. (HRT counselling).
16. Stephanie Davidson is 41 years old woman who came to your office
asking for a mammogram. Please talk to her in the next 5/10/15
minutes. (mammogram counseling).
17. Catherine Brown is 65 year old woman came to your office because
of breast nipple discharge. Please take a focused history in the next
5/10/15 minutes. The examiner will stop you at the last minute to
ask you questions. (Breast nodule/ Nipple discharge).
18. Catherine Brown is 25 year old woman came to your office because
she felt a lump in her right breast. Please take a focused history in
the next 5/10/15 minutes. The examiner will stop you at the last
minute to ask you questions. (Breast nodule/ Nipple discharge).
19. Tania Chaw is 18 years old girl came to your office because she
wants to know how pap smears are done and why and when. Please
talk to her in the next 5/10/15 minutes. (Pap smear counselling).
20. Jasmine Chaw is a 21 year old pregnant woman at 30 weeks who has
been investigated by your colleague, Dr Mark Brown. She came to
see you as you are covering for Dr. Brown while he is away because
the ultrasound results came 'Small for gestational age'. Please
counsel her and address her concerns in the next 5/10/15 minutes.
(IUGR).
Psychiatry OSCEs
Prepare yourself for these common psychiatric topics in Objective Structured Clinical Examinations
The common topics that have been tested in OSCE
exams during USMLE Step 2 CS, MCCQE Part II,
PLAB 2, OSCEs for medical students and
medical school clinical finals, Clinical Skills
Assessment for International Medical Graduates are:
Depression, episode, chronic, dysthemia, and post partum..
Manic episode.
Hypomania.
Delusional disorder.
Personality disorder/ Antisocial personality disorder/ Borderline
disorder.
Psychosis, acute and chronic.
Panic disorder.
Anxiety.
Social phobia.
Dementia (Forgetfulness).
Delirium (Confused).
Suicide.
Anorexia nervosa.
Fatigue.
Somatization disorder.
Mini-mental exam/ Complete mental exam.
Spousal abuse.
Child abuse.
Alcohol abuse/ withdrawal/ Alcohol cessation planning.
Drug abuse (Pain killers and street drugs), Cocaine Intoxication.
Common psychiatry OSCEs
Common OSCE exam cases that have been seen in
USMLE Step 2 CS, MCCQE II, PLAB 2, OSCEs for
medical students and medical school clinical
finals, Clinical Skills Assessment for
International Medical Graduates are:
(Please note: For USMLE Step 2 CS, there is no examiner in the room.
The encounter is video monitored and taped. Thus, there will be no
questions asked in the room other than the patient's questions. However,
during physical examination, you are still required to explain what are you
going to do to the patient before physically touching him/her. All USMLE
Step 2 CS stations are of 15 minutes long and require focused history
taking, physical examination, and counseling as needed. Thus, ignore the
last statement in the following sample stations about the available time
and required tasks to do.).
1. James brown, a 45 year old man, came to your office because his
wife insisted to see you. Please talk to him in the next 5/10/15
minutes. (Alcohol abuse).
2. James brown, a 45 year old man, came to your office asking for help
to stop drinking. Please talk to him in the next 5/10/15 minutes.
(Alcohol cessation planning).
3. The nurse in the surgical ward reported that Janet Johnson is 50 year
old woman who had a hystrectomy three days ago is hallucinating.
Please talk to her and perform a mini-mental exam in the next
5/10/15 minutes. (Delirium / Mini-mental exam).
4. Ann Downy, a 38 years old woman, came to the emergency because
of a wound in her scalp. Your colleague had sutured the wound.
Please talk to her in the next 5/10/15 minutes before discharging
her. (Spousal abuse).
5. Sarah Livingstone is a 23 year old lady and a mother of a 7 months
girl who came to emergency because of a swelling in he left thigh. X-
ray showed fractured femur. Your colleague managed the fracture
adequately. Please talk to her in the next 5/10/15 minutes. (Spousal
abuse).
6. Marie Girotti, a 17 year old female, has attempted suicide by an
overdose of Aspirin. She was treated in the emergency and feels well
now. In the next 5/10/15 minutes talk to her and assess her suicide
risk for admission or discharge. (Suicide).
7. Elizabeth Brown, an 81 year old woman, came to your office
complaining of feeling low. Talk to her in the next 5/10/15 minutes.
(Depression).
8. Donna McNally, an 76 year old woman, came to your office
complaining of too many medications. Her husband passed away 6
months ago. Talk to her in the next 5/10/15 minutes. (Depression).
9. Mary Lawrence, a 23 year old female, came to your office
complaining of fatigue and poor work performance. Talk to her in the
next 5/10/15 minutes. (Depression).
10. Joanne Sunfield brought her 65 years old mother, Sandra, to your
office because she is complaining from radiation leak in her house.
Talk to the mother in the next 5/10/15 minutes. (Psychosis).
11. Anthony James, a 47 year old lawyer has been brought by his wife
to your office. She states he is very anxious, has been sleeping only
few hours a night, has told the family he wants to sell he family
house and move to the capital to be a minister in the next
government. Please talk to him in the next 5/10/15 minutes. (He
paces the floor and talkative). (Mania).
12. Nick McPherson, a 23 year old male has been brought by the police
after a complaint from his wife that he is planning to kill their two
children. He states he is the son of God. Please talk to him in the
next ten minutes. (He paces the floor and talkative). (Psychosis).
13. Ron Lillicrap, a 72 year old man came to your office because his wife
asked you to see him as she believes he is not himself. Please talk to
him in the next 5/10/15 minutes. (Depression).
14. Helen St. Pierre is a 26 year old woman who came to the walk-in
clinic because of unexpected attacks of heart racing. That made her
very anxious and she wants to know exactly what is going on with
her heart. You are the physician on duty today. Please talk to her in
the next 5/10/15 minutes. (Panic).
15. Michael Foster came to your office to talk about his father, Frank
Foster, who is 78 year old. He think he has got forgetfulness. Please
talk to him in the next 5/10/15 minutes concerning his father and
your possible plan. (Dementia).
16. Frank Foster, a 78 year old man came to your office because his son,
Michael, asked you to see him because he think his father has got
forgetfulness. Please talk to him in the next 5/10/15 minutes.
(Dementia).
17. Karen Plater is 33 year old woman who came to the walking-in clinic
complaining of left upper quadrant abdominal pain for years that no
doctor is able to help her. You are the physician on duty today.
Please talk to her in the next 5/10/15 minutes. (Somatization).
18. Denise Demers is a 24 years old college student who has sent to you
by the college because she puts on gloves all the time and dose not
touch any thing there. Please talk to her in the next 5/10/15 minutes.
(Obsessive).
19. Sara Reavley is 20 years old woman who is from out of the city came
to your office complaining of severe headache. Please talk to him in
the next 5/10/15 minutes. (Drug seeker).
20. Sandy Becker, a 21 years old woman, has been brought to your
office by her parents because she is threatening to kill her boyfriend
if he leaves her. Please talk to her in the next 5/10/15 minutes.
(Personality disorder).
21. Rose Fallen is 56 year old woman who came to your office
complaining of feeling tired. Please talk to her in the next ten
minutes. (Fatigue).
22. Louisa Miller is 20 year old college student who has been brought to
the emergency by her friends because of sudden right arm paralysis.
Please take a focused history in the next 5/10/15 minutes.
(Conversion).
23. Suzy Nicholson is 17 years old female who has been brought to the
emergency by her parents because of generalized muscular
weakness. Routine investigations showed she her serum potassium
is 2.9 mEq/L. Your colleagues have treated her adequately and she is
stable now. Please talk to her in the next 5/10/15 minutes before
discharge. (Anorexia nervosa).
24. Stephanie Anderson is a 31 year old woman who had delivered a
baby boy, Jim, last month comes to your office feeling tired and
hopeless about the recent changes in her life. Please talk to her in
the next 5/10/15 minutes. (Postpartum depression).
25. Diana Boudreau came to your office and wants to talk to you. Please
talk to her in the next 5/10/15 minutes. (She found drugs in her sons
room). (Drug abuse).
Ethics OSCEs
Prepare yourself for these common ethics topics in Objective Structured Clinical Examinations
The common topics that have been tested in
OSCE exams during USMLE Step 2 CS,
MCCQE Part II, PLAB 2, OSCEs for medical students and medical school clinical finals
Clinical Skills Assessment for International Medical Graduates are:
Decision to forgo treatment.
Respect patient's decision and provide education, support, and empathy.
Delivering bad news: HIV, Cancer, Death.
Telling the truth.
Confidentiality / Breaking confidentiality.
Competency / Capacity.
Death before arrival.
Pharmacist / health care provider refusal to provide care.
Brain death and organ donation.
Relative as a decision maker.
Surrogate decision maker.
Women abuse.
Child abuse.
Drug seeking.
Informed consent.
Angry patient.
Violent patient.
Seduction.
Common ethics OSCEs
Common OSCE exam cases that have been seen in
USMLE Step 2 CS, MCCQE II, PLAB 2, OSCEs for
medical students and medical school clinical finals,
Clinical Skills Assessment for International Medical
Graduates are:
(Please note: For USMLE Step 2 CS, there is no examiner in the room. The encounter is video
monitored and taped. Thus, there will be no questions asked in the room other than the
patient's questions. However, during physical examination, you are still required to explain
what are you going to do to the patient before physically touching him/her. All USMLE Step 2
CS stations are of 15 minutes long and require focused history taking, physical examination,
and counselling as needed. Thus, ignore the last statement in the following sample stations
about the available time and required tasks to do.).
1. Ronald King is a 58 years old diabetic patient who has got leg gangrene but refusing
surgery. Please talk to him in the next 5/10/15 minutes. (Decision to forgo treatment /
Respect patient's decision and provide education, support, and empathy)
2. Kevin Mcfadden requested HIV test two weeks ago and the results has come positive.
Please talk to him in the next 5/ 10/15 minutes. (Refuses to tell his partner: Breaking
confidentiality/ reportable)
3. Sheila Rogers is a young women who comes to your office complaining of headache.
Please interview her in the next 5/ 10/15 minutes and address her concerns. (Drug
seeking).
4. Rosita Lazzam is the daughter of your patient Mr. John Lazzam, a 68 years old man
who just was diagnosed with pancreatic cancer. Rosita has asked to see you
immediately to talk to you about an important matter. Please talk to her in the next 5/
10/15 minutes and address her concerns. (Telling the truth / Competency / Capacity
5. You are the ER physician working in a rural area of 5000 population. Julie Murphy is
a 16 years old girl who came to your office in the morning concerning her unprotected
sex last night with her boyfriend. You prescribed the morning after-pill for this and she
went to the only pharmacy of this area. The pharmacist, Dr. Stewart, refused to fill the
medication for her. You decided to go to the pharmacy and talk to him directly. Please
enter the room and talk to him in the next 5/ 10/15 minutes. (Pharmacist / health care
provider refusal to provide care).
6. Mrs. Hilary Weston found your appointment card in her daughter's coat when she was
taking it to the laundry. She has come to your office to find out why her daughter,
Laura, came to see you. Please address her concern in the next 5/ 10/15 minutes.
(Confidentiality).
7. Kathy Astrom is Mr. David Astrom's wife waiting in the meeting room to talk to you.
David was involved in an accident 4 days ago with severe head injury and now has all
the criteria of brain death. All attempts to restore his brain function failed. Two
neurologist and neurosurgeon also confirmed that with "apnea test". Please enter the
room and talk to her about this issue and the prognosis in the next 5/ 10/15 minutes.
(Brain death and organ donation/ empathy).
8. Mrs. Elaine Young was diagnosed with lung cancer recently but she refuses to get
chemotherapy and surgery as treatment. She wants to go to Mexico to get homeopathy
treatment for that. Please enter the room and talk to her in the next 5/ 10/15 minutes.
(Decision to forgo treatment / Respect patient's decision and provide education,
support, and empathy).
9. Margaret Hart is a 78 year old women known case of COPD who comes frequently to
the ER with severe episodes of shortness of breath. Yesterday she came with same
problem and you intubated and resuscitated her. She was hospitalized in the ward and
now is alert and fine. Her daughter, heather is requesting to you to write a "DNR: Do
Not Resuscitate" order in her chart. Please enter the room and talk to her in the next 5/
10/15 minutes. (Competency / Capacity / Relative as a decision maker).
10. James Ottlyk is the husband of Mary Ottlyk who got involved in a bad accident six
years ago and since then she has been in a vegetative state. She never regained her
consciousness and only open her eye's but doesn't seem to follow anything. She is
100% dependent on the nurses care. She has had feeding tube for a long time. Now Mr
Ottlyk is in the meeting room to discuss removal of the feeding tube. Please enter talk
to him in the next 5/ 10/15 minutes. (Competency / Capacity / Relative as a decision
maker).
11. Mrs. Tara McDonald is a 52 year old woman, a known case of diabetes type I, who
was rushed to the hospital in a profound coma, but dies almost immediately. You are
the emergency physician who saw her first and there was no pulse or respiration. She
was pronounced dead. You must notify the coroner. Her husband and daughter are
waiting to talk to you. Please enter the room and talk to them in the next 5/ 10/15
minutes. (Note: You'll find that the husband gave her an extra insulin dose unknowing
she already had an overdosed shot). (Death before arrival/ Delivering bad news).
12. Joanne Brown, a middle aged woman, came to your office because she is very angry
and upset with a surgeon colleague of yours who operated on her father before her
father's death during the bypass surgery last week. She wants to sue this surgeon and
wants you to agree that the surgeon caused her father's death. Please talk to her in the
next 5/ 10/15 minutes. (Angry patient).
13. You are working in the emergency. A young man with a gun shot wound was
admitted. Within minutes, officer Stephen George, a policeman, arrived informing you
that this young man has just shot someone downtown and you must give him his chart
for investigation. Please talk to him in the next 5/ 10/15 minutes. (Confidentiality).
14. Lucy Armstrong is 23 year old woman who came to your office after she felt a lump in
her right side of her upper neck. In the next 10/15 minutes take a focused history and
perform a focused physical exam. (Note: She keeps her bra and thighs exposed with
gestures of seduction and may ask if you are free tonight (even if your are a female
doctor). The case is infectious mononucleosis and she is sexually active. Take sexual
history and safe sex counselling too.) (Lymphadenopathy/ Seduction/ Safe sex).
Multisystem Undifferentiated OSCEs
Prepare yourself for these common undifferentiated multi-system topics in Objective Structured Clinical Examinations
The common topics that have been tested in
OSCE exams during USMLE Step 2 CS,
MCCQE Part II, PLAB 2, OSCEs for medical
students and medical school clinical
finals, Clinical Skills Assessment for
International Medical Graduates are:
Fall.
Syncope / Fainting.
Loss of consciousness / Coma.
Fatigue / Tiredness.
Vague abdominal pain.
Vague chest pain.
Violent patient.
Vomiting.
Headache.
Fever.
Fit.
Unsteadiness / Dizziness.
Abdominal distension.
Edema.
Common Undifferentiated OSCEs
Common OSCE exam cases that have been seen
in USMLE Step 2 CS, MCCQE II, PLAB 2,
OSCEs for medical students and medical
school clinical finals, Clinical Skills
Assessment for International Medical
Graduates are:
(Please note: For USMLE Step 2 CS, there is no examiner in the room.
The encounter is video monitored and taped. Thus, there will be no
questions asked in the room other than the patient's questions. However,
during physical examination, you are still required to explain what are you
going to do to the patient before physically touching him/her. All USMLE
Step 2 CS stations are of 15 minutes long and require focused history
taking, physical examination, and counselling as needed. Thus, ignore the
last statement in the following sample stations about the available time
and required tasks to do.).
1. Jane Anderson, a 30 years old woman, came to your office
complaining from fatigue for 2 months. In the next 5/10/15 minutes
take focused history. (Fatigue).
2. Elizabeth Smith, a 81 years old women, came to your office
complaining of aches and pains all over her body. In the next
5/10/15 minutes take focused history. (Depression/ Somatization/
Neuropathies/ Metabolic)
3. Suzy Taylor, a 26 years old female, has been brought to the
emergency by ambulance after being found unconscious in her
home. You are the physician on duty in the ER today. She is in the
room with a nurse. In the next 5/10/15 minutes, please enter the
room and mange the patient. (Unconscious / Coma).
4. John Brown, a 50 years old male, came to your office because his
wife insisted that he comes to see you. In the next 5/10/15 minutes
talk to him and address is wife concerns. (Alcohol abuse / Drug
abuse)
5. Fatima Abdul Salam brought he father, a 62 years old man, to the
emergency because he fell to the ground this morning. The
emergency team ruled out any trauma. Mr Abdul Salam is waiting for
you in the room. You had just started your shift in the ER. Please
enter the room and talk to him in the next 5/10/15 minutes. (Fall).
6. Sandy Sony, a 67 years old woman, came to your office complaining
of feeling dizzy. In the next 5/10/15 minutes take focused history.
(Dizziness).
7. Terry McDonald is 57 years old. He came to the walk-in clinic
complaining from vomiting. you are the physician on duty here
today. In the next 5/10/15 minutes take focused history. (Vomiting
8. Eric Brown, a 47 years old male came to your office because he
noticed that his pants became tide. In the next 5/10/15 minutes take
focused history and perform a focused physical examination.
(Abdominal distension).
9. The police brought Mike Hurt to the emergency because he was
throwing bottles out of his apartment window and scramming. He is
22 years old and has been kept in this room. In the next 5/10/15
minutes enter the room and talk to him. (Psychosis/ Mania/
Violent)
10. Ann Johnson, a 59 years old women, came to your office complaining
of ankle swelling. In the next 5/10/15 minutes take focused history.
(Edema)
Surgery OSCE
Prepare yourself for these common Surgical topics in Objective Structured Clinical Examinations
The common topics that have been tested in OSCE
exams during USMLE Step 2 CS, MCCQE Part II, PLAB
2, OSCEs for medical students and medical school
clinical finals, Clinical Skills Assessment for
International Medical Graduates has been included within each body
system. Here are others:
Hand pain / Numbness / Physical examination.
Pre-op care.
Post-op care.
Splenic injury.(ER)
Pelvic fracture.(ER)
Hemothorax. (ER)
Bowel obstruction. (ER)
Suturing. (ER)
Common Surgical OSCEs
Common OSCE exam cases that have been
seen in USMLE Step 2 CS, MCCQE II, PLAB 2
OSCEs for medical students and medical
school clinical finals, Clinical Skills
Assessment for International Medical Graduates are:
(Please note: For USMLE Step 2 CS, there is no examiner in the room.
The encounter is video monitored and taped. Thus, there will be no
questions asked in the room other than the patient's questions. However,
during physical examination, you are still required to explain what are you
going to do to the patient before physically touching him/her. All USMLE
Step 2 CS stations are of 15 minutes long and require focused history
taking, physical examination, and counseling as needed. Thus, ignore the
last statement in the following sample stations about the available time
and required tasks to do.).
1. Please enter the room and suture a small laceration of the forearm
in the next 5/10/15 minutes. (Suturing). (Not in USMLE).
2. Jackie Scot is a 44 year old woman who comes to the emergency
because of right upper quadrant pain and vomiting. In the next
5/10/15 minutes take a focused history and perform a focused
physical examination. (Bowel obstruction).
3. Tom Robertson is a 31 year old man who has just arrived to the
emergency because he fell at work from a platform and hit his left
side on a step. In the next 5/10/15 minutes manage (Internal
bleeding / Splenic injury / Pelvic fracture).
4. Tom Robertson is a 31 year old man who has just arrived to the
emergency because he fell at work from a platform and hit his head
on a step. In the next 5/10/15 minutes manage (Head/ C-Spine
injury).
5. John Aukland is a 19 year old man who came to emergency because
of a laceration over his wrist. In the next 5/10/15 minutes perform a
focused physical examination. (Hand exam).
6. Sandy Smith is a 48 year old woman who came to the clinic a week
before her hysterectomy surgery as requested for pre-operative
assessment. In the next 5/10/15 minutes take a focused history and
perform a focused physical examination. (Pre-op).
7. Sandy Smith is a 48 year old woman who had a hysterectomy done
three days ago. The word nurse reported that she is confused and
hallucinating. In the next 5/10/15 minutes take a focused history.
(Post-op confusion).
Difficult Patients' OSCEs Scenarios
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'Difficult Patient' OSCE Scenarios
Common 'Difficult Patient' topics in
Objective Structured Clinical Examinations
The common topics that have been tested in OSCE exams during USMLE
Step 2 CS, MCCQE Part II, PLAB 2, OSCEs for medical students and
medical school clinical finals, Clinical Skills Assessment for
International Medical Graduates are:
'Difficult Patients' in OSCEs
The Silent or Reticent patient. The Rambling or Talkative
patient. The Vague patient. The Angry patient. The Depressed or Sad patient. The Denial patient. The Anxious patient. Patient with Somatization. The Dependent and Demanding
patient. The Dramatic or Manipulative
patient. The Long Suffering, Masochistic
patient. The Orderly and Controlled
patient. The Manic, Restless patient. The Guarded Paranoid patient. The Superior patient. Breaking bad news. Caring for the dying patient. Conflicted Roles. Solving Conflicts.
Common 'Difficult Patient' OSCEs
Common 'Difficult Patient' OSCEs cases that
have been seen in OSCEs during USMLE Step
2 CS, MCCQE Part II, PLAB 2, OSCEs for
medical students and medical school
clinical finals, Clinical Skills Assessment
for International Medical Graduates are:
1. Elizabeth Noseworthy is a 58 years old diabetic patient who was
brought to the emergency by her husband, Jack Noseworthy,
unconscious. Your colleague told you that she had been received
dead and they failed to resuscitate her. Please talk to Mr
Northsworthy in the next 5/10/15 minutes. (Breaking bad news/ in
this scenario you will discover that the cause of death was an extra
insulin shoot given by the husband when he found his wife
unconscious assuming that she ate too much at the party that night.
As you tell him the bad news, he turns very upset and restless
blaming him self for killing his wife).
2. Joan Lavis is the mother of your 17 year old patient, Sandra Lavis,
she came to your office asking to see you. Please talk to her in the
next 5/ 10/15 minutes. (Confidentiality/ Demanding/ in this
scenario you will discover that the mother found an appointment
card in her daughter pocket while doing the laundry. She demands
and insists to know the reason of her daughter's visit. Note: no
reason was given for the visit in the stem question).
3. George Baclham is 32 year old man who came to your office for the
first time. Please talk to him in the next 5/ 10/15 minutes. (Drug
seeker/ in this scenario you will discover that he is out of town and
has headache. His doctor prescribed a pain killer with codeine and
wants you to prescribe it again. He interrupts you repeatedly and
rudely during your history taking telling you that his doctor had
already asked him these questions and there is no point to repeat
the process. Note: no reason was given for the visit in the stem
question).
4. Jonathan Simons is 26 year old man who was brought by the police
to the emergency after his wife claimed that he attempted to kill her.
You are the physician on duty today. Please talk to him in the next 5/
10/15 minutes. (Acute psychosis/ in this scenario you will discover
that the patient is agitated restless pacing the room and refuses to
sit down to talk).
5. Anthony Rochester is 32 year old business man came to your office
because his wife insisted that he should see you. Please talk to him
in the next 5/ 10/15 minutes. (Mania/ in this scenario you will
discover that the patient is restless pacing the room and refuses to
sit down to talk, full of joy and happy and don't want to discuss that
being so happy is an illness. Note: no reason was given for the visit
in the stem question).
6. Jane Smith is 53 year old woman who came to your office
complaining from left upper quadrant pain. In the next 5/ 10/15
minutes take focused history and discuss a plan. (Somatization/
Talkative/ in this scenario you will discover that the patient keeps
talking and don't let you ask her questions or be in control of the
interview) .
7. Marie Price is 57 year old came to your office because her husband
insisted that she should see you. Please talk to her in the next 5/
10/15 minutes. (depression/ in this scenario you will discover that
the patient is says almost nothing and doesn't know why she is here.
Note: no reason was given for the visit in the stem question).
8. Lucy Armstrong is 23 year old woman who came to your office after
she felt a lump in her right side of her upper neck. In the next 10/15
minutes take a focused history and perform a focused physical
exam. (Note: She keeps her bra and thighs exposed with gestures of
seduction and may ask if you are free tonight (even if your are a
female doctor). The case is infectious mononucleosis and she is
sexually active. Take sexual history and safe sex counselling too.)
(Lymphadenopathy/ Seduction/ Safe sex).
Dealing with 'Difficult Patients':
In real medical practice, dealing with 'difficult patients' are seen almost daily. 'Difficult patients' are ordinary people who come to your health institute, whatever is that, because they have to, not because they want to. Sometimes, they have even been brought in unwillingly by a family member or a friend. They come in with their vast range of different personalities, cultural background, and current emotional state.
Being in a health care facility adds more worries and stresses due to lost time, expenses, and more importantly losing control. People are usually in
control of what they have to do now, well at least they think so. But on the moment they put their feet in front of your registration desk, they lose this control. We, the strangers, take control!... We give instructions and orders to follow starting right from that registration desk... Give me your ID, .. insurance,.. wait there,.. sit there,.. you have to wait,.. take off your cloths,.. touching them, .. etc.
So, by the time of their medical encounter with us, the physicians, they are already up on the edge in their stress and comfort levels. And guess what, we as the highest ranking authority here and thus have to receive all the blame and deal with them in these 'difficult patient' situations. Although, some of these people will look like trouble makers by personality, most of the exaggeration is due to the building up stress and worry, or simply part of their illness!
Dealing with 'difficult patients' in medical encounters needs a lot of communication skills to sooth them and calm them down or to let them at ease and open for effective communication. However, although this is part of our duty in addition to establishing rapport and friendly environment, it is not our goal in medical encounters! We are not social workers. Our goal is to figure out what is going wrong with them physically and psychologically in order to help them. These good communication skills are not the goal, they are wonderful magical means to achieve our goal, the patient well being. Communication skills are our vehicle to take a thorough medical history, perform accurate safe physical examination, and assure patient compliance, and yet efficiently in respect to our time and resources limits.
As you may realize now, it is important to learn the specific communication skills to deal with these 'difficult patients' in real life. This will make us friendly caring clever doctors and build a good reputation while staying thorough, focused, organized, and efficient. This is what successful considerate physician know very well!
'Difficult Patient' OSCEs:
As Objective Structured Clinical Examination stations (OSCEs) are simulation of real life medical encounters. 'Difficult to deal with patient' scenarios will be also seen in these exams. These difficult behaviours will be seen either embedded as a short part of the station scenario or as a full station by itself.
We need to prepare ourselves to these 'difficult patient' OSCEs because we will be assessed mainly for our communication skills in these OSCE exam stations. These OSCE Exams need a lot of empathy too but be careful don't act as a social worker. Act as an attending caring efficient physician and use the communication skills as a mean, not as a goal.
Now how to improve your way of dealing with each of these 'difficult patient' OSCEs?
Ask yourself:
What would I do if my OSCE standardized patient (SP) was angry and threatening me? Is what am I doing with this difficult patient correct ethically? Dose it serve me well? Dose it resolve the situation? How to improve my way of doing that?...
What would I do if my OSCE SP was a depressed woman who refuses to talk? Again, is what am I doing with this difficult patient correct ethically? Dose it serve me well? Dose it resolve the situation? How to improve my way of doing that?...
What would I do if my OSCE SP was a restless young man who kept pacing the room refusing to calm down and sit to talk? ...
What would I do if my OSCE SP was a talkative middle aged woman who kept telling me her stories wasting my valuable exam time? ...
What would I do if my OSCE SP was a teenage boy or girl who wants me to go out with him/her for a date? ...
What would I do if my OSCE SP was an HIV positive man who refuses to inform his wife about his illness? ...
What would I do if my OSCE SP was a sixteen year old boy with history of epilepsy and insisting to have a letter to the driving license authority? ...
What if?....... & what if?....... & what if?............
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