MCEM Part C: 110 OSCE Stations

Kiran Somani BA (Hons) MBBS MRCP DTM&H FCEM Post CCT Fellow in Emergency Medicine, University Hospital Southampton, UK Nitin Jain MBBS MS Orth MRCS Eng FCEM Clinical Superintendent at Sydney South West Area Health Service, New South Wales, Australia Nick Jenkins MBBS FCEM DipMedEd FHEA Consultant in Emergency Medicine, Wexham Park Hospital, UK

CONTENTS





Preface
MCEM Part C OSCE exam – Curriculum summary
How to use the book
Principles for OSCE success
Preparation/training/practice – How to prepare for the exam
Practicalities – What to expect on the day
Additional resources for the exam


Chapter 1: History taking, including acute presentations





Introduction
Abdominal pain, renal colic
Abdominal swelling, change in bowel habit, PR bleed
ALTE
Back pain
Blackout, collapse, syncope, seizure
Chest pain
Diabetes, hypoglycaemia
Dizzines, falls
Dysphagia, sore throat
Febrile convulsion
Fever, GU
Haematuria
GI bleed
Headache
Jaundice
Needlestick
Limping child
Palpitations
Rash
Sexual history, HIV, PID, PV bleed
Shortness of breath, haemoptysis, cough
Snake bite
Weakness (non-stroke), TIA, CVA
Weight loss


Chapter 2: Communication skills





Introduction
Angry parent, patient: missed fracture, diagnosis, not prescribing antibiotics, no x-ray for pulled elbow
Breaking bad news: death, CVA, head injury, stopping ventilation
Capacity
CDU ward round
Confidentiality: police
Consent: blood transfusion, Gillick
Difficult referral
Driving post seizure
Major incident preparation
NAI
Prioritising patients, CDU ward round
Teaching


Chapter 3: Systems examinations





Introduction
Cardiovascular
Eye examination, slit lamp, red eye
Gastroenterology
Neurology: upper limbs
Neurology: lower limbs
Neurology: cranial nerves
Respiratory
Thyroid examination, status


Chapter 4: Joint examinations  





Introduction
Ankle
Back
Elbow
Hand
Hip
Knee
Neck
Shoulder


Chapter 5: Psychiatry





Introduction
Depression
DSH, suicide risk: SAD PERSONS, poisoning: toxidromes
Mania
Mental state examination, mini mental state examination
Psychosis
Substance misuse, aggressive, disturbed behaviour


Chapter 6: Procedures/Teach a colleague





Introduction
ABG, arterial cannulation
Airway assessment, protection
Ascitic tap, drain
Central venous cannulation
Chest drain
Clearing a c-spine
Connection to a ventilator
DC cardioversion
FAST, aorta, vascular access scan
Handwashing
Intraosseous needle insertion
Knee aspiration
Lumbar puncture
Nasal packing
Nerve block: femoral
Opthalmoscopy
Otoscopy
Peak flow, inhaler, spacer, nebuliser technique
Performing an ECG
Phlebotomy, cannulation, blood cultures
Plastering
Pleural tap and aspiration, pneumothorax
Rapid sequence intubation
Surgical airway
Teach while managing an acute situation: airway, anaphylaxis
Thomas splint, Donway splint
Urinary Catheter
Vaginal examination, speculum examination
Wound management, suturing


Chapter 7: Resuscitation, including major presentations



ALS introduction





Anaphylaxis
BLS
Delivering a baby normal, abnormal circumstances
Pacing
PEA/asystole
Periarrest/cardioversion
Post-resuscitation care
Pre-ecplampsia
Pregnancy, OD, hypothermia, drowning
VF/VT


ATLS introduction





 Burns
 Cardiac tamponade, thoracotomy
 Haemothorax, pneumothorax
 Head injury: airway problem, neuroprotection
 Pregnancy  
 Shock, bleeding from abdomen or pelvis
 Trauma: airway problem


Chapter 8: Closing comments





Final preparation
Managing an OSCE station you didn’t expect