How to prepare for MRCEM OSCE (Clinical Exam)

2nd February, 2023

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Doctors

You’ve passed your MRCEM Primary and Intermediate and now you’re looking for the best ways to prepare for MRCEM OSCE (Objective Structure Clinical Examination). We have searched the internet and spoken to former candidates to create this guide for all of your MRCEM resources and guidance.

If you are a doctor and looking for Emergency Medicine locum or permanent opportunities, you can browse our A&E vacancies.

Am I eligible to apply for MRCEM OSCE?

To apply for the MRCEM OSCE, you need to hold a medical qualification approved by the GMC for purpose of registration, have completed the UK Foundation Programme or equivalent, have passed MRCEM Primary and MRCEM Intermediate SBA after August 2021 (or the previous equivalents) and have 24 months experience including 6 months experience in Emergency Medicine above FY1.

Places into each sitting of OSCE are limited and if oversubscribed the following criteria will be applied to allocate the available places:

Candidates in a GMC approved UK ST3 training post
Candidates in year 3 of the approved Irish training programme
Candidates holding an employment contract with the NHS (which covers the examination date)
Candidates who were not allocated a place at the most recent sitting (on a first come, first-served basis, if required)
All other candidates on a first-come, first-served basis

What is the format of the exam?

This is a practical exam where you will be tested on your clinical skills while you examine a patient in front of an examiner. The MRCEM OSCE consists of 18, seven-minute stations. An additional one minute of reading time is provided for candidates between each OSCE station.

How much does it cost?

At the time of writing this book, the price of the exam was as follows:

MRCEM (OSCE) Objective Structured Clinical Examination

£450 in the UK / £650 India / £750 (Malaysia)

How do I register?

You can apply for the MRCEM Primary exam directly on the RCEM website. Online applications for all examinations will open at approximately 10 am (GMT time) on the application opening date listed on the exam information page, in the dates and fees section. Applications close automatically at 5.00 pm (GMT time) on the listed closing date.

How to prepare for MRCEM OSCE

How can I prepare?

Whilst books and question banks will have supported you through MRCEM Primary and MRCEM Intermediate SBA, OSCE is all about practical assessment and clinical examination. The best preparation is lots of practice. Picking up physical signs is crucial. Tell your supervisor that you are sitting OSCE, find the consultants within your hospital who are OSCE examiners or registrars who have passed recently so they can observe and comment on your history taking and exam skills. Form a group with other doctors who are sitting their MRCEM OSCE exam so you can share patients and practice delivering your findings out loud. This process won’t only enable you to pass but provide you with confidence in your examinations, be thoughtful when diagnosing and be clear in your communication with patients and colleagues.

Which skills are assessed?

OSCE is mapped to the Specialty Learning Outcomes (SLO) of the Emergency Medicine 2021 Curriculum which is available on the curriculum website. All applicants for the MRCEM are strongly advised to familiarise themselves with the Year 1-3 competencies in preparation for sitting this examination. Clinical and communication skills of trainees are objectively reviewed to ensure they are ready to enter higher training.

1 Complex stable patient SLO1
2 Complex stable patient SLO1
3 Complex stable patient SLO1
4 Complex stable patient SLO1
5 Answer questions SLO2
6 Answer questions SLO2
7 Resus SLO3
8 Resus SLO3
9 Injured SLO4
10 Injured patient SLO4
11 PEM SLO5
12 Procedural skills SLO6
13 Procedural skills SLO6
14 Procedural skills SLO6
15 Complex challenging situations SLO7
16 Complex challenging situations SLO7
17 Supervise & teach SLO9
18 Supervise & teach SLO9

Time

If you can start well in advance and try to practice 3 or 4 patients per shift, you should be able to run through the most likely scenarios within a month. Confidence is key so you should allow enough time to practice with a variety of people covering as many scenarios as possible so that you feel prepared.

It’s important not to assume or let nervousness negatively impact you on exam day. Make sure you take the minute before each station to fully read and digest the task at hand. It’s easy to take a mental shortcut and assume you know what is being asked but be meticulous with your reading and formulate a plan for the scenario at hand.

Additional Resources

YouTube offers a huge catalogue of videos where you can see an example and mock OSCE stations and observe candidates going through the process. Go Emergency Medicine’s channel offer in-depth tips under MRCEM OSCE for history taking and communications skills.

Understanding the pie charts

In your reading time, you will see a pie chart explaining how the marks are broken down at that station. This could be teaching skills, communications skills or clinical knowledge. If the scenario lends itself to a topic you know in great detail it’s tempting to showcase all of your knowledge, however, if this only accounts for 25% of the mark and teaching skills account for a greater percentage, you need to demonstrate your teaching skills as the priority. You can show your knowledge by demonstrating your teaching in this scenario.

Reading the room

When you walk into the station, don’t overlook anything. If there is any equipment or ques from the actor – it’s meant to be addressed as part of the examination. I’ve read many testimonials online where people have overlooked clues and props from hand gel to x-ray machines and lost marks in the assessment.

Top tips for revision

Practice, practice, practice.
Use your reading time before each station to make sure you fully understand the task, objective and scoring on each station.

We are continually talking to doctors about their exam experiences and career goals to ensure we are creating up to date, valuable, credible and educational material for you. We’re passionate about the quality of our people and proud of the services we provide. Our team are here to help doctors find great work opportunities in the UK. We want to wish you the best of luck with your MRCEM exams. Next up we have FRCEM: The Ultimate Guide for you and the next stage in your career. If you would like to be notified when this FRCEM preparation material is released, register today with Pulse.