Case OSCEs

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


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


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


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




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





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



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



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


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


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




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


(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


(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


clinical finals, Clinical Skills


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






Note: Usually there is no child in the room and so no physical

examination.







taking, physical examination, and counseling as needed. Thus, ignore the



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


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






Graduates are:










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


exams during USMLE Step 2 CS, MCCQE Part II,

PLAB 2, OSCEs for medical students and

medical school clinical finals, Clinical Skills


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















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



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



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




students and medical school clinical



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






Graduates are:










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


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













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


'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


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?............

Case OSCEs

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Transcript of Case OSCEs