What books should I use to study for the NAC OSCE?

 

This is a common question that we receive from IMGs all over the globe. With more people fighting for residency in Canada it’s important to crush this exam and increase your chances of a potential CaRMS match.  Unfortunately there are not a lot of study options out there. When we completed our NAC OSCE in 2014 nearly everyone showed up to the exam with the NAC OSCE comprehensive review in print or on a tablet, they were rushing through it, trying to load the last few things into their memories. Unfortunately this book is less than ideal. There are overwhelming negative reviews of this book on Amazon which state that the book does not reflect the content of the exam well, it does not reflect the current therapeutic guidelines required for the exam, there are various errors and even grammatical and spelling mistakes in the book. Nearly every review advises you to look elsewhere in your preparations.

So, what should you study? We suggest picking up a copy of OSCE and Clinical Skills Handbook by Katrina F. Hurley MD. Why this book? Well it was written by well established Canadian physician to help medical  students and residents for prepare for OSCEs. It covers nearly every possible case you could see on the NAC and will force you to think in depth about the exam as well as help you improve your history and physical skills. It came highly recommended to us when we were preparing for our NAC OSCE by various administrators of the exam and was extremely important to securing a high score and a residency position. A read through it will help you identify your area’s of weakness and allow you to practice, practice, practice. We found this most effective by doing mock OSCEs over, and over, and over, and over (you get the idea).

 

Hope that helps, happy studying!

 

Author Bio:

Dr. Katrina Hurley graduated from medical school at Memorial University of Newfoundland in 2001. She pursued a residency in Emergency Medicine at Dalhousie University and concurrently completed the Clinician Investigator Program and a Masters in Health Informatics. She has been an Emergency Physician at the IWK since 2009 and is an Assistant Professor in the Department of Emergency Medicine.

Dr. Hurley is the Division of Pediatric Emergency Medicine Research Director.

 

Sample OSCE Case 1 – Solution

 

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We will be doing a series of Sample Osce cases for you to practice and review, followed by a case review the following week.  Read the Stem, proceed to rehearse the case, what questions would you ask, will you do a physical exam? If so what will you examine? Be sure to talk out loud explaining what you are doing and why you are doing it. “I’m listening to the heart for any evidence of murmurs etc…

CASE 1:

68 year old Anita MacDonald has presented to the clinic today reporting that she has been feeling “down” for the last 3 months. She reports that her husband passed away 4 years ago and is in otherwise good health. In the following 8 minutes please conducted a focused history. Do not perform a physical exam. Do not perform a mini mental status exam. At the 8 minute mark the examiner will ask you a series of questions.

SOLUTION:

  • Enters room, hands sticker to examiners
  • Washes hands
  • Introduces self to patient
  • Patient delivers opening response/line
  • Asks about onset of Sx
  • Asks how long Sx have been present
  • Asks about SIGECAPS
    • Sleep changes more/less
    • Interest in daily life
    • Guilt – feelings of worthlessness, hopelessness, etc
    • Energy – lack of
    • Concentration – can they focus? are they easily distracted
    • Appetite – more? less?
    • Psychomotor – are they lethargic? are they agitated?
    • Suicide? have they had thoughts of self harm? harming others? If so do they have a plan? who?
  • Ask about other redflags
    • Hearing voices others don’t hear
    • Seeing things others do not see
    • Paranoia
  • Social Hx
    • Who is at home with them?
    • Support? family, friends?
    • Pets?
    • Smoking? Alcohol? Recreational Drugs?
    • Income/Work/Welfare
  • Previous Medical Hx
    • Depression? Mental health?
    • Overall Medical Hx
  • Medications
  • Review of Systems if time permits/any other concerns
  • FIFE
    • How do you feel about your mood?
    • Do you have an ideas about what has led to your mood factors
    • How is this affecting your function?
    • What are your expectations?
  • Close the interview
  • Prepare to answer series of questions such as:
    • What is your next step in management of this patient?
    • What is your primary diagnosis, give 2 differential Dx
    • If this patient were actively planning to harm themselves what would be your next step?

Sample Osce Case 1

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We will be doing a series of Sample Osce cases for you to practice and review, followed by a case review the following week.  Read the Stem, proceed to rehearse the case, what questions would you ask, will you do a physical exam? If so what will you examine? Be sure to talk out loud explaining what you are doing and why you are doing it. “I’m listening to the heart for any evidence of murmurs etc…

 

CASE 1:

68 year old Anita MacDonald has presented to the clinic today reporting that she has been feeling “down” for the last 3 months. She reports that her husband passed away 4 years ago and is in otherwise good health. In the following 8 minutes please conducted a focused history. Do not perform a physical exam. Do not perform a mini mental status exam. At the 8 minute mark the examiner will ask you a series of questions.