osce

Got OSCE allocations!

AAH!

They’ve done this stupid thing this year where they’ve put our OSCE’s (our practical exam) before our written paper. The poor sods at the end of the alphabet have their OSCE the day before their written paper. Being one of those at the start of the alphabet I’m on the second day of exams (they put all the Grads first). I literally only just make it onto the second day though, numbers 1-14 are on the Thursday and I’m number 15 who gets to be on Friday.

The down side is that it’s at 8.45am. Gah! I’m going to set like a hundred alarms that morning to wake up at like, half 7. I haven’t needed to get up that early in months! It’s gonna be a bit of a shock to the system…

My OSCE is just under a month away. Which means that my written paper is a month and a week away. My written paper which is about everything we’ve done so far. They can ask us anything.

Please let me pass.

Five weeks of nothing to do all day but revise. I did everything in 4 weeks last summer, so 5 weeks is a luxury by comparison. But I didn’t have to learn anything new then, whereas now I still haven’t really learnt neuro or pharmacology, so that’s gonna take a while.

But then, there are modules that I’ve revised 5 times now, surely they can’t take too long?

Agh. I just want it to all be over, and it’d be quite nice if me and all my friends could pass. That’s all I want for Christmas!

2

Buerger’s Test

  • a clinical examination to identify ischaemia in the lower limb
  • raise the leg for 2-3 mins, suspect insufficient blood supply if pallor develops, with skin mottling
  • the leg is then lowered, if reactive hyperaemia (i.e. leg goes pink-red) then positive buerger’s test 
  • explanation - when leg is raised, tissues become ischaemic, vasodilation –> hyperaemia when leg lowered

More right-wing politicians are warning incoming international observers not to interfere in the U.S. elections, or else. Among them is Texas Attorney General Greg Abbot, who sent the head of an Organization of Security and Cooperation in Europe (OSCE) observers team a terse letter informing them that any attempt to meddle in voting will result in arrest and prosecution. The OSCE did not take kindlyto the insinuation in a letter to Secretary of State Hillary Clinton:

“The threat of criminal sanctions against OSCE/ODIHR observers isunacceptable,” [Ambassador Janez Lenarčič, the Director of the OSCE Office for Democratic Institutions and Human Rights (ODIHR),] said. “The United States, like all countries in the OSCE, has an obligation to invite ODIHR observers to observe its elections.”

The ODIHR Director also stressed that any concerns or reports that the election observers intended to influence or interfere with the election process were groundless. He underlined that OSCE/ODIHR election observers adhere to all national laws and regulations, as well as a strict code of conduct.

“Our observers are required to remain strictly impartial and not to intervene in the voting process in any way,” Lenarčič said. “They are in the United States to observe these elections, not to interfere in them.” Yet Abbott isn’t convinced. He repeated his warning Wednesday on Fox News

Abbot’s reaction is part of a larger narrative being spun by the right, in which the observers’ presence serves as a threat to their attempts to crack down on supposed voter fraud. This comes despite the fact that these observers have been present at every U.S. national electionfor the last decade.

In an example of the sudden Republican distrust of these observers, Rep. Connie Mack (R-FL)said in a statement that the idea that the United Nations “would be allowed, if not encouraged, to install foreigners sympathetic to the likes of Castro, Chavez, Ahmadinejad and Putin to oversee our elections is nothing short of disgusting.”

Despite all the fearmongering, the OSCE monitors have agreed to (and are mandated to) abide by state and local law. According to OSCE spokewoman Giovanna Maiola, the team will beobserving the complete election process, focusing on a number of areas on the state level, including the overall legal system, election administration, the campaign, the campaign financing and new voting technologies used in various states.

quilavastudy asked:

Hi, I'm a 2nd year medical student in the UK! I was just wondering if you had any tips for OSCE style exams - my med school is obsessed with them (we have way more OSCEs than written exams) but I don't seem to be able to get the knack of them. I know the stuff, but I'm always awkward in them and get brain freezes. Thanks!

Hello!!

Ha I know a thing or two about being awkward and getting brain freezes in OSCEs. In my OSCE on wednesday I was interpreting an ECG and I was trying to work out the rate. I was doing the thing where you count the number of squares between two R waves and then do 300 divide the number of squares. My ability to do mental maths COMPLETLY evaporated and I was just sat there going “so the rate is 300 divided by 7… what’s 300 divided by 7?!?! um um um um um” and the examiner looked at me like I was completly insane and was just like “ok 300/7 is good enough, lets move on”.

So embarrasing.

So I know the feeling!

Here are my list of tips to passing OSCEs!

1) Practice your examinations as much as physically possible

The scary thing about OSCEs is that there are a lot of variables you can’t control such as scary examiners, uncooperative patients etc… One thing that is in your control though is being able to deliver a slick perfomance of your examinations. It might not feel like it but it is really obvious when you are observing someone if they are someone who is confident and knows what they are doing vs someone who just learnt how to do a cardiovascular examination last wek. 

When you are nervous it is really easy to get wound up  but if you have the examination bits solid in your mind you can sort of put your brain on autopilot which definately helped me

2) Practice with other people and time yourselves

Three is a good number for OSCE practice so you have one person being the patient, one being assessed and one being the observer. Time yourselves! We had 10 minutes for a history and 8 minutes for examinations so practice sticking to those time limits and give each other lots of feedback.

3) Practice data interpretation with other people

For our osce we had a data interpretation station which could be anything from ECG, radiology, interpreting ABGs, blood results etc. It’s one thing to be able to look at a CXR and go yep thats a pneumothorax. It’s a very different skill to be able to present an X ray in the format that an examiner wants and to be able to approach these things in a systematic way.

4) Fake it! Confidence is everything

OSCEs are one big performance. It’s such an artificial environment and the best way to pass an OSCE is to treat it like you are putting on a show. 

On the day choose something to wear that makes you feel confident. When I am about to go into the first station I always  feel sick with nerves. Just take a deep breath, put on a smile, open that door and walk in like you are in control and you know exactly what you need to do.

5) If you don’t know the answer to what they are asking you just keep talking

This might not work for everyone but my policy is if I don’t know the answer, I will keep verbalising my thought process and try and logically work the answer out. Often if you are going along the right lines, some examiners will try and push you in the right direction. The examiners want to give you marks so I think my policy is the more I say, the more chance I have of getting to the answer they are looking for

6) Remember that the examiners are on your side!

They want to pass you, regardless of whether they have a poker face or smile at you none of them are out to fail you.

7) Summarise

In history taking stations, if you get stuck a helpful thing to do is to summarise the information you have already gained from the patient. It often buys you time to think of the next question.

Also there is no shame in saying ” I just need a minute to gather my thoughts” and pausing for a few seconds.

8) Management

If you have management stations in your OSCE practice looking things up in a BNF and writing out a management plan within your time constraints. It’s easy to get in a flap if you aren’t familiar with a BNF so again practicing this within a time limit is something I found useful this time. 


So this has turned into a bit of an essay but I hope some of this was useful! If you want any help with a particular aspect of the OSCE/ particular type of station that I haven’t talked about here drop a message in my ask box.

youtube

Cerebellar Dysfunction - remember the acronym DANISH Pastry”

  • Dysdiadochokinesia = inability to perform fast repetitive tasks
  • Ataxia
  • Nystagmus
  • Intention tremor 
  • Slurred speech
  • Hypotonia
  • Past pointing 

The video demonstrates a left sided intention tremor and past pointing

Immediately obvious when Kiev does provocations. They suddenly saw 30 people killed in Mariupol and declared mourning! And the fact that before in Donetsk and Luhansk were killed more than 4,000 civilians, no one noticed, and do not mourning!  Poroshenko hypocrisy has exceeded all standards.

Pro-russian terrorists did not let OSCE to the place of downed MH17… 
I am speechless…Freaks..I have no other words to call these animals… 
Will this someday end in my country?
On the photo:
OSCE vs pro-russian terrorist .

p.s. I feel the same as the man from OSCE on this photo…
I am so sad, that I am woman… I would go to kill these freaks too, if I was a man :(

Just came back from my surgery OSCE. Which means I had to wear a tie under my white coat. It’s probably the only time I wear a tie these days in a clinical setting. Even though I’m technically supposed to wear a tie in the hospital when I’m not wearing scrubs, I don’t. Not cause I’m a huge rebel. But because I don’t want to dry clean my dry-clean-only ties every week. Ties are a horrible source of infection.

Saw 3 standardized patients. Did an abdominal exam on a patient complaining of abdominal pain. She was a pretty good actor. Did another exam on a patient complaining about calf pain. He was a pretty good actor too, joking about his alcohol and smoking habits. And the 3rd patient I saw was a woman who needed a breast exam. 

I didn’t like my performance on the breast exam. It felt rushed. At least I got a chance to drop some knowledge at the end. By that I mean that I was able to discuss breast cancer prevention and current recommendations regarding mammograms. Oh, and I’m glad that I didn’t tell her that her breasts “looked good.” I correctly stated that they looked “healthy.” I also suggested she do monthly breast self exams (BSE). Yes, I know the studies and statistics saying that BSE don’t really reduce mortality/morbidity. But whatever. I think it’s important and I will continue to recommend them to patients for now.

Anyways, she was either a great actor or she felt uncomfortable. Or maybe I was nervous because I felt rushed and so she felt nervous. But I loved her accent.