Thursday, November 27, 2008

OSCE = Standardized Waste Of Time?

OSCE stands for Official Structured Clinical Exam. This is an exam that tests a physicians clinical abilities. Forget that book learning, this is where we prove we can interview patients and perform clinical procedures (like a chest exam).

Although I think testing med students on their clinical abilities is essential, testing med students in the first term of their first year is pointless! They can test us on any clinical procedures because we don't know any (not entirely true, we can measure blood pressures, but they don't test us on that) so the OSCE tests our ability to do a medical interview. I think this OSCE is a waste of time because so far, in class, we've done at least 3 practice interviews in front of a tutor and several classmates. We've also had plenty of experience doing interviews when we went out to work in the clinics throughout the term. We really do know how to do these interviews, if we didn't, the faculty would have heard about it by now!

I had to drive all the way out to VGH to do a simple 8 minute interview where we get to know a standardized (read: actor) patient, ask him about his chief presenting complaint, and see how he feels about it. Seriously...I had to drive out their for 8 minutes of chit chat! Yes...I realize that there are BIGGER problems in the world I could be complaining about, but I'm pretty sure this is a close second to obstetric fistula (maybe not, but I thought I'd raise some awareness while I had the chance).

Now I understand that schools live to examine students, so maybe we HAD to have an OSCE, but at least make the OSCE a challenge! Let us practice our complete history taking skills, I've already shown you that I can FIFE! I complaining about an easy exam?! Ok, I'm sorry...I take it back!

Something that I found funny was how I was a victim of standardized examination. In the OSCE, our tutors have a list of questions we are supposed to ask. These range from asking the patient for his/her name and age to asking about how the patient's complaint is effecting their daily function. My patient was a 28 year old professional soccer player who came in with a knee injury. During the feedback session, my tutor told me I aced the OSCE except for the one question I missed...I didn't ask the patient if he was in a relationship. Ok...on what planet would that have been a relavent piece of information in THIS case?! (Turns out my tutor also didn't ask this question when she did a practice run earlier that day...well, at least I'm in good company!)

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