OSCE stations exam
Arab board of surgery
Aden training center
Yemen
Dr Tamimi
Station No1
• You will meet Mr. Ahmed 23 years old , who was
previously healthy,
• One day abdominal pain in the right lower
quadrant
• Please ask three important question regarding
this pain
• Examine his abdomen , ask for two important
blood investigations
• Best imaging study , possible diagnosis
• Options of treatment
Checklist station NO 1
SN
Points to be asked
1.
Introduce himself, good
appearance and confidant= 1
Severity of pain=0.5
2. Associated GIT symptom=0.5
Similar attack=1
Permission for exam=1
3. Point to pain site=0.5
Tenderness =0.5
Rovsing =0.5
Psoas test=0.5
4. Cough test0.5
Done
Not
done
SN
Points to be asked
CBC =0.5
5. C-reactive protein=0.5
Abdominal ultrasound=0.5
6.
Acute appendicitis =0.5
7.
Open appendectomy=0.5
Lap appendectomy=0.5
Drain± =0.5
.
Total
Done Not
done
Station NO 2
• Young adult man give history of blunt abdominal in
injury sustained during football match.
• Treated conservatively,, and then readmitted again
with severe upper abdominal pain with mild distension
• Please ask two important points in the history
• Examine the abdomen
• request one imaging study
• One important blood investigation
• Diagnosis and options of treatment
• One important complication
Checklist station NO 2
SN
Points to be asked
Done
Not
done
SN
Points to be asked
Pseudopancreatic cyst=1
1.
Introduce himself, good
appearance and confidant= 1
2. Time of injury=0.5
Fever =0.5
Ask about pain =0.5
3. Vomiting =0.5
6.
Internal drainage =0.5
7. External if infection=0.5
Conservative if small=0.5
Laparoscopy =0.5
8. Open =0.5
Pancreatic fistula
Take permission to exam=0.5
4. Mass exam=1
Cullen sign+gray terner =0.5
9.
Abdomen CT=0.5
5. Serum amylase again raised=0.5
10.
Total
Done Not
done
Station NO 3
• You are going to meet adult man 60 who give
history of right parotid swelling .
• He was informed by the family doctor that he
may have advanced cancer and referred to you
• Please examine this patient
• Mention the possible diagnosis
• Arrange for two important investigations
• Options of treatment
SN
Checklist station NO
3
See the teeth=0.5
Points to be asked
Greeting the patient ,
introduce himself, take
permission, and stand to the
right = 1
Ask for pain before
palpation=0.5
Site =0.5
Skin over=0.5
Size= 0.5
Done Not
done
Closed mouth blowing=0.5
Closed eye=0.5
Try open the eye=0.5
Wrinkled forehead=0.5
Mixed parotid tumor =0.5
FNAC =0.5
MRI =0.5
Surgery superficial
parotidectomy = 0.5
Hard consistency=0.5
Mobility=0.5
L nodes =0.5
Thank the patient after exam=0.5
Facial nerve affection=0.5
Total
Station 4
• At the pediatric surgical unit , your senior
consultant send you to explain the procedure of
day case surgery to young child 2 years with
single pediculated rectal polyp
• He was fully investigated and fit for intervention.
• His mother in the office waiting for you
• Please explain every thing regarding the surgery
and possible related events
SN
Checklist station
NO 4 Medication like pain control=0.5
Points to be asked
Greeting the patient ,
introduce himself, take
permission, and stand to the
right = 0.5
Investigations ,fitness =0.5
Consent form=0.5
Fasting 4h =0.5
Bowel preparation =0.5
Anesthesia GA =1
Proctoscopy or
sigmoidoscopy =1
Identify the polyp =0.5
Look for other plyp =0.5
Excision =0.5
Start feeding =1
Done Not
done
Discharge at night =0.5
Complications
pain=0.5
Bleeding=0.5
infection =0.5
When to return=0.5
How to contact=0.5
Total
Station NO 5
• You are going to meet miss Fatima , she is a
close relative of 40 years old female that give
history of breast lump since 3 months
• Please take focused history
• At the end give your possible diagnosis
• Initial important investigation
• Best diagnostic investigation
• Options of surgery
• Prognosis
Checklist station NO
5
SN
Points to be asked
Greeting the patient ,
1.
introduce himself, take
permission, and stand to the
right = 0.5
2.
Which breast affected =0.5
3.
Painful or painless= 0.5
Ask about the size and rapid
growth =0.5
4.
5.
Nipple discharge =1
Changes in the skin = 0.5
Done Not
done
6.
Any mass in the axilla = 0.5
7.
Family history =1
8.
Left breast carcinoma=1
9.
Bilateral mammography =1
10.
FNAC =1
Breast conserving surgery =1
11. MRM and axillay clearance =1
Total
Station NO 6
• Your professor asking you this morning to
meet the family of an old male 76 years with
metastatic adenocarcinoma of the stomach
• HB 6g/dl, elevated urea and creatinine
• He request to explain his bad recent condition
and to plan an effective terminal care
Checklist station NO 6
SN
Points to be asked
Greeting the patient ,
introduce yourself,=1
Explain how bad this cancer
Mets, age =1
No place for surgery or any
palliative =0.5
Nutrition
Entral =0.5
Parentral=1
Stoma =1
Blood transfusion=0.5
Done Not
done
Medication like pain control
Drugs =1
Non drugs ( religious ) =1
Care for
Bed sore=0.5
Mouth hygiene=0.5
hypothermia =.5
Home care0.5
We are ready to help any time
=0.5
Total
Station 7
• You will meet a husband of young lady who said
to you that his wife is already diagnosed as acute
cholecystitis
• He blamed the first surgeon that he lie on him
and want to operate on her urgently.
• He prefer you to do the operation if necessary
• How can you behave in this situation
• Would you operate on her or not ? And why ?
Checklist station NO 7
SN
Points to be asked
Done
Not
done
SN
Points to be asked
Ask to return again=1
1.
Introduce himself, good
appearance and confidant=
0.5
Ethical consideration=1
2. Our professor =0.5
Reassurance =0.5
3. Ask if examine the pt =0.5
Investigate him=0.5
4.
5.
Explain why urgent =1
Risk of this delay =0.5
Mention option of surgery=1
Same intervention or may be
better =1
6.
Once he blame for nothing he
7.
will blame you =1
Ethical and Dr –Dr
8. relationship=1
9.
10.
Total
Done Not
done
Station NO 8
• You will meet a brother of Miss Noora which
involved in road traffic accident and brought
to you in shock state and still not well
responded
• Initial investigation showed spleen injury
• How can you explain all the events related to
such serious case
Checklist station NO 8
SN
Points to be asked
1.
Introduce himself, good
appearance and confidant= 1
Reassure =1
2. FAST=2
Blood transfusion=0.5
3. Emergency surgery=0.5
Consent form=1
Done
Not
done
SN
Infection after
6. splenectomy+0.5
Vaccine =0.5
7.
8.
4.
5.
Remove spleen=1
May be other trauma=1
Dead on table =1
Points to be asked
9.
10.
Done Not
done
Station NO 9
• Your professor ask you to meet a co-patient (
relative ) of a gentleman 63 years old give
history of bleeding per rectum and mucous
discharge,, he will give you histopathological
report after taken biopsy per anus 5cm from
the anal verge. And the result was poorly
differentiated adenocarcinoma
• Please gently break this bad news and
arrange your further management ?
Checklist station
NO 9
SN
1.
Points to be asked
Introduce himself, good
appearance and confidant= 1
Try to break this bad news
2. correctly ,sympathy, body
language ,religious = 1
Need of imaging study for
3.
distant mets like abdominal
CT= 1
Surgical treatment ==
4.
abdomino- perineal =1
Surgical treatment = stapler
anastomosis =1
Colostomy =1
5.
Done
Not
done
SN
Points to be asked
Post operative chemotherapy
6.
=1
7.
Neoadjvant chemo
radiotherapy=1
8.
Side effect of surgery like
impotence =1
9.
Side effect of chemotherapy
=0.5
10.
Prognosis = 0.5
Total
Done Not
done
Station 10
• You are 5th year registrar in arab board of
surgery
• Your senior asked you to discharge male
patient operated for abdominal gun shot with
temporary colostomy and stable pelvic
fracture
• Arrange the possible instructions
• Further follow up
Checklist station NO
10
SN
1.
2.
3.
4.
5.
Points to be asked
Introduce himself, good
appearance and confidant= 1
Surgical wound clean=0.5
Your condition stable =0.5
Change position =0.5
Colostomy care =0.5
Psychological support=0.5
Train to change the bag=0.5
Skin ulcer or hypermia =0.5
Complication as stenosis ,
hernia , prolapse=1.5
Done
Not
done
SN
Points to be asked
6.
Reverse colostomy after 8-12
weeks=2
7.
Another surgery and
anesthesia =1
8.
Side effect of surgery like
failure , infection =1
9.
10.
Total
Done Not
done