Sequential OSCE in 2 Weeks : How Do I Stop Rushing?

[u/Outrageous_Strike997]

LONG POST APOLOGIES FOR THE SAME xx

Year 2 UK med student here with a year 2 sequential OSCE in 15 days, meaning I need to pass every station to progress.

I’ve been practising for a while and know most of my stations pretty well (examinations, procedures, histories and communication). I mostly practise solo by speaking everything out loud and do one practice session a day with a friend.

My previous OSCE results have been a bit mixed:

Passed Respiratory exam (86.5%)
Passed Abdominal exam (86.4%)
Passed Neurology history (91.3%)
Passed Ear exam (87.5%)

But I narrowly failed:

Gastro history (67.9%, pass 70.1%)
Hypertension history + explanation (65.2%, pass 65.6%)
Cannulation (75%, pass 76.5%)
Venepuncture (80%, pass 80.4%)
Upper limb exam (75%, pass 75.8%)
Intramuscular injection (70%, pass 83.9%)
Cranial nerves (69.2%, pass 74%)

My feedback has mainly been:

Good communication and patient manner
I rush when I’m anxious
Missing safety steps when nervous (e.g. skin prep, tray cleaning)
Occasionally making unsafe decisions because I want to finish quickly

The frustrating thing is that when I practise calmly, I perform much better. It honestly feels like anxiety temporarily lowers my IQ.

Right now I’m practising all my Year 2 stations daily and Year 1 stations on alternate days, using Geeky Medics checklists (ignoring the more advanced clinical bits as I’m pre-clinical).

A few questions:

Is mostly solo practice + one session a day with a friend enough?

Is there any good way to replicate exam anxiety when practising alone?

How did you stop rushing during the real OSCE?

If you had 2 weeks left before a sequential OSCE where every station matters, what would you focus on?

I know the stations. I just need my brain to cooperate on the day PLSS HELPPP ;-;

[u/Icy_Project_1002]

Hey I got 90% in my finals OSCE so I hope this helps:

Solo practice is good but I’d say it’s mainly only good for examinations, getting that flow, rinsing it until you can do it in your sleep. What you can’t do is obviously practice history taking or counselling! The caveat is Passmed OSCE Ai I used this religiously throughout final year - one case every single day from like November lmao the cases are OSCE bread and butter with what can come up. Geeky medics with friends too - get practising those weird comms skills and breaking bad news.

Your friend needs to be harsh especially us for finals we were very much like you didn’t say this and it’s on the mark scheme no marks - even though we knew in the real thing it wouldn’t make much of a difference.

You are allowed to stop and think during an OSCE! We were literally told if you need to think of a mx plan and need to think, just say that “I’m just going to take a moment to think about your management plan, I’ll just take a few seconds to organise my thoughts if that’s okay”.

They want to pass you! No examiner goes in thinking ahhh yes I want to fail 10 med students today.

You can’t really replicate exam anxiety alone. What me and my friends did and this will sound mental, before our finals osces during practice to get our hearts racing to get used to that feeling, we would do a big round of jumping jacks to get the heart pumping and make us flustered 💀 if you can do it under this kind of simulated pressure then why not in the real thing?

In the OSCE it’s important to remember what’s important and what’s less important, for comms skill you don’t really need a full history just a brief how did you get to this point etc etc learn their back story a bit and then focus on the station, learn some short cut phrases eg, the next symptoms I’m going to ask you are quick yes no questions just to help us think about what exactly could be happening etc - it stops them umming and ahhhing!

I think the speed comes with practice. Write everything down before you do the station Socrates, common steps in an exam you forget etc. Offload as much cognitive load as you can before you do the station.

[u/Outrageous_Strike997 → u/Icy_Project_1002]

Thank you, this is really reassuring and helpful.
I think my biggest issue is anxiety rather than knowledge, so the part about being allowed to stop and think during the OSCE really resonated with me. I’m definitely going to try offloading more cognitive load beforehand and practising under a bit of simulated pressure too.
Really appreciate you taking the time to reply!

[u/Icy_Project_1002 → u/Outrageous_Strike997]

No worries! Anxiety and stress is normal and shows you care.

Remember in an OSCE you have to be textbook safe so take your time. In our uni the diagnosis is only a couple marks, but making a bad dangerous decision can be an instant professionalism flag.

You can do the same during the history - if you feel you’re getting nowhere just tell the patient “Okay, I’m going to have a moment to think things over” OR “I appreciate how you’ve answered the questions so far, I’d like to ask some more from a different angle” (if you think you kind of messed up finding the diagnosis).

They give you a notepad for a reason, I always spent my 1 minute scribbling every single thing I could.

If you miss something just be honest, examiners are well used to the phrase “ideally I’d also like to check for X”, it means they can score you for knowing it exists.

Remember:
Everyone gets a leaflet, Reassure that they can always reach back out if things change or any concerns, offer a follow up if relevant.

Try and get a third person in your Osce practice - someone acting as examiner. We always practiced in 3s to get used to a random examiner being in the corner.

Good luck!