Tuesday, December 23, 2003
Back to MRCPsych revision main page
Back to OSCE main page
MRCPsych part 1 OSCE autumn 2003
Day 2 scenarios 30th october 2003 at Guy's Hospital in LONDON
1. Physical examination:
Task: Cranial nerves examination II - XII. you are not supposed to do fundoscopy, pin prick sensation on face,
gag reflex & taste sensation.
Comment: this was a fairly straight forward station. The actress was very cooperative. She let me finish the task without
any interuptions. You can score high marks in this sort of scenarios.
2. Explaining treatment:
Instructions: You are seeing a young lady, who was recently discharged from hospital. She was admitted following her
first manic episode. She was commenced on lithium when she was in hospital.
Task: Explain to her the implications of lithium treatment & respond to their concerns about the treatment.
Comments: I managed to obtain the following from the patient
i) She had some baseline bloods taken when she was in hospital. She had also an ECG done.
ii) She has been tolerating the treatment very well.
iii) She hadn't had much information about lithium.
iv) She was planing to get married to her boyfriend & have a baby in 6 months time.
v) She was abit concerned about the side effects.
vi) she asked about the duration of lithium treatment.
3. Explaining management:
Instructions: You are seeing a 25 year old lady, who has been troubled by fears of dirt & compulsive hand washing.
your consultant diagnosed her as suffering from Obsessive compulsive disorder & asked you to explain
to her the management of OCD.
Task: Explain to her about the biological & psychological treatment of OCD.
Comments: i) The patient refused to shake hands when I tried to do so.
ii) She hadn't had much information about management of her disorder.
" you are the doctor, you are supposed to tell me about it"
iii) She heared about PROZAC & it's side effects.
iv) She had never taken any antidepressants before.
v) She was willing to accept treatment.
vi) I think there was alot to do here in 7 minutes.
4. Explaining treatment:
Instructions: Explain systemic desensitisation to a patient with agoraphobia.
(This is a repeat. See Spring 2003.)
5. Explaining diagnosis:
Instructions: You are about to see a 32 year old man with a history of symptoms suggestive of a panic disorder such as the following
i) palpitation
ii) shortness of breath
iii) chestpain
iv) thoughts of impending doom
He believed that he was having a heart attack.
Several investigations by his GP failed to show any organic pathology.
Task: Explain to him that he suffers from a panic disorder.
Also explain that hyperventilation could precipitate a panic attack.
Comment: The patient had several investigations including an ECG and an Echocardiogram. He wondered whether these tests although showing normal results, could be wrong. His father and uncle had a history of myocardial infarctions. On the whole the patient was cooperative and allowed me to proceed with the explanation without much interruption. At the end he asked me about the causes of panic disorder. Using visual aids is quite useful in explaining the psychological basis of panic disorder. Make sure you use the note pad provided in the examination.
6. History taking (PTSD)
7. History taking (Psychosis)
8. Cognitive assessment
9. Risk assessment
10. Risk assessment (talking to your consultant about the patient you saw in station 9)
11. Physical examination (thyroid status)
12. History taking (eating disorder)
Back to OSCE main page
MRCPsych part 1 OSCE autumn 2003
Day 2 scenarios 30th october 2003 at Guy's Hospital in LONDON
1. Physical examination:
Task: Cranial nerves examination II - XII. you are not supposed to do fundoscopy, pin prick sensation on face,
gag reflex & taste sensation.
Comment: this was a fairly straight forward station. The actress was very cooperative. She let me finish the task without
any interuptions. You can score high marks in this sort of scenarios.
2. Explaining treatment:
Instructions: You are seeing a young lady, who was recently discharged from hospital. She was admitted following her
first manic episode. She was commenced on lithium when she was in hospital.
Task: Explain to her the implications of lithium treatment & respond to their concerns about the treatment.
Comments: I managed to obtain the following from the patient
i) She had some baseline bloods taken when she was in hospital. She had also an ECG done.
ii) She has been tolerating the treatment very well.
iii) She hadn't had much information about lithium.
iv) She was planing to get married to her boyfriend & have a baby in 6 months time.
v) She was abit concerned about the side effects.
vi) she asked about the duration of lithium treatment.
3. Explaining management:
Instructions: You are seeing a 25 year old lady, who has been troubled by fears of dirt & compulsive hand washing.
your consultant diagnosed her as suffering from Obsessive compulsive disorder & asked you to explain
to her the management of OCD.
Task: Explain to her about the biological & psychological treatment of OCD.
Comments: i) The patient refused to shake hands when I tried to do so.
ii) She hadn't had much information about management of her disorder.
" you are the doctor, you are supposed to tell me about it"
iii) She heared about PROZAC & it's side effects.
iv) She had never taken any antidepressants before.
v) She was willing to accept treatment.
vi) I think there was alot to do here in 7 minutes.
4. Explaining treatment:
Instructions: Explain systemic desensitisation to a patient with agoraphobia.
(This is a repeat. See Spring 2003.)
5. Explaining diagnosis:
Instructions: You are about to see a 32 year old man with a history of symptoms suggestive of a panic disorder such as the following
i) palpitation
ii) shortness of breath
iii) chestpain
iv) thoughts of impending doom
He believed that he was having a heart attack.
Several investigations by his GP failed to show any organic pathology.
Task: Explain to him that he suffers from a panic disorder.
Also explain that hyperventilation could precipitate a panic attack.
Comment: The patient had several investigations including an ECG and an Echocardiogram. He wondered whether these tests although showing normal results, could be wrong. His father and uncle had a history of myocardial infarctions. On the whole the patient was cooperative and allowed me to proceed with the explanation without much interruption. At the end he asked me about the causes of panic disorder. Using visual aids is quite useful in explaining the psychological basis of panic disorder. Make sure you use the note pad provided in the examination.
6. History taking (PTSD)
7. History taking (Psychosis)
8. Cognitive assessment
9. Risk assessment
10. Risk assessment (talking to your consultant about the patient you saw in station 9)
11. Physical examination (thyroid status)
12. History taking (eating disorder)
