2) No more checklists. Following on from the changed EM curriculum, checklists for marking OSCEs are now replaced with 'Domains'.
The 7 domains that will be tested within FRCEM OSCE
1 - Clinical reasoning/ Decision making
2 - Communication skills/ Conflict resolution
3 - History taking/ information gathering
4 - Clinical examination skills
5 - Practical/ Pinnacle skills
6 - Teaching skills
7 - Organisation/prioritization
3) Domain-based marking: Each station will relate to 2 to 4 domains and the candidate will be scored from 0 to 4 in the domains
0 - Well below the level of competence
1 - Below the level of competence
2 - Level of acceptable competence (1st day as a consultant)
3 - Above the level of competence
4 - Well above the level of competence
4) Number of stations has increased to sixteen (from 12).
You will get 1 extra minute to read & orient before each station.
Each station will run for 8 minutes.
5) Type of stations
Each station may focus on any of the 3 aspects
(See point numbers 2 & 3, each station can test more than one, out of the seven domains)
a) Clinical - 12 stations
The remaining 4 stations would relate to Management/ CLA
b) Management
c) Research/ Critical Literature Appraisal (CLA)
[UPDATE 6th October 2021; there will be four management stations and no dedicated research stations in the November 2021 diet of the FRCEM OSCE]
The 12 clinical stations would be mapped against the new RCEM curriculum SLOs (covering 9 of them) and categorized as:
3 stations: SLO 1 - Complex stable patients
Care for physiologically stable patients attending the ED across the full range of complexity
3 stations: SLO 3 - Resuscitation
Resuscitate and stabilize patients in the ED, knowing when it is appropriate to stop
2 stations: SLO 4 - Injured patient
Care for injured patients across the full range of complexity
1 station: SLO 5 - Paediatric Emergency
Care for children of all ages in the ED, at all stages of development and children with complex needs
2 stations: SLO 7/ 8 - Emergency Physician in Charge (EPIC)
Deal with complex or challenging situations in the workplace
Lead the ED shift
1 station: SLO 9 - Teaching
Support, supervise and educate
This could even be structured as an MSO (Multi-Station Oral examination) asking to prepare educational objectives and education delivery to a group of learners for a chosen topic.
The 4 Management/ CLA (Critical Literature appraisal/ research) stations
[UPDATE 6th October 2021; there will be four management stations and no dedicated research stations in the November 2021 diet of the FRCEM OSCE]
2 stations: SLO 10 - Critical Literature Appraisal
Participate in research and manage data appropriately
2 stations (up to 4, if tested in combination with SLO 10):
SLO 12 - Management: Manage administer & lead
6) The resuscitation stations:
There are NO double (longer duration) resuscitation stations.
You will have to pass at least ONE resuscitation station (out of three) apart from gaining an overall pass.
These stations may be structured as
a) A short hands-on scenario based on a moulage/ simulated resuscitation setup.
b) Answering questions on, how? a particular resus scenario could be managed.
c) Debriefing a resuscitation situation that has occurred.
d) other possibilities
7) The Management Stations (SLO 12)
(The very old FRCEM, used to have Management viva/ longcase - this is perhaps coming back! )
These stations could be a structured discussion to test the ability to lead the Emergency Department by
a) Responding to complaints OR safety & quality (Root Cause Analysis, critical incidents, etc.) issues
b) Emphasizing relevant legislation (medicolegal/ coroner's report etc.) OR safeguarding related situations
c) A departmental training or management/organizational structure issue.
etc.
8) The Critical Literature review (SLO 10)
(The old critical appraisal exam is no more, but Critical appraisal is still very much part of the RCEM assessment - it's gone Nowhere! just added on to the OSCE)
[UPDATE 6th October 2021; there will be four management stations and no dedicated research stations in the November 2021 diet of the FRCEM OSCE]
These stations would be blueprinted to the SLO 10 of the new curriculum OR could be tested in conjunction with another management (SLO 12) related station.
They are likely to be structured as a guided conversation to test the ability to critically appraise published biomedical research.
It is possible that candidates would be provided a published research paper prior to attending the exam, which they can prepare (No written summary/ notes would be allowed to be brought to the station, obviously!).
A copy would be available in the station to refamiliarize with the paper during the preparation time and refer to during the discussion.
Not just diagnostic & therapeutic papers (as was the common practice for critical appraisal exams of the past) you must now expect to be tested in the knowledge of other forms of scientific literature like meta-analysis & systematic reviews etc.
9) The FRCEM OSCE is based on a revised blueprint emphasizing on leadership & Management. Keep looking at upcoming & updated information on the RCEM website/ communications.
No external resource (book/ website/ course) can replicate the Nov'2021 exam accurately as this is going to be the 1st FRCEM OSCE based on the new curriculum and it is going to be a new experience for examinees, examiners, and trainers.
10) Again, This is not the same OSCE as any other in terms of preparation because the level of competence acceptable to pass the FRCEM final OSCE is that of a 1st day Emergency Medicine Consultant (the level expected to pass the MRCEM OSCE is that of a 1st day EM registrar).
So, gather all the shop floor management skills & experience gained from years of training, all the available evidence-based EM knowledge resources along with the best possible attitude to give your best.
All the best.
