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OBGYN 546

OSCE Tips & Tricks

2026-2027

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Core Content

  1. Pre-clerkship content (study notes, lectures)�
  2. Use your course and session level objectives as your guide�
  3. Content, cases, and concepts presented during the two orientation days�
  4. Mandatory Aquifer cases

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Supplementary Content

  • Recorded University of Alberta Lectures
  • Surgery 101 https://surgery101.org/series/obstetrics-and-gynecology/
  • Optional Aquifer content�
  • ALARM Manual�
  • Toronto Notes (University of Alberta Library - can sign out for 24 hours)�
  • Williams Obstetrics (University of Alberta Library - available online)�
  • Williams Gynecology (University of Alberta Library - available online)�
  • SOGC Guidelines (University of Alberta Library - search, published in Journal of Obstetrics and Gynecology Canada - JOGC)�
  • CREOGS over Coffee - PODCAST�
  • GYNECOLOGY SURGEONS UNSCRUBBED - PODCAST https://www.sgsonline.org/gynecologic-surgeons-unscrubbed-podcast

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“Every test, examination and OSCE is a celebration

of what you have learned”

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What does OSCE stand for?

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Objective Structured Clinical Examination

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History of the OSCE

  • 1979: Professor Ronald Harden University of Dundee, Scotland

Assessment of Clinical Competence Using an Objective Structured Clinical Examination (OSCE). Medical Education 1979; 13: 41-54

  • Embraced widely as a method to supplement assessment of biomedical knowledge

https://www.bmj.com/content/bmj/1/5955/447.full.pdf

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OSCE Stations

The purpose of each station may vary

In addition to biomedical knowledge, OSCEs can assess:

  • Communication skills
  • Professionalism
  • Attitudes for effectively interacting with patients and healthcare worker

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OBGYN 546

Week 6 - Thursday or Friday

All students to report at

8:45 AM and finish between 11:30 AM and 12:00 PM

OSCE

  • Zeidler Ledcor CTC
  • HSERC
  • Katz Small Group Rooms

Hybrid

Three student groups;

All students will be sequestered before and/or after the exam

Format

  • Students (in-person)
  • SPs (in-person)
  • Examiners (virtual)

Three stations

2 minutes to read and prepare, 10 minute stations,

Pen & paper allowed

Details

  • Closed book exam
  • Schedule on the website
  • MCQ at 1:00 PM

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Top 10 OSCE Tips and Tricks

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Wear appropriate attire

  • Dress for success (whatever that might mean to you)
  • Don’t wear those shoes that aren’t comfortable, that shirt that’s too small
  • Avoid anything that will make you think about it/fidget with it

1

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The assessor in this station doesn’t know what happened in the last station

  • “Think of each station as separate. Don't let a bad station shake your confidence and focus! Take a deep breath and move on.”

- PGY4 OBGYN Resident

2

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Describe your answer if you can’t recall the exact specific medical terminology

  • There are part marks
  • There is a difference between saying “I don’t know” and “I don’t know but…”

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Read the stem very carefully

  • Pull out points you need
    • Ex) Where are you? If the stem says you’re in ED, don’t say “I would tell the patient to go to the ED”
  • Notice what the question at the end is asking
    • Ex): Is it asking for a full history or a focused history?
    • If you take a complete history when they only asked for a focused history, you may not get through the station…

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“Under pressure you don’t rise to the occasion, you sink to the level of your training”

  • This is what you tell yourself when you are in a station where you have no idea what is going on.
  • Confidence in your training is the method

5

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Have (or at least fake) CONFIDENCE!!

  • There comes a point where you have studied enough and you know what you need to know
  • Then it’s about showing it
  • May impact ‘global performance/global impression’ score

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Having confidence

vs

Projecting confidence

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Practice, Practice, Practice

  • Obtaining a history should be rote memorization:
    • HPI, PMedHx, FamHx, PSurgHx, PPsych Hx, OBGYN Hx, Allergies, Rx, SocHx
  • ROS should be rote (ie. Head to toe, have a method and get good at it)
  • “Practice with a friend, practice with your mom, your dog, your plant (the idea is PRACTICE) and practice saying it out loud (not just in your head).”
  • PGY1 OBGYN Resident

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Narrate. No one can read your mind

  • Nothing is “obvious” to the examiner
  • Incorrect thinking: “they know what I’m doing”

“I think overall the best advice is to talk/think out loud and explain all the steps you are taking. Even if you’re performing a skill correctly, vocalizing what you are doing and what you are looking for is key to ensure the examiner awards you credit.”

  • PGY2 OBGYN Resident

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Leave the jokes at the door

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Don’t forget the easy points

  • Introduce yourself
  • Wash your hands (yes, even virtually)
  • Vitals signs
  • Most commonly forgotten: Allergies and social history

“Remember to include appropriate draping, lighting, patient comfort etc. as part of your practicing.”

  • PGY3 OBGYN Resident

10

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Get ready to give an OSCAR winning performance

We have a “global rating score” component

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Words of Wisdom

“If the examiner prompts you, don't panic, it doesn't mean you are failing. Likely they are just trying to get you all the points you deserve for your knowledge.”

  • PGY4 OBGYN Resident

“I think a good osce tip is to practice answering certain questions quickly example: on physical exam I will look at general appearance, ABCs, and vitals. Then get more specific. But saying the first part always gets you points!”

  • PGY4 OBGYN Resident

“My best tip would be to not worry about mistakes or bombing a station, move on and focus on the next because often messing up one station is ok and you can still pass if you do your best on the rest!”

  • PGY2 OBGYN Resident

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Let’s practice…

You have two minutes with this stem – What are you going to do with yourself?�

You are called by the ER staff to assess a patient:

Ms. Jones is a 22 year old who presents to the ER with a 2 days history of left lower quadrant and generalized pelvic pain.

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You walk in the examination room…

  • What do you want to know on history?

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History

  • Age
  • Onset of pain, characteristics, duration, nature
  • Aggravating and relieving factors, similar episodes in the past 
  • GI or urinary symptoms
  • Fever
  • Vaginal discharge or bleeding 
  • Post coital bleeding
  • PMH: GI problems, UTI’s, Renal stones, endometriosis, musculoskeletal 
  • PSH: appendectomy, pelvic/abdominal laparoscopy/laparotomy
  • Gyn: LMP, menstrual history, last pap, STI’s, PID’s, contraception, IUD use, vaginal douching, age at first intercourse, number of sexual partners
  • ObHx: previous ectopics, details of GTPAL
  • Social Hx: occupation, sexual activities, smoking, drugs, alcohol, SES, abuse
  • Family Hx
  • Medications and allergies

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The patient tells you the following…

The patient is a 22 year old, G2P0A2. 

The pain started two days ago and has been worsening in the LLQ. It doesn’t radiate, relieved a bit with acetaminophen and ibuprofen. She has no urinary or GI symptoms other than some nausea. She noticed some yellow thick vaginal discharge, and is unsure if she has had a fever. 

She works as a cashier. Her past medical and surgical histories are unremarkable other than two D&Cs for therapeutic abortions when she was 17 and 18 years old. 2 years ago, she had chlamydia which was treated with “one pill”. Her LMP was “sometime last month”, her last pap was 2 years ago. Her age at first intercourse was when she was 15, she had 4 sexual partners in the last year, all males. She is on the pill, and uses condoms when she remembers. She smokes one pack per day, and likes go out with her friends and drink at least 4 times a week.

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Then the examiner asks…

  • What is your differential diagnosis?

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Points would be given for:

Gyne Causes:

  • Adnexal torsion/cyst
  • PID
  • Cystitis
  • Degenerating myoma
  • Ectopic pregnancy
  • Endometriosis
  • Ovulation

Non-Gyne Causes:

  • Diverticulitis
  • Functional pain
  • Meckel's diverticulum
  • Mesenteric lymphadenitis
  • Urolithiasis
  • Cystitis 
  • IBD

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Next question asked:

  • What would you do on physical exam?

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Points would be given for:

Skin:

  • Rash (palm and soles)
  • Disseminated gono.

Head:

  • Alopecia

Face:

  • Mouth herpetic ulcers
  • Hairy leukoplakia

Neck:

  • Lymphadenopathy

Chest and Cardiovascular Exam

Abdomen:

  • Signs of Peritonitis (guarding rigidity)
  • Tenderness and rebound
  • Liver and spleen span
  • Other masses

Pelvic:

  • Inguinal LN
  • Vulva for ulcers
  • Vagina for ulcers and discharge
  • Cervix for hyperemia, friability and discharge
  • Nitrazine paper for p
  • Swaps for: CG, trich and sample for saline suspension 
  • Pap if not done in the past year
  • Bimanual: Cervical motion tenderness and uterine size and mobility and for adnexal mass and tenderness

Vitals, BMI

General Appearance

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The patient then tells you…

Her BMI is 25, she looks generally well but a mildly flushed. Her vitals are normal, however her temperature is 37.8 degrees celsius. There are no abnormalities on head and neck, chest or respiratory exam. Her abdomen is tender, especially in the left lower quadrant, but there is no guarding or peritoneal signs. There are no palpable inguinal nodes. The vulva is normal. On speculum exam you see purulent discharge from the vagina. Bimanual exam is difficult to perform since she is exceedingly tender. 

What labs would you like to do as a work up?

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Points would be given for:

  • Pregnancy test
  • Microscopic exam of vaginal discharge in saline
  • Cervical swab for chlamydia, gonorrhea, HSV (if suspected)
  • Vaginal swab for C+S (yeast, BV, trichomoniasis)
  • CBC
  • Urinalysis
  • STI serology:
    • HIV testing
    • Hepatitis B surface antigen and surface antibody
    • VDRL/ syphilis screen
  • Pelvic and abdominal ultrasound
  • ESR / CRP (optional)

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The patient then says…

Her pregnancy test comes back negative. Microscopy of vaginal fluid shows ≥3 WBC per high power field (most sensitive but not specific). WBC is 15000. Urine negative. All other cultures/ PCR/ serology are pending. Pelvic US shows swelling of the fallopian tubes bilaterally but no definite collections.

�What is your most likely diagnosis at this point?

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Diagnosis

PID/Endometritis/Salpengitis/TOA

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Additional examiner or patient questions…

  • What minimum criteria would you like to find on the physical examination before starting empiric treatment?
  • What additional criteria would support your diagnosis of PID?
  • What are the most specific criteria for diagnosing PID
  • Ms. Jones would like to go home, what criteria would make you encourage her to be treated as an inpatient
  • Based on your clinical assessment and judgment, you decide to treat her as an outpatient, what medication would you give her? What are the available regimens?
  • Is there anything else you would like to do before she leaves?