Case OSCEs

Respiratory OSCEs

Prepare yourself for these common respiratory topics in Objective Structured Clinical Examinations The common topics that have been tested in OSCE exams during USMLE Step 2 CS, MCCQE Part II, PLAB 2, OSCEs for medical students and medical school clinical finals, Clinical Skills Assessment for International Medical Graduates are: 

Asthma: in all scenarios: Acute ER setting management, Worsening follow up, After attack follow up, Consult.

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Wheezes.

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Pneumonia, typical and atypical.

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Chest pain.

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Cough.

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Coughing up blood (Haemoptysis).

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COPD: in all scenarios: Acute ER setting management, Worsening follow up, After attack follow up, Consult.

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Shortness of breath.

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Chronic shortness of breath.

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Pulmonary embolism in ER setting.

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Anticoagulant counseling for pulmonary embolism.

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Bronchiectasis.

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Pleural effusion.

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Interstitial lung disease, occupational cough/SOB.

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Solitary pulmonary nodule on X-ray.

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Pneumothorax in ER setting.

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Rhinorrhea / Sore throat.

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Sinusitis.

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Chest X-ray interpretation.

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Pulmonary Function Tests interpretation.

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Arterial blood gases interpretation.

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Smoking consult.

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Respiratory system examination.

Common respiratory OSCEs Common OSCE exam cases that have been seen in USMLE Step 2 CS, MCCQE II, PLAB 2, OSCEs for medical students and medical school clinical finals, Clinical Skills Assessment for International Medical Graduates are:

(Please note: For USMLE Step 2 CS, there is no examiner in the room. The encounter is video monitored and taped. Thus, there will be no questions asked in the room other than the patient's questions. However, during physical examination, you are still required to explain what are you going to do to the patient before physically touching him/her. All USMLE Step 2 CS stations are of 15 minutes long and require focused history taking, physical examination, and counseling as needed. Thus, ignore the last statement in the following sample stations about the available time and required tasks to do).

1. Ronald Davidson is a 43 year old man who comes to your office complaining of shortness of breath. In the next 5/10/15 minutes take focused history. (SOB). 2. Jeffrey Hanson is a 52 year old man who has come to your office because of frequent episodes of shortness of breath. In the next 5/10/15 minutes take focused history. (SOB).

3. James Fairman is a 57 year man who comes to your office because during an employment routine check up he was found to have a nodule in his lung. In the next 5/10/15 minutes take focused history. (Lung nodule). 4. Julian Cameron is a known case of chronic bronchitis who has come to your office for a regular check up. In the next 5/10/15 minutes perform focused physical exam. (Exam). 5. Albert Henderson is a 62 year old man who comes to your office with cough for three months. In the next 5/10/15 minutes take focused history. In the last minute the examiner will stop you to ask questions, (Cough). 6. John Hunter is 54 year old man who comes to the emergency because of cough and recurrent lung infections. In the next 5/10/15 minutes take focused history. (COPD). 7. George Camay is a 32 year old man and an asthmatic patient of your colleague Dr. Eric Goodson. He comes to your office for a follow up visit as your covering Dr Goodson while he is away. In the next 5/10/15 minutes talk to him (Asthma). 8. Nikkei Johnson is a 29 year old woman who has been diagnosed with asthma recently. In the next 5/10/15 minutes talk to her. (Asthma). 9. Steven Copper is 19 year old man who came to emergency with sudden right sided pain. In the next 5/10/15 minutes take focused history and focused physical examination. (chest pain/ Spontaneous Pneumothorax). 10. Norman Pearson is a 77 year old man who came to your office complaining of hoarseness for three months. In the next 5/10/15 minutes take focused history.(Cough). 11. James Timothy is a 66 year old man who comes to your office complaining of coughing up blood. In the next 5/10/15 minutes take focused history. (Hemoptasis). 12. Nick Camberley is 65 year old man known case of COPD who comes to the emergency complaining of shortness of breath for two days. In the next 5/10/15 minutes, mange him. (COPD exacerbation).

13. Julie Osler is 67 year old woman who came to your office because of a bothersome dry cough for two months. In the next 5/10/15 minutes take focused history and answer her concerns. (Cough/ Atypical pneumonia). 14. Sandy Homer is 22 year old asthmatic woman who comes to the emergency because of worsening shortness of breathing. In the next 5/10/15 minutes manage her. (Asthma exacerbation). 15. Sandy Homer is 22 year old asthmatic woman who comes to the emergency because of worsening shortness of breathing. You managed her and she is stable now. In the next 5/10/15 minutes talk to her before discharge. (Asthma

exacerbation).

Cardiovascular OSCEs

Prepare yourself for these common cardiovascular topics in Objective Structured Clinical Examinations The common topics that have been tested in OSCE exams during USMLE Step 2 CS, MCCQE Part II, PLAB 2, OSCEs for medical students and medical school clinical finals, Clinical Skills Assessment for International Medical Graduates are: 

Chest pain.

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Myocardial ischemia/infarction: ER management.

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Cardiac arrest.

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Palpitation.

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Atrial fibrillation.

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Syncope.

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Hypertension.

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Hypotensive shock: ER management.

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Digoxin toxicity, ER management, and counselling setting.

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Pericarditis.

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Infective endocarditis.

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Heart failure/ generalized edema/ ankle swelling.

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Intermittent claudication.

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Acute/ chronic leg pain.

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Deep venous thrombosis.

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Complete cardiovascular examination.

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ECG interpretation.

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Cardiopulmonary Resuscitation (CPR).

Common cardiovascular OSCEs Common OSCE exam cases that have been seen in USMLE Step 2 CS, MCCQE II, PLAB 2, OSCEs for medical students and medical school clinical finals, Clinical Skills Assessment for International Medical Graduates are: (Please note: For USMLE Step 2 CS, there is no examiner in the room. The encounter is video monitored and taped. Thus,

there will be no questions asked in the room other than the patient's questions. However, during physical examination, you are still required to explain what are you going to do to the patient before physically touching him/her. All USMLE Step 2 CS stations are of 15 minutes long and require focused history taking, physical examination, and counselling as needed. Thus, ignore the last statement in the following sample stations about the available time and required tasks to do.).

1. William Hartman is a 46 year old man who comes to your office with chest pain. In the next 5/10/15 minutes take focused history and address his concerns. (Chest pain). 2. Michael McCarthy is 52 year old man, who is a known case of hypertension. He came to your office for his annual check up. In the next 5/10/15 minutes perform a complete physical examination. On the last minute the examiner will stop you and ask you questions. (Hypertension). 3. Melissa Pilgrim is a 27 year old woman who has come to your office because oh heart racing. In the next 5/10/15 minutes take focused history and talk to her about a possible management plan. (Palpitation). 4. Dan Greenspan is a 68 year old man who had brought to the emergency because he passed out earlier today at home. In the next 5/10/15 minutes perform a complete physical examination. (Syncope). 5. Jenny Davidson is a 23 year old girl who suddenly lost her consciousness today and fainted. In the next 5/10/15 minutes take focused history and address her concerns. (Syncope). 6. Lenny Sullivan is a 56 year old man who got a sudden bad chest pain when he was having lunch with his family. He was brought to emergency few minutes ago. In the next 5/10/15 minutes manage him. (MI). 7. Alfred Sabitto is a 53 year old man who comes to your office because ho got swelling of his legs. In the next ten minutes take focused history and address his concerns. (Heart failure). 8. David Perry is a 54 year old diabetic man who came to your office because of leg pain after walking. In the next 5/10/15 minutes take focused history and perform a focused physical examination. (Claudication). 9. Eric O'Malley is a 51 year old man who came to emergency because of chest pain and palpitation. In the next 5/10/15 minutes take focused history and address his concerns.

(Chest pain/ Atrial Fibrillation). 10. Sandra Anderson is 81 year old woman who was brought to emergency by ambulance semiconscious, hypotensive and bradycardia. In the next 5/10/15 minutes manage him. (Digoxin intoxication). 11. Andrew McDonald is 60 year old man who has a cardiac arrest while the ambulance is rolling into the emergency. He is quickly brought into the resuscitation room. In the next 5/10/15 minutes run code blue and manage him. (Cardiac arrest). 12. Tina White is a 22 year old woman who was referred to you by a community nurse because of high blood pressure. In the next 5/10/15 minutes take focused history and talk to her about a possible management plan. (Hypertension/ Pheochromocytoma). 13. Tim Brown is a 39 year old male who came to emergency because of sharp chest pain. He feels unwell and trouble breathing. In the next 5/10/15 minutes take focused history and perform a focused physical examination. (Pericarditis).

Gastrointestinal OSCEs

Prepare yourself for these common gastrointestinal topics in Objective Structured Clinical Examinations The common topics that have been tested in OSCE exams during USMLE Step 2 CS, MCCQE Part II, PLAB 2, OSCEs for medical students and medical school clinical finals, Clinical Skills Assessment for International Medical Graduates are: 

Difficulty swallowing (Dysphagia).

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Nausea / vomiting.

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Heartburn/ Gastroesophageal Reflex Disease.

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Peptic ulcer disease.

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Upper GI bleeding.

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Lower GI bleeding.

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Diarrhea, acute & chronic.

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Constipation.

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Steatorrhea.

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Irritable bowel syndrome.

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Inflammatory bowel disease, Crohn's & ulcerative colitis.

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Diverticulosis/ Diverticulitis.

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Abdominal pain, acute & chronic.

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Jaundice.

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Biliary colic.

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Hepatomegally/ hepatitis..

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Splenomegally.

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Abdominal distension.

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Abdominal mass.

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Complete abdominal examination.

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Liver function tests interpretation.

Common gastrointestinal OSCEs Common OSCE exam cases that have been seen in USMLE Step 2 CS, MCCQE II, PLAB 2, OSCEs for medical students and medical school clinical finals, Clinical Skills Assessment for International Medical Graduates are:

(Please note: For USMLE Step 2 CS, there is no examiner in the room. The encounter is video monitored and taped. Thus, there will be no questions asked in the room other than the patient's questions. However, during physical examination, you are still required to explain what are you going to do to the patient before physically touching him/her. All USMLE Step 2 CS stations are of 15 minutes long and require focused history taking, physical examination, and counselling as needed. Thus, ignore the last statement in the following sample stations about the available time and required tasks to do.).

1. Anthony Smith is a 73 year old man presents to your office complaining of trouble swallowing. In the next 5/10/15 minutes take focused history. (Dysphagia). 2. Natasha Husinoff is a 36 year old woman presents to your office complaining from diarrhea for six months. In the next 5/10/15 minutes take focused history. (Diarrhea). 3. Mark Joe is a 52 year old man who was brought to emergency with abdominal pain and vomiting. His vitals are: BP 80/40 mmHg, HR 120 bpm, RR 18 bpm,

Temp 37.5 C. In the next 5/10/15 minutes mange him. (Upper GI

bleeding). 4. Catherine Roberson is 81 year old who was brought to emergency by her daughter because of blood with bowel motion. Her vitals are: BP 140/90 mmHg, HR 70 bpm, RR 17 bpm, Temp 37.5 C. In the next 10/15 minutes take focused history and perform focused physical examination. (Lower GI

bleeding). 5. Michael Johnson is a 62 year old man who came to emergency complaining of LLQ pain and fever. In the next 5/10/15 minutes take focused history and perform focused physical examination. (Diverticulitis). 6. Michael Johnson is a 62 year old man who came to emergency complaining of LLQ pain. In the next 10/15 minutes take focused history and perform focused physical examination. (Ischemic colitis). 7. Leo Alfonso is 19 year old male who was brought to emergency because of abdominal pain. His vitals are BP 90/50 mmHg, HR 120 bpm. In the next 5/10/15 minutes mange him. (Appendicitis). 8. Lorry Samuel is 25 year old female who came to emergency complaining of recurrent RLQ pain. In the next 10/15 minutes take focused history and perform focused physical examination. (Crohn). 9. Kim Ho is 27 year old man who came to emergency because he turned yellow. In the next 10/15 minutes take focused history and perform focused physical examination. (Jaundice). 10. Lora Timber is 40 year old woman who came to emergency complaining of recurrent RUQ pain. In the next 5/10/15 minutes take focused history and perform focused physical examination. (Cholecystitis). 11. Jessica Smith is 22 year old woman who came to your office complaining of greasy foul smelling stool and weight loss. In the next 5/10/15 minutes take focused history. (Steatorrhea). 12. George Wilson is 64 year old man who comes to your office requesting a laxative because he is always 'blocked up'. In the next 5/10/15 minutes take

focused history. (Constipation). 13. Steve Gomella was brought to the emergency by his friends after vomiting blood. In the next 5/10/15 minutes take focused history and talk to him about your possible plan of management. (Hematamesis).

Endocrine OSCEs

Prepare yourself for these common endocrine topics in Objective Structured Clinical Examinations The common topics that have been tested in OSCE exams during USMLE Step 2 CS, MCCQE Part II, PLAB 2, OSCEs for medical students and medical school clinical finals, Clinical Skills Assessment for International Medical Graduates are: 

Diabetes, all scenarios including ER for DKA and consult.

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Hypoglycemia.

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Hypercalcemia.

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Abnormal lipid profile / Hypercholestrolemia

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Obesity / Weight gain counselling.

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Weight Loss.

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Hirsutism/ Virilization.

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Galactorhea.

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Gynecomastia.

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Neck mass.

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Thyroid nodule/ Enlarged thyroid/ Hyperthyroidism/ Hypothyroidism.

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Pituitary adenoma.

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Polydipsia.

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Adrenal insufficiency/ excess.

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Failure to mature.

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Failure to thrive.

Common endocrine OSCEs Common OSCE exam cases that have been seen in USMLE Step 2 CS, MCCQE II, PLAB 2, OSCEs for medical students and medical school clinical finals, Clinical Skills Assessment for International Medical Graduates are:

(Please note: For USMLE Step 2 CS, there is no examiner in the room. The encounter is video monitored and taped. Thus, there will be no questions asked in the room other than the patient's questions. However, during physical examination, you are still required to explain what are you going to do to the patient before physically touching him/her. All USMLE Step 2 CS stations are of 15 minutes long and require focused history taking, physical examination, and counselling as needed. Thus, ignore the last statement in the following sample stations about the available time and required tasks to do.).

1. Dick Homer is an 21 year old man came to the emergency complaining of nausea, vomiting and diarrhea. In the next ten minutes take focused history. At the eighth minute the examiner will stop you to ask questions. (Lab results). (DKA). 2. Debbie Hamilton is thirty year old woman who came to your office complaining of fatigue for two months. In the next ten minutes take focused history. (Hypothyroidism). 3. Rochelle Patrick is 58 year old woman who came last week for her routine annual check up. Her investigations came back with serum calcium 12 mg/dL. In the next ten minutes take focused history and perform focused physical examination. At the eighth minute the examiner will stop you to ask questions. (Hypercalcemia).

4. George Hunter is 51 year old man who came last week for his routine annual check up. His investigations came back with elevated serum cholesterol. In the next ten minutes take focused history and address his concerns. At the eighth minute the examiner will stop you to ask questions. (Hyperlipidemia). 5. Victoria Atkins is a 31 year old woman who comes to your office with hoarseness. In the next ten minutes take focused history. (Hypothyroidism). 6. Patricia Spence is 28 year old woman who was sent by the community nurse to you because of abnormal thyroid tests. In the next ten minutes take focused history and perform focused physical examination. (Hyperthyroidism). 7. Tanya Allison is 48 year old woman who was sent by the community nurse to you because she thinks she felt a thyroid lump. In the next ten minutes take focused history and perform focused physical examination. (Thyroid nodule). 8. Mary Hamilton is a 53 year old woman who is a patient of your colleague, Dr. Watson, came to your office because you are covering for Dr. Watson while he is away. Her blood glucose results has come back 8.7 and 9.1 mmol/L in two fasting tests. She is very anxious to know what is wrong. In the next ten minutes talk to her and address her concerns. (DM, initial visit). 9. Mr. Russell Shantini is a 49 year old man who is a known case of diabetes. He came to your office for his annual follow up bringing his log book. In the next ten minutes talk to him . (DM, follow up). 10. Sandy Robert is a 23 year old woman who comes to your office complaining of recurrent headache and abnormal hair growth on her chin. In the next ten minutes take a focused history. (Pituitary adenoma). 11. Laura Battler is 26 year old woman who comes to your office complaining from weakness and weight gain. (Cushing). 12. Sarah Anderson is 18 year old girl who came to your office because she notice her neck is wide. In the next ten minutes take focused history and perform focused physical examination. (Goitre). 13. Tony Black is 30 year old man who came to your office complaining from

feeling dizzy and weight loss. In the next ten minutes take focused history. (Adrenal Insufficiency). 14. Martin O'Malley is 34 year old man who cam the emergency because of persistent headache and heart racing. In the next ten minutes take focused history. (Pheochromocytoma). 15. Jim Charles is 12 year old boy, who is know for diabetes type I, was rushed to the emergency by his parents after falling unconscious. Please mange him in the next ten minutes. (Hypoglycemia).

Hematology OSCEs

Prepare for these common hematology & Immunology topics in Objective Structured Clinical Examinations The common topics that have been tested in OSCE exams during USMLE Step 2 CS, MCCQE Part II, PLAB 2, OSCEs for medical students and medical school clinical finals, Clinical Skills Assessment for International Medical Graduates are: 

Anemia.

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Eosinophilia.

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Neutropenia.

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Thrombocytopenia.

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Easy bruising/ Bleeding tendency.

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Patechae/ Purpura.

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Elevated hemoglobin/ Polycethemia.

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Splenomegaly.

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Hypercoagulable state.

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Urticaria/ Angioedema/ Anaphylaxis.

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Allergic reactions/ Atopy/ food allergies.

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Lymphadenopathy; Generalized/ localized.

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Blood transfusion reactions.

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Neck mass.

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Mediastinal mass.

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Complete hematological examination.

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Abnormal Complete Blood Profile, WBC.

Common Hematology & immunology OSCEs Common OSCE exam cases that have been seen in USMLE Step 2 CS, MCCQE II, PLAB 2, OSCEs for medical students and medical school clinical finals, Clinical Skills Assessment for International Medical Graduates are:

(Please note: For USMLE Step 2 CS, there is no examiner in the room. The encounter is video monitored and taped. Thus, there will be no questions asked in the room other than the patient's questions. However, during physical examination, you are still required to explain what are you going to do to the patient before physically touching him/her. All USMLE Step 2 CS stations are of 15 minutes long and require focused history taking, physical examination, and counselling as needed. Thus, ignore the last statement in the following sample stations about the available time and required tasks to do. ).

1. Kim Quang is a 17 year old woman who presents to your office with recurrent episodes of bleeding from her nose. Please take focused history in the next 5/10/15 minutes. (ITP). 2. Jackie Levis is 22 year old woman who has been booked by the surgeon to undergo laparoscopic cholecystectomy in two days. She comes to your office with questions about the risk of blood transfusions as her friend warned her about the possibility of HIV and Hepatitis infection. Please talk to her in the next 5/10/15 minutes. (Blood transfusion). 3. Rajeev Khan is a fifty year old man who is supposed to have his forth blood

transfusion today. He has a hematological disease that he needs blood transfusion every few weeks. Last time he had a bad reaction that made him feverish and ill. He refused to go on until he talks to you because he is afraid it might happen again. Please talk to him in the next 5/10/15 minutes. (Blood

transfusion). 4. Scott Fuller is a 47 year old man who comes with fatigue and a hemoglobin of 95. Please talk to him in the next 5/10/15 minutes and address his concerns. (Anemia). 5. Lucy Armstrong is 23 year old woman who came to your office after she felt a lump in her right side of her upper neck. In the next 5/10/15 minutes take a focused history and perform a focused physical exam. (Note: She keeps her bra and thighs exposed with gestures of seduction. The case is infectious mononucleosis and she is sexually active. Take sexual history and safe sex counselling too.) (Lymphadenopathy/ Seduction/ Safe sex). 6. Andres Fallen is a 45 years old man who is a known case of Hodgkin disease under the care of your colleague Dr, James Brown who is away and you are covering for him. He came to your office for a follow up. In the next 5/10/15 minutes take a focused history and perform a focused physical exam. (Lymphadenopathy). 7. Mark Anthony is a 42 year old man comes to your office because he felt few lumps in his groins. In the next 5/10/15 minutes take a focused history and perform a focused physical exam. (Lymphadenopathy). 8. Mary Copper is a 31 year old woman who had delivered a healthy boy last week came to your office because of bluish dots and areas over her body. In the next 5/10/15 minutes take a focused history. (Patechae/ Purpura). 9. Sandra Hunter is 27 year old business woman who had just returned from Asia in a business trip came to your office because of right calf pain. In the next 5/10/15 minutes take a focused history and perform a focused physical exam. (DVT).

Neurology OSCEs

Prepare yourself for these common neurology topics in Objective Structured Clinical Examinations The common topics that have been tested in OSCE exams during USMLE Step 2 CS, MCCQE Part II, PLAB 2, OSCEs for medical students and medical school clinical finals, Clinical Skills Assessment for International Medical Graduates are: 

Head injury: ER management.

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Cervical spine trauma.

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Bacterial meningitis.

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Unsteadiness/ Dizziness/ Ataxia.

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Loss of consciousness/ Comatose management.

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Tremor/ Parkinsonism.

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Stroke/ TIA.

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Subarachnoid hemorrhage.

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Headache: all types and settings.

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Temporal arteritis.

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Seizure: attack at ER setting/ Follow up consult.

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Memory impairment.

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B 12 neuropathy.

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Chronic back pain.

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Carpal tunnel syndrome.

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Sciatica/ leg pain.

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Gait disturbances.

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Weakness.

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Numbness.

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Pituitary adenoma.

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Complete neurological examination.

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Limb neurological examination.

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Cranial nerves examination.

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Coordination examination.

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Glasgow coma scale.

Common Neurology OSCEs Common OSCE exam cases that have been seen in USMLE Step 2 CS, MCCQE II, PLAB 2, OSCEs for medical students and medical school clinical finals, Clinical Skills Assessment for International Medical Graduates are:

(Please note: For USMLE Step 2 CS, there is no examiner in the room. The encounter is video monitored and taped. Thus, there will be no questions asked in the room other than the patient's questions. However, during physical examination, you are still required to explain what are you going to do to the patient before physically touching him/her. All USMLE Step 2 CS stations are of 15 minutes long and require focused history taking, physical examination, and counselling as needed. Thus, ignore the last statement in the following sample stations about the available time and required tasks to do.).

1. Larry Warren is a 32 year old man who presents to the you in the walk-in clinic complaining of headache. Please take focused history and address his concerns in the next 5/10/15 minutes. (Headache). 2. Jerry La point is a 53 year old gentleman who comes to the emergency complaining of sudden severe headache. Please take focused history and perform a focused physical examination in the next 10/15 minutes. (Headache).

3. Michael Jones is a 55 year old bus driver who was brought to the emergency by family members because he had a 'spell'. Please take a focused history in the next 5/10/15 minutes. (Seizure). 4. Albert Russel is 55 year old man who comes to your office for the first time to have a check up examination. Please perform a complete cranial nerves examination in the 5/10/15 ten minutes. (Cranial nerves examination). 5. Steve Barreto is 67 year old man who came to your office because he has been having frequent falls which made him very concerned. Please talk to him and address his concerns in the next 5/10/15 minutes. (Fall / Unsteadiness/ Dizziness/ Ataxia.). 6. Frank Sullivan is a 57 year old man who came to the emergency by an ambulance because of weakness of his right arm and leg. Please take a focused history and perform a focused neurological exam in the next 10/15 minutes. (Stroke). 7. Javid Ehsani is 58 years old man who had some transient attacks of left eye blindness and was rushed to the emergency by his family. Please take focused history and address his concerns in the next 5/10/15 minutes. (Temporal arteritis). 8. David Harrison is a 66 year old businessman who comes to your office because of unsteady walking pattern. Please take focused history and perform a focused neurological exam in the next 5/10/15 minutes. (Unsteadiness/ Dizziness/ Ataxia.). 9. A middle aged man was brought by the police to the emergency after being found unconscious. Please manage the case in the next 5/10/15 minutes. (Loss of consciousness/ Comatose management.). 10. John Smith is 80 years old man presents to the emergency having sudden onset of speaking difficulty earlier today. It has now resolved. Please take focused history and perform a focused neurological exam in the next 5/10/15 minutes. (TIA). 11. Tony Longfield is 16 years old male who is a know case of epilepsy on medication came to your office referred from the driver licence authority. Please talk to him in the next ten minutes. (Epilepsy). 12. Maria Lanzonzo is 60 year old woman came to your office complaining of tremor. Please take a focused history and perform a focused neurological exam in the next 5/10/15 minutes. (Tremor/ Parkinsonism). 13. George Haung is 26 year old man who was brought to the emergency by his partner.

She said that he had the 'flu' for the last two days and has complained of headache and fever. Please take a focused history and perform a focused neurological exam in the next 5/10/15 minutes. (Meningitis). 14. Leanne Price is 32 year old who came to your office because of right hand tingling and numbness. Please take a focused history and perform a focused neurological exam in the next 5/10/15 minutes. (Carpel Tunnel). 15. Anthony Smitherman is 44 year old man who came to your office because of fatigue and problems with walking with staggering. Please take a focused history and perform a focused neurological exam in the next 5/10/15 minutes. (B12 Neuropathy). 16. Eric Brown, a 28 year old male, was brought to the emergency unconscious after falling from a platform at work this morning. Please perform a complete neurological exam in the next 5/10/15 minutes. (Head injury/ Cervical spine: ER management.). 17. Bob Jackson, a 46 year old construction man, came to your office because of sudden back pain for two days. Please take a focused history and perform a focused neurological exam in the next 10/15 minutes. (Back pain). 18. Leo alfanso is 47 year old man who had leg pain for years getting worse recently. Please take a focused history and perform a focused neurological exam in the next 5/10/15 minutes. (Sciatica). 19. John Riddle is 26 year old male who had a minor car accident a week ago. He came to your office because he noticed that he don't see on the sides. Please take a focused history and perform a focused neurological exam in the next 10/15 minutes. (Pituitary). 20. Sue Haung is 30 year old woman who had a car accident three days ago. She came to your office because of neck pain. Please take a focused history and perform a focused neurological exam in the next 10/15 minutes. (Whip splash C-spine injury).

Renal OSCEs

Prepare yourself for these common renal topics in Objective Structured Clinical Examinations The common topics that have been tested in OSCE exams during USMLE Step 2 CS, MCCQE Part II, PLAB 2, OSCEs for medical students and medical school clinical finals, Clinical Skills Assessment for International Medical Graduates are: 

Urinary tract infection/ Dysuria/ Frequency.

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Urethral/ penile discharge in males.

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Hematuria/ red urine/ blood in urine.

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Renal failure, acute and chronic.

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Protienurea.

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Hyperkalemia/ Hypokalemia

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Hypernatremia/ Hyponatremia.

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Impotence/ Erectile dysfunction.

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Incontinence.

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Benign prostatic hypertrophy.

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Prostatic cancer.

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Scrotal pain.

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Scrotal swelling/ mass.

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Hernias.



Abnormal serum hydrogen ion concentration.

Common renal OSCEs Common OSCE exam cases that have been seen in USMLE Step 2 CS, MCCQE II, PLAB 2, OSCEs for medical students and medical school clinical finals, Clinical Skills Assessment for International Medical Graduates are:

(Please note: For USMLE Step 2 CS, there is no examiner in the room. The encounter is video monitored and taped. Thus, there will be no questions asked in the room other than the patient's questions. However, during physical examination, you are still required to explain what are you going to do to the patient before physically touching him/her. All USMLE Step 2 CS stations are of 15 minutes long and require focused history taking, physical examination, and counseling as needed. Thus, ignore the last statement in the following sample stations about the available time and required tasks to do.).

1. Jasmine Corel is a 22 year old woman who comes to the emergency complaining of burning sensation with urination. In the next 10/15 minutes take a focused history and perform a focused physical examination. (UTI). 2. Jack William is a 70 year old man who comes to the emergency complaining of difficulty making his urine. In the next 10/15 minutes take a focused history and perform a focused physical examination. (UTI/ Prostate). 3. Mick Humper is a 48 year old man who comes to the emergency complaining of the worst pain he has ever had and at the hospital he noticed is urine is red.. In the next 10/15 minutes take a focused history and perform a focused physical examination. (Renal colic/ stone). 4. Sam Longwill is a 69 year old man who comes to your office because he saw blood in his urine. In the next ten minutes take a focused history and perform

a focused physical examination. (Hematuria). 5. Marie Brono is a 56 year old woman who comes to your office complaining of urine leaking. In the next 5/10/15 minutes talk to her. (Incontinence). 6. Andre Heatherford is a 19 year old male who comes to the walk-in clinic complaining of penile discharge. In the next 5/10/15 minutes talk to him. (Urethral/ penile discharge). 7. Anthony martin is a 43 year old man who presents to your office having a problem getting and maintaining erection. In the next 5/10/15 minutes talk to him. (Erectile dysfunction). 8. Eric Smith is a 82 year old man he comes to emergency complaining of problems with emptying his bladder. In the next 5/10/15 minutes talk to him. (Prostate). 9. Amy Davidson is a 61 year old woman who is a patient of your colleague Dr. Wong. She comes to your office complaining of being unwell. Dr Wong sent for some investigations and she is here for the results. Her hemoglobin is 100, creatinine 1000, and BUN 22.4. In the next 5/10/15 minutes talk to her. (Renal failure). 10. David Robert is a 64 year old man who is a patient of your colleague Dr. Wong. He comes to your office complaining of being unwell. Dr Wong sent for some investigations and he is here for the results. His blood pressure is165/ 100, and creatinine 700. In the next 5/10/15 minutes talk to her. ( HTN/

Renal failure). 11. Andre Heatherford is a 19 year old male who comes to the walk-in clinic complaining of scrotal painful swelling. In the next 5/10/15 minutes take a focused history . (Scrotum).

Musculoskeletal OSCEs

Prepare yourself for these common musculoskeletal topics in Objective Structured Clinical Examinations The common topics that have been tested in OSCE exams during USMLE Step 2 CS, MCCQE Part II, PLAB 2, OSCEs for medical students and medical school clinical finals, Clinical Skills Assessment for International Medical Graduates are: 

Back pain, acute and chronic.



Siatica.



Neck pain/ trauma.



Ankylosing spondylitis.



Joint pain/ any joint



Osteoarthritis.



Inflammatory arthritis/ Rheumatoid.



Septic arthritis.



Osteoporosis.



Complete joint examination: Cervical and lumbar pain, shoulder, elbow, wrist, hip, knee, and ankle.



Wound suturing.

Common musculoskeletal OSCEs Common OSCE exam cases that have been seen in USMLE Step 2 CS, MCCQE II, PLAB 2, OSCEs for medical students and medical school clinical finals, Clinical Skills Assessment for International Medical Graduates are:

(Please note: For USMLE Step 2 CS, there is no examiner in the room. The encounter is video monitored and taped. Thus, there will be no questions asked in the room other than the patient's questions. However, during physical examination, you are still required to explain what are you going to do to the patient before physically touching him/her. All USMLE Step 2 CS stations are of 15 minutes long and require focused history taking, physical examination, and counselling as needed. Thus, ignore the last statement in the following sample stations about the available time and required tasks to do.).

1. Eric Samuel is 43 year old man who came to your office complaining of lower back pain for two days. Please take a focused history and perform a focused physical examination in the next 10/15 minutes. (Back pain). 2. Cathy Smitherman is 62 year old woman who came to your office complaining of bilateral leg pain for years which getting worse recently. Please take a focused history and perform a focused physical examination in the next 10/15 minutes. (Sciatica). 3. John Hamber is a 40 year old man who came to your office complaining of neck pain after a car accident two months ago. Please take a focused history and perform a focused physical examination in the next 10/15 minutes. (Whip

splash injury). 4. Michael Turner is 36 year old man who came to emergency because of a sudden right knee pain during football game. Please take a focused history and perform a focused physical examination in the next 10/15 minutes. (Joint

pain). 5. Patty Applewood is a 47 year old woman who came to your office because of right shoulder pain. Please take a focused history and perform a focused physical examination in the next 10/15 minutes. (Joint pain).

6. Tony Andreson is 22 years old who came to your office because of right knee swelling. Please take a focused history and perform a focused physical examination in the next 10/15 minutes. (Septic). 7. Elizabeth Johnson, a 55 year old woman, came to you office because of stiffness in her fingers. Please take a focused history in the next 5/10/15 minutes. (Inflammatory). 8. Anthony Smith is a 65 year old man who came to your office complaining of right hip pain. Please take a focused history and perform a focused physical examination in the next 5/10/15 minutes. (Joint pain). 9. Susan Rinker is a 55 year old woman who has been investigated by your colleague, Dr Mark Brown. She came to see you as you are covering for Dr. Brown while he is away. The results of the bone density scan came back as 'Osteoporosis'. Please counsel her and address her concerns in the next 5/10/15 minutes. (Osteoporosis). 10. Martin Brown is 42 year old man who came to your office complaining from pain in his right elbow after a playing golf. Please take a focused history and perform a focused physical examination in the next 10/15 minutes. (Joint

pain). 11. Jonathan Brown is 57 year old man who came to your office complaining of left ankle pain. Please take a focused history and perform a focused physical examination in the next 10/15 minutes. (Joint pain). 12. Please enter the room and perform a wound suturing in the next 5/10/15 minutes.

Pediatric OSCEs

Prepare yourself for these common pediatric topics in Objective Structured Clinical Examinations The common topics that have been tested in OSCE exams during USMLE Step 2 CS, MCCQE Part II, PLAB 2, OSCEs for medical students and medical school clinical finals, Clinical Skills Assessment for International Medical Graduates are: 

Fever.



Rash.



Vomiting.



Diarrhea.



Seizure; febrile and epilepsy



Cough: Asthma, viral, cystic fibrosis.



Running nose/ ear pain.



Anemia.



Neonatal jaundice.



Failure to thrive.



Feeding counseling.



Short stature.



Growth chart interpretation.



Speech delay.



Enuresis.



Recurrent abdominal pain.



Acute abdominal pain.



Infant colic.



Hyperactive child.



Urinary tract infection.



Immunization counseling.



Acute poisoning.



Peanut allergy.



Child abuse.

Common pediatric OSCEs Common OSCE exam cases that have been seen in USMLE Step 2 CS, MCCQE II, PLAB 2, OSCEs for medical students and medical school clinical finals, Clinical Skills Assessment for International Medical Graduates are:

Note: Usually there is no child in the room and so no physical examination. (Please note: For USMLE Step 2 CS, there is no examiner in the room. The encounter is video monitored and taped. Thus, there will be no questions asked in the room other than the patient's questions. However, during physical examination, you are still required to explain what are you going to do to the patient before physically touching him/her. All USMLE Step 2 CS stations are of 15 minutes long and require focused history taking, physical examination, and counseling as needed. Thus, ignore the last statement in the following sample stations about the available time and required tasks to do.).

1. Andrew Bold came to your office concerning his six month old Jimmy. He has some questions about vaccinations. Talk to him in the next ten minutes. (Immunization).

2. Rochelle Davidson came to your office and want to talk to you about her one year old son Tom. Her sister noticed that Tom is so small. Address her concerns in the next 5/10/15 minutes. (Failure to thrive /or Child abuse

/or Single mother/ Feeding). 3. Eric George is 16 year old came to your office asking for a letter to the transportation authority. Talk to him in the next 5/10/15 minutes. (Epilepsy). 4. John Smitherman came to your office worried about his three and half year old daughter, Julie, speech. Talk to him in the next 5/10/15 minutes. (Speech

delay). 5. Leanne Goldson brought her two year old daughter, Lisa, to the emergency because of diarrhea for three days. The ER team managed Lisa is in the next room and she is stable now. Mrs Goldson is waiting in this room. You are the physician on duty now. In the next 5/10/15 minutes enter the room an take a focused history from the mother. (Diarrhea). 6. Sandra Levis brought her two month old son, Leo, to the emergency because of vomiting for two weeks. The ER team managed Leo and he is stable now in the next room. Mrs Levis is waiting in this room worried and crying. You are the physician on duty now. In the next 5/10/15 minutes enter the room an talk to her. (Infant colic /or Single mother /or spousal abuse). 7. Luisa Huang brought her three day old son, Kim, to the emergency because he turned yellow. The ER team managed Kim is in the next room and he is stable now. Mrs Huang is waiting in this room worried. You are the physician on duty now. In the next 10/15 minutes enter the room and talk to her. In the last two minutes the examiner will ask you few questions. (Neonatal

Jaundice). 8. Mary Hansfield brought her two and a half year old son, Tony, to the emergency because he just had a fit. The ER team managed Tony is in the next room and he is stable now. Mrs Hansfield is waiting in this room. You are the physician on duty now. In the next 5/10/15 minutes enter the room an talk to her. (Febrile convulsion).

9. Martin Simon came to your office concerned about his 18 month old son, Patrick. He thinks he looks pale. In the next ten minutes address his concerns. (Anemia). 10. Barbara Hancocks is the mother of a six month old baby, Jim, who brings her child to your office because of fever. Jim is in another room with your nurse. Please enter this room and talk to the mother in the next 5/10/15 minutes. (Fever). 11. Mary Levis is the mother of a 4 week old baby, Nick. She brought him to the emergency because of vomiting for two weeks. The ER team managed Nick and he is stable now in the next room.. Mrs Levis is waiting in this room. You are the physician on duty now. In the next 5/10/15 minutes enter the room an talk to her. (Vomiting / Pyloric). 12. Erin Mayer came to your office concerned about her four year old daughter, Emmy, who has cough for quiet some time. In the next 5/10/15 minutes take a focused history and initiate counseling. (Cough). 13. Nicole Bennet came to your office because she thinks her 18 month old daughter, Jane, is not growing well. Please address her concerns in the next 5/10/15 minutes. (Failure to thrive /or Child abuse /or Single mother/

Feeding). 14. Wanda Hung came to your office because she thinks her six year old son, Kim, is short. Please address her concerns in the next 5/10/15 minutes. (Short

stature). 15. Catherine Wellman is in your office to talk about her five year old Eric who wet his bed at night. Please address her concerns in the next 5/10/15 minutes. (Enuresis / UTI). 16. Lesia Malanchuk come to your office because her seven year old daughter, Cathy, is complaining for abdominal pain. Please address her concerns in the next 5/10/15 minutes. (Recurrent abdominal pain). 17. Elizabeth Hartman came to your office because she received a letter from her son's elementary school principle asking her to consult with a physician about

his condition. Please address her concerns in the next 5/10/15 minutes. (Hyperactive child). 18. Jennifer Black asked you to see her 15 year old daughter, Tracy, because she refuses to eat and lost over twenty pounds of her weight. Tracy is now here in your office. Please talk to Tracy in the next 5/10/15 minutes. (Anorexia). 19. Jeffery Hamilton brings his two year old son, Martin, to the emergency for a hand injury. When you took X-rays, you found a spiral fracture of the humerus. You also noticed old fractures of both the forearm bones. Please talk to Mr. Hamilton in the next 5/10/15 minutes. (Child abuse). 20. Ellen Anderson came to your office complaining that her two year old son, Tim, cannot sit with the family during dinner and finish his plate. Please talk to her in the next 5/10/15 minutes. (Feeding /or Hyperactive child ). 21. Jane Dave is calling concerning her 18 month son, John, who has swallowed his aunt's blood pressure medications. In the next 5/10/15 minutes enter the room and pick up the telephone and talk to her about John and advice her. (Poisoning). 22. Julie Copper is calling concerning her 7 year old daughter, Jessica, who has swallowed 10 birth control pills. She is worried if that will initiate early puberty. In the next 5/10/15 minutes enter the room and pick up the telephone and talk to her about Jessica and advice her. (Poisoning). 23. Andrea Jackson came to the emergency bringing her 18 month old son, Roy, who has been crying for the last ten hours. Please talk to her in the next 5/10/15 minutes. (Acute abdomen/ Intussusception). 24. Yee Man Lee came to your office because her 4 year old son, Kim, has rash. Please talk to her in the next 5/10/15 minutes. (Rash). 25. Susan Coupland came to your office because her 4 year old daughter, Julie, has recurrent urinary tract infections. Please talk to her in the next 5/10/15 minutes. (UTI).

Gynaecology & Obstetric OSCEs

Prepare yourself for these common gynaecology & obstetric topics in Objective Structured Clinical Examinations The common topics that have been tested in OSCE exams during USMLE Step 2 CS, MCCQE Part II, PLAB 2, OSCEs for medical students and medical school clinical finals, Clinical Skills Assessment for International Medical Graduates are: 

Vaginal discharge.



Pelvic inflammatory disease.



Sexually transmitted diseases (STD).



Vaginal bleeding (Gynaecological, post menopausal, 1st trimester, 3rd trimester).



Ectopic pregnancy.



Irregular menses.



Post-menopausal bleeding.



Amenorrhea.



Lower abdominal pain, acute and chronic.



Endometriosis.



Fatigue and nausea (Pregnancy).



Pre-eclampsia/ Pregnancy induced hypertension.



Hormone replacement therapy counselling.



Birth control counselling.



Early pregnancy counselling and routine tests.



Pregnancy planning counselling; teenage, young, and old women.



Coagulation disorders with pregnancy.



IUGR counselling.



Abortion counselling.



Pap smear counselling.



Breast nodule/ Nipple discharge/ Self Breast exam.



Mammogram counselling.



Women abuse.

Common gynaecology & obstetric OSCEs Common OSCE exam cases that have been seen in USMLE Step 2 CS, MCCQE II, PLAB 2, OSCEs for medical students and medical school clinical finals, Clinical Skills Assessment for International Medical Graduates are:

(Please note: For USMLE Step 2 CS, there is no examiner in the room. The encounter is video monitored and taped. Thus, there will be no questions asked in the room other than the patient's questions. However, during physical examination, you are still required to explain what are you going to do to the patient before physically touching him/her. All USMLE Step 2 CS stations are of 15 minutes long and require focused history taking, physical examination, and counselling as needed. Thus, ignore the last statement in the following sample stations about the available time and required tasks to do.).

1. Jessica Maul is a 24 year old woman who comes to your office complaining of vaginal discharge. Please take a focused history in the next 5/10/15 minutes.

(STD/ Pelvic inflammatory disease). 2. Elizabeth Harwal is a 19 year old woman who comes to the office because her periods are irregular and she missed three periods now. She is a bit concerned about this. Please talk to her in the next 5/10/15 minutes. (Irregular

menses). 3. Janet Nicholas is 25 year old woman who came the emergency because of lower abdominal pain. You are the physician on duty here now. Please take a focused history and a focused physical examination in the next 10/15 minutes. (Ectopic/ or any gynaecological cause) 4. Cathy Simmons is 35 year old who came to your office because of irregular vaginal spotting. Please take a focused history in the next 5/10/15 minutes. (Vaginal bleeding). 5. Susan Rinker is a 32 year old woman who has been investigated by your colleague, Dr Mark Brown. She came to see you as you are covering for Dr. Brown while he is away. The results of the pathology came back as 'Endometriosis'. Please counsel her and address her concerns in the next 5/10/15 minutes. (Endometriosis). 6. Judy Jurkovich is a 68 years old woman who came to your office because of vaginal bleeding. She is very worried about this. Please take a focused history and address her concerns in the next 5/10/15 minutes. (Vaginal bleeding). 7. Debrough Collicot is a 26 year old woman who came to your office complaining of felling sick and tired. Please talk to her in the next 5/10/15 minutes. (happy lady). (Early pregnancy counselling and routine tests). 8. Helen Bianco is 10 week pregnant woman who came to your office with vaginal bleeding. This her first pregnancy and she is upset with what is happening. Please talk to her in the next 5/10/15 minutes. (Abortion

counselling). 9. Helen Bianco is 6 week pregnant college student who came to your office considering abortion. Please talk to her in the next 5/10/15 minutes. (Abortion counselling).

10. Janice Weigelt a 36 year old pregnant woman at 34 weeks came to the emergency because of sudden vaginal bleeding. You are the physician on duty here. Please take a focused history in the next 5/10/15 minutes. The examiner will stop you at the last minute to ask you questions. (3rd Trimester vaginal

bleeding). 11. Sarah Timberlake is 28 years old pregnant woman at 36 weeks came to your office because she put on 5 kg in the last two weeks and she feels her legs are so puffy the she cannot put her shoes on. Please take a focused history in the next 5/10/15 minutes. The examiner will stop you at the last minute to ask you questions. (Eclampsia). 12. Marie Salem is a 25 years old pregnant woman who came to your office complaining of petechiae and easy bruising. Please take a focused history in the next 5/10/15 minutes. The examiner will stop you at the last minute to ask you questions. (Idiopathic Thrompocytopnia). 13. Tania Chaw is 18 years old girl came to your office because she wants to go on the birth control pills. Please talk to her in the next ten minutes. (Birth

control counselling). 14. Chawla Heuang is 36 years old woman came to your office because she wants to go on the birth control pills. Please talk to her in the next 5/10/15 minutes. (Birth control counselling). 15. Debbie Johnson is 52 years old woman who came to your office asking for your opinion about hormone replacement therapy. Please talk to her in the next 5/10/15 minutes. (HRT counselling). 16. Stephanie Davidson is 41 years old woman who came to your office asking for a mammogram. Please talk to her in the next 5/10/15 minutes. (mammogram counseling). 17. Catherine Brown is 65 year old woman came to your office because of breast nipple discharge. Please take a focused history in the next 5/10/15 minutes. The examiner will stop you at the last minute to ask you questions. (Breast

nodule/ Nipple discharge).

18. Catherine Brown is 25 year old woman came to your office because she felt a lump in her right breast. Please take a focused history in the next 5/10/15 minutes. The examiner will stop you at the last minute to ask you questions. (Breast nodule/ Nipple discharge). 19. Tania Chaw is 18 years old girl came to your office because she wants to know how pap smears are done and why and when. Please talk to her in the next 5/10/15 minutes. (Pap smear counselling). 20. Jasmine Chaw is a 21 year old pregnant woman at 30 weeks who has been investigated by your colleague, Dr Mark Brown. She came to see you as you are covering for Dr. Brown while he is away because the ultrasound results came 'Small for gestational age'. Please counsel her and address her concerns in the next 5/10/15 minutes. (IUGR).

Psychiatry OSCEs

Prepare yourself for these common psychiatric topics in Objective Structured Clinical Examinations The common topics that have been tested in OSCE exams during USMLE Step 2 CS, MCCQE Part II, PLAB 2, OSCEs for medical students and medical school clinical finals, Clinical Skills Assessment for International Medical Graduates are: 

Depression, episode, chronic, dysthemia, and post partum..



Manic episode.



Hypomania.



Delusional disorder.



Personality disorder/ Antisocial personality disorder/ Borderline disorder.



Psychosis, acute and chronic.



Panic disorder.



Anxiety.



Social phobia.



Dementia (Forgetfulness).



Delirium (Confused).



Suicide.



Anorexia nervosa.



Fatigue.



Somatization disorder.



Mini-mental exam/ Complete mental exam.



Spousal abuse.



Child abuse.



Alcohol abuse/ withdrawal/ Alcohol cessation planning.



Drug abuse (Pain killers and street drugs), Cocaine Intoxication.

Common psychiatry OSCEs Common OSCE exam cases that have been seen in USMLE Step 2 CS, MCCQE II, PLAB 2, OSCEs for medical students and medical school clinical finals, Clinical Skills Assessment for International Medical Graduates are:

(Please note: For USMLE Step 2 CS, there is no examiner in the room. The encounter is video monitored and taped. Thus, there will be no questions asked in the room other than the patient's questions. However, during physical examination, you are still required to explain what are you going to do to the patient before physically touching him/her. All USMLE Step 2 CS stations are of 15 minutes long and require focused history taking, physical examination, and counseling as needed. Thus, ignore the last statement in the following sample stations about the available time and required tasks to do.).

1. James brown, a 45 year old man, came to your office because his wife insisted to see you. Please talk to him in the next 5/10/15 minutes. (Alcohol abuse). 2. James brown, a 45 year old man, came to your office asking for help to stop

drinking. Please talk to him in the next 5/10/15 minutes. (Alcohol cessation

planning). 3. The nurse in the surgical ward reported that Janet Johnson is 50 year old woman who had a hystrectomy three days ago is hallucinating. Please talk to her and perform a mini-mental exam in the next 5/10/15 minutes. (Delirium

/ Mini-mental exam). 4. Ann Downy, a 38 years old woman, came to the emergency because of a wound in her scalp. Your colleague had sutured the wound. Please talk to her in the next 5/10/15 minutes before discharging her. (Spousal abuse). 5. Sarah Livingstone is a 23 year old lady and a mother of a 7 months girl who came to emergency because of a swelling in he left thigh. X-ray showed fractured femur. Your colleague managed the fracture adequately. Please talk to her in the next 5/10/15 minutes. (Spousal abuse). 6. Marie Girotti, a 17 year old female, has attempted suicide by an overdose of Aspirin. She was treated in the emergency and feels well now. In the next 5/10/15 minutes talk to her and assess her suicide risk for admission or discharge. (Suicide). 7. Elizabeth Brown, an 81 year old woman, came to your office complaining of feeling low. Talk to her in the next 5/10/15 minutes. (Depression). 8. Donna McNally, an 76 year old woman, came to your office complaining of too many medications. Her husband passed away 6 months ago. Talk to her in the next 5/10/15 minutes. (Depression). 9. Mary Lawrence, a 23 year old female, came to your office complaining of fatigue and poor work performance. Talk to her in the next 5/10/15 minutes. (Depression). 10. Joanne Sunfield brought her 65 years old mother, Sandra, to your office because she is complaining from radiation leak in her house. Talk to the mother in the next 5/10/15 minutes. (Psychosis). 11. Anthony James, a 47 year old lawyer has been brought by his wife to your office. She states he is very anxious, has been sleeping only few hours a night,

has told the family he wants to sell he family house and move to the capital to be a minister in the next government. Please talk to him in the next 5/10/15 minutes. (He paces the floor and talkative). (Mania). 12. Nick McPherson, a 23 year old male has been brought by the police after a complaint from his wife that he is planning to kill their two children. He states he is the son of God. Please talk to him in the next ten minutes. (He paces the floor and talkative). (Psychosis). 13. Ron Lillicrap, a 72 year old man came to your office because his wife asked you to see him as she believes he is not himself. Please talk to him in the next 5/10/15 minutes. (Depression). 14. Helen St. Pierre is a 26 year old woman who came to the walk-in clinic because of unexpected attacks of heart racing. That made her very anxious and she wants to know exactly what is going on with her heart. You are the physician on duty today. Please talk to her in the next 5/10/15 minutes. (Panic). 15. Michael Foster came to your office to talk about his father, Frank Foster, who is 78 year old. He think he has got forgetfulness. Please talk to him in the next 5/10/15 minutes concerning his father and your possible plan. (Dementia). 16. Frank Foster, a 78 year old man came to your office because his son, Michael, asked you to see him because he think his father has got forgetfulness. Please talk to him in the next 5/10/15 minutes. (Dementia). 17. Karen Plater is 33 year old woman who came to the walking-in clinic complaining of left upper quadrant abdominal pain for years that no doctor is able to help her. You are the physician on duty today. Please talk to her in the next 5/10/15 minutes. (Somatization). 18. Denise Demers is a 24 years old college student who has sent to you by the college because she puts on gloves all the time and dose not touch any thing there. Please talk to her in the next 5/10/15 minutes. (Obsessive). 19. Sara Reavley is 20 years old woman who is from out of the city came to your office complaining of severe headache. Please talk to him in the next 5/10/15

minutes. (Drug seeker). 20. Sandy Becker, a 21 years old woman, has been brought to your office by her parents because she is threatening to kill her boyfriend if he leaves her. Please talk to her in the next 5/10/15 minutes. (Personality disorder). 21. Rose Fallen is 56 year old woman who came to your office complaining of feeling tired. Please talk to her in the next ten minutes. (Fatigue). 22. Louisa Miller is 20 year old college student who has been brought to the emergency by her friends because of sudden right arm paralysis. Please take a focused history in the next 5/10/15 minutes. (Conversion). 23. Suzy Nicholson is 17 years old female who has been brought to the emergency by her parents because of generalized muscular weakness. Routine investigations showed she her serum potassium is 2.9 mEq/L. Your colleagues have treated her adequately and she is stable now. Please talk to her in the next 5/10/15 minutes before discharge. (Anorexia nervosa). 24. Stephanie Anderson is a 31 year old woman who had delivered a baby boy, Jim, last month comes to your office feeling tired and hopeless about the recent changes in her life. Please talk to her in the next 5/10/15 minutes. (Postpartum depression). 25. Diana Boudreau came to your office and wants to talk to you. Please talk to her in the next 5/10/15 minutes. (She found drugs in her sons room). (Drug

abuse).

Ethics OSCEs

Prepare yourself for these common ethics topics in Objective Structured Clinical Examinations The common topics that have been tested in OSCE exams during USMLE Step 2 CS, MCCQE Part II, PLAB 2, OSCEs for medical students and medical school clinical finals, Clinical Skills Assessment for International Medical Graduates are: 

Decision to forgo treatment.



Respect patient's decision and provide education, support, and empathy.



Delivering bad news: HIV, Cancer, Death.



Telling the truth.



Confidentiality / Breaking confidentiality.



Competency / Capacity.



Death before arrival.



Pharmacist / health care provider refusal to provide care.



Brain death and organ donation.



Relative as a decision maker.



Surrogate decision maker.



Women abuse.



Child abuse.



Drug seeking.



Informed consent.



Angry patient.



Violent patient.



Seduction.

Common ethics OSCEs Common OSCE exam cases that have been seen in USMLE Step 2 CS, MCCQE II, PLAB 2, OSCEs for medical students and medical school clinical finals, Clinical Skills Assessment for International Medical Graduates are:

(Please note: For USMLE Step 2 CS, there is no examiner in the room. The encounter is video monitored and taped. Thus, there will be no questions asked in the room other than the patient's questions. However, during physical examination, you are still required to explain what are you going to do to the patient before physically touching him/her. All USMLE Step 2 CS stations are of 15 minutes long and require focused history taking, physical examination, and counselling as needed. Thus, ignore the last statement in the following sample stations about the available time and required tasks to do.).

1. Ronald King is a 58 years old diabetic patient who has got leg gangrene but refusing surgery. Please talk to him in the next 5/10/15 minutes. (Decision to forgo treatment / Respect patient's decision and provide education, support, and empathy) 2. Kevin Mcfadden requested HIV test two weeks ago and the results has come positive. Please talk to him in the next 5/ 10/15 minutes. (Refuses to tell his partner: Breaking confidentiality/ reportable) 3. Sheila Rogers is a young women who comes to your office complaining of headache. Please interview her in the next 5/ 10/15 minutes and address her concerns. (Drug seeking). 4. Rosita Lazzam is the daughter of your patient Mr. John Lazzam, a 68 years old man

who just was diagnosed with pancreatic cancer. Rosita has asked to see you immediately to talk to you about an important matter. Please talk to her in the next 5/ 10/15 minutes and address her concerns. (Telling the truth / Competency / Capacity). 5. You are the ER physician working in a rural area of 5000 population. Julie Murphy is a 16 years old girl who came to your office in the morning concerning her unprotected sex last night with her boyfriend. You prescribed the morning after-pill for this and she went to the only pharmacy of this area. The pharmacist, Dr. Stewart, refused to fill the medication for her. You decided to go to the pharmacy and talk to him directly. Please enter the room and talk to him in the next 5/ 10/15 minutes. (Pharmacist / health care provider refusal to provide care). 6. Mrs. Hilary Weston found your appointment card in her daughter's coat when she was taking it to the laundry. She has come to your office to find out why her daughter, Laura, came to see you. Please address her concern in the next 5/ 10/15 minutes. (Confidentiality). 7. Kathy Astrom is Mr. David Astrom's wife waiting in the meeting room to talk to you. David was involved in an accident 4 days ago with severe head injury and now has all the criteria of brain death. All attempts to restore his brain function failed. Two neurologist and neurosurgeon also confirmed that with "apnea test". Please enter the room and talk to her about this issue and the prognosis in the next 5/ 10/15 minutes. (Brain death and organ donation/ empathy). 8. Mrs. Elaine Young was diagnosed with lung cancer recently but she refuses to get chemotherapy and surgery as treatment. She wants to go to Mexico to get homeopathy treatment for that. Please enter the room and talk to her in the next 5/ 10/15 minutes. (Decision to forgo treatment / Respect patient's decision and provide education, support, and empathy). 9. Margaret Hart is a 78 year old women known case of COPD who comes frequently to the ER with severe episodes of shortness of breath. Yesterday she came with same problem and you intubated and resuscitated her. She was hospitalized in the ward and now is alert and fine. Her daughter, heather is requesting to you to write a "DNR: Do Not Resuscitate" order in her chart. Please enter the room and talk to her in the next 5/ 10/15 minutes. (Competency / Capacity / Relative as a decision maker).

10. James Ottlyk is the husband of Mary Ottlyk who got involved in a bad accident six years ago and since then she has been in a vegetative state. She never regained her consciousness and only open her eye's but doesn't seem to follow anything. She is 100% dependent on the nurses care. She has had feeding tube for a long time. Now Mr Ottlyk is in the meeting room to discuss removal of the feeding tube. Please enter talk to him in the next 5/ 10/15 minutes. (Competency / Capacity / Relative as a decision maker). 11. Mrs. Tara McDonald is a 52 year old woman, a known case of diabetes type I, who was rushed to the hospital in a profound coma, but dies almost immediately. You are the emergency physician who saw her first and there was no pulse or respiration. She was pronounced dead. You must notify the coroner. Her husband and daughter are waiting to talk to you. Please enter the room and talk to them in the next 5/ 10/15 minutes. (Note: You'll find that the husband gave her an extra insulin dose unknowing she already had an overdosed shot). (Death before arrival/ Delivering bad news). 12. Joanne Brown, a middle aged woman, came to your office because she is very angry and upset with a surgeon colleague of yours who operated on her father before her father's death during the bypass surgery last week. She wants to sue this surgeon and wants you to agree that the surgeon caused her father's death. Please talk to her in the next 5/ 10/15 minutes. (Angry patient). 13. You are working in the emergency. A young man with a gun shot wound was admitted. Within minutes, officer Stephen George, a policeman, arrived informing you that this young man has just shot someone downtown and you must give him his chart for investigation. Please talk to him in the next 5/ 10/15 minutes. (Confidentiality). 14. Lucy Armstrong is 23 year old woman who came to your office after she felt a lump in her right side of her upper neck. In the next 10/15 minutes take a focused history and perform a focused physical exam. (Note: She keeps her bra and thighs exposed with gestures of seduction and may ask if you are free tonight (even if your are a female doctor). The case is infectious mononucleosis and she is sexually active. Take sexual history and safe sex counselling too.) (Lymphadenopathy/ Seduction/ Safe sex).

Multisystem Undifferentiated OSCEs

Prepare yourself for these common undifferentiated multi-system topics in Objective Structured Clinical Examinations The common topics that have been tested in OSCE exams during USMLE Step 2 CS, MCCQE Part II, PLAB 2, OSCEs for medical students and medical school clinical finals, Clinical Skills Assessment for International Medical Graduates are: 

Fall.



Syncope / Fainting.

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Loss of consciousness / Coma.

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Fatigue / Tiredness.

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Vague abdominal pain.



Vague chest pain.

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Violent patient.

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Vomiting.



Headache.

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Fever.



Fit.

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Unsteadiness / Dizziness.



Abdominal distension.



Edema.

Common Undifferentiated OSCEs Common OSCE exam cases that have been seen in USMLE Step 2 CS, MCCQE II, PLAB 2, OSCEs for medical students and medical school clinical finals, Clinical Skills Assessment for International Medical Graduates are:

(Please note: For USMLE Step 2 CS, there is no examiner in the room. The encounter is video monitored and taped. Thus, there will be no questions asked in the room other than the patient's questions. However, during physical examination, you are still required to explain what are you going to do to the patient before physically touching him/her. All USMLE Step 2 CS stations are of 15 minutes long and require focused history taking, physical examination, and counselling as needed. Thus, ignore the last statement in the following sample stations about the available time and required tasks to do.).

1. Jane Anderson, a 30 years old woman, came to your office complaining from fatigue for 2 months. In the next 5/10/15 minutes take focused history. (Fatigue). 2. Elizabeth Smith, a 81 years old women, came to your office complaining of aches and pains all over her body. In the next 5/10/15 minutes take focused history. (Depression/ Somatization/ Neuropathies/ Metabolic) 3. Suzy Taylor, a 26 years old female, has been brought to the emergency by ambulance after being found unconscious in her home. You are the physician

on duty in the ER today. She is in the room with a nurse. In the next 5/10/15 minutes, please enter the room and mange the patient. (Unconscious /

Coma). 4. John Brown, a 50 years old male, came to your office because his wife insisted that he comes to see you. In the next 5/10/15 minutes talk to him and address is wife concerns. (Alcohol abuse / Drug abuse) 5. Fatima Abdul Salam brought he father, a 62 years old man, to the emergency because he fell to the ground this morning. The emergency team ruled out any trauma. Mr Abdul Salam is waiting for you in the room. You had just started your shift in the ER. Please enter the room and talk to him in the next 5/10/15 minutes. (Fall). 6. Sandy Sony, a 67 years old woman, came to your office complaining of feeling dizzy. In the next 5/10/15 minutes take focused history. (Dizziness). 7. Terry McDonald is 57 years old. He came to the walk-in clinic complaining from vomiting. you are the physician on duty here today. In the next 5/10/15 minutes take focused history. (Vomiting). 8. Eric Brown, a 47 years old male came to your office because he noticed that his pants became tide. In the next 5/10/15 minutes take focused history and perform a focused physical examination. (Abdominal distension). 9. The police brought Mike Hurt to the emergency because he was throwing bottles out of his apartment window and scramming. He is 22 years old and has been kept in this room. In the next 5/10/15 minutes enter the room and talk to him. (Psychosis/ Mania/ Violent) 10. Ann Johnson, a 59 years old women, came to your office complaining of ankle swelling. In the next 5/10/15 minutes take focused history. (Edema)

Surgery OSCE

Prepare yourself for these common Surgical topics in Objective Structured Clinical Examinations The common topics that have been tested in OSCE exams during USMLE Step 2 CS, MCCQE Part II, PLAB 2, OSCEs for medical students and medical school clinical finals, Clinical Skills Assessment for International Medical Graduates has been included within each body system. Here are others: 

Hand pain / Numbness / Physical examination.



Pre-op care.

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Post-op care.



Splenic injury.(ER)



Pelvic fracture.(ER)

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Hemothorax. (ER)

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Bowel obstruction. (ER)



Suturing. (ER)

Common Surgical OSCEs

Common OSCE exam cases that have been seen in USMLE Step 2 CS, MCCQE II, PLAB 2, OSCEs for medical students and medical school clinical finals, Clinical Skills Assessment for International Medical Graduates are:

(Please note: For USMLE Step 2 CS, there is no examiner in the room. The encounter is video monitored and taped. Thus, there will be no questions asked in the room other than the patient's questions. However, during physical examination, you are still required to explain what are you going to do to the patient before physically touching him/her. All USMLE Step 2 CS stations are of 15 minutes long and require focused history taking, physical examination, and counseling as needed. Thus, ignore the last statement in the following sample stations about the available time and required tasks to do.).

1. Please enter the room and suture a small laceration of the forearm in the next 5/10/15 minutes. (Suturing). (Not in USMLE). 2. Jackie Scot is a 44 year old woman who comes to the emergency because of right upper quadrant pain and vomiting. In the next 5/10/15 minutes take a focused history and perform a focused physical examination. (Bowel

obstruction). 3. Tom Robertson is a 31 year old man who has just arrived to the emergency because he fell at work from a platform and hit his left side on a step. In the next 5/10/15 minutes manage (Internal bleeding / Splenic injury /

Pelvic fracture). 4. Tom Robertson is a 31 year old man who has just arrived to the emergency because he fell at work from a platform and hit his head on a step. In the next 5/10/15 minutes manage (Head/ C-Spine injury). 5. John Aukland is a 19 year old man who came to emergency because of a laceration over his wrist. In the next 5/10/15 minutes perform a focused physical examination. (Hand exam). 6. Sandy Smith is a 48 year old woman who came to the clinic a week before her hysterectomy surgery as requested for pre-operative assessment. In the next 5/10/15 minutes take a focused history and perform a focused physical

examination. (Pre-op). 7. Sandy Smith is a 48 year old woman who had a hysterectomy done three days ago. The word nurse reported that she is confused and hallucinating. In the next 5/10/15 minutes take a focused history. (Post-op confusion).

Difficult Patients' OSCEs Scenarios

Isn't it awful and stressful to be the weak side when facing a 'difficult angry patient'? How many times you were felt hurt and failed? "How To Unlock Difficult Medical Encounters" Is Your Tool In Dealing with 'Difficult Patients'! Click here to Buy the full version and save your time! Download a sample version

'Difficult Patient' OSCE Scenarios Common 'Difficult Patient' topics in Objective Structured Clinical Examinations The common topics that have been tested in OSCE exams during USMLE Step 2 CS, MCCQE Part II, PLAB 2, OSCEs for medical students and medical school clinical finals, Clinical Skills Assessment for International Medical

Graduates are:

'Difficult Patients' in OSCEs                   

The Silent or Reticent patient. The Rambling or Talkative patient. The Vague patient. The Angry patient. The Depressed or Sad patient. The Denial patient. The Anxious patient. Patient with Somatization. The Dependent and Demanding patient. The Dramatic or Manipulative patient. The Long Suffering, Masochistic patient. The Orderly and Controlled patient. The Manic, Restless patient. The Guarded Paranoid patient. The Superior patient. Breaking bad news. Caring for the dying patient. Conflicted Roles. Solving Conflicts.

Common 'Difficult Patient' OSCEs Common 'Difficult Patient' OSCEs cases that have been seen in OSCEs during USMLE Step 2 CS, MCCQE Part II, PLAB 2, OSCEs for medical

students and medical school clinical finals, Clinical Skills Assessment for International Medical Graduates are:

1. Elizabeth Noseworthy is a 58 years old diabetic patient who was brought to the emergency by her husband, Jack Noseworthy, unconscious. Your colleague told you that she had been received dead and they failed to resuscitate her. Please talk to Mr Northsworthy in the next 5/10/15 minutes. (Breaking bad news/ in this scenario you will discover that the cause of

death was an extra insulin shoot given by the husband when he found his wife unconscious assuming that she ate too much at the party that night. As you tell him the bad news, he turns very upset and restless blaming him self for killing his wife). 2. Joan Lavis is the mother of your 17 year old patient, Sandra Lavis, she came to your office asking to see you. Please talk to her in the next 5/ 10/15 minutes. (Confidentiality/ Demanding/ in this scenario you will discover

that the mother found an appointment card in her daughter pocket while doing the laundry. She demands and insists to know the reason of her daughter's visit. Note: no reason was given for the visit in the stem question). 3. George Baclham is 32 year old man who came to your office for the first time. Please talk to him in the next 5/ 10/15 minutes. (Drug seeker/ in this

scenario you will discover that he is out of town and has headache. His doctor prescribed a pain killer with codeine and wants you to prescribe it again. He interrupts you repeatedly and rudely during your history taking telling you that his doctor had already asked him these questions and there is no point to repeat the process. Note: no reason was given for the visit in the stem question). 4. Jonathan Simons is 26 year old man who was brought by the police to the

emergency after his wife claimed that he attempted to kill her. You are the physician on duty today. Please talk to him in the next 5/ 10/15 minutes. (Acute psychosis/ in this scenario you will discover that the patient is

agitated restless pacing the room and refuses to sit down to talk). 5. Anthony Rochester is 32 year old business man came to your office because his wife insisted that he should see you. Please talk to him in the next 5/ 10/15 minutes. (Mania/ in this scenario you will discover that the patient is

restless pacing the room and refuses to sit down to talk, full of joy and happy and don't want to discuss that being so happy is an illness. Note: no reason was given for the visit in the stem question). 6. Jane Smith is 53 year old woman who came to your office complaining from left upper quadrant pain. In the next 5/ 10/15 minutes take focused history and discuss a plan. (Somatization/ Talkative/ in this scenario you will

discover that the patient keeps talking and don't let you ask her questions or be in control of the interview) . 7. Marie Price is 57 year old came to your office because her husband insisted that she should see you. Please talk to her in the next 5/ 10/15 minutes. (depression/ in this scenario you will discover that the patient is says almost

nothing and doesn't know why she is here. Note: no reason was given for the visit in the stem question). 8. Lucy Armstrong is 23 year old woman who came to your office after she felt a lump in her right side of her upper neck. In the next 10/15 minutes take a focused history and perform a focused physical exam. (Note: She keeps her bra and thighs exposed with gestures of seduction and may ask if you are free tonight (even if your are a female doctor). The case is infectious mononucleosis and she is sexually active. Take sexual history and safe sex counselling too.) (Lymphadenopathy/ Seduction/ Safe sex).

Dealing with 'Difficult Patients': In real medical practice, dealing with 'difficult patients' are seen almost daily. 'Difficult patients' are ordinary people who come to your health institute, whatever is that, because they have to, not because they want to. Sometimes, they have even been brought in unwillingly by a family member or a friend. They come in with their vast range of different personalities, cultural background, and current emotional state. Being in a health care facility adds more worries and stresses due to lost time, expenses, and more importantly losing control. People are usually in control of what they have to do now, well at least they think so. But on the moment they put their feet in front of your registration desk, they lose this control. We, the strangers, take control!... We give instructions and orders to follow starting right from that registration desk... Give me your ID, .. insurance,.. wait there,.. sit there,.. you have to wait,.. take off your cloths,.. touching them, .. etc. So, by the time of their medical encounter with us, the physicians, they are already up on the edge in their stress and comfort levels. And guess what, we as the highest ranking authority here and thus have to receive all the blame and deal with them in these 'difficult patient' situations. Although, some of these people will look like trouble makers by personality, most of the exaggeration is due to the building up stress and worry, or simply part of their illness! Dealing with 'difficult patients' in medical encounters needs a lot of communication skills to sooth them and calm them down or to let them at ease and open for effective communication. However, although this is part of our duty in addition to establishing rapport and friendly environment, it is not our goal in medical encounters! We are not social workers. Our goal is to figure out what is going wrong with them physically and psychologically in order to help them. These good communication skills are not the goal, they are wonderful magical means to achieve our goal, the patient well being. Communication skills are our vehicle to take a thorough medical history, perform accurate safe physical examination, and assure patient compliance, and yet efficiently in respect to our time and resources limits.

As you may realize now, it is important to learn the specific communication skills to deal with these 'difficult patients' in real life. This will make us friendly caring clever doctors and build a good reputation while staying thorough, focused, organized, and efficient. This is what successful considerate physician know very well!

'Difficult Patient' OSCEs: As Objective Structured Clinical Examination stations (OSCEs) are simulation of real life medical encounters. 'Difficult to deal with patient' scenarios will be also seen in these exams. These difficult behaviours will be seen either embedded as a short part of the station scenario or as a full station by itself. We need to prepare ourselves to these 'difficult patient' OSCEs because we will be assessed mainly for our communication skills in these OSCE exam stations. These OSCE Exams need a lot of empathy too but be careful don't act as a social worker. Act as an attending caring efficient physician and use the communication skills as a mean, not as a goal.

Now how to improve your way of dealing with each of these 'difficult patient' OSCEs?

Ask yourself: What would I do if my OSCE standardized patient (SP) was angry and threatening me? Is what am I doing with this difficult patient correct ethically? Dose it serve me well? Dose it resolve the situation? How to improve my way of doing that?... What would I do if my OSCE SP was a depressed woman who refuses to talk? Again, is what am I doing with this difficult patient correct ethically? Dose it serve me well? Dose it resolve the situation? How to improve my way of doing that?... What would I do if my OSCE SP was a restless young man who kept pacing the room refusing to calm down and sit to talk? ... What would I do if my OSCE SP was a talkative middle aged woman who kept telling me her stories wasting my valuable exam time? ... What would I do if my OSCE SP was a teenage boy or girl who wants me to go out with him/her for a date? ... What would I do if my OSCE SP was an HIV positive man who refuses to inform his wife about his illness? ... What would I do if my OSCE SP was a sixteen year old boy with history of epilepsy and insisting to have a letter to the driving license authority? ... What if?....... & what if?....... & what if?............