YEAR 1 of the clinical years
On the Cambridge Graduate Course in Medicine, Stage 1 (i.e. the 1st clinical year of the medical course) is distributed over the holidays of the first two pre-clinical years. This means one is learning clinical information without having a complete foundation of pre-clinical knowledge, which isn’t ideal. Furthermore, as the main focus is on passing the pre-clinical exams, one cannot devote as much time to clinical study as one would like.
Thankfully, the stage 1 OSCE exams are relatively easy: they only test examination skills, communication skills and practical skills, leaving out the bulk of the medical information that one could/should have absorbed in a year of clinical study. I found it very difficult to do clinical reading with pre-clinical exams looming over my head, so I can’t give good advice on anything other than the actual exam preparation (although I am working on it… ;-)).
In terms of books, I recommend Siklos’ Clinical Clerking to start with, it’s small but you get a LOT of value out of it.
Here is some advice and material on the stage 1 OSCE exams:
1. Clinical examinations
Here is a list of 13 protocols for clinical examinations: Abdominal, cardiovascular, respiratory, upper and lower peripheral neurological examination, arterial, venous and varicose vein peripheral vascular examination, GALS (gait-arms-legs-spine), groin, thyroid/neck and breast examinations.
In this section, you can find some example marking sheets. The first few pages stem from the Cambridge Graduate Course Society website, which is sadly no longer online today.
2. Practical Skills
Here are a few protocols for OSCE practical skills stations relating to catheterisation, urinalysis, using inhalers/nebulisers, 12-lead ECG and suturing.
Most protocols available in the course handbook are comprehensive, but for the more elaborate procedures, I've prepared more detailed protocols:
3. Communication skills
Clinical communication skills almost has the status of a religion in Cambridge. To survive, take it with a pinch of salt, play along and keep calm. I started working with the official course book, but did not get anything out of it that wasn’t already in the information packages we were given. Perhaps it’s wiser to work with the teaching edition of the book, because it contains some marking grids for exams. I also found this link very useful that a friend of mine discovered.
4. What came up in our stage 1 OSCE exam
Examination stations: Abdo (kidney transplant), cardio (mitral regurge) , resp (?), peripheral neuro (Charcot-Marie-Tooth disease), peripheral vascular arterial, GALS.
Practical skills stations: Handwashing, blood pressure, removal of sutures, swabbing, inhaler technique, urinalysis, 12-lead ECG, OBS, female catheterisation, BMI
Communication skills stations: History of lady with GI symptoms waiting to see a surgeon in the outpatient clinic, history of a gentleman waiting in A&E with shortness of breath, dealing with a distressed patient in hospital for a knee replacement who is worried about his wife at home who suffers from Alzheimer’s, breaking bad news to a patient about a below the knee amputation, discharge summary for an elderly patient hospitalised after a fall.
GOOD LUCK 🙂