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PRE-EXAM CANDIDATE ORIENTATION

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Introduction to the OSCE

What is an OSCE? Objective Structured Clinical Examination

• A form of performance-based testing used to measure candidates’ clinical competence

• During an OSCE, candidates are observed and evaluated as they go through a series of stations in which they interview, examine and treat standardized patients (SPs) who present various types of medical problems

The NAC OSCE consists of 12 clinical stations of 11 minutes each.

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NAC ExamThe National Assessment Collaboration (NAC) exam assesses the competence of candidates; specifically the knowledge, skills and attitudes essential for entrance into postgraduate training in Canada.

The NAC exam may include problems in:• Medicine• Surgery• Pediatrics• Obstetrics and Gynecology• Psychiatry• Preventive Medicine and Community Health

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Confidentiality

During the application process, you agreed NOT to disseminate or reveal to others the exam materials and content. That means you CANNOT discuss or disclose exam content at any time, in any way, even after the exam is over. Examples of this includes, but are not limited to, comparing patient responses with your colleagues, sharing content with future exam candidates, using exam content in study groups, posting case information online, and sharing case information in social media.

Any breach may lead to disciplinary and legal measure, including invalidating your results and preventing you from participating in future exams.

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Duration• The exam duration is about 3 hours

• Plan to be at the exam site for a minimum of 6.5 to 7 hours

• No external contact will be permitted during the exam and sequestering period

• No conversations about the exam will be permitted

• Candidates will not be dismissed until the time specified on the information sheet

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• Reflex hammer • Stethoscope • White lab coat without a

university or hospital logo

• Cell phones, pagers, media players, laptops

• Electronic devices with internet access, transmission, reference or recording capabilities(including smartwatches)

• Electronic stethoscopes• Pens, pencils, pen lights• Paper, books, notebooks• Bags, briefcases, wallets, keys

Items to bring:

Items that are NOT permitted:

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Coat check• A coat check will be provided at the site to

store your personal items during the exam and sequestering period

• Storage space will be limited: ◦ please leave all handbags, large bags, and

unnecessary personal belongings at home

NOTE: While every effort will be made to store your belongings safely, the Medical Council of Canada (MCC) cannot be held responsible for theft or damage.

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Candidate Notebook• Do not open until the exam begins

• Inside, you will find a sheet of bar code ID labels and 16 blank pages for your use during the exam

• You will be given 1 notebook ̶ additional pages CANNOT be added

• Never rip out any pages ̶ your notebook must be returned intact at the end of the exam

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Candidate InstructionsAt each clinical station, there is a written statement (CANDIDATE INSTRUCTIONS) that:• Introduces a clinical problem• Directs the candidate to appropriately

interact with a standardized patient (SP)• Specifies the task such as:

◦ obtaining a focused history◦ conducting a focused physical examination◦ conducting a combined history/physical◦ addressing the patient’s concerns

• Indicates whether there are examiner oral questions at the 8-minute signal A copy of the instructions will be available

inside the room for your reference.

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SignalsA signal indicates the beginning and the end of each station.• Some signals may be a sound and others may be a verbal announcement,

depending on which exam site you are at

The 8-minute warning signal will indicate:• EITHER that your time with the patient is over and the physician examiner

will begin to ask you questions• OR if there are no questions (as indicated on the candidate instructions),

that you still have 3 minutes with the patient

After each final signal, you will have 2 minutes to move to the next station and read your instructions.

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Labels, Physician Examiners and SPs• Hand 1 bar code label

to the examiner as you walk into the room as per the instructions on the door

• Standardized patients (SPs) are trained to simulate patients’ signs and symptoms in a reliable and consistent manner Treat them as you

would a real patient

• Examiners observe and assess your performance with preset rating sheets A second examiner

may be present to observe protocols and for quality assurance

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Physical examinations• You will be expected to use the

hand sanitizer that will be available in every physical examination station. You may be prompted by the examiner.

• Be sure to drape the standardized patients (SPs) appropriately

• Carry out any maneuvers necessary for assessing the presenting problem Examiners only give credit for

tasks completed satisfactorily!

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Physical examinationsExaminers may intervene to:• Ask you to reread the instructions

◦ The intent is to remind you to refocus on the task and to save you time

• Stop you from performing genital, rectal, vaginal, breast or other invasive examinations◦ If such examinations are

appropriate, all you need to do is clearly inform the examiner

Help the examiner score by:• Telling the examiner what you

are doing (e.g., inspection)• Describing any findings

◦ Include findings that are normal

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Examiner oral questions at 8 minutesPhysician examiner oral questions may follow the warning signal. They are:

• Related to the patient you just saw• Regarding matters like diagnosis, management

decisions, and/or your response to an ethical issue

Candidate instructions on station doors will indicate whether there are oral questions at the 8-minute signal.

• Once an oral question is answered and the next question has been asked, you cannot go back and modify your answers

• If you decide to skip a question, you cannot go back and answer it at a later time

• You cannot interact with the SP after the warning signal in stations where there are oral questions

If there are no oral questions, you will have the full 11 minutes with the patient.

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Signing out• Before leaving, you must follow the sign-out procedure

• When it is your turn, hand in your:

◦ Candidate notebook (all pages intact)◦ ID badge◦ Unused bar code labels including the backing sheet

• Sign out on the sheet

Congratulations! At this point, the exam is over!

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SequesteringCandidates may be required to remain on site before or after the exam for security reasons.

• The length of time depends on the time zone

• There is no access to personal belongings or telephones during this time

• Talking with other candidates will not be allowed during post-exam sequestering

REMEMBER: Breaking confidentiality can lead to a denied standing on the exam and/or being barred from

taking MCC exams in the future.

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Reporting concernsIf you encounter issues during the exam that you believe may significantly affect your results, you MUST:

1. Immediately communicate your concern to a Senior Staffmember or the Chief Examiner.

2. Submit a message through your physiciansapply.ca account detailing the incident immediately following the exam.

An MCC review of concerns is possible only if candidates provide notification of the concern/problem in this manner.

Please visit MCC’s website for more information

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Final review of important points Read the instructions carefully Complete the specified task Demonstrate your clinical skills Treat the SPs as real patients REMEMBER: once an oral question is answered and the next question has been

asked, you cannot go back and modify your answers. If you decide to skip a question, you cannot go back and answer it at a later time

You cannot interact with the SP after the warning signal in stations where there are oral questions

DO NOT leave without signing out DO NOT divulge or disseminate any exam content, even after the exam is over

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Focus on the exam Your group leader and the support staff are there to

answer your questions and guide you from station to station

Try to relax and stay focused on the exam

The purpose of the exam is to provide a fair and accurate assessment of your clinical skills

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Bathroom breaks

Before the exam begins

After the exam is over

For urgent need: notify staff

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IMPORTANTBefore you start the exam:

• If you are unwell or have extenuating circumstances which may negatively impact your performance today, and wish to withdraw from the exam, please notify a staff member as soon as possible

• If you choose to start the exam, it will count as an attempt, even if you cannot finish

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Reminders• Your badge has a station number

that indicates your start station

• Candidate instructions are posted outside each station

• READ everything carefully

• Pay attention to the statement which explains your task

• A copy of the instructions will be available inside the room for your reference

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ResultsResults will be made available to you in your physiciansapply.ca account.

• Depending on the date of your exam, candidate results may be released at different times within 4-6 weeks from your exam date

Through your physiciansapply.ca account, you will be able to:

• view your results documents• share them with other organizations