Common Reasons for Failing the OSCE exam

1. You haven’t solved the main drug related problem or in CBT, the critical questions. This is a major reason for failing OSCE and CBT. There is usually one major problem, but you have to gather information to solve the problem. Sometimes the problems are subtle and not easy to find.

2. You have put a patient at harm or risk. If you make a recommendation to a patient or doctor and the recommendation puts the patient at risk, you will most likely fail. For example, if a patient complains of stomach pains and you recommend ibuprofen, you’d probably fail since the patient might have a bleeding ulcer.

3. You have given wrong information. If you have given an incorrect dose or an incorrect recommendation you might fail. If you catch yourself making a wrong recommendation, correct yourself and save yourself.

4. You have not completed all the steps of pharmaceutical care. Make sure you know all the steps of pharmaceutical care. If you miss a step, you will lose marks. Do not forget to document your interaction (just tell the patient that you are keeping a record of the interaction). Do not forget the follow up with the patient.

5. You could not be understood by the evaluator. It could be because your English was not understood or you were too quiet. Make sure your patient can understand you. Do not use technical language. Make sure your spoken and written English is well understood.

6. You wasted too much time looking into the references. This is a very common mistake. Students will search the BMF for 5 minutes and run out of time without finding what they were looking for. Make certain you can find the information quickly in the references. The BMF is a difficult book to find information. Know how to use it!

7. Your interview was incomplete and missing some valuable information. You might have missed family history or the fact the patient was not using their medication. The patient might have cognitive impairment and you did not acknowledge it.

8. You did not use your time wisely. You only have 15 minutes and time passes very quickly especially when you are nervous. Make sure you listed for the 2 minute warning bell. When you hear the 2 minute warning, it is time to wrap up and summarize everything.

9. You haven’t used the ‘clues’ in the station to help you solve the problem. I always tell students that there are several clues in a station. The best clue is the patient. Ask questions to help you solve the problem. If there is a medication record on the table, use it. The medication record can tell you a lot of useful information. If there is a pamphlet on the table, it is there for a reason. Use it if needed.

10. You did not know your OTC ingredients well enough. Make sure you know your OTC ingredients and when to recommend them. You will most certainly get an OTC station where you have to make a recommendation. Make sure you know the ingredients and when to recommend and when not to recommend.

11. You did not use your PROFESSIONAL JUDGEMENT. This is often the most difficult for some people to use. You must make tricky decisions. Not all situations are black and white. Make sure you use your judgement. That is why you are a professional!

12. You could not control your nervousness. This is also a major problem. Learn to control your stress levels. Practice deep breathing continuously during OSCE day. Everyone will be nervous. If you mess up an OSCE station, forget it and move on. Do not think about it during the day.