The ACEM Fellowship OSCE: how to prepare for the Clinical Exam
The OSCE is a performance exam. Knowing the material is necessary, but it is the practice of doing it aloud, to time, that separates candidates.
The structure
The Fellowship Clinical Exam, the OSCE, is held over two consecutive days and runs for 132 minutes in total. It has up to 12 stations, each 11 minutes: 4 minutes of reading time and 7 minutes with the examiner. ACEM allows it to be taken during Training Stage 4, and allows up to four attempts.
The station types
ACEM describes stations covering history taking, physical examination, a challenging communication station, a resuscitation standardised case-based discussion, teaching or advice to junior staff, and standardised case-based discussion. Each asks for something different, so prepare each type deliberately.
Practise the clock, not just the content
Seven minutes with an examiner is shorter than it sounds. Practise with the real split: four minutes to read and plan, seven to perform. Use the reading time to decide your opening and your priorities, because the examiner will not wait while you work them out.
Speak it, do not think it
Reading a station and knowing what you would do is easy. Saying it, in order, out loud, to someone watching, is a separate skill. Practise with a colleague or consultant who can play the role and then give you feedback on what they saw and heard, not just on the medicine.
Give yourself time
ACEM’s own guidance on preparing for the clinical exam has suggested allowing several months of dedicated practice, not weeks. Start early enough that you can repeat each station type several times and respond to feedback in between.
Use the college’s materials
ACEM has published past examiner reports and other resources for trainees. Check what is currently available to you. They show what examiners look for and how stations are marked, which no unofficial source can tell you with the same authority.
Where to check the official details
Format, timing, sitting dates and attempt limits are on ACEM’s examinations page. ClintixPro is independent of ACEM and is not endorsed by it.
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