The first cohort of OSCE Part 1 candidates reaching Part 2

In her letter (Psychiatric Bulletin, February 2005, 29,72-73) Dr Narula asked how the candidates taking the Part 2 clinical examination in May 2005 would cope? Unlike their predecessors, the current cohort has no previous experience of doing a ‘long case’ in the old-style Part 1 examination.

We are a team of specialist registrars who help run the Guy’s, King’s and St Thomas’ MRCPsych course. This, among other things, involves arranging mock clinical examinations. We observed that the candidates sitting the mock Part 2 examination in March 2005 struggled with the long case component. Candidates particularly had difficulties with their timing, often taking well over 10 min to present the case, and found it difficult to succinctly summarise the key features of the history of presenting complaint. The feedback we received from the candidates after the mock examination was that they were afraid to leave out what they perceived as important information from the history even if it meant going over time.

Given the increased specialisation of training posts and the changing working patterns owing to the European Working Time Directive, are candidates receiving less opportunity to take full histories from patients previously unknown to them? We recommend increased focus on basic skills during training, such as the ability to take concise but informative histories, which should be presented to supervisors during clinical work and in examination-focused teaching groups.