September-2017 OSCE Station 3 - Candidate Instructions and Assessment

Sep 20, 2026

Uploaded by Fez

OSCE station scenario for a 45-year-old man with schizoaffective disorder on multiple psychiatric medications, referred for symptom assessment and medication review. The candidate must perform a focused physical examination to exclude cardiac abnormalities and identify metabolic syndrome, interpret ECG and blood investigations, and assess cardiovascular risks from polypharmacy. Required competencies include accurate BP and BMI measurement, explaining components of raised metabolic profile, QTc prolongation, addressing patient concerns, and managing metabolic syndrome via psychoeducation, diet and exercise.

LanguageEnglish

CategoryExam

FormatPDF

Pages16

Reading Time40 min

AccessFree to download

1.0 Descriptive summary of station

1.1 Main assessment aims

1.2 Required competencies

1.3 Station coverage and references

1.4 Station requirements

2.0 Instructions to Candidate

Patient background and medication history

Exam tasks and timing

Blood results

1.0 Descriptive summary of station: In this station the candidate will review a man with schizoaffective disorder who is on multiple medications , and is referred by his GP for assessment of symptoms and a medication review. The candidate needs to demonstrate the ability to identify cardiovascular risk of polypharmacy, appropriately interpret investigation results and undertake a focussed physical examination to exclude any cardiac abnormalities , and identify metabolic syndrome. 1.1 The main assessment aims are: 􀁸 To undertake a focussed physical examination to exclude cardiac abnormalities and identify metabolic syndrome. 􀁸 To accurately interpret investigation results (ECG and blood investigations) . 􀁸 To identify cardiovascular risks related to psychotropic polypharmacy. 􀁸 To present the diagnosis and management plan to the examiner. 1.2 The candidate MUST demonstrate the following to achieve the required standard: 􀁸 Use accurate technique to assess blood pressure and BMI. 􀁸 Accurately explain at least two of hypercholesterolemia, hypertriglyceridemia , hyperlipidaemia, raised LDL or fasting glucose as part of a raised metabolic profile. 􀁸 Link presentation to polypharmacy. 􀁸 Explain QTc prolongation on the Electrocardiogram (ECG) . 􀁸 Address the patient’s concern of tiredness. 􀁸 Manage the metabolic syndrome through psychoeducation, dietary management and exercise. 1.3 Station covers the: 􀁸 RANZCP OSCE Curriculum Blueprint Primary Descriptor Category: Medical Disorders in Psychiatry; Psychotic Disorders 􀁸 Area of Practice: Adult Psychiatry 􀁸 CanMEDS Domains: Medical Expert, Collaborator 􀁸 RANZCP 2012 Fellowship Program Learning Outcomes: Medical Expert (Assessment – Physical – Selection; Diagnosis – Investigation Analysis; Diagnosis; Management – Initial Plan) References: 􀁸 The Maudsley Prescribing guidelines in Psychiatry, 12th Edition, D Taylor, C Paton, S Kapur 􀁸 Metabolic syndrome: Overview and current guidelines, Julian Halcox & Arshed A. Quyyumi, PP 1-12, Hospital physician 2006 􀁸 A comprehensive definition for Metabolic syndrome, Paul L Huang, Disease Model & Mechanics. 2009 May-Jun; 2(5-6): 231–237. 􀁸 Clinical examination – A systematic guide to physical diagnosis, 3rd Edition – Talley N.J. , O’Connor S 􀁸 ECG Interpretation made incredibly easy, 5th edition, Lippincott Williams and Wilkins. 􀁸 Waist Circumference and Waist-Hip Ratio – Report of a WHO expert Consultation, Geneva, December 2008 1.4 Station requirements: 􀁸 Standard consulting room: physical examination requirements – cardiac, measuring tape, BMI calculating table 􀁸 Five chairs (examiners x 2, role player x 1, candidate x 1, observer x 1) . 􀁸 Laminated copy of ‘Instructions to Candidate’. 􀁸 Role player: 40-year-old male, approximately 170cm tall and weighing about 100kg, wearing a buttoned shirt and casual pants 􀁸 Pen for candidate. 􀁸 Timer and batteries for examiners. 2.0 Instructions to Candidate You have fifteen (15) minutes to complete this station after five (5) minutes of reading time. You are working as a junior consultant psychiatrist in a community mental health setting. Mr Ryan Butler has been referred by his General Practitioner Dr Thomas for an assessment and a review of his medication. Ryan is a 45-year-old single unemployed man, diagnosed with schizoaffective disorder 8 years ago. He has had 3 hospital admissions and was case managed in the past. One year ago, he was discharged to his GP on olanzapine 25mg nocte and lithium 500mg BD as his condition was stable. Ryan suffered a minor soft tissue injury a few months ago leading to ongoing pain. At that time , he noted worsening in his mood and sleep. His GP increased the olanzapine to 30mg nocte and lithium to 500mg mane and 750mg nocte. In the past few weeks the GP also prescribed quetiapine 100mg nocte and 50mg PRN, mirtazapine 30mg nocte, diazepam 10mg daily , and amitriptyline 25mg nocte. Ryan smokes up to 10 ci

FAQs

What are the main assessment aims in this OSCE station?

Undertake a focused physical examination to exclude cardiac abnormalities and identify metabolic syndrome; interpret ECG and blood results; identify cardiovascular risks related to psychotropic polypharmacy and present the diagnosis and management plan.

What must the candidate demonstrate to meet the required standard?

Accurately assess blood pressure and BMI; explain at least two elements of a raised metabolic profile; link findings to polypharmacy; explain QTc prolongation on ECG; address tiredness; and manage metabolic syndrome with psychoeducation, dietary management, and exercise.

What are the three exam tasks and when does the third task start?

First two tasks are a focused physical examination with explanatory commentary, and interpreting blood results and ECG in context of findings. At eleven minutes, the examiner presents the third task.

Sep 20, 2026

Uploaded by Fez