Year-4-Formative OSCE 2021 Station 3 - Reading for Station 3

Sep 20, 2026

Year 4 Formative OSCE 2021 Station 3 provides an ED-focused neuropsychiatric assessment scenario involving a simulated young adult with first-episode psychosis. The task requires taking a focused neuropsychiatric history using the Mental State Exam elements and assessing safety to self and others within eight minutes, followed by stating two differential diagnoses with reasoning and listing further investigations. The simulated patient is paranoid, disorganised, and reports auditory messages from trees about government control.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

Reading for Station 3

Scenario overview

Assessment tasks (8 minutes)

Simulated patient information

History (HxPC)

Mental State Exam (MSE)

Self-harm and safety

Year 4 Formative OSCE 2021 Station X Year 4 Formative OSCE 2021 READING FOR STATION 3 You are a medical student working in the ED of a rural town. Elliot/Ellie Smith is a 28 year old brought to ED by QAS after reports from their neighbours about some disturbing behaviour. Below is an extract from the QAS report: Patient: Elliot/Ellie Smith Age: 28 Year Old Male/Female (SP dependant) ● QAS reported to scene at 20:32 ● Patient found only wearing underwear and kangaroo hopping along street at residence ● Patient visualised to be talking to self, with fixed attention to surrounding trees Assessment Tasks In a total of eight (8) minutes: ● Take a focused neuropsychiatric history of the patient, incorporating, where relevant, elements of the Mental State Exam (MSE), and assessing safety to self & others ● Provide 2 differential diagnoses and your reasoning, including relevant elements of the MSE ● List further investigations to help you in your diagnosis You should imagine that you are alone in the room with the patient while taking the history. You should only interact with the examiner once you have completed interviewing the patient and have differential diagnoses to present. The examiner will give you a prompt when there are two (2) minutes remaining. There is no need to perform any physical examination on the patient Year 4 Formative OSCE 2021 Station X Simulated Patient Information Thank you for supporting this GUMS formative OSCE. Your contribution is greatly appreciated! Each candidate will be with you for eight (8) minutes with a 2-minute break in between. Instructions for simulated patient You are a medical student working in the ED of a rural town. Elliot/Ellie Smith is a 28 year old brought to ED by QAS after reports from their neighbours about some disturbing behaviour. Below is an extract from the QAS report: Patient: Elliot/Ellie Smith Age: 28 Year Old Male/Female (SP dependant) ● QAS reported to scene at 20:32 ● Patient found only wearing underwear and kangaroo hopping along street at residence ● Patient visualised to be talking to self, with fixed attention to surrounding trees Assessment Tasks In a total of eight (8) minutes: ● Take a focused neuropsychiatric history of the patient, incorporating, where relevant, elements of the Mental State Exam (MSE), and assessing safety to self & others ● Provide 2 differential diagnoses and your reasoning, including relevant elements of the MSE ● List further investigations to help you in your diagnosis You should imagine that you are alone in the room with the patient while taking the history. You should only interact with the examiner once you have completed interviewing the patient and have differential diagnoses to present. The examiner will give you a prompt when there are two (2) minutes remaining. There is no need to perform any physical examination on the patient Year 4 Formative OSCE 2021 Station X | For SP
You are a young adult with a first presentation of psychosis. Throughout the interview, remain paranoid of cameras in the corners of the ceiling and the messages they’re sending into your mind.
Your behaviour is disorganised-you may sit on the floor, move around in the chair etc but not in a way that is threatening or distracts significantly from questioning
Your speech is confident but involves loose associations, tangents & flight of ideas. (so if asked a question feel free to answer it abstractly and start talking about other random things e.g. I have been hearing voices, you know who else heard voices? My Grandma she was horrible, but not as horrible as salt and vinegar chips, etc, etc)
However, answer direct questions when prompted due to time constraints. | | | --- | --- | | HxPC | ● Started hearing voices about a month ago
● Messages are received from the trees outside about the government
● Trees telling you how the government is watching everyone
● Government

FAQs

What are the required assessment tasks in Year 4 Formative OSCE Station 3?

In eight minutes, take a focused neuropsychiatric history using relevant Mental State Exam elements and assess safety, provide two differential diagnoses with reasoning (including relevant MSE elements), and list further investigations to support your diagnosis.

What key symptoms and beliefs does the simulated patient report?

The patient reports hearing voices/messages from trees about the government watching everyone, controlling the body, and instructing them to blend in, which leads to acting like a kangaroo. They also describe paranoia limiting leaving the house and poor eating.

How should safety and self-harm risk be addressed during the history?

The station includes direct questions about thoughts of ending life, frequency/severity/duration, and plans/intent. The history should assess safety to self and others as part of the required task.

Sep 20, 2026

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