OSCE stations · Core + Pro practice
200+ OSCE Stations for realistic clinical practice.
Build exam-ready clinical reasoning with structured OSCE cases. Browse Core specialties and advanced Pro challenges, or try four complete free stations with graded decisions, mark schemes and feedback.
4 complete free casesCore + Pro collectionsGraded clinical reasoning
OSCE station practice
What is an OSCE station?
An OSCE station is a timed clinical task that tests what you can do, not just what you can recall. Depending on the station, you may need to take a focused history, perform or prioritise an examination, communicate with a patient, interpret clinical information, form a differential diagnosis, choose investigations, or plan management.
The most useful practice therefore combines clinical knowledge with visible performance: make a decision, explain your reasoning, compare it with a mark scheme, then repeat the part that cost you marks.
Browse the case library
OSCE stations organised for how you want to practise.
Start with Core Cases organised by clinical specialty, or switch to Pro Cases when you want more diagnostic uncertainty, urgency, comorbidity and escalation.
Core
Core Cases
Build breadth across the major clinical specialties in the Core collection.
GI presentations, examination, investigations and management.
Cardiovascular
Neurology
Respiratory
Emergency Medicine
Paediatrics
Endocrinology
Obstetrics
Psychiatry
Pro
Pro Cases
Test higher-complexity decisions across advanced clinical challenge types.
Time-Critical
Common & High-Yield
Rare & Fatal
Diagnostic Challenge
Comorbid Cases
Management Escalation
Four complete Core cases are free below. Core and Pro subscriptions unlock the wider case library and advanced practice.
Compare Core & Pro →Filter the free examples:
4 complete free OSCE stations
Practise a full case before you subscribe.
Open any station below and work through communication, examination priorities, diagnosis, investigations and management. Commit to your answer before opening the rationale so you practise decision-making rather than recognition.
01
Cardiology OSCE Station: Chest discomfort with a wide QRS tracing
64-year-old male presenting with chest discomfort and fatigue.
Candidate brief
Your OSCE task
Robert Klein is a 64-year-old retired electrician who came to the emergency department because intermittent chest discomfort has been troubling him over the last two days. He describes a vague pressure sensation that is difficult to localize, along with new fatigue on minimal exertion. He denies syncope. He is worried he might be having a heart attack. In triage his vital signs are stable. A 12-lead ECG is obtained and shows a widened QRS complex. Initial information is incomplete - cardiac markers are pending and bedside echocardiography is not yet available. The team must interpret the ECG systematically and recognize conduction defects that can complicate assessment of ischemia while prioritizing patient safety.
BP118/74 mmHg
HR88 bpm
RR18 bpm
SPO296 %
TEMP98.6 F (37.0 C)
Learning objective
To recognize a widened QRS as an intraventricular conduction defect, identify a bundle branch block pattern as the primary ECG interpretation, and manage chest symptoms safely while acknowledging limitations in ischemia interpretation when conduction defects exist.
1
History & communication
Respond to the patient
Does a wide QRS on the ECG automatically mean I am having a heart attack?
View mark scheme & rationale
- 5/5 · Best answerA wide QRS means the electrical signal is taking longer to travel through the ventricles, which can be due to a conduction pattern like a bundle branch block. It does not automatically prove a heart attack, but it can make ST changes harder to interpret. We will interpret the ECG carefully, check your blood tests, and involve cardiology promptly if there are concerning features.
Explains what wide QRS means, avoids false reassurance, and gives a concrete plan acknowledging interpretive limitations and next steps.
- 2/5 · Limited creditIt could still be a heart attack, and the blood tests will help us decide. Because those results are pending, the best approach is to wait for them before taking any further action. The wide QRS does not change what we need to do right now, so there is no need for urgent ECG comparison, imaging, or cardiology review unless the markers are abnormal or the patient becomes unstable.
Accurate that blood tests help, but it underplays that a wide QRS changes ECG interpretation and may require earlier escalation based on ECG pattern.
- 1/5 · Low creditA wide QRS in someone with chest discomfort should be treated as proof of a heart attack until shown otherwise. The safest course is to begin full heart-attack treatment immediately and interpret the conduction abnormality later. Waiting for biomarkers, prior ECG comparison, imaging, or specialist input would only delay treatment of what the ECG has already confirmed.
Incorrect; wide QRS can reflect conduction defects and does not by itself diagnose infarction. Overcalling can lead to inappropriate management.
2
Physical examination
Prioritise your examination
Prioritise the examination steps that are most relevant to this presentation and explain why they matter.
- Vital signs5/5
Confirm hemodynamic stability and oxygenation while evaluating a potentially significant ECG abnormality.
- Cardiac auscultation3/5
Supports overall cardiac assessment; ECG interpretation remains central, especially with conduction patterns.
- Abdominal examination1/5
Low yield for a primary ECG conduction question compared with cardiovascular assessment and stability.
3
Clinical reasoning
Commit to a diagnosis
Choose the single best diagnosis.
View mark scheme & rationale
- 5/5 · Best answerLeft Bundle Branch Block (LBBB)
A widened QRS (>120 msec) with a conduction pattern consistent with left-sided ventricular conduction delay fits LBBB as a primary ECG interpretation.
- 3/5 · Partial creditRight Bundle Branch Block (RBBB)
RBBB is also defined by a widened QRS and a bundle branch block morphology.
- 1/5 · Low creditAcute ST-Elevation Myocardial Infarction
Chest discomfort can be ischemic, and urgent evaluation is required.
- 1/5 · Low creditNormal ECG
Stable vitals and non-specific symptoms can occur with normal ECG findings.
- 1/5 · Low creditProlonged QTc
QTc is an interval that should be checked in any ECG interpretation.
- 1/5 · Low creditSinus Tachycardia
Sinus tachycardia is a common rhythm and can accompany chest discomfort.
4
Investigation & management
Choose the next steps
Investigation checkpoint
Which test best helps clarify the cause and hemodynamic impact while the ECG shows a conduction defect?
View mark scheme & rationale
- 5/5 · Best answerTransthoracic echocardiography
Echo provides rapid structural and functional assessment while other data are pending and can support safe escalation decisions.
- 1/5 · Low creditNo further tests; a wide QRS confirms myocardial infarction
Wide QRS indicates conduction abnormality and does not confirm infarction without additional criteria and supporting data.
- 1/5 · Low creditWait for symptoms to resolve before any investigation
Chest symptoms with an abnormal ECG require active evaluation rather than watchful waiting in the ED.
- 1/5 · Low creditOnly repeat vital signs; no cardiac testing is needed
Vitals are important, but abnormal ECG findings require appropriate cardiac evaluation.
Management checkpoint
What is the most appropriate next management direction while awaiting results?
View mark scheme & rationale
- 5/5 · Best answerMonitor, complete ischemia evaluation with blood tests and imaging, and escalate based on cardiology assessment
This aligns with careful interpretation when conduction defects exist and avoids premature or delayed action.
- 1/5 · Low creditDischarge once repeat vital signs remain stable, because stable observations make a dangerous cardiac cause unlikely despite the abnormal ECG
A new abnormal ECG pattern with chest symptoms requires evaluation before safe discharge.
- 1/5 · Low creditBegin thrombolysis for the chest discomfort and wide QRS now, without waiting for biomarkers, imaging, or specialist ECG review
QRS widening does not diagnose STEMI; inappropriate thrombolysis carries significant risk.
- 1/5 · Low creditTreat the pain, continue routine observation, and defer further cardiac testing unless symptoms worsen or the vital signs become unstable
Symptom relief alone is insufficient when an ECG conduction abnormality is present with chest symptoms.
Exam takeaways
Key learning points
- A widened QRS (>120 msec) suggests an intraventricular conduction defect.
- Bundle branch block patterns can complicate ST-segment interpretation, so ischemia should not be assumed from QRS widening alone.
- Systematic ECG interpretation includes rate, rhythm, axis, and intervals before conclusions.
- In chest symptoms with abnormal ECG patterns, combine ECG interpretation with biomarkers and imaging rather than relying on a single feature.
- Escalate to cardiology when conduction defects and chest symptoms coexist, even if initial vitals are stable.
Want the full simulation?Continue this case in OSCE AI with guided feedback and performance tracking.
Practise interactively →02
Gastrointestinal OSCE Station: The burn unit melena and the stressed stomach
56-year-old male construction supervisor hospitalized after burn injury, now with melena and epigastric pain.
Candidate brief
Your OSCE task
Omar Haddad is a 56-year-old construction supervisor currently admitted to the hospital after a significant burn injury. Over the last 24 hours, the nursing team reports that his stools have turned black and tarry, and he has complained of a burning discomfort in the upper middle part of his abdomen. He feels nauseated and says he has had one episode of vomiting, though he is not sure if there was any blood. He looks tired and uneasy, asking why his stomach is acting up when his burns are already overwhelming. He denies alcohol use while hospitalized and has not taken any over-the-counter medicines on his own, but he is aware he has been under intense physical stress since the injury. On assessment he appears pale and sweaty, with a fast heart rate and lower blood pressure than earlier in his admission. The clinician must recognize that black stools and epigastric pain in a severely ill patient can reflect stress-related gastric mucosal injury and decide on the most appropriate next diagnostic step while starting supportive treatment based strictly on the provided testing and treatment options.
BP98/62 mmHg
HR112 bpm
RR20 bpm
SPO297 %
TEMP99.5 F (37.5 C)
Learning objective
Manage a high-risk hospitalized presentation by recognizing stress-related gastric mucosal injury patterns linked to burn injury, prioritizing the gold standard diagnostic option described, and selecting treatment strategies and follow-up logic strictly from the provided material.
1
History & communication
Respond to the patient
Is this happening because of the burns? What are you going to do next?
View mark scheme & rationale
- 5/5 · Best answerSevere illness like burn injury can be linked to stress-related stomach lining inflammation. We will start stomach-protective treatment and arrange the most appropriate test to identify the cause.
Matches the material linking severe illness and burns to stress ulcers and frames an immediate plan without naming a final diagnosis.
- 1/5 · Low creditThe burns may be putting your body under enough stress to irritate the stomach lining. Because these symptoms can sometimes settle, we can watch you closely for now and arrange testing later if the bleeding continues.
Downplays a high-risk symptom listed in the material (melena) and delays appropriate diagnostic escalation.
- 1/5 · Low creditBurn injuries do not usually cause this kind of stomach problem, so the black stools and discomfort are probably unrelated. We should focus on the burns first and investigate the stomach symptoms later if they persist.
Contradicts the key fact that Curling ulcers are associated with burn injuries and risks missing serious pathology.
2
Physical examination
Prioritise your examination
Prioritise the examination steps that are most relevant to this presentation and explain why they matter.
- Vital signs5/5
Black stools with tachycardia and lower blood pressure suggest physiologic impact and require urgent prioritization.
- Abdominal examination3/5
Epigastric tenderness supports an upper gastrointestinal source of symptoms described in the material.
- Chest wall palpation1/5
Low yield compared with hemodynamic assessment and abdominal evaluation in this presentation.
3
Clinical reasoning
Commit to a diagnosis
Choose the single best diagnosis.
View mark scheme & rationale
- 5/5 · Best answerStress ulcers (Curling ulcers)
The material states stress from severe illness can cause acute gastritis and notes Curling ulcers are associated with burn injuries; melena is listed among symptoms.
- 3/5 · Partial creditAcute gastritis
Acute gastritis is described as rapidly developing and can occur due to stress from severe illness; symptoms can include epigastric pain and melena.
- 1/5 · Low creditChronic gastritis, type B
Type B may be caused by H pylori and is associated with PUD; H pylori is listed among causes of gastritis.
- 1/5 · Low creditChronic gastritis, type A
Type A is a defined subtype of chronic gastritis in the material.
- 1/5 · Low creditStress ulcers (Cushing ulcers)
The material describes Cushing ulcers as stress ulcers associated with traumatic brain injury.
- 1/5 · Low creditGastric adenocarcinoma
The material links chronic gastritis to increased risk of gastric adenocarcinoma.
4
Investigation & management
Choose the next steps
Investigation checkpoint
Which test is described as the gold standard for diagnosis of gastritis and H pylori, and is most invasive?
View mark scheme & rationale
- 5/5 · Best answerEndoscopic biopsy
The table describes endoscopic biopsy as the gold standard for diagnosis of gastritis and H pylori and the most invasive test.
- 3/5 · Partial creditStool antigen test
Stool antigen testing is high sensitivity and specificity and cost-effective, but it is not described as the gold standard.
- 3/5 · Partial creditUrea breath test
Urea breath testing has high specificity but lower sensitivity and can be affected by PPIs; it is not described as the gold standard.
- 1/5 · Low creditSerology
Serology cannot distinguish treated from active disease and is not the gold standard test.
Management checkpoint
What is the most appropriate definitive management plan based on the provided material for a high-risk stress setting?
View mark scheme & rationale
- 5/5 · Best answerProvide prophylactic PPI in at-risk ICU patients and treat gastric inflammation with listed therapies; treat H pylori if detected
The material states to give prophylactic PPIs to ICU patients at risk for stress ulcers and describes acid suppression or mucosal protection options, with triple therapy for confirmed H pylori infection.
- 1/5 · Low creditTreat the current symptoms, then use repeat blood serology after therapy to confirm that any H pylori infection has cleared
The key fact states antibodies stay positive even when infection is cleared and recommends urea breath test or stool antigen as a test of cure.
- 1/5 · Low creditStop the gastric medications once the pain and bleeding improve, without arranging additional eradication testing or follow-up
Symptom improvement does not confirm eradication of H pylori if present, and the material describes specific approaches to treatment and follow-up testing.
- 1/5 · Low creditContinue potentially aggravating agents such as NSAIDs when useful for pain, rather than removing them because of the gastric symptoms
The treatment section explicitly states to stop exacerbating agents such as NSAIDs or alcohol.
Exam takeaways
Key learning points
- Stress from severe illness can cause acute gastric mucosal inflammation, and burns are associated with Curling ulcers.
- Gastritis symptoms can include epigastric pain, nausea, vomiting, hematemesis, and melena.
- Endoscopic biopsy is described as the gold standard for diagnosis of gastritis and H pylori and is the most invasive test.
- Serology has high sensitivity but lower specificity and cannot distinguish treated from active infection.
- PPIs, H2 blockers, sucralfate, and antacids may help; prophylactic PPIs are recommended for ICU patients at risk of stress ulcers.
- Urea breath test or repeat stool antigen can be used as a test of cure because antibodies may remain positive after clearance.
Want the full simulation?Continue this case in OSCE AI with guided feedback and performance tracking.
Practise interactively →03
Respiratory OSCE Station: The sudden crash after transfusion
46-year-old female delivery driver with sudden worsening shortness of breath in the ICU shortly after blood transfusion following abdominal surgery.
Candidate brief
Your OSCE task
Diane Porter is a 46-year-old delivery driver recovering in the surgical ICU after emergency surgery for a perforated abdominal infection. She had ongoing fevers and was being treated with antibiotics. Earlier today she received a unit of packed red blood cells for postoperative anemia. Within a short time of the transfusion finishing, staff noticed abrupt worsening shortness of breath and agitation. She now looks exhausted, breathing rapidly, and cannot speak full sentences. Her oxygen saturation has dropped into the low 80s despite high oxygen support. She is hypotensive and tachycardic. On auscultation there are diffuse crackles across both lungs. A chest x-ray shows new diffuse bilateral opacities. The team is considering multiple causes: worsening infection-related lung injury, hydrostatic pulmonary edema from fluids, or an acute transfusion-associated lung process. A pulmonary artery catheter is placed because her shock and respiratory failure are progressing quickly, and the wedge pressure is not elevated. Her family is shocked by the sudden change and asks why this happened right after a transfusion. The ICU team must rapidly stabilize oxygenation and circulation, stop potential triggers, and avoid missing a time-critical alternative diagnosis.
BP84/48 mmHg
HR124 bpm
RR34 bpm
SPO282 %
TEMP100.6 F (38.1 C)
Learning objective
Manage a rapidly deteriorating postoperative ICU patient with acute hypoxemic respiratory failure temporally linked to transfusion by prioritizing stabilization, safety notification, and appropriate ventilatory support.
1
History & communication
Respond to the patient
Did the transfusion cause this? Should I never get blood again?
View mark scheme & rationale
- 5/5 · Best answerThe timing makes a transfusion reaction one possibility, but we must stabilize you first. We will stop any triggering products, treat your breathing and pressure urgently, and document this carefully for future safety.
Addresses the concern without certainty, prioritizes immediate stabilization, and commits to documentation and future safety planning. This helps the patient feel heard and protected.
- 3/5 · Partial creditIt might be related to the transfusion, but infection or another ICU problem can also cause sudden breathing difficulty. We will keep treating you and run more checks to decide what happened before drawing conclusions about future transfusions.
Reasonable uncertainty, but the answer is less action-focused about immediate safety steps and future documentation, so the patient may feel less reassured about prevention.
- 1/5 · Low creditIt is probably not related to the transfusion, so try not to focus on that connection right now. Once your breathing settles, we can review what happened, but we should wait for another test before treating this as a transfusion reaction.
Dismisses a time-linked high-risk concern and minimizes severe respiratory failure. This can delay key safety actions and undermines trust during an emergency.
2
Physical examination
Prioritise your examination
Prioritise the examination steps that are most relevant to this presentation and explain why they matter.
- Chest auscultation and work of breathing assessment5/5
Immediate respiratory assessment establishes severity of gas-exchange failure and guides urgent escalation of ventilatory support in a crashing patient.
- Blood pressure and heart rate3/5
Shock physiology needs rapid recognition, but it must be integrated with airway and breathing stabilization in severe hypoxemia.
- Abdominal examination1/5
Relevant context postoperatively, but it should not delay airway, breathing, and circulation priorities during acute deterioration.
3
Clinical reasoning
Commit to a diagnosis
Choose the single best diagnosis.
View mark scheme & rationale
- 5/5 · Best answerTransfusion-Related Acute Lung Injury
Acute hypoxemia and diffuse bilateral opacities developing soon after transfusion with no evidence of elevated filling pressures supports a transfusion-associated noncardiogenic pulmonary edema mechanism.
- 3/5 · Partial creditAcute Respiratory Distress Syndrome
Sepsis and abdominal infection can trigger diffuse inflammatory lung injury with bilateral opacities and severe hypoxemia.
- 3/5 · Partial creditCardiogenic Pulmonary Edema
Critically ill patients can develop hydrostatic pulmonary edema after fluids or cardiac dysfunction.
- 1/5 · Low creditAnaphylaxis
Acute deterioration after transfusion can occur with severe allergic reactions.
- 1/5 · Low creditPulmonary Embolism
Recent surgery increases thrombosis risk and can cause acute hypoxemia.
- 1/5 · Low creditPneumothorax
Sudden respiratory distress can occur in pneumothorax.
4
Investigation & management
Choose the next steps
Investigation checkpoint
Which imaging study is most appropriate next for this patient?
View mark scheme & rationale
- 5/5 · Best answerPortable chest x-ray review and bedside lung ultrasound
Bedside imaging confirms diffuse alveolar pattern and excludes pneumothorax or large effusions during acute deterioration without unsafe transport.
- 2/5 · Limited creditCT pulmonary angiography immediately
PE is possible postoperatively, but the strongest clue is timing with transfusion; stabilize first and target imaging based on highest-likelihood causes.
- 2/5 · Limited creditCT chest with contrast for detailed characterization
CT may add detail, but it risks transport-related decompensation in severe hypoxemia and does not precede urgent stabilization.
- 1/5 · Low creditNo imaging needed at this time
In a crashing hypoxemic patient, bedside imaging helps confirm the pattern and exclude urgent reversible causes; deferring increases risk of missed treatable problems.
Management checkpoint
What is the most appropriate definitive management for this patient?
View mark scheme & rationale
- 5/5 · Best answerIntubation and lung-protective ventilation with appropriate PEEP
Severe refractory hypoxemia with instability requires ventilatory support using lung-protective strategy, alongside treatment of the trigger and shock support.
- 1/5 · Low creditContinue nonrebreather and wait for improvement
Waiting delays escalation in a patient failing high oxygen and showing exhaustion; deterioration can be sudden with high risk of arrest.
- 1/5 · Low creditBronchodilators and reassurance, then reassess later
Bronchodilators do not correct alveolar flooding and shunt physiology; this approach risks worsening hypoxemia in an unstable patient.
- 1/5 · Low creditTransfer out of ICU once oxygen briefly rises above 90%
This is unstable critical illness; premature de-escalation risks recurrent deterioration and prevents rapid response to worsening shock or hypoxemia.
Exam takeaways
Key learning points
- Acute deterioration shortly after transfusion is a critical timing clue that should trigger transfusion-associated differential diagnoses.
- Diffuse bilateral opacities with severe hypoxemia can arise from cardiogenic and noncardiogenic mechanisms - hemodynamics help differentiate.
- Instability with hypotension and hypoxemia requires immediate escalation and close monitoring.
- Stop potential triggers promptly and document safety-critical events for future care.
- Lung-protective ventilation with appropriate PEEP is central when refractory hypoxemia persists.
- Empathic, action-focused communication helps patients cope with air hunger and fear during sudden ICU deterioration.
Want the full simulation?Continue this case in OSCE AI with guided feedback and performance tracking.
Practise interactively →04
Neurology OSCE Station: When words vanish at the busiest hour
62-year-old male with abrupt speech difficulty, right-sided weakness, and visual field symptoms within hours of onset.
Candidate brief
Your OSCE task
Arion Veynar, a 62-year-old school principal, arrived at the emergency department during the evening rush. Ten minutes before leaving home, his daughter watched him freeze mid-sentence; his words stuck, and coffee splashed as his right hand failed to grip. He insisted he was fine, but in triage he bumped into the rail on his right and spoke in short, effortful bursts. Yesterday he had a brief spell of tangled speech after a shower that fully resolved; an urgent care clinician called it an ear problem and gave me tablets, which he took once. Arion hates hospitals and once stopped pills prescribed for an irregular heartbeat because they made him tired. His daughter, shaken and angry at the delay, told the nurse she begged him to come sooner. He is proud, private, and anxious about appearing weak in front of his community. No fever, no trauma, no seizure witnessed. He now grips his phone with his left hand while avoiding eye contact, trying to hide the right-sided clumsiness that betrays him.
BP198/102 mmHg
HR108 bpm, irregular
RR18 bpm
SPO297 %
TEMP36.7 °C
Learning objective
Rapidly recognize a time-critical focal neurological syndrome and initiate imaging and specialist pathway without delaying for nonessential steps.
1
History & communication
Respond to the patient
If I just rest, will I wake up unable to speak to my child?
View mark scheme & rationale
- 5/5 · Best answerTime matters now. We’ll move quickly for brain imaging and specialist care to protect your speech and movement.
Validates fear, emphasizes urgency, and outlines concrete, immediate steps without overpromising outcomes.
- 3/5 · Partial creditIt’s too soon to predict. We need to complete urgent checks and then agree the safest plan together.
Process-oriented but lacks clarity on urgency; provides limited reassurance and no concrete next steps.
- 1/5 · Low creditRest may help, and we can observe for a while before deciding on any immediate actions here today.
Minimizes a time-sensitive problem and risks harmful delays; not appropriate for acute focal deficits.
2
Physical examination
Prioritise your examination
Prioritise the examination steps that are most relevant to this presentation and explain why they matter.
- NIH Stroke Scale (full assessment)5/5
Standardizes severity, captures language, visual, motor deficits, and guides eligibility for time-critical therapies.
- Capillary blood glucose (point-of-care)5/5
Rapidly excludes a common mimic and is mandatory before considering thrombolysis or antiplatelet decisions.
- Speech and language assessment (dysarthria/aphasia)4/5
Characterizes cortical involvement and safety risks; informs airway, nutrition, and rehabilitation planning.
- Motor strength and drift (upper and lower limbs)4/5
Quantifies hemiparesis for baseline, progression, and treatment response tracking.
3
Clinical reasoning
Commit to a diagnosis
Choose the single best diagnosis.
View mark scheme & rationale
- 5/5 · Best answerAcute Ischaemic Stroke
Sudden focal language deficit with right-sided signs, visual field loss, arrhythmic pulse, and tight onset timing are highly consistent with an arterial occlusion.
- 3/5 · Partial creditIntracerebral Haemorrhage
Acute focal deficits and hypertension can accompany a parenchymal bleed and must be excluded urgently with imaging.
- 3/5 · Partial creditFocal Seizure with Todd’s Paresis
Transient weakness following a focal seizure can mimic unilateral motor deficits and may be precipitated by metabolic factors.
- 1/5 · Low creditHemiplegic Migraine
Can produce transient unilateral weakness and language disturbance resembling a focal neurological event.
- 1/5 · Low creditHypoglycaemia
Can cause confusion, slurred speech, and weakness and must be excluded early due to reversibility.
- 1/5 · Low creditFunctional Neurological Disorder
Emotional stress and abrupt symptoms can lead to motor-speech changes that resemble structural neurological disease.
4
Investigation & management
Choose the next steps
Investigation checkpoint
Which imaging strategy best supports rapid, appropriate intervention now?
View mark scheme & rationale
- 5/5 · Best answerImmediate NCCT head with CTA head/neck
Perform immediate non-contrast CT head to exclude bleed and CT angiography head/neck to detect proximal occlusion amenable to thrombectomy.
- 1/5 · Low creditMRI brain with diffusion as first-line imaging
Intermediate fault: MRI-first delays time-dependent therapy in many EDs despite sensitivity; do not postpone rapid CT-based pathway.
- 2/5 · Low creditNon-contrast CT head only, no vascular imaging
Intermediate fault: NCCT alone excludes bleed but omits vascular imaging to detect treatable proximal occlusion for thrombectomy.
- 1/5 · Low creditDelay imaging until all laboratory results are available
Basic fault: Waiting for full labs before imaging causes harmful delays in a time-critical emergency.
Management checkpoint
What is the most appropriate definitive pathway after initial assessment and imaging preparation?
View mark scheme & rationale
- 5/5 · Best answerActivate reperfusion: IV thrombolysis ± EVT after exclusion of bleed
Proceed with reperfusion pathway: IV thrombolysis within window if eligible and prompt endovascular thrombectomy for large-vessel occlusion after hemorrhage exclusion.
- 1/5 · Low creditHigh-dose corticosteroids for acute neurological deficit
Intermediate fault: Steroids target inflammation, not acute focal ischemia; risks outweigh benefits.
- 1/5 · Low creditStart prophylactic anticonvulsants to prevent further events
Intermediate fault: Prophylactic anticonvulsants without seizures add sedation and hinder reassessment without benefit.
- 1/5 · Low creditImmediate heparin infusion before imaging and specialist review
Advanced fault: Therapeutic heparin before imaging increases bleeding risk and delays definitive reperfusion decisions.
Exam takeaways
Key learning points
- Time anchors everything: establish exact onset and last-known-well immediately.
- Always check capillary glucose before any reperfusion or antiplatelet decision.
- Use NIHSS systematically; don’t miss language, vision, neglect, or subtle facial weakness.
- Do not delay non-contrast CT ± CTA with unnecessary steps or observation.
- Avoid aggressive BP reduction before reperfusion; follow thresholds tied to therapy eligibility.
- Differentiate mimics (seizure, migraine, hypoglycaemia) without delaying imaging.
- Screen for swallow early to prevent aspiration; keep NPO until assessed.
- Document onset times, exam changes, and communicate clearly with the stroke team.
Want the full simulation?Continue this case in OSCE AI with guided feedback and performance tracking.
Practise interactively →A better practice loop
How to practise an OSCE station effectively.
Reading a mark scheme is revision. Performing first, reviewing second and repeating deliberately is practice.
Perform before you peek
Read the candidate brief, set a timer if useful, and complete the task aloud before opening the answer key.
Commit to decisions
Choose your examination priorities, differential, investigation and management instead of mentally keeping every option open.
Review the mark scheme
Identify exactly where marks were lost and why a stronger answer was safer, clearer or better prioritised.
Repeat the weak component
Separate a knowledge gap from a performance gap. Rehearse the weak opening, explanation, examination sequence or close rather than blindly repeating the whole station.
Useful self-check: “Was that a knowledge gap or a performance gap?” The answer tells you what to practise next.
From case to performance
Practise the whole clinical decision pathway.
OSCE performance is more than recalling a checklist. The strongest practice connects communication, examination, clinical reasoning and management inside the same patient encounter.
Realistic station flow
Move through patient briefing, history, examination, diagnosis, workup and management as one connected case.
Clinical reasoning feedback
Compare decisions with graded alternatives and rationales so you understand why one choice is stronger than another.
Exam-focused scoring
See where your choices gain or lose credit instead of receiving a simple right-or-wrong reveal.
Independent practice
Rehearse when a study partner is unavailable, then use real people to calibrate communication and unpredictability.
Core + Pro progression
Build breadth across clinical specialties, then move into time-critical, rare, comorbid and escalation-focused scenarios.
Progress analytics
Track recurring weaknesses across the OSCE workflow so your next practice session targets the right skill.
OSCE guides & resources
Learn the structure, then practise it in a station.
Use these guides to strengthen examination technique, mark-scheme awareness and your repeatable OSCE approach.
Ready to practise?
Turn the next case into deliberate practice.
Start with the four free stations, then use Core and Pro cases when you want broader coverage and harder clinical decisions.
Frequently asked questions
OSCE station FAQs
What is an OSCE station?
An OSCE station is a timed clinical task used to assess practical skills such as history taking, physical examination, communication, clinical reasoning, investigation and management.
Can I practise OSCE stations for free?
Yes. This page includes four complete free OSCE station examples in cardiology, gastroenterology, respiratory medicine and neurology, with graded decisions and rationales.
What is the difference between Core and Pro OSCE cases?
Core Cases are organised around major clinical specialties. Pro Cases focus on advanced clinical challenges such as time-critical decisions, diagnostic uncertainty, comorbidity and management escalation.
Do the free OSCE stations include mark schemes?
Yes. The free examples include graded communication responses, examination priorities, diagnosis options, investigations, management choices and rationales.
Can I practise OSCE stations alone?
Yes. You can use the free examples for independent practice and review, then continue into OSCE AI for interactive station practice, scoring and performance tracking.
How should I use OSCE stations to improve?
Perform the station before checking the mark scheme, review what you missed, separate knowledge gaps from performance gaps, and repeat the weakest part of the station deliberately.