So I had my second set of station exams on Friday.  Like the ones in Birmingham last month, I was amazed at how quickly the time went.  We had seventeen stations, including a rest stop (which I had last, oh well), and then we got one-to-one feedback from the examiners at each station.

I was really impressed with the amount of feedback I received and, if you read my last post, you’ll be pleased to know that this time I did well in the colour vision testing station (after failing it in Aston) but focimetry… well, I’ll get to that one in due course.

So, there were a couple of stations that were similar to those I sat in Aston:

For colour vision, I had the exact same scenario so there really was no excuse for not doing well.  This time I saw the lamp, the ruler, the score sheet.  The only thing I forgot (and I’m kicking myself about it) was to ask the patient if they had glasses right at the start of the test.  In the scenario, the patient was a presbyope so they probably would’ve needed a pair of readers for the test.

Indirect ophthalmoscopy involved finding symbols in the peripheral retina (previously it was words).  Again, I was given a choice of Volk lens and opted for the 90D.  I could only see two sets of symbols so I panicked and asked the examiner if that’s all there were.  He told me to read the instructions.  I then asked if I could move the eye (“No”).  In the end, there were only two sets and I got both in vaguely the right places.  One thing I forgot to do was to cross out symbols I’d drawn but then modified the location of, to make more accurate.  Given I had plenty of time at this station, I really should’ve checked the sheet before I handed it in but instead I spent the rest of the time double checking for more symbols around the eye.  I also used the dummy’s nose to focus the slit lamp rather than the rod and I really should’ve written down that it was the left eye, although you could argue that, given the structures on the drawing, it was pretty obvious.

I, again, had a communication station relating a child’s prescription to a parent.  I got some pretty clear feedback from the Aston examiner on what they wanted to hear, I went with what the examiner had fed back to me rather than with what I would say in real life.  In this case, I got the opposite feedback.  It’s interesting to see how opinion varies on something that’s so ubiquitous.  Anyway, my main feedback was to make clear that I was giving the full prescription and for full time wear.  Also, my examiner didn’t like some of the language I used.  I talked about a “wee prescription” and how we’d get the child a pair of glasses that they’d love.  I countered that I like to use positive language, especially when dealing with children and their parents.

There was also the “child is allergic to the dog” station, which, unsurprisingly, I managed to do well on.

This time around, I was more aware of my surroundings and, in the stations with a patient, I remembered to finish my diagnosis/management/etc with “Do you have any questions?” I also tried to repeat the main points at the end, if I had time.

The focimetry station I failed abysmally.  I actually walked in, saw the focimeter and just gave up.  I half-heartedly spoke to the patient then looked at her specs but I just couldn’t muster much beyond focusing the focimeter.  I’m planning on going into uni on a day off and just sitting at the focimeter practising until I feel confident.  That was the only station I failed so I don’t feel too bad about the OSCEs.  It is really embarrassing, though, when you get something that is relatively simple so wrong.

There were a couple of data interpretation stations, which I like.  My mind usually just jumps straight to an answer so I find it difficult to work backwards and give a differential diagnosis.  The cases that the College present tend to be classic examples of the pathology you are being asked to diagnose and manage.  My examiner’s feedback was really helpful – she said that “this is a red eye so list all the differential diagnoses for a red eye”, they don’t have to fit the signs completely.

The BV station was one that I had been dreading.  It was just an examiner, a laptop and a piece of paper.  The video I was shown wasn’t particularly good as the lady who was being recorded doing motility had her head tilted to one side.  In the end, I watched the video twice before settling on a diagnosis and management.

All in all, I quite enjoyed the mock OSCEs.  My real OSCEs are on the 1st July.

Oh, and I haven’t forgotten about building slit lamp cameras, I’ve just come across a problem getting a hold of the correct type of foam.  I called Kayfoam and they don’t supply it so I bought some EVA gym floor mats from eBay and I’m waiting on them turning up to see if they are suitable.

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