Better late than never – ACEM releases detailed information on the new Fellowship Exam

With less than 100 days to go to the 2015.1 exam, ACEM has finally released some specific details about the upcoming exam format, in particular the OSCE.

They’re not that easy to find, but head over to the Fellowship Exam page on the ACEM website, and click on the two tabs on the right: “2015 Onwards” and “Resources”.

In addition to the written exam examples (MCQ, EMQ and SAQ examples that have been available for a while, and which there sadly isn’t much more information about) you will find:

  • Fellowship Exam Curriculum
    • This is the main document you should base your study on, and includes the Core Competencies, Learning Objectives & Levels of Practice you need to have nailed before you sit the exam.
    • It is definitely in your best interest to print this out, and ensure you have covered (at a minimum) all of the Expert and High level topics.
    • NB: This is the same set of topics/levels of practice as the old exam, published in 2012. It’s not clear if these will be updated for the new exam.
  • A full set of example OSCE station questions
    • This is a simple topic grid/summary – not detailed questions/answers
    • It includes the station type,  the specific skill being tested, a brief summary of the scenario, the expected response and the curriculum reference. It gives you an idea of the breadth, depth and type of stations that will be included.
    • It’s worth noting that 55% of questions have “Communication” listed as a core curriculum domain
    • Based on this, candidates should familiarise themselves with the detailed version of the Curriculum Framework, in particular the Communication domain. Failure to do this would be exam suicide, as the questions are mapped to the curriculum. I’ll post more about this soon.
    • There is a video describing how to use the Curriculum Framework here.
  • Detailed written OSCE station examples – examples below
  • Demonstration OSCE videos – go to this page, click on the “Resources” tab and scroll down
    • These include:
      • Written example Instructions to Candidate (i.e. the “stem”, or what you get to read outside the room before you go in)
      • Written example Examiner Assessment Criteria
        • These are definitely worth looking at in detail, in particular the “Detailed Assessment Criteria” section, to give you an idea of what the examiners are looking for

There is a lot of information to absorb here, and some of you may find the new OSCE format confronting. There will be a large emphasis on communication, there will obviously be many different styles of OSCE station, many of which use simulation including high fidelity manikins, part task trainers/training manikins, simulated patients/relatives and simulated colleagues (from individuals to resus teams). You may be asked to write discharge letters, and even speak to non-ED colleagues on the phone! The old style of SCE with the examiners handing you prompts and directly questioning you is conspicuously absent. It seems the new style involves much more “acting”, on the candidates part, with much less, or no direct interaction with the examiners.

Whilst this more realistically mimics “a day at work” than the old short and long cases, and even the old SCE’s, it seems the majority of the new OSCEs will be like the old “communication” SCEs.

You will need to factor this in to your preparation. Specifically you will need to practice simulated cases, simulated skills, and simulated communication with each other.  You will need to develop a style that allows you to think on your feet and engage in a scenario, whilst also thinking about the stem, the specific questions and items that you’ll need to address, whilst maintaining a calm professional demeanour, and pretending it’s a real patient

It seems that a lot of the prompting and directing of the scenarios that used to be done by examiners will be done by actors and simulated patients/staff, so I hope that they have their scripts squared away!

As far as marking goes, there is still no marking system for any of the exam elements available. The new system relies on “standard setting”, and I’ve made direct enquiries to ACEM for more information about this for exam candidates, and am still awaiting a response.

Food for thought, and I hope you find these new resources useful. If you have any tips or questions about the new exam format, leave a comment below!