OSCE Survival Guide: My Top Tips as a Newly Qualified Optometrist

Many candidates worry about communication stations because they feel “fake” — you’re often speaking to an actor or examiner instead of a real patient. That can make it harder to show your natural empathy and professionalism.

The trick is to have a clear template for how you approach each conversation. Here’s one that worked for me:

• Introduce yourself — “Hi, my name is Anisa, I’m your pre-registration optometrist today.”
• Start with the good news — e.g. “The back of your eyes looks healthy.”
• Deliver the diagnosis clearly — always use the correct term (e.g. papilloedema, not just “pressure behind the eye”).
• Explain in plain language — describe which part of the eye is affected and what that means. Use diagrams, the eye chart in your practice, or even draw on the paper provided.
• Show empathy — “I understand this may not be what you wanted to hear today.”
• Balance with reassurance — e.g. “It’s great you came in today — we’ve caught this early, and treatment is available.”
• Outline the next steps — explain what will happen after referral, or give a brief overview of procedures like cataract surgery to manage expectations.

Patients (and examiners) want to hear not just what’s wrong, but also what’s next. Practising these explanations for common conditions like cataract, keratoconus, or uveitis will really boost your confidence.

2. History & Symptoms: Go Beyond the Basics

It’s tempting to think history taking is straightforward — but in the OSCE, you’re being marked on how systematic and thorough you are.

Some examples:

• Flashes & Floaters
  • Ask about timing, which eye, onset, trauma, and family history of retinal detachment.
  • Keep differentials in mind: posterior vitreous detachment, retinal detachment, or visual aura.
• Diplopia
  • Clarify: true double vision or blurred vision?
  • Is it monocular or binocular? Horizontal or vertical? Constant or intermittent?
  • Think differentials: palsies, tumours, Duane’s, Brown’s, decompensating phorias, or cataract.
• Red Eye
  • Explore onset, pain, discharge, vision changes, and past episodes.
  • Remember: differentials are wide — use College guidelines as your anchor.
• Sudden Vision Loss
  • Pin down onset, laterality, duration, and associated symptoms like flashes, floaters, scalp tenderness, or neurological signs.
  • Differentials include retinal detachment, CRAO/CRVO, optic neuritis, wet AMD, vitreous haemorrhage, TIA, or angle closure.

The more you practise asking these questions — with peers, colleagues, or even family — the more natural and efficient it will feel.

3. Data Interpretation: Describe Everything You See

Data interpretation can feel daunting because there’s so much variation. My best advice? Say what you see — out loud.

For example:

• Start with the basics: “This is a right-eye fundus photo” or “This is an OCT scan of the macula.”
• Describe systematically: disc, vessels, macula, periphery.
• Even if it feels obvious (“IOPs are normal,” “disc looks healthy”), you get marks for it.
• Link symptoms, age, and findings logically.

Example: A 45-year-old patient with fluctuating morning vision and glare. Normal pressures, healthy fundus. The corneal photo shows stromal changes and a “beaten metal” appearance of the endothelium. Likely diagnosis? Fuchs’ endothelial dystrophy.

The same approach works with AMD photos or OCT scans — describe drusen, pigment changes, haemorrhages, or fluid, then suggest whether it’s dry or wet AMD and what the management would be.

Practise with as many images as you can find — Google, textbooks, colleagues. The key is building that descriptive fluency.

4. Clinical Examinations & Practical Skills: Practice, Practice, Practice

This is where nerves can really trip people up. My golden rules:

• Retinoscopy: Do it on every patient. Some days will be good, others not — but the more you do it, the more consistent you’ll be.
• Ophthalmoscopy: Practise on children, colleagues, anyone you can. Remember to invert your findings when recording.
• Colour vision & stereo tests: Don’t just do these with kids — practise on adults so you’re fluent with instructions and interpretation.
• Slit lamp techniques: Work on Van Herrick’s, conical beam, and other methods you don’t use daily.
• Fixation disparity, Maddox rod/wing: Go over the instructions until they’re second nature.

Use your time in practice wisely — lunch breaks, quieter clinics, even staff as mock patients. The OSCE tests whether you can perform under pressure, so the more automatic your techniques, the better.

And remember: if one station goes badly, don’t let it snowball. Reset, breathe, and tackle the next one fresh. Most failures are down to nerves, not lack of knowledge.

Final Thoughts

The OSCE is intense, but it’s also achievable. With structured practice, a calm approach, and confidence in your preparation, you’ll give yourself the best chance of success.

Remember:

• Prepare with peers.
• Practise the “boring” techniques.
• Stick to a clear structure.
• And don’t let one bad station shake your confidence.

If you’ve made it to OSCEs, you’ve already done something incredible. You can absolutely do this.