Preparing for Your OSCE: A Practical Guide for Pre-registration Optometrists

The OSCE is a practical exam designed to test both your clinical knowledge and your ability to apply it in real-world scenarios. It usually takes place four times a year (January, March, July, and September) and consists of 17 short tasks, known as stations, each lasting five minutes, plus one minute outside to read instructions.

You’ll also have two rest stations to reset during the circuit. Importantly, some stations may be pilot stations—these don’t count towards your grade, but you won’t know which ones they are, so treat them all equally seriously.

Common OSCE Station Types

1. History Taking & Diagnosis

You’ll often be asked to take a structured history from a patient or examiner, identify the likely diagnosis, and suggest next steps. Presentations might include blurred vision, red eye, double vision (diplopia), headaches, or systemic disease with ocular manifestations.

• Use a systematic approach (e.g., LOFTSE: Location, Onset, Frequency, Type, Severity, Effects, plus associated symptoms).
• Tailor questions logically to patient responses.
• Explain your reasoning, even if you’re not 100% sure of the final diagnosis.

2. Communication Skills

Every OSCE assesses communication, but some stations focus on it entirely. You may need to:

• Explain a diagnosis or treatment plan in plain language.
• Break bad news sensitively.
• Discuss referral pathways (emergency, urgent, or routine).
• Advise on optical appliances, contact lenses, or low-vision aids.
• Communicate with other healthcare professionals (sometimes via role-play).

Empathy, clarity, and professionalism are key.

3. Data Interpretation

You may be shown clinical data—such as visual field plots, OCT scans, fundus photos, or anterior eye images—and asked to:

• Describe what you see in detail.
• Suggest possible diagnoses.
• Explain your interpretation to the examiner or a patient.

If you’re unsure of the diagnosis, describe logically and outline safe management (e.g., referral if abnormal findings are present).

4. Clinical Examination & Practical Skills

Expect to demonstrate core clinical techniques, which may include:

• Direct or indirect ophthalmoscopy (always assessed).
• Cover tests and motility assessments.
• Retinoscopy.
• Keratometry and calculating corneal astigmatism.
• Slit-lamp techniques.
• Gonioscopy calibration.

A structured, step-by-step approach is essential—introduce yourself, explain the procedure, disinfect equipment, and maintain patient comfort.

Top Tips for Success

• Practice timing early. Five minutes per station passes quickly.
• Always wash your hands and use wipes/equipment provided—it’s easy marks.
• Read the station instructions carefully before entering.
• Say what you see. If unsure of the diagnosis, describe findings logically.
• Be confident. Even if you don’t feel it, show structure and professionalism.
• Engage with patients. Listen actively, acknowledge their concerns, and tailor responses.
• Work with peers. Practising with other trainees is one of the best ways to prepare.
• Use your resources. The College of Optometrists’ website and AOP clinical guides are excellent revision tools.

Final Thoughts

The OSCE is not just about passing an exam—it’s about demonstrating safe, structured clinical practice and effective communication with patients and colleagues. Preparation, logical reasoning, and confidence will carry you a long way.

Remember: practice consistently, learn from peers and supervisors, and approach each station with a clear structure. Good luck—you’ve got this!