My First OSCE: A Tale of Tears

Ally-Rich-banner“Now, this last comment is personal advice for you as you move forward in medicine.”

It was the fall of 2013, and I was in my first year of medical school. Specifically, I was receiving feedback from my standardized patient—notably an OHSU physician—in my first OSCE (objective structured clinical examination). For those of you who don’t know, an OSCE is a series of encounters with standardized patients where you must show your ability to effectively communicate while exhibiting your mastery of taking a history and performing a physical exam. At the end of the encounter, the standardized patient gives feedback on your performance.

My standardized patient wanted to know how I thought the encounter went. I told her that I thought that the most difficult part for me was the pretending. Indeed, OSCEs entail one to act the part of a doctor, and at the beginning of my first year in medical school I felt like nothing of the sort. I can remember waiting until the last second to put on my white coat for preceptorship, afraid that a patient or non-healthcare worker would assume I was a doctor.

The personal advice that my patient gave me that day was to look in the mirror every morning and tell myself that I belonged at OHSU, because she knew that I did. She told me that she was very much looking forward to watching me grow throughout my four years at OHSU. As she began to say this, I realized to my horror that I was going to start crying. It must have been the combination of ending a tremendously anxiety-provoking experience with an exceptionally kind woman. It was just too much for me to handle. I bawled. Then, I hugged her. Then, I walked out into the hall where other first year students were waiting. Two of these students have become my best friends, but at the time I’m sure they were questioning my sanity.

I’m writing about this for a couple reasons. First, thinking back on this experience always makes me laugh. I mean, I cried my eyes out during a medical school examination. I think that it might be on tape somewhere and it would probably be really great to watch. Second, I wanted to illustrate that it is okay to feel out of place, anxious and at times totally broken. In case you were wondering, I passed the exam and OSCEs have since become something that I feel more comfortable with. And good thing, too, because I hear OSCEs are great prep for Step 2, so hopefully the crying is out of my system. I also now wear my white coat with confidence and pride. So, trust the process. If you’re here, it’s for a reason and you are most definitely an incredible person, well deserving of the privilege of learning at OHSU.

Finally, I hope that at graduation I can receive an award for best first OSCE performance. I have incredible stage fright so this would be a serious milestone for me.

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