How to pass the MFOM Part 2/AFOM OSCE

Preparing for the MFOM Part 2 / AFOM OSCE?

The MFOM Part 2 / AFOM examination includes an Objective Structured Clinical Examination (OSCE). This assessment evaluates whether candidates can apply occupational medicine knowledge in realistic clinical situations.

Rather than testing factual recall, the OSCE focuses on practical professional skills required for independent occupational medicine practice.

The exam typically consists of:

12 OSCE stations
10 minutes per station
~2 minutes reading time
A mixture of simulated patients, scenarios, and data interpretation tasks

Each station assesses one or more of the following competencies:

Occupational history taking
Focused clinical examination
Risk communication
Fitness-for-work decision making
Ethical and legal reasoning
Occupational health procedures

The OSCE is designed to simulate the types of consultations you will perform in real occupational medicine practice.

Why OSCE Technique Matters

From experience, candidates do better in the OSCE compared to the written. However, some candidates fail the OSCE not because they lack knowledge, but because they lack structure under time pressure.

Common problems include:

Poor confidence when taking a history or examining the simulated patient
Spending too long gathering history with poor structure and running out of time
Forgetting to address the occupational context
Failing to explain fitness-for-work decisions clearly
Missing communication cues from the simulated patient
Not summarising or closing the consultation

A reliable structure ensures that you demonstrate competence in every station. This can be achived with practice, practice and more practice.

The Five-Step OSCE Approach

Read the Station Brief Carefully

Use the reading time to identify exactly what the station is asking you to do. The task might be focused history taking, explanation, examination, or risk advice.

Open the Consultation Professionally

Introduce yourself, confirm the patient’s identity, explain your role, and obtain consent before beginning the task. It would also be a great idea to check the patient's understanding of why they are here.

Perform the Core Task Efficiently

Focus on the key elements required for the station — whether that is occupational history, focused examination, or explaining management.

Address the Occupational Implications

Discuss how the condition affects work, workplace exposures, and possible adjustments. This is a key part of occupational medicine consultations.

Summarise and Close the Station

Summarise key findings, explain the next steps, check understanding, and thank the patient. You would then present your findings concisely to the examiners. Practice presenting your summary as there are marks for this.

Step 1: Read the Station Brief Carefully

The instructions outside the station door tell you exactly what examiners expect.

Typical instructions include:

“Take a focused occupational history”
“Explain the diagnosis and fitness for work”
“Perform a focused musculoskeletal examination”
“Advise the patient about workplace exposure”

If the station asks for explanation, do not spend most of the time asking questions.

If the station asks for focused history, do not attempt a full history. There is not enough time.

Step 2: Open the Consultation Professionally

Examiners score communication from the very beginning.

A professional opening should include:

Introduce yourself and your role
Confirm patient identity
Explain the purpose of the consultation
Ask permission to proceed
Check they understand why they are here

This takes less than 30 seconds but demonstrates professionalism. Make sure you practice your introduction several times as this will provide you with confidence and make you look slick.

Step 3: Perform the Core Task Efficiently

Most stations require focused assessment, not a full consultation.

For example:

Occupational history stations

Focus on:

Current job role
Specific exposures
Symptom timing relative to work
Workplace control measures
Impact on ability to perform duties

Examination stations

Perform a structured focused exam, explaining what you are doing. Have differential diagnoses in the back of your mind as you go along.

Explanation stations

Use clear language and avoid medical jargon. Always check their understanding before moving on and have time to answer their questions.

Step 4: Address Occupational Implications

This is where the OSCE differs from general clinical exams.

Always consider:

Does the condition affect ability to work?
Are workplace exposures contributing?
What adjustments might help?
Is further occupational assessment needed?

Demonstrating this reasoning is critical. This is an occupational medical exam.

Step 5: Summarise and Close the Station

Many candidates lose marks by finishing abruptly when time is called.

A strong close includes:

Summary of findings
Explanation of implications for work
Proposed next steps
Opportunity for patient questions

Even a 10-second summary improves examiner scoring.

At this stage, you will need to have a few differential diagnoses with your most likely diagnosis as well as be able to answer questions based on your findings.

Common OSCE Traps

⚠ Ignoring the Occupational Context

Candidates sometimes conduct a standard medical consultation without exploring workplace exposures or job duties.

⚠ Overly Detailed History

The station only lasts 10 minutes. Focus on the elements relevant to the scenario.

⚠ Forgetting Fitness-for-Work Advice

Occupational medicine consultations almost always involve discussing work capability or adjustments.

⚠ Poor Time Management

If you spend 6 minutes gathering history of the presenting complaint, there is no time left to ask about social history or medical history.

Time Management

MFOM Part 2/AFOM OSCE Timing

Stations

10 min

Per Station

2 min

Reading Time

Most of the stations will go like this:

Minute 0–1: introduction
Minute 1–6: core task and summarising
Minute 7–10: answering examiner questions

Practice Makes Perfect

The best preparation for the OSCE is repeated practice with realistic scenarios.

Effective preparation includes:

Practising focused history taking
Rehearsing fitness-for-work explanations with adjustments
Performing structured examinations
Practising communication under time pressure
Ensure you are competent in all procedures that an Occupational Health Physician may be expected to do

When Practising OSCE Stations

Use a timer	Simulate the 10-minute station format with 6 minutes for the core task
Practise aloud	Communication skills cannot be developed silently.
Get feedback	Peers or mentors can identify missing elements. Try to record yourself and send it to a colleague for feedback
Repeat weak stations	Target areas where you are likely to lose marks

Preparing systematically will help you approach the OSCE with confidence and demonstrate the professional competencies expected of a qualified occupational physician.

It is generally advised to begin OSCE prep shortly after the Single Best Answer sitting but we advise anywhere between 4-6 weeks for OSCE revision.

OSCE Resources

Reviewing the MFOM Part 2 OSCE Blueprint is vital.

Cases for PACES by Stephen Hoole (Royal Papworth Hospital, Cambridge, UK), Andrew Fry (Addenbrooke's Hospital, Cambridge, UK), Rachel Davies (Hammersmith Hospital, London, UK)

PACES examination station videos on Youtube

Geeky Medics videos on Youtube