My experience sitting the MFOM Part 2/AFOM OSCE

Introduction

The MFOM Part 2 / AFOM OSCE is the final major hurdle in occupational medicine training. Unlike Part 1, this exam is not about recalling knowledge—it is about applying it under pressure in a structured, professional way.

Each station is only 10 minutes long, and success depends on how efficiently you can:

Communicate
Structure your approach
Demonstrate safe clinical reasoning

This exam is very passable—but only if you prepare deliberately and practically.

Understanding the OSCE Structure

The exam is divided into four main station types:

History Taking

Focused consultations with occupational relevance

Explanation

Data interpretation and communication

Examination

Structured physical examination

Procedures

Practical skills and interpretation

History Taking Stations

The Time Pressure Reality

Each station is only 10 minutes, with 3–4 minutes reserved for questions.

This means your history must be:

Focused
Efficient
Purpose-driven

Key Pitfall

Trying to take a full history. You will run out of time and lose marks.

The 2-Minute Advantage

You are given 2 minutes outside the station to read the vignette.

This is critical.

Use it to:

Identify the likely issue
Plan your structure
Anticipate questions

Core Approach

Keep your introduction under 30 seconds
Always explain why the employee is attending
Take a focused history aligned to the scenario

What You Must Always Cover

Reason for referral
Occupational impact
Red flags (safety critical role)
Functional limitations
Fitness for work considerations
Consider RIDDOR

Thinking Like a Senior Occupational Physician

Strong candidates go beyond basic history:

Differentials → Always consider at least 2–3
Investigation and management knowledge → Common conditions (anxiety, depression, RA)
Legal & ethical awareness (What various regulations and legal principles are relevant - EA2010 etc)
MDT involvement (e.g. GP reports)

For reasonable adjustments, use this consistently:

Hours → phased return, reduced hours, breaks
Duties → modify workload, pacing, coaching
Environment → DSE assessment, WFH, risk assessment
Support → supervision, wellness action plan, training, EAP

Employer-Focused Thinking

Be ready to answer:

Fitness for work
Adjustments
Ill-health retirement considerations
Fitness for disciplinary meetings
What goes into a report (including identifiers)

Explanation Stations

These often involve data interpretation and clear communication.

High-Yield Topics

Audiometry
Spirometry
Occupational asthma
Blood-borne viruses
Measurement of hazards
Research and statistics
Breaking bad news

Trend Awareness

Be aware of current occupational health topics, such as:

Respirable Crystalline Silica (RCS)
Noise induced hearing loss
The current state of the fit note system

How to Structure Your Explanation

Describe the data
Interpret it clinically
Link to occupational relevance
Explain implications
Answer questions clearly

Examination Stations

You will usually encounter three examination stations.

This is about structure and efficiency, not just knowledge.

Common Mistake

Lack of structure. Examiners notice immediately.

Key Principles

Wash hands before and after (easy marks)
Be systematic
Don’t miss obvious signs
If a sign is present, identify it clearly and think about the implications on health and work
Know your scars

Say clearly:

"I did not identify any abnormal findings."

Never invent signs.

Presentation Structure

Presentation is where you gain easy marks:

Inspection
Findings
Interpretation
Likely diagnosis

Always practise this.

Procedures Stations

The MFOM Part 2 OSCE Blueprint is broad—so your preparation should be too.

Common Procedures

Audiometry
Spirometry
Venepuncture
Vaccinations
Skin prick testing
HAVS assessment
Peak flow monitoring
Drug & alcohol testing
Vision testing
Prescribing

How to Prepare

Read guidelines
Watch demonstrations online
Practise physically where possible

- Consent - Safety - Clear explanation - Correct sequence - Interpretation of results

Final Thoughts

The Three Pillars of OSCE Success

🧠

Structure

Have a clear approach for every station

⚡

Efficiency

Work within strict time limits

🎯

Clinical Reasoning

Think like a senior occupational physician

Start practising early. Build structure into your daily work. Always think about the legal and ethical implications in every worker you see.

By the time you reach the OSCE, it should feel like a natural extension of your clinical practice—not a performance.

Good luck with your preparation. If you are revising for Part 2 SBA, our MFOM Part 2 question bank includes 400+ SBA questions and OSCE-focused content to support your preparation.