Keep in mind the NAC OSCE score plays an important role in whether or not you match into a

program in Canada. You should aim for a score above 90 on the OSCE to be competitive for the
Canadian programs. Most successful applicants in Canada also have very high MCCEE scores that
is at least two SD above the mean. This means a competitive score is around 375-450 for the
Canadian programs.
All Canadian programs have predetermined score cut offs on the MCCEE and OSCE and have
filters in place so that if you don't have the right scores your application won't even be reviewed.

In its current state, the NAC examination consists of 12 stations (of 11 minutes each) based on
clinical scenarios. The clinical scenarios sample from problems in Medicine, Pediatrics, Obstetrics
and Gynecology, Psychiatry and Surgery. Performance on each scenario is assessed on up to nine
possible competencies, including: history-taking, physical examination, organizational skills,
communication skills, language fluency, diagnosis, data interpretation, investigations,
management, and therapeutics.

http://mcc.ca/examinations/nac-overview/preparation-resources/

http://mcc.ca/examinations/nac-overview/competency-descriptors/

The NAC OSCE is a typical osce style exam. Its based on clinical encounters with standardized
patients for which you will be scored by an examiner using present rating scales. If you are
familiar with step 2 CS it ll be relatively easy for you. Scoring well on this exam depends on what
your current skills are. I think the most important is language, most IMG's have trouble
communicating properly because they don't have complete command over English. The next is
being familiar with the western style of conducting a medical interview and looking at things like
involving the patient in decision making, listening, empathy etc. The last and least important is
your knowledge. Most of the cases are generic and its only testing how you approach a station
rather than your knowledge in getting to a specific diagnosis. If you have never done any exam
like this before try to practice with someone who has given the exam before or take the IMG
courses that are offered. The only people I'd recommend the course to are people who are older
graduates, ve language difficulties, people who have never attempted an OSCE style exam before.

http://nac-osce-mccqe2-usmle-step2cs-clinical-skills-review-course.thinkific.com/courses/a-
beginners-guide-to-the-nac-osce-exam-preparation

https://mdconsultants.ca/5-expert-tips-to-do-well-on-the-mccqe-2-and-nac-osce/

https://www.youtube.com/watch?v=iQAArBOLwGE

https://www.youtube.com/watch?v=Ce51P9gbjGU

http://www.crackthenac.com/
Books: (Also, some good notes written by various course offering Institutes are also available)

1. NAC OSCE comprehensive review

2. Dr. Basil Notes- Nac Osce Vip
3. OSCE and Clinical Skills Handbook
4. OSCE material (Ontario IMG school material)
5. First Aid for the USMLE Step 2 CS
6. Clinical Skills Review: Scenarios Based on Standardized Patients
7. Master the NAC

 Canada QBank for the USMLE Step 2 CS (Free)

Prior to the examination, if you are unfamiliar with disease management practices in North
America, you may wish to consult the latest edition of Therapeutic Choices edited by Jean
Gray, published by the Canadian Pharmacists Association, as a source of general information.

Free recourse for OSCE learning stations

https://www.medistudents.com/en/learning/osce-skills/

You tube:

https://www.youtube.com/user/geekymedics123/videos

https://www.youtube.com/channel/UC8Si5Q9ObZH9I0-LZLB6KiA

https://www.youtube.com/user/medquarterly88/videos

https://www.youtube.com/user/ABCMedicine2012/videos

Other Resources:

https://sites.google.com/site/nacoscemontreal/home/study-materials/clinical-examination-
videos

http://www.oscehome.com/
http://www.oscehome.com/A-step-by-step-guide-to-mastering-the-OSCEs.html

https://www.gacguidelines.ca/index.cfm?id=21080&form_submitted=1

Course: Medical Training Express course or other live online courses e.g. Ontario IMG School
course or Focused Education centre

Making Online Group Study: http://www.rxpgonline.com/forum372.htm

Before the OSCE:

1. Prepare a checklist for each major organ system history and examination you are required to
cover
2. Have a structure for how you approach histories (e.g. Identifying Information, Chief Complaint,
History of Presenting Illness, Associated Symptoms, Medications, Past Medical History, Allergies,
and a small section for Differential Diagnosis to guide your questioning).
3. Having a Focused History: Taking a good history is more than just having a checklist of questions.
This is really difficult to do as a first year student unless you’ve had a lot of clinical exposure and
practise with patients. This takes a lot of practice. The goal of the history is to rule in or rule out
what is in your differential diagnosis (a list of diagnosis that may explain the patient’s chief
complaint). Make a list of important Associated Symptoms and Differential Diagnosis that is
important to cover with certain major organ systems. For example: If your OSCE scenario is “68-
year-old male who presents with shortness of breath”, think of what organ systems cause
shortness of breath – is respiratory (ventilation/perfusion mismatch?), cardiovascular (congestive
heart failure), metabolic (metabolic acidosis), muscular (muscular dystropy), hematological
(anemia), neurologic (cancerous mass impinging on the brain’s central breathing centre”).
4. Physical Examination: Also have a systematic, and structured technique for each physical
examination you have prepared for the OSCE. For example, the cardiovascular exam, apart from
IPPA (inspection, palpation, percussion and auscultation), include Hepatojugular reflex, height of
JVP, presence of pitting edema, etc.
5. Practice with your Classmates: Google “Sample OSCE Scenarios” and print some sheets off. With
a few of your PA classmates (or family members and boyfriends or girlfriends, or even pets), re-
enact the OSCE evaluation environment. Give yourself 2 minutes to read the scenario and 8
minutes to perform it.
6. Counseling Patients: Mental health is no exception to the OSCE scenarios. Be prepared to
interview the depressed patient, the grieving patient, the seductive patient (yes, they have OSCE
scenarios where that does happen) or the angry/irritable patient. In cases of psych, always ask
about suicide, supports, hallucinations/delusions, mood. If you get stuck, it never hurts to ask
“How does that make you feel?”

Top 10 tips for CLINICAL CASE SCENARIO preparation: Duration of preparation: 3 months
1. Start preparation early. Practice daily for at least 2 hours, if you are working. Over the weekends
study for 4-6 hours atleast.
2. Do group study with 3-4 dedicated members. Smaller groups have better results.
3. Make a time table for the week & follow it strictly.
4. Communicate with each member of the group. Learn from each others mistakes & strengths. It is
better to make mistakes during preparation, than in the real exam.
5. Practice in front of the mirror at home or record your preparation, if you are studying alone.
6. Be professional & punctual while studying. Stick to the timing of 7 minutes per case every time you
practice from the beginning. You can use timers or stop watch for effective time management.
7. A typical case scenario should deal with one clinical topic only. Dont try to complicate a case by
adding multiple diagnosis.
example: Practice a case of bronchial asthma specifically. Dont complicate it with a past history of CCF or
domestic abuse.
8. Work on communication skills from day 1.
9. Minimize gossip time by concentrating on the goal ahead.
10. Practice! Practice! Practice! The more you practice, the better you will get.