OSCE Talk

In this episode we focus on breaking bad news to patients.

This often comes in the form of breaking diagnosis to patients such as cancer, MS, epilepsy, or even explaining a mistake made by the medical team to patients.

We follow the SPIKES structure and the importance of the warning shot in preparing patients for difficult news.

This episode is all about empathy, honesty, being able to communicate in a simple way with no medical jargon, and guiding patients to the next steps when discussing life changing news.

🎧 Listen & Follow:🎙️ Spotify → ⁠⁠https://open.spotify.com/show/01yz38z....🍎 Apple Podcasts → ⁠⁠https://podcasts.apple.com/us/podcast....▶️ YouTube → / @oscetalkpod 📸 Instagram → / oscetalk_ 🎵 TikTok → / oscetalk_

Disclaimer

OSCE Talk is an educational resource designed primarily to help healthcare students prepare for clinical examinations. Episodes on the key, exam-relevant and salient points of each topic and are not intended to provide a complete or exhaustive review of clinical management.

​

Content is for educational purposes only and should not be used as a substitute for formal teaching, clinical supervision, local policies or current national guidance. While we aim to keep our content accurate and useful, medical guidance changes over time and episodes may contain omissions or necessary simplifications.

​

Always refer to appropriate guidance when making clinical decisions or caring for patients. 

In this episode of OSCE Talk, we focus on one of the most important medications in neurology — levodopa, the cornerstone of treatment in Parkinson’s disease.

We break down how levodopa works, how it should be prescribed, and—most importantly—how to explain and counsel it clearly in an OSCE or real clinical setting.

We start by explaining the mechanism of action, including how levodopa crosses the blood-brain barrier and is converted into dopamine, helping to improve the classic motor symptoms of Parkinson’s such as bradykinesia, rigidity, and tremor. We also cover why levodopa is given alongside carbidopa to reduce peripheral side effects and improve its effectiveness.

From there, we discuss the key practical prescribing points that are essential for both exams and the wards. This includes the fact that levodopa is a time-critical medication, taken multiple times per day due to its short half-life, and why missing doses can lead to a rapid deterioration in symptoms such as freezing and rigidity—particularly important in hospital patients who are nil by mouth.

We then move on to side effects and long-term complications, including:

• Nausea, dizziness, and postural hypotension
• The “on-off” phenomenon, where symptom control fluctuates throughout the day
• Dyskinesias (involuntary movements) with long-term use
• Neuropsychiatric effects such as confusion, hallucinations, and impulse control issues

We also highlight key clinical safety points, including why levodopa should never be stopped abruptly, and situations where caution is needed—such as in patients with glaucoma or pre-existing cognitive or psychiatric symptoms.

A major focus of this episode is learning how to structure a clear, safe explanation in an OSCE, using the ATHLETIC framework (Action, Timing, How to take, Length, Effects, Tests, Interactions, Contraindications). This gives you a reliable way to cover all the important counselling points while still sounding natural and patient-friendly.

Disclaimer

OSCE Talk is an educational resource designed primarily to help healthcare students prepare for clinical examinations. Episodes on the key, exam-relevant and salient points of each topic and are not intended to provide a complete or exhaustive review of clinical management.

​

Content is for educational purposes only and should not be used as a substitute for formal teaching, clinical supervision, local policies or current national guidance. While we aim to keep our content accurate and useful, medical guidance changes over time and episodes may contain omissions or necessary simplifications.

​

Always refer to appropriate guidance when making clinical decisions or caring for patients. 

In this episode of OSCE Talk, we break down Parkinson’s Disease in a clear, structured, and clinically relevant way.

We start with what Parkinson’s actually is — a progressive neurodegenerative condition caused by loss of dopaminergic neurons in the substantia nigra — and explain how this leads to the classic features of Parkinsonism.

We then cover the key clinical features using the TRAP mnemonic (Tremor, Rigidity, Akinesia/Bradykinesia, Postural Instability), alongside important non-motor symptoms such as autonomic dysfunction, sleep disturbance, and cognitive changes.

We also go through how Parkinson’s presents in real life — from subtle early symptoms like loss of smell and reduced dexterity, to more advanced disease with falls, hallucinations, and functional decline.

A key focus of this episode is learning how to think through differentials, including:

• Drug-induced Parkinsonism
• Multiple System Atrophy (MSA)
• Progressive Supranuclear Palsy (PSP)
• Lewy Body Dementia
• Essential Tremor

We explain how to distinguish these conditions in exams and clinical practice.

Finally, we cover investigation and management, including the role of levodopa, dopamine agonists, and key practical points for the wards — such as never stopping Parkinson’s medications abruptly.

This episode is designed to help you recognise Parkinson’s, differentiate it safely, and approach it confidently in OSCEs and real clinical settings.

Disclaimer

OSCE Talk is an educational resource designed primarily to help healthcare students prepare for clinical examinations. Episodes on the key, exam-relevant and salient points of each topic and are not intended to provide a complete or exhaustive review of clinical management.

​

Content is for educational purposes only and should not be used as a substitute for formal teaching, clinical supervision, local policies or current national guidance. While we aim to keep our content accurate and useful, medical guidance changes over time and episodes may contain omissions or necessary simplifications.

​

Always refer to appropriate guidance when making clinical decisions or caring for patients. 

🎧 Subscribe to OSCE Talk Premium here 👇
https://members.spotify.com/to/osce-talk

In this episode of OSCE Talk, we break down Chronic Kidney Disease (CKD) in a clear, structured, and clinically relevant way.

We cover what CKD actually is, how to recognise it, and—most importantly—how to approach it safely as a medical student or junior doctor.

We start with the definition of CKD and why it matters, before working through the most common causes, including diabetes, hypertension, and nephrotoxic medications.

We then explain the underlying pathophysiology, including nephron loss, hyperfiltration, and why proteinuria develops—linking this directly to key treatments like ACE inhibitors and SGLT2 inhibitors.

We also cover how CKD presents in real life, from asymptomatic early disease picked up on routine bloods, to advanced uraemia, fluid overload, and complications like anaemia and bone disease.

From there, we go through a practical and safe approach to:

• Investigations (eGFR, ACR, bloods, imaging)
• Staging (GFR + albuminuria)
• Management (blood pressure control, diabetes optimisation, medication choices)
• Complication management (anaemia, bone disease, electrolyte imbalance)

We also touch on end-stage kidney disease, including dialysis (haemodialysis and peritoneal dialysis) and renal transplant.

Finally, we finish with a clear, structured approach to explaining CKD to a patient in an OSCE, using a simple framework you can apply in exams and clinical practice.

Disclaimer

OSCE Talk is an educational resource designed primarily to help healthcare students prepare for clinical examinations. Episodes on the key, exam-relevant and salient points of each topic and are not intended to provide a complete or exhaustive review of clinical management.

​

Content is for educational purposes only and should not be used as a substitute for formal teaching, clinical supervision, local policies or current national guidance. While we aim to keep our content accurate and useful, medical guidance changes over time and episodes may contain omissions or necessary simplifications.

​

Always refer to appropriate guidance when making clinical decisions or caring for patients. 

🎧 Subscribe to OSCE Talk Premium here 👇
https://members.spotify.com/to/osce-talk

This episode focusses on hyperkalaemia and its emergency management.We work through the common causes of hyperkalaemia including renal disease, medications, DKA, burns and rhabdomyolysis.

Alongside this we review common ECG changes of peaked T Waves, flattened P waves, and broad QRS segments.

We look at the need for calcium gluconate, insulin, dextrose, salbutamol and potassium binders to prevent arrest in these patients.
🎧 Listen & Follow:🎙️ Spotify → ⁠⁠https://open.spotify.com/show/01yz38z....🍎 Apple Podcasts → ⁠⁠https://podcasts.apple.com/us/podcast....▶️ YouTube → / @oscetalkpod 📸 Instagram → / oscetalk_ 🎵 TikTok → / oscetalk_

Disclaimer

OSCE Talk is an educational resource designed primarily to help healthcare students prepare for clinical examinations. Episodes on the key, exam-relevant and salient points of each topic and are not intended to provide a complete or exhaustive review of clinical management.

​

Content is for educational purposes only and should not be used as a substitute for formal teaching, clinical supervision, local policies or current national guidance. While we aim to keep our content accurate and useful, medical guidance changes over time and episodes may contain omissions or necessary simplifications.

​

Always refer to appropriate guidance when making clinical decisions or caring for patients. 

🎧 Subscribe to OSCE Talk Premium here 👇
https://members.spotify.com/to/osce-talk

In this episode we focus on the pathophysiology of ectopic pregnancy, alongside risk factors, and clinical presentation. We discuss what investigations are required, how to manage ectopic pregnancies that are stable vs emergency management and the need to get senior obstetrics/gynaecology input early.

Peter talks through how to counsel patients sensitively on this condition also. We finish with a mock example history going through the key signs and symptoms to pick up on in these patients. 🎧 Listen & Follow:🎙️ Spotify → ⁠⁠https://open.spotify.com/show/01yz38z....🍎 Apple Podcasts → ⁠⁠https://podcasts.apple.com/us/podcast....▶️ YouTube → / @oscetalkpod 📸 Instagram → / oscetalk_ 🎵 TikTok → / oscetalk_

Disclaimer

OSCE Talk is an educational resource designed primarily to help healthcare students prepare for clinical examinations. Episodes on the key, exam-relevant and salient points of each topic and are not intended to provide a complete or exhaustive review of clinical management.

​

Content is for educational purposes only and should not be used as a substitute for formal teaching, clinical supervision, local policies or current national guidance. While we aim to keep our content accurate and useful, medical guidance changes over time and episodes may contain omissions or necessary simplifications.

​

Always refer to appropriate guidance when making clinical decisions or caring for patients. 

This episode focusses on the main causes of paediatric limp and MSK evaluation - the main conditions covered are DDH, Perthes Disease, Slipped Capital Femoral Epiphysis, Transient Synovitis and Septic Arthritis alongside Osteosarcoma.

We go through the main risk factors, diagnostic methods and treatment options for these. Alongside red flags for paediatric limp to not miss in medical school exams and in clinical practice.

🎧 Listen & Follow:🎙️ Spotify → ⁠https://open.spotify.com/show/01yz38z..⁠.🍎 Apple Podcasts → ⁠https://podcasts.apple.com/us/podcast..⁠.▶️ YouTube → / @oscetalkpod 📸 Instagram → / oscetalk_ 🎵 TikTok → / oscetalk_

Disclaimer

OSCE Talk is an educational resource designed primarily to help healthcare students prepare for clinical examinations. Episodes on the key, exam-relevant and salient points of each topic and are not intended to provide a complete or exhaustive review of clinical management.

​

Content is for educational purposes only and should not be used as a substitute for formal teaching, clinical supervision, local policies or current national guidance. While we aim to keep our content accurate and useful, medical guidance changes over time and episodes may contain omissions or necessary simplifications.

​

Always refer to appropriate guidance when making clinical decisions or caring for patients. 

Neonatal jaundice is one of the most common paediatric presentations you will encounter in both exams and clinical practice. While most cases are physiological and harmless, recognising the red flags is essential to avoid missing serious underlying pathology.

In this episode of OSCE Talk, we break neonatal jaundice down into a clear, structured approach that you can apply in OSCEs and on the wards.

We cover the key pathophysiology, including how bilirubin is produced and processed, and why unconjugated bilirubin can cross the blood–brain barrier and cause neurological injury. Understanding this is crucial when thinking about complications such as kernicterus.

We then explain physiological jaundice, including its typical onset after 24 hours of life, peak around days 3 to 5, and resolution within the first one to two weeks. This helps you build a strong baseline before identifying what is abnormal.

The most important part is recognising pathological jaundice. You should always be concerned if jaundice appears within the first 24 hours, persists beyond 14 days, or is associated with pale stools and dark urine. These features suggest serious conditions such as haemolysis, sepsis, or biliary atresia. A baby who is lethargic, feeding poorly, or clinically unwell should always raise suspicion.

We also go through investigations in a practical way, including when to use transcutaneous bilirubin measurements and when serum bilirubin is required. Differentiating between conjugated and unconjugated bilirubin is key to guiding diagnosis and management. Other important tests include blood group compatibility, Coombs testing, and infection screening where appropriate.

From an OSCE perspective, we outline how to structure your history and examination. This includes focusing on timing, feeding, stool and urine colour, and red flag symptoms, as well as performing a targeted examination for hydration, neurological status, and abdominal findings.

Finally, we cover management, including the use of NICE treatment threshold charts, phototherapy as first-line treatment, and when escalation to exchange transfusion is required.

This is a high-yield topic that frequently appears in OSCEs and written exams. Mastering neonatal jaundice will not only help you perform well in assessments but also ensure safe clinical practice.

Disclaimer

OSCE Talk is an educational resource designed primarily to help healthcare students prepare for clinical examinations. Episodes on the key, exam-relevant and salient points of each topic and are not intended to provide a complete or exhaustive review of clinical management.

​

Content is for educational purposes only and should not be used as a substitute for formal teaching, clinical supervision, local policies or current national guidance. While we aim to keep our content accurate and useful, medical guidance changes over time and episodes may contain omissions or necessary simplifications.

​

Always refer to appropriate guidance when making clinical decisions or caring for patients. 

This episode focusses on obstetic history taking and haemorrhage. Looking at the differentials of antepartum haemorrhage to be aware of including: placental abruption, placenta previa/vasa previa.

Other causes of haemorrhage in the perinatal period including miscarriage and ectopic pregnancy.

We look at how best to approach management of these in an exam scenario, including the need for adequate examination, resuscitation and key investigations including bloods, ultrasound and CTG monitoring.

We finish this episode with a quick example history.

🎧 Listen & Follow:🎙️ Spotify → https://open.spotify.com/show/01yz38z...🍎 Apple Podcasts → https://podcasts.apple.com/us/podcast...▶️ YouTube → / @oscetalkpod 📸 Instagram → / oscetalk_ 🎵 TikTok → / oscetalk_

Disclaimer

OSCE Talk is an educational resource designed primarily to help healthcare students prepare for clinical examinations. Episodes on the key, exam-relevant and salient points of each topic and are not intended to provide a complete or exhaustive review of clinical management.

​

Content is for educational purposes only and should not be used as a substitute for formal teaching, clinical supervision, local policies or current national guidance. While we aim to keep our content accurate and useful, medical guidance changes over time and episodes may contain omissions or necessary simplifications.

​

Always refer to appropriate guidance when making clinical decisions or caring for patients. 

🎧 Subscribe to OSCE Talk Premium here 👇
https://members.spotify.com/to/osce-talk

In this episode of OSCE Talk, we cover schizophrenia and Schneider’s First Rank Symptoms, one of the most important concepts for psychiatry OSCEs and medical exams.

Schizophrenia rarely begins suddenly. Many patients experience a prodromal phase first, where family members may notice social withdrawal, reduced motivation, changes in behaviour, sleep disturbance and declining daily functioning. Over time this can progress into psychosis, where patients may develop hallucinations, delusions and disturbances in thought.

In this episode we break down Schneider’s First Rank Symptoms of schizophrenia, explaining what they are, how they present clinically, and how to explore them safely during a psychiatric history.

We also discuss the positive, negative and cognitive symptoms of schizophrenia and how they affect patients’ ability to function day-to-day.

• Auditory hallucinations (voices commenting or discussing the patient)
• Command hallucinations
• Thought insertion
• Thought withdrawal
• Thought broadcasting
• Passivity phenomena (external control of thoughts, actions or emotions)
• Delusional perception

Symptoms added to normal experience:
• Hallucinations
• Delusions
• Thought disorder
• Disorganised behaviour

Loss of normal functioning:
• Reduced motivation (avolition)
• Social withdrawal
• Reduced speech (alogia)
• Flattened emotional expression
• Reduced engagement with daily activities

• Impaired working memory
• Reduced concentration
• Executive dysfunction
• Difficulty with organisation and decision-making

When assessing a patient with schizophrenia or psychosis it is essential to evaluate:

• Risk to self (including suicidal thoughts)
• Risk to others
• Command hallucinations
• Vulnerability and exploitation
• Self-neglect
• Ability to function independently

Collateral history from family or carers can often be essential because patients may lack insight into their symptoms.

Psychotic symptoms can also occur in:

• Bipolar disorder (mania)
• Psychotic depression
• Delirium
• Drug-induced psychosis
• Alcohol withdrawal
• Neurological or organic brain disease

Organic causes should always be considered and may require investigations such as CT brain, MRI brain or EEG.

Management of schizophrenia often involves:

• Antipsychotic medications (e.g. olanzapine, risperidone, clozapine)
• Psychological therapies
• Community mental health team follow-up
• Inpatient psychiatric care if risk is high

In OSCE stations, it is important to explain schizophrenia in simple terms:

Schizophrenia affects how the brain processes information and filters thoughts and perceptions. This can lead to hearing voices, developing strong beliefs that don’t match reality, or finding it difficult to organise thoughts. Treatments are available that help manage symptoms and improve quality of life.

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Follow OSCE Talk for practical OSCE teaching, psychiatry revision and clinical explanations for medical students.

Disclaimer

OSCE Talk is an educational resource designed primarily to help healthcare students prepare for clinical examinations. Episodes on the key, exam-relevant and salient points of each topic and are not intended to provide a complete or exhaustive review of clinical management.

​

Content is for educational purposes only and should not be used as a substitute for formal teaching, clinical supervision, local policies or current national guidance. While we aim to keep our content accurate and useful, medical guidance changes over time and episodes may contain omissions or necessary simplifications.

​

Always refer to appropriate guidance when making clinical decisions or caring for patients.