Medical School OSCE History Mnenomic: NOPQRST AAARF

OSCE. A term I associate with freshly ironed white coats, buzzers, and anxiety. These objective structured clinical examinations are periodic hurdles in the course towards doctorhood.

An OSCE is generally set up in a hallway of little rooms. Within each room is an examiner and an actor playing the role of a patient. On the door of each room is a prompt, describing a clinical situation and instructing you to do something like "take a history" (1st year), "perform a physical exam", "counsel the patient", or "provide a diagnosis" (4th year). 

The call to order in an OSCE is the buzzer. It goes off to let you know when to start reading the prompt, when to enter the room, when you have one minute remaining, and when you have to exit and move on to the next station.

An OSCE is like a box of chocolates -- you never know what you're gonna yet. That being said, there are two surefire things that you can do to prepare:

1. Know how to perform each physical exam with your eyes closed. Yes, it's contrived. And yes, it's acting. But if you've practiced enough that you can go through the motions, you'll be able to breeze through the physical stations without having to do much thinking on your feet.
2. Know an algorithm for taking histories. All histories are variations on the same set of questions, which can be remembered by this mnemonic: NOPQRST AAARF. It's a conglomerate of several popular mnemonics, but I like that this one follows a pretty logical order and encompasses everything that you need to ask. And it's not just for OSCEs -- I use it whenever I assess a patient. That's four times an hour in family practice! I had no clue what questions to ask when I started family practice visits in 1st year. This would have been a good place to start... You can bet you'll be asking these questions several thousand times over the next four or five decades!