Get time on your side

2023 is a big year for radiology trainees and IMGs who will be sitting the RANZCR OSCER exam under the new format. It has been a steep learning curve for trainees and fellows alike, both as candidates and educators. How you present cases and structure your responses has changed, and we are all learning as we go. But one thing is for certain, timing is as important as ever - perhaps more so.

As it stands, each OSCER station is 25 minutes. In these 25 minutes you will be presented with a set number of cases. Releases from RANZCR have indicated eight cases, each worth ten marks each.

So lets do some math here: if there are ten questions, for each case you will need to give yourself 3 and a bit minutes. This includes time for the case to pop up on your screen, time for the examiner to ask the 3-5 questions and time for you to collect your thoughts. So lets trim that down. On my guess, you will have just under 3 minutes to get the case read-out and get through the related questions that are thrown your way. The questions will be hidden from you, so you won't know what is coming up or how much time you need to have up your sleeve.

3 minutes per case is not a lot of time, and will require you to be at the peak of your game. Your imaging interpretation skills need to be on point. Your knowledge will need to be well organised and at the front of your mind. You will need to be able to focus your search and presentation on what is relevant and what is high-yield. There is no time to wander off topic down rabbit-holes.

The best way to do this is to put yourself against the clock.

Timed practice is going to be crucial for the new exam format. When you are sitting in the chair under pressure, your sense of time can fall away. If you are floundering, you may have no idea that minutes have gone by. Conversely, you may be just a bit too brief as you rush to get the case down and the next one up, missing out on valuable marks.

In the spirit of replicating exam conditions as best you can, get out the stopwatch. This goes for practice in a tutorial, with your study group or on your own. Set a countdown timer to put yourself under pressure, or start the timer to see how long you are actually spending on each case.

How long you give yourself per case is ultimately up to you. Accepting the unknowns of the new format I myself cannot give you a straight recommendation, but for the case presentation itself I would guess no more than 45-60 seconds should be allocated for a complex case. For a more straightforward case involving a plain film, mammogram or single phase CT, 30 seconds may be more appropriate.

Replicating the exam environment will help you perform better come exam day, as you will be well practiced in getting the important information out and delivering under stress. If you are practicing an OSCER case in its entirety, that is with case and questions, I would suggest giving yourself a hard cut off at two minutes. Get used to feeling that pressure and the discomfort of having to move on. You've got this.