ACEM Fellowship Structured Clinical Examination (SCE)
The candidate completes six stations during one hour. Each station consists of three minutes reading time followed by seven minutes examination time. All stations are equally weighted in marking. Marks are allocated out of 10 for each of the six stations. Candidates are required to pass 4 stations and have a total score of 30 or greater to pass this section of the examination. Candidates are required to have both the raw score and the number of SCEs passed in order to obtain a particular grade.
The SCE may involve an interaction with a trained actor to facilitate the assessment of the patient encounter (communication skills) and crisis management
During the three minute reading time, the candidate is provided with written information such as a brief case scenario. The examiners first question may be included as part of the written information for selected SCEs. For the three minutes reading time, no writing is allowed. The candidate then undergoes examination for a seven minute period, with two examiners present. One examiner acts as lead examiner and the other as scribe. The examiner pair provide an agreed mark for the candidate for that SCE.
SCEs aim to test the candidate’s
- ability to assess a clinical scenario and prioritize diagnostic and management endeavours
- ability to manage complex, acute situations including resuscitation of the critically unwell patient
- verbal and non verbal communication skills
- description of visual data
- team function and leadership
- clinical administration
- manual dexterity
The Fellowship Examination Committee determines the questions and material for the SCEs. A final workshop for the SCEs occurs prior to the examination, by examiners who will be examining at each SCE station. The SCE’s are intended to allow examiners to assess candidates across a range of subjects in keeping with the curriculum and at consultant level. For the six SCEs, there will be one selected from each of the three core topics of paediatrics, medicine and surgery (including trauma) and three others selected from the same or other sub-speciality topics. Several subjects may be covered within each SCE (eg. a SCE based on the scenario of a fitting child might involve all of paediatrics, trauma, resuscitation and anaesthetics). A range of skills may be examined including problem solving, clinical judgement, communication skills, interpretation of investigations (eg ECG, radiology, laboratory), assessment, management and administrative issues. Candidates are again reminded that the SCE component of the examination may involve the presence of a simulated patient (actor) in the examination room in order to facilitate assessment of communication skills as well as knowledge and management.
The examiners are expected to move the candidate through the SCE in a timely fashion. The candidate may be prompted or re-directed by the examiners as appropriate. The format of the SCE should remain consistent for all candidates.