Some of what ICBSE expects is not written into any individual station, because it applies to all of them. Those expectations carry marks, and candidates lose them without ever being told why.
This is the most consequential sentence in the guidance, and the easiest to breach while trying hard.
“It is important that candidates follow the instructions precisely as marks will only be awarded in relation to the task required at that station.”
ICBSE, Guide to the intercollegiate MRCS examination, August 2021
ICBSE illustrates it with a knee station. The instruction is to examine the knee, so the task is the knee examination and nothing else — the guidance states plainly that candidates should not take a history or undertake a general examination.
The failure this produces is counter-intuitive: a candidate does more than the task, runs out of time, and scores less than one who did only what was asked and finished. Extra work is not neutral. It is unmarked work done in marked time.
“[A]t all stations candidates will be expected to introduce themselves, outline the purpose of the task, confirm the patient’s identity and check that they consent to the required task. Candidates should always clean their hands before and after patient contact with the alcohol-based hand gel provided.”
ICBSE, Guide to the intercollegiate MRCS examination, August 2021
Five things, stated as applying to every station rather than to particular ones:
Note the wording on hand hygiene: before and after. The second one is the one that gets forgotten, because by then the candidate is thinking about presenting their findings.
“All the stations in the examination (apart from preparation stations) are manned. Most have a single examiner but some stations (e.g. stations assessing communication skills) are double manned. Normally each examiner in a double-manned station will be assessing different aspects of the candidate’s performance (e.g. communication and clinical skill).”
ICBSE, Guide to the intercollegiate MRCS examination, August 2021
Two consequences worth carrying in:
| Element | What the guidance says |
|---|---|
| Reading time | One minute at the start of each station to read the instructions, which remain available inside |
| Station length | Completed after 9 minutes |
| Between stations | One minute to move on, during which examiners complete the mark sheet and the patient is prepared for the next candidate |
| The 6-minute signal | In examination and history stations you are stopped at 6 minutes, asked to summarise your findings and then asked questions |
| Preparation stations | May precede a station requiring more complex communication. These are the only unmanned stations |
| Who you meet | Simulated patients (trained actors or volunteers), real patients with positive clinical signs, mannequins and simulators, prosections |
ICBSE gives the candidate instruction format verbatim. The shape is worth recognising in advance:
“At this station you are required to take a focused history from a patient who presents to the Emergency Department with severe abdominal pain. You have up to 6 minutes to complete the task, at which stage the examiners will stop you and ask you to summarise your findings and answer some questions.”
Three things are fixed in that format: the task, the time, and what happens when the time is up. If the instruction says you will be asked to summarise, a summary is part of the task — not an afterthought if there happens to be time.
“Some stations will clarify whether the candidate should describe what they are doing as they proceed with physical examination but typically a dialogue with the examiner is not required as the purpose of the examination of these stations is for the examiner to observe the candidate perform the task and for the candidate to report their findings at the appropriate time.”
ICBSE, Guide to the intercollegiate MRCS examination, August 2021
So running commentary is the exception, not the default. Unless the station asks for it, the examiner is watching you examine and waiting for your findings at the point the station calls for them. Narrating throughout can cost you time and make an otherwise clean examination look hesitant.
The station book teaches these expectations where a particular station happens to need them. Checked against the station library in preparation, several of the rules above appear nowhere in it at all: that communication stations are double manned, that preparation stations exist, that marks are awarded only for the task set, and that hand hygiene is expected before and after patient contact at every station.
None of that is an error in the book — they are cross-cutting rules rather than station content. But a candidate who meets two examiners for the first time in the exam, or who loses time taking a history at an examination station, has been caught by something that was published in advance.