FAICO Glaucoma Part 2

This was held almost 2 months after Part 1.   

I received an email (more than a month before the exam, so there’s ample time to make travel arrangements) which said that my centre would be at KEM Hospital, Mumbai. You also get the contact number of the person you are supposed to report to at the venue. 

You can contact the co ordinator on this number and ask regarding the arrangements for the exam (examiners, number of OSCE stations, if short cases are being kept for the exam, etc)

Timing of exam: 10 am to 3 pm. 

The email stated:

 “At each OSCE Station the candidate will examine a short case / a Photograph / a case situation / instrument etc. etc. of the concerned Specialty for 5 Minutes and answer the relevant questions placed along with it. This will be followed by Viva examination (10^th Station)”.

Please note that in the initial notification put out by the AIOS for the FAICO examination, it says that the OSCE is the second stage of the exam for which the cut off is 50%. This would be followed by the 3^rd stage which is the Viva. This notification also stated that there would be 2 examiners (1 local, 1 external).

But, in reality, there is no real cut off for the OSCE. Everybody has to go through both the OSCE and Viva. In fact, our OSCE papers were corrected right at the end of the day (after the viva), just before I left the venue. Also, there are actually 4 examiners instead of the 2 mentioned in the notification.

At the OSCE stations, there will either be a short case or a picture of a clinical condition/instrument/ printout of HFA, HRT, GDX, OCT/surgical implant with associated questions.

A short case can also be kept at OSCE stations. In our case, 3 stations were short cases. You are expected to take a short history and examination.

All instruments for examining the patient were provided (4 Mirror Gonioscope, 90D lens, even a direct ophthalmoscope for those who want it). But, to be on the safe side, I brought my own because I'm comfortable with my own instruments)

Initially, only the direct ophthalmoscope was kept in the exam hall.

Interestingly, although I didn’t have a problem with this, some of the doctors in the room got nervous when they saw this and confessed that they were not at all confident using the DO and asked for the 90D lens, which was finally provided.  (I found this a bit odd. All these doctors were fellowship trained in Glaucoma from prominent eye hospitals, but they couldn’t use a DO confidently. That’s something to think about.). Yes, I agree that binocular view with the 90D lens is vital for disc evaluation, but that's besides my point.

 Visual acuity (and IOP, if you ask for it) of the patients was provided to us. 

There was just one slit lamp with an applanation tonometer, so we had to wait our turn to examine the patients.

I felt sorry for the 3 patients who were kept as short cases, because there were around 13 candidates giving the exam. Ideally, each patient should have been seated at a separate slit lamp, which would have made things easier.

You are supposed to get 5 minutes at each station but they were lenient about this. We got more than enough time for the short cases. We don’t have to present the cases, just have to write a short history and examination findings. This is a part of the OSCE and is evaluated along with the other OSCE answers. No questions regarding these cases were asked to us during the viva (at least they were not asked to me or anyone who took the exam with me)

In our case, 2 of the examiners were late as they were stuck in traffic. So we had 2 vivas with 2 examiners each and the OSCE was held in between. (Normally, there’s just one Viva with all 4 examiners together).

I’ll be posting the questions that they asked me (what I can remember) during the viva shortly. The questions asked were less of theory and more of the practical/clinical type related to things that you would face in day to day Glaucoma OPD and also regarding latest developments in the field.

All the examiners were accomplished Senior Glaucoma specialists of the country and although overwhelming at first, it was an honour to be examined by them.