MBBS OSCE · Obstetrics and Gynaecology
OSCE — Contraception
Eight-minute OSCE station on Contraception: focused history, examination priorities, investigations, emergency and definitive management.
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Exam tags
Brief (to candidate)
You will assess a patient with a presentation consistent with Contraception.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Contraception methods span hormonal (combined oral contraceptive pill, progestogen-only pill, implant, injectable, hormonal intrauterine system), intrauterine (copper IUD), barrier (condom, diaphragm), natural (fertility awareness, lactational amenorrhoea), emergency contraception, and permanent sterilisation. Choice depends on efficacy, safety, side effects, reversibility, coital independence, age, comorbidities, and patient preference. Long-acting reversible contraception (LARC) — copper IUD, LNG-IUS, implant — is most effective and offered first-line. UK Medical Eligibility Criteria (UKMEC) categorise every method from 1 (no restriction) to 4 (unacceptable risk) across medical conditions.
Candidate tasks
- Clarify onset, severity, associated features, and red-flag symptoms.
- State focused examination priorities.
- List first-line investigations and any named score/criteria.
- Give immediate resuscitation steps.
- Outline definitive management with doses/routes where standard.
- Name complications and disposition (ward / HDU / theatre / discharge safety-net).
- Mention one special-population modifier (pregnancy, child, elderly, CKD).
Examiner checklist
| Domain | Pass behaviours |
|---|---|
| Definition | Correct working diagnosis language |
| Assessment | Focused, prioritised, red flags sought |
| Investigations | Appropriate first-line + interpretation |
| Emergency care | ABC / time-critical actions first |
| Definitive care | Specific drugs/procedures, not generic phrases |
| Safety | Chest pain, dyspnoea, calf pain or swelling, severe headache, visual disturbance |
| Safety | Severe abdominal pain in an IUD/IUS user — uterine perforation (about 1 in 1000) |
| Safety | Pregnancy with an IUD in situ — locate device; if not seen on ultrasound suspect |
| Communication | Clear plan and safety-netting |
Model outline
Lead with the working diagnosis and life threats. Resuscitate before definitive tests when unstable. Use guideline-standard therapy with named agents and doses. Document escalation criteria and follow-up. A safe candidate is specific, structured, and never delays critical care for non-urgent imaging.