OSCE — Developmental Milestones · MBBS OSCE

Brief (to candidate)

You will assess a patient with a presentation consistent with Developmental Milestones.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.

Clinical context

Developmental milestones are age-specific functional skills achieved by children across four domains: gross motor, fine motor, language, and social/adaptive. Principles: cephalocaudal (head to toe), proximodistal (centre to periphery). Screening tools: ASQ-3, Denver II, Bayley scales. Red flags: loss of any skill (regression), no smile by 8 weeks, no words by 16 months, no 2-word phrases by 24 months, asymmetric movements. Global developmental delay = delay in 2+ domains; specific delay = 1 domain.

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	id: 1
Safety	id: 2
Safety	id: 3
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.