MBBS OSCE · General Medicine
OSCE — ECT & Brain Stimulation Therapies
Eight-minute OSCE station on ECT & Brain Stimulation Therapies: focused history, examination priorities, investigations, emergency and definitive management.
On this page
Study tools
Exam tags
Brief (to candidate)
You will assess a patient with a presentation consistent with ECT & Brain Stimulation Therapies.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Electroconvulsive therapy (ECT) is the most effective acute treatment in psychiatry: a generalised, therapeutically-adequate seizure is induced under general anaesthesia and a muscle relaxant, with continuous EEG monitoring, to treat severe mental illness. First-line indications: severe depression with psychotic features, catatonia, treatment-resistant depression, severe mania, postpartum psychosis, life-threatening psychiatric illness (refusal of food/fluids, active suicidality), Parkinson disease (refractory motor and affective symptoms), and neuroleptic malignant syndrome. The index course is 2 to 3 sessions per week, 6 to 12 treatments in total, continued until sustained improvement. Mai
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 | Severe depression with psychotic features, catatonia, or active suicidality - EC |
| Safety | Catatonia unresponsive to lorazepam - ECT; highly effective (about 80 percent re |
| Safety | Life-threatening psychiatric illness - refusal of food/fluids or active suicide |
| 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.