MBBS OSCE · Gastroenterology
OSCE — Gastro-Oesophageal Reflux Disease (GORD)
Eight-minute OSCE station on Gastro-Oesophageal Reflux Disease (GORD): focused history, examination priorities, investigations, emergency and definitive management.
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Brief (to candidate)
You will assess a patient with a presentation consistent with Gastro-Oesophageal Reflux Disease (GORD).
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Gastro-oesophageal reflux disease (GORD) is the condition in which stomach content refluxes into the oesophagus causing troublesome symptoms and/or complications. The cardinal symptoms are retrosternal burning (heartburn) and acid regurgitation; atypical features include chest pain, chronic cough, laryngitis, dental erosion and worsening asthma. Two endoscopic phenotypes: erosive reflux disease (ERD) with visible mucosal breaks graded by the Los Angeles classification (A to D), and non-erosive reflux disease (NERD) (normal mucosa). Pathophysiology centres on transient lower-oesophageal sphincter relaxations (TLESRs), a weak/hypotensive LES, hiatus hernia, impaired oesophageal clearance and d
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 | Heartburn with dysphagia, odynophagia, weight loss, anaemia, vomiting or haemate |
| Safety | New onset reflux over age 55, or symptoms not responding to a 4 to 8 week PPI co |
| Safety | Chest pain that may be cardiac - always exclude ACS first; GORD is a diagnosis o |
| 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.