MBBS OSCE · General Surgery / General Medicine
OSCE — Oesophageal & Gastric Cancer
Eight-minute OSCE station on Oesophageal & Gastric Cancer: 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 Oesophageal & Gastric Cancer.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Oesophageal and gastric cancer are the two principal upper-gastrointestinal malignancies. Oesophageal cancer has two distinct histologies: adenocarcinoma arising in the lower oesophagus and gastro-oesophageal junction (GOJ) from Barrett's intestinal metaplasia (driven by obesity and chronic acid reflux), and squamous cell carcinoma of the upper and middle oesophagus (driven by alcohol, smoking, very hot beverages, achalasia and nitrosamine-rich diets). Gastric adenocarcinoma is driven by Helicobacter pylori (a Class I carcinogen), salted and smoked diets, smoking, blood group A, family history and pernicious anaemia; the Correa cascade (chronic gastritis through atrophic gastritis, intestina
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 | Progressive dysphagia (solids then liquids) with weight loss — oesophageal or ga |
| Safety | New or worsening dyspepsia in a patient aged 55 or over, with weight loss, early |
| Safety | Unexplained iron-deficiency anaemia in any adult (especially men and postmenopau |
| 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.