MBBS OSCE · General Surgery
OSCE — Oesophageal Cancer
Eight-minute OSCE station on Oesophageal 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 Cancer.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Oesophageal cancer is the 8th most common cancer worldwide. Squamous cell carcinoma predominates globally (Asia, Africa); adenocarcinoma predominates in Western countries (Barrett's oesophagus from GORD). Presentation: progressive dysphagia (solids then liquids), weight loss. Staging: endoscopy + biopsy, EUS (T/N staging), CT/PET-CT (M staging), laparoscopy for GOJ tumours. Multimodal treatment: neoadjuvant ChemoRT (CROSS: carboplatin + paclitaxel + 41.4 Gy) then surgery (Ivor Lewis oesophagectomy).
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 | Recognise severe Oesophageal Cancer |
| Safety | Escalate unstable patients immediately |
| 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.