Anesthesiology APPLIED Exam › Exam skills and answer structure

OSCE day: stations, timing, who is in the room

Exam skills and answer structure·~6 min read· Physician-reviewed✓ Sourced · 5

Stem

It is OSCE morning. You stand outside the first of seven doors with the stem in your hand and the 4-minute read timer running. The card says a 58-year-old man's daughter has asked to speak with the anesthesiologist about her father's planned surgery. Behind the later doors are more communication stations, a monitors and echo station, and the ultrasound station.

Question

How do you use these four minutes, and how do you run each station once the door opens?

Ideal answer

I treat the day as seven scored 8-minute exams (eight doors in 2027; the pilot's timing is unpublished).¹ In the 4-minute read I name the task, the person I will meet, and the three or four checklist behaviors the station is built to score, and I write my opening sentence in my head. When I enter, I introduce myself, confirm who I am talking to, and state the purpose of the encounter in one sentence: "I'm Dr. Patel, one of the anesthesiologists; I understand you have questions about your father's anesthetic." Five stations are communication and professionalism with a trained actor or facilitator. The rooms are video-recorded and scored from the recording, not by an examiner in the room,² so I talk to the person, not the camera. In the monitors and echo station a non-physician facilitator reads the questions for three scenarios, and I have about 60 seconds to answer each.³ The ultrasound station is the only room with a live examiner, who runs the machine while I hold the probe and complete three tasks.² At the 2-minute warning I close: summarize, ask for final questions, and state the follow-up plan. Then I reset before the next door. From 2027 there is also an eighth station, an unscored pilot of either airway management or a team-based scenario, so I treat it like any other door.¹

Breaking down the answer

The format is unforgiving — seven scored 8-minute stations, each with a 4-minute stem read, about 1 hour 24 minutes in all in the 2026 manual,² on a day that runs about 5.25 hours when I also sit the SOE.⁴ The bell does not wait and no examiner rescues a candidate who runs out of time. Candidates fail by wasting the read, opening without a plan, or carrying a bad station into the next.
Use the read to write the opening and map the checklist — the first 30 seconds set the tone with the actor and the grader. Each communication station is graded on published observable behaviors: concern for the patient, lay terms, eliciting questions, a confirmed decision.⁵ Naming them during the read means I hit each one deliberately.
Talk to the actor, not the camera — the grader sees only what the recording captures. Narrating my reasoning to the room breaks the encounter and loses the behaviors that require engagement.
Monitors: watch first, speak second — each scenario plays once, there is no going back, and the facilitator adds no information.³ I answer the question asked and ask to move on.
Ultrasound: narrate the probe — I choose the transducer, position the standardized patient, ask for depth, gain and a freeze, then identify the structures asked for, keeping each task under 2 minutes 30 seconds.³
Close at the warning, reset between stations — at 6 minutes I stop adding content and move to summary, questions and plan, because every checklist scores the close. Each station is graded independently: a poor station costs one; carrying it costs two.

Follow-up question

Four minutes in, the daughter's voice rises: "Nobody has told us anything, and I don't trust any of you." She folds her arms and waits. What do you do?

Follow-up answer

I recognize the scripted push-back: the standardized patient is trained to refuse, get angry, cry or ask an unanswerable question at a set moment, and a rehearsed script stalls here. I name the emotion, pause, and return to the task: "I can see how frightening and frustrating this has been. I want to make sure you have what you need." Three seconds of silence is acceptable; arguing is not. I ask what she has been told, answer in lay terms, and check that she has what she needs before I close at the warning. The technical stations break differently: the image that will not come up or the clip I did not understand. There I say what I can see and what I would do next, and move on, because the next task is scored separately.

Pitfalls that cost points

Reading the stem for medical content only and missing the communication task it actually assigns.
Jargon with the standardized patient: "hemodynamic instability," "aspiration risk," "NPO."
Running past the 2-minute warning with new information instead of closing.
Silent scanning in the ultrasound station; the examiner credits only what I say.
Letting one hard station shape the rest of the day.

Rapid-fire

Q: Is the actor allowed to help me? A: No. Standardized patients follow a script and respond to what I do; they will not prompt a missed behavior.

Q: Can I take notes into the room? A: Personal items, pens included, stay in the locker; the stem goes in with me and stays in the pocket inside the door when I leave.² The opening line and checklist must be in my head.

Q: What happens when the bell rings mid-sentence? A: The station ends. I finish the sentence, leave, and wait for the tone to rotate to the next stem; if I finish early I may leave before 8 minutes.²

Q: Does the OSCE grade the same attributes as the SOE? A: No. Communication stations are graded on observable behaviors; the technical stations grade interpretation and technique.

Numbers to know

Item	Value
Scored stations	7: 5 communication, 1 monitors/echo, 1 ultrasound²
2027 pilot station	1 more, unscored: airway or team-based¹
Station length	8 min
Stem read before each station	4 min
Warning bell	At 6 min (2 min remaining)²
Monitors/echo station	3 scenarios, ~60 s per answer³
Ultrasound application station	3 tasks, ≤2 min 30 s each³

Links

The monitors and echo station: format and timing, The ultrasound application station: format and tasks, Treatment options and informed consent, Disclosing a peri-procedural complication or error, Ethical issues: DNR, capacity, surrogates, refusal, Communication with other professionals and conflict, Practice-based learning and QI projects
ABA APPLIED Examination OSCE Content Outline; ABA APPLIED Exam Manual; ABA OSCE Example Scenarios

Sources

1.ABA Announces 8th OSCE Station Pilot for 2027 APPLIED Exams · ABA, 2026 · theaba.orgAnnounced Aug 25, 2026: one additional, unscored pilot station in 2027; each candidate takes either an airway management or a team-based scenario. Duration, format and equipment not published.
2.What to Expect for Your APPLIED Exam (APPLIED Exam Manual) · ABA, 2026 · theaba.orgRevised July 2026.
3.OSCE Example Scenarios · ABA, 2023 · theaba.org
4.APPLIED Exam FAQ · ABA · theaba.org
5.APPLIED Examination OSCE Content Outline · ABA · theaba.org

Facts on this page were checked against these sources on Oct 14, 2026. Guidelines change; confirm doses against current institutional protocols.