Frequently Asked Questions (FAQ)

My name is David Christmas and I am a consultant psychiatrist in Dundee.

I have been a consultant since 2006 and before that, like most people, I spent time (and money) studying for my MRCPsych. As the OSCE format became more widespread it seemed a useful way to pull together preparation material that could be helpful for other people.

'Trickcyclists' is a (American) euphemism for psychiatrists. It seems that it isn't particularly common in the UK (not many people have heard of it), but hey, I liked the name so decided to stick with it.

No, it's a labour of love. The site is not supported by any kind of external sponsorship whatsoever. I don't have a merchanising line to support my endeavours, so I rely on positive feedback from people who have found the site useful.

For a number of reasons:

1. Knowledge has zero transaction value.
2. See number one. That's it.

No, not with the examinations side of things. I was previously an elected member of the Executive Committee of the Royal College of Psychiatrists in Scotland and I was also the Academic Co-Secretary of the Faculty of General Adult Psychiatry. Like most psychiatrists, I pay my College subscriptions for the privilege of using the initials 'MRCPsych' but that's it.

I have sat OSCE exams as part of my undergraduate training (!). I have taught using OSCEs on our local postgraduate training scheme, and we use the OSCE format extensively for our trainees. I also help examine undergraduates at Dundee using the OSCE, and have been a site supervisor for the OSCE examinations. I have also taken part in the PREP Dublin OSCE course (now defunct).

As far as I can tell, no. The college have elected to use a much less objective marking scheme where candidates are graded A-E. Purists will argue that this is not really an OSCE, since a valuable degree of objectivity is lost. The pass mark for the overall MRCPsych OSCE or each station is as transparent as thick mud, and although the marks are weighted, even the examiners don't know how the weighting is calculated.

The format used on the site is closer to that used by North American colleges. It is truly objective in the sense that if you perform a specific task, you get a mark (or two). It is possible to calculate the pass mark for each station, as well as the overall pass mark for the OSCE exam. How this is done is on the page about organising local exams.

When this site was first conceived, the Royal College used 'normative-based' assessment (NBA), whereby a specific number of candidates will pass depending on the overall performance of the whole. This means that around 80% (or whatever the figure is) are going to pass whatever. Cynics would argue that this is essential in order for the Royal College to maintain their revenue stream from the exams.

The shift in assessment in recent years has been towards 'criterion-based' assessment (CBA) where candidates are marked according to whether they meet specific criteria which have been agreed beforehand. You can get an overview of the differences between the two at this page at the University of Toronto. This is arguably a much fairer way of determining the skills of the candidates. You could score 95% on the exam under NBA and still fail if 80% of people get 98%. The College really have to sort this out, in my humble opinion.

Examiners have intimated that the Royal College is looking into how the OSCEs are marked, and to be fair, they are endeavouring to introduce a new format to the exam system. Hopefully, in a few years time all of these teething problems and inconsistencies will have been resolved.