What are the 5 task types in the AMC Part 2 OSCE?

The AMC Part 2 Clinical OSCE is built from a fixed blueprint. Every sitting samples the same five task types across a mix of clinical domains: medicine, surgery, paediatrics, women's health, mental health, emergency medicine, and general practice. Knowing the five task types in advance lets you build a small set of structures and frameworks that map cleanly onto whichever station you happen to draw.

This guide works through each task type with one worked example station and the framework an Australian intern is expected to apply. For the overall structure of the day (20-station circuit, 14 scored, pass standard 9/14, in-person vs Zoom) see the companion guide on AMC Part 2 OSCE format.

1. Focused history-taking

A history station gives you a patient with a clinical complaint and 8 minutes to take a hypothesis-driven history, present a working diagnosis, and propose initial management. The examiner is not looking for an exhaustive systems review. They want focused, targeted history-taking that probes the most likely diagnoses while excluding the dangerous ones.

Worked example: 52-year-old presenting with palpitations

Door prompt: "Mr Patel is a 52-year-old businessman presenting to his GP with palpitations over the last 3 days. Please take a focused history and present your differential diagnosis and initial management plan to the examiner."

A pass-tier approach:

• Introduce, confirm identity, signpost. "Hello Mr Patel, I'm Dr [your name], one of the doctors today. I understand you've been having some palpitations. I'd like to ask you a few questions about that, would that be alright?"
• Characterise the symptom. Onset, frequency, duration, regularity (regular vs irregular), triggers, associated symptoms (chest pain, syncope, dyspnoea, dizziness), and what he was doing when it happened.
• Red flags. Syncope, chest pain, dyspnoea on exertion, family history of sudden cardiac death.
• Risk factors. Hypertension, diabetes, hypercholesterolaemia, smoking, alcohol (binge drinking can trigger AF, known in Australia as "holiday heart"), recreational drugs, thyroid symptoms, caffeine, stress.
• Past history and medications. Including any anticoagulant, antiplatelet, or stimulant.
• ICE. Ideas, concerns, expectations. Many patients with palpitations are worried about having a heart attack.
• Differential and plan. Atrial fibrillation tops the list given age, irregular palpitations and risk factors. Differential includes supraventricular tachycardia, ventricular ectopics, anxiety, anaemia, thyrotoxicosis. Initial plan: 12-lead ECG, basic bloods (FBE, U&E, TFT, magnesium), Holter monitor if non-diagnostic, calculate CHA2DS2-VA score (Australia uses CHA2DS2-VA rather than CHA2DS2-VASc as the National Heart Foundation and CSANZ aligned on the sex-neutral score in 2023), and refer for echocardiogram. Discuss anticoagulation with a DOAC if AF confirmed and CHA2DS2-VA score warrants it.

2. Focused physical examination

An examination station gives you a patient with signs (or a scenario in which signs may be present) and asks you to perform a focused, structured examination of a specific system. You verbalise as you go, present positive and negative findings, and offer a clinical interpretation. In the online sitting the examination is described verbally rather than performed; the examiner gives you findings as you reach each step.

Worked example: focused cardiovascular examination

Door prompt: "Mrs Nguyen is a 68-year-old retired teacher with exertional dyspnoea over 6 months. Please perform a focused cardiovascular examination and present your findings and clinical interpretation to the examiner."

A pass-tier approach:

• Introduce, confirm identity, wash hands, gain consent.
• General inspection from the end of the bed. Comfort, respiratory effort, central or peripheral cyanosis, pallor, oedema, mobility aids, GTN spray on the bedside table.
• Hands and arms. Peripheral cyanosis, clubbing, splinter haemorrhages, Janeway lesions, Osler nodes, tendon xanthomata. Capillary refill, pulse rate, rhythm, character, radioradial delay, blood pressure.
• Face and neck. Conjunctival pallor, corneal arcus, malar flush, central cyanosis, JVP at 45 degrees with the head turned slightly.
• Praecordium. Inspect for scars (median sternotomy, left lateral thoracotomy, pacemaker box). Palpate apex beat (position and character), heaves, thrills. Auscultate with diaphragm and bell at the four valve areas, with manoeuvres for murmurs if found (left lateral, sitting forward in expiration, dynamic manoeuvres).
• Posterior chest and lower limbs. Sacral oedema, bibasal crackles, peripheral oedema, pulses.
• Closing. Thank the patient, cover them, wash hands, present findings systematically and offer a clinical interpretation (for example, "Mrs Nguyen has signs consistent with aortic stenosis: a slow-rising pulse, displaced apex beat, and an ejection systolic murmur radiating to the carotids. I'd like to confirm with an echocardiogram").

3. Counselling and explanation

A counselling station gives you a patient who needs information explained: a new diagnosis, a new medication, lifestyle advice, or a treatment plan. Your task is to communicate in plain English, address concerns, and check understanding. These stations are scored heavily on patient-centred communication, not on volume of information delivered.

Worked example: warfarin counselling for new AF

Door prompt: "Mr Lawson, a 72-year-old retired carpenter, has just been diagnosed with atrial fibrillation. The consultant has decided to start him on warfarin rather than a DOAC because of his stage 4 chronic kidney disease. Please counsel him on starting warfarin."

A pass-tier approach:

• Open and assess existing understanding. "Mr Lawson, the team has asked me to talk through your new medication, warfarin. Before I start, can you tell me what you already know about it?" This is the ICE step (ideas, concerns, expectations).
• Why warfarin. Atrial fibrillation increases stroke risk; warfarin reduces that risk significantly. Explain why a DOAC (apixaban, rivaroxaban, dabigatran) is not being used here (stage 4 CKD limits options).
• How it works in plain English. "Warfarin thins your blood so clots are less likely to form in the heart and travel to the brain."
• Monitoring. Regular INR blood tests via your GP or pathology service, target INR 2 to 3 for AF, dose adjusted based on results. Carry your warfarin book or use an app.
• Diet and interactions. Keep vitamin K intake consistent (green leafy vegetables in similar quantities week to week, not avoided), limit alcohol, watch for new medications including over-the-counter (especially aspirin, NSAIDs, antibiotics) and herbal supplements.
• Side effects and red flags. Bleeding gums, easy bruising, nosebleeds, blood in urine or stool, severe headache, head injury: present to ED.
• Practical. PBS-subsidised, generally affordable, available at any Australian pharmacy. Medical alert bracelet recommended.
• Teach-back and close. "Just to make sure I've explained things clearly, can you tell me what you'd do if you noticed dark stools at home?" Address any remaining concerns, confirm follow-up, offer written information.

4. Procedural skills

A procedural station tests safe performance (or in the online sitting, safe verbal walk-through) of a common ward or community procedure. The examiner has a checklist of consent, preparation, technique, aftercare, and disposal. The procedure itself does not need to be elegant; it needs to be safe and step-correct.

Worked example: IV cannulation

Door prompt: "Ms Williams is a 34-year-old presenting to the emergency department with persistent vomiting and clinical dehydration. She needs IV fluids. Please obtain IV access and explain your procedure as you go."

A pass-tier approach:

• Wash hands, introduce, confirm identity, explain the procedure, gain verbal consent. "I'd like to put a small plastic tube into a vein in your arm so we can give you fluids. It'll feel like a sharp scratch."
• Position the patient and prepare equipment. Tourniquet, alcohol swab, appropriate-gauge cannula (in this case 18G in a non-dominant arm for fluids), saline flush, dressing, sharps bin within reach.
• Hand hygiene and gloves. Non-sterile gloves are sufficient for peripheral IV cannulation.
• Apply tourniquet, select a vein (typically antecubital fossa or dorsal hand), clean for 30 seconds and let dry. Anchor the skin distally.
• Insert bevel up at approximately 15 to 30 degrees, advance until flashback, then advance the catheter over the needle while withdrawing the stylet.
• Release tourniquet, dispose of sharp directly into the sharps bin (never pass through your other hand), connect, flush with 5 to 10 mL of normal saline, secure with a transparent dressing, label with date and time.
• Document in the notes including site, gauge, attempts, and any complications. Thank the patient and confirm next steps (commence IV fluids per local protocol).

In the online sitting you describe each step against the same checklist while the examiner observes.

5. Ethics and communication

An ethics or communication station presents a scenario with a difficult conversation: breaking bad news, disclosing an error, managing an angry relative, addressing a confidentiality concern, or navigating capacity and consent. Examiners want a structured, empathic, patient-centred response that draws on Australian standards of practice (Medical Board of Australia good medical practice, Ahpra requirements for open disclosure, and state-based mental health and consent law where relevant).

Worked example: breaking bad news using SPIKES

Door prompt: "Mr Harrison is a 58-year-old man who underwent a colonoscopy last week. The biopsy result has confirmed colorectal adenocarcinoma. Please explain the result to him."

A pass-tier approach uses SPIKES:

• S, Setting. Quiet room, no interruptions, sit at eye level, ensure tissues and water available, ask if he'd like anyone present.
• P, Perception. "Mr Harrison, before I share the results, can you tell me what you understand so far and what you've been thinking might be going on?"
• I, Invitation. "How much detail would you like me to go into today?"
• K, Knowledge. Use a warning shot ("I'm afraid the news is not what we'd hoped for") then deliver the result in plain language ("The biopsy has shown a cancer in your bowel"). Pause. Avoid jargon. Avoid filling the silence.
• E, Emotion. Acknowledge and validate the response ("I can see this is a lot to take in"). Offer presence, not platitudes. Do not move on until the patient is ready.
• S, Strategy and summary. Outline next steps: multidisciplinary team discussion at the colorectal MDT, referral to a colorectal surgeon, staging investigations (CT chest abdomen pelvis, CEA), and a follow-up appointment. Ask what support he has at home. Offer written information and the contact details of a cancer nurse coordinator.
• Safety net. Confirm a follow-up appointment within days, not weeks. Provide a contact number for questions before then. Ask whom he would like to be told.

How the task types interact with the clinical domains

The five task types crosscut the clinical domains. You could have a history station in mental health (an adolescent with low mood), an examination station in paediatrics (a 6-month-old with a heart murmur), a counselling station in women's health (cervical screening explanation), a procedural station in emergency medicine (suturing a simple laceration), and an ethics station in general practice (a teenager requesting contraception confidentially under Gillick competence). Practising frameworks lets you adapt the same scaffold to any combination.

How PRIMEX maps to the task types

• Station libraries tagged by task type so you can practise weak categories deliberately.
• AI viva simulator for solo rehearsal of history and counselling stations when you do not have a study partner.
• Door prompts written in the AMC style, with standardised patient briefs and examiner rubrics.
• Australian guideline-aligned management plans (eTG, PBS, RACGP, ANZCA where relevant) so your answers match the standard examiners are scoring against.

Frequently asked questions