The Stage B Practical Examination tests a Trainee’s clinical skills in Occupational and Environmental Medicine at the end of Stage B training.

Instructions to candidates

Key dates

Eligibility

You must meet the following criteria:

• be a Stage B trainee of AFOEM
• have an Educational Supervisor
• be currently registered and approved for the training period
• have paid all outstanding fees
• have certification of the most recent training period, i.e. all teaching and learning activities and assessments completed
• have completed a minimum of 18 months active certified training (three training periods)
• have completed the relevant University Graduate Diploma or equivalent and submitted the certificate to the Faculty prior to sitting the exam
  OR
• have been endorsed by the Faculty Education Committees for special consideration, e.g. Overseas Trained Physician

Apply

Application dates for AFOEM Stage B Practical Examination will also be published in the AFOEM eBulletin a month prior to applications opening.

Trainees pay a fee to sit the exam. Refer to the membership fees page for fees to sit the Stage B Practical Examination in Australia or New Zealand.

Exam attempts

You are allowed five attempts to pass the Stage B Practical Examination. See the Progression Through Training Policy and accompanying Frequently Asked Questions (FAQs) for further information.

Exam preparation

To prepare for the practical examination:

• use the mini-CEX (for history-taking and physical examination)
• use the Direct Observation of Field skills and Case-based discussion (for the exhibit-based station)
• get together with other trainees and devise your own scenarios
• attend the session on exam preparation at the Annual Training Meeting

Exam structure and content

The examination content is based on the Occupational and Environmental Medicine Advanced Training Curriculum.

The examination is structured into three pairs of stations (six stations) conducted over two days.

Two examiners will be present at each station. Typically, one will take the lead in directing candidates.

To be successful, candidates must pass at least four stations and at least one station in each of the three station pairs.

Exam components

Exhibit Based Assessment

Each Exhibit Based Assessment station has an occupation-related or environment-related scenario. An Exhibit Based Assessment station may include photographs, diagrams, safety statistics, a video or other illustrative material to support the scenario.

Each scenario refers to:

• a type of exposure (physical, chemical, biological)
• a design issue
• a psychosocial problem

Candidates must recognise and prioritise the issues they observe, or would think likely to exist, from the information given.

A candidate must explain their approach to addressing issues, including:

• the use of monitoring equipment – e.g. a choice between a sound level meter or personal sound exposure meter, or between different types of air sampling trains or radiation monitors
• control measures – health surveillance, communication with those affected, notification of public health authorities
• interpretation of individual patient screening results – e.g. spirometry, blood, urine or other body fluid tests for specific toxins, liver function tests, electrocardiograms, skin patch tests and a comment on match or mismatch with air testing or other ambient monitoring
• selection of personal protective equipment appropriate for a nominated task – gloves, boots, respirators, goggles, ear protectors etc

Typically, one examiner will lead the candidate through the unfolding scenario, and the other will record and notate the responses received.

Occupational History Taking Exercise

An Occupational History Taking Exercise assesses a candidate’s ability to take an occupational history from a simulated patient, who plays a role consistent with an occupational medical problem.

The candidate should get a standardised history from the patient that includes:

• clinical symptoms
• relationship with work
• past occupational history
• relevant exposure information
• relevant past medical history
• lifestyle factors

Clinical scenarios may include the identification of occupational causes of a medical problem, or assessment of fitness to start, continue or return to work.

Examples of possible questions include:

• What is the most likely cause of this patient's condition?
• What investigations would you wish to order for this patient?
• What further worksite assessment would you conduct?
• What advice would you give?

Candidates gain marks in the Occupational History Taking Exercise for:

• Asking questions during history taking
• Answering questions at the end of the history taking exercise
• Interviewing technique and communication skills

Examiners allocate marks according to a pre-set marking guide.

Each Occupational History Taking Exercise station takes 30 minutes to complete. The assessment is broken into four parts.

1. Read and consider a brief referral letter
2. History taking
3. Summarise the case
4. Answer questions on the case (this may include additional clinical material introduced by the examiners)

Note: The candidate is not required to physically examine the simulated patient.

Short Case Clinical Examination

A Short Case Clinical Examination assesses a candidate's ability to examine a patient. A candidate is assessed on their physical examination technique, their ability to elicit physical signs, and their ability to interpret and place appropriate significance to these findings.

As part of the assessment, a candidate may be asked to comment on relevant diagnostic tests, e.g. x-rays, spirometry and/or nominate appropriate investigations.

The candidate must physically examine a patient then:

• describe and demonstrate the clinical findings
• interpret the findings
• answer questions about the findings
• comment on appropriate diagnostic tests (where necessary)
• nominate appropriate further investigations (where necessary)

Short Case Clinical Examination includes two examiners who mark independently, then come to an agreed mark for each candidate.

There will be one short case per 15-minute session.

Note: Candidates examine a real patient for the Short Case Clinical Examination.

Location

The Stage B Practical Examination is held in a number of venues in capital cities across Australia and New Zealand.