Cracking the Clinical Exam (CE)

The Clinical Exam (CE) is a critical hurdle on the road to surgical training in many specialties. For anyone aiming at orthopaedics, urology and plastic surgery, passing it is non-negotiable before you can even apply.

So, what is it exactly?

According to the Royal Australasian College of Surgeons:

Sounds straightforward? Not quite. The challenge is in the scope: the CE can test you on anything across the nine surgical specialties, plus a wide range of general skills.

When should I sit the CE?

From my experience, about a year into registrar life is the sweet spot. Why?

• Your day job becomes training. By then, you’ve done countless histories, exams and procedures that double as practice.

• You’re less overwhelmed. The registrar role feels more manageable, making it easier to carve out study time.

• Your knowledge is still broad. You haven’t gone too deep into one subspecialty yet, so the general exam content is fresher.

• Your network grows. By this stage, you probably know other registrars across different specialties. They can give you feedback, swap practice cases, and help plug gaps in your weaker areas.

How do I prepare?

The key is practice, practice, practice. While reading and obtaining the content knowledge is important, for any OSCE exam, it is essential that you familiarise yourself with the action of performing the assessed tasks.

Recommended ways to practice:

• Gather a group. This way, you can take turns practising, observing, and being the pretend patient.

• Set up a regular practice schedule. I recommend once a week for 2-3 months leading up to the exam.

• Use a checklist. This serves as a marking schedule, ensuring that all assessable tasks have been completed.

• Time yourself. Get slick at the exams so you look confident, and cover everything without running out of time.

Quote of the day:

“Tough luck. Move on.”

Before sitting my exam, a consultant (and examiner) shared this piece of advice. At first, it sounded blunt—even harsh. But it stuck with me.

"Tough luck. Move on."

The message is simple: don’t dwell.

Whether it’s in the exam or in real clinical practice, you can’t afford to carry the baggage of one bad outcome into your next patient, or one shaky station into the next.

• In mass casualty settings, letting emotions about one patient cloud your focus can put the next patient at risk.

• In the CE, replaying a botched station in your head only sabotages the ones that follow.

The discipline is to “move on in the moment, process later.” Debrief afterwards, by all means—but in the heat of action, your job is to give your full attention to what’s in front of you.

Bonus Tip: Turn admissions into OSCE practice

One of the most useful hacks I discovered was timing myself during acute admissions. Each CE station is five minutes, so I practiced keeping my histories and exams to that limit.

It trained me to work under time pressure, sharpened my efficiency, and actually made me a better clinician.

⚠️ A caveat though: don’t shortchange real patients. If someone needs more time, give it. The exam is important—but patient safety always comes first.

Final thoughts

The CE is a test of breadth, resilience, and focus as much as it is of knowledge. Prepare widely, use your everyday clinical work as practice, and adopt the mindset of moving forward no matter what.

One station won’t define your exam—just like one patient doesn’t define your career.

All the best, you've got this!