The ABA OSCE: the seven stations and the 2027 eighth pilot station

By The MockOral.ai team. Updated October 2026. Last reviewed October 22, 2026.

The OSCE is seven eight-minute encounters: five about communication and professionalism and two technical stations. In 2027 every candidate also sits an unscored eighth station. This guide walks through what the ABA says each one assesses and how to use the eight minutes.

How the OSCE runs

The Objective Structured Clinical Examination is the second component of the APPLIED Exam. According to the ABA's exam manual:

• There are seven scored stations, each up to eight minutes, with four minutes before each to read the scenario taped outside the door. The manual puts the block at 84 minutes; the 2027 pilot station (below) is in addition to these seven, and the ABA has not yet published revised 2027 timing.
• A two-minute warning bell sounds six minutes into each encounter.
• Five are communication and professionalism stations, one is interpretation of monitors and echocardiograms, and one is application of ultrasound.
• In most rooms you talk to a standardized patient or an exam facilitator, not an examiner. Sessions are video recorded and scored remotely. The ultrasound station has an examiner in the room who scores you there.
• The group rotates together, room to room, until everyone has done all seven.

The OSCE is scored separately from the SOE. If you pass one and fail the other, you retake only the failed component.

The five communication and professionalism skills

The ABA's OSCE Content Outline names five skills in this domain, and its public example scenarios give one sample of each. For every station, read the task statement twice: it tells you exactly what to do and, often, what not to do (for example, "you should NOT repeat your colleague's history and physical").

1. Treatment options and informed consent

You discuss anesthetic options with a patient or an authorized proxy and obtain consent. The outline asks you to show concern for the patient's situation, explain the indications and conduct of each option in lay terms, cover both common minor risks and rare serious ones, say how you will minimize those risks, invite questions, and confirm a decision without coercion.

How to use eight minutes: introduce yourself, ask what the patient already understands and what worries them, offer the options, then risks and mitigation, then check understanding and confirm the choice. Plain words beat complete words.

2. Peri-procedural complications

You evaluate a complication (in the ABA example, a medication error that caused transient tachycardia), form a plan, and discuss it with the patient. The outline lists a focused history, a focused physical evaluation, likely causes, expected outcomes, the plan, questions in lay terms, and empathy.

For an error: say plainly what happened, take responsibility, apologize, explain the effect on the patient and what you are doing about it, and describe what will change so it does not recur. Do not blame a colleague or the lighting.

3. Ethical issues

You frame and work through a dilemma with a patient, family or other stakeholders. The outline's list includes surrogate decision makers, capacity and informed refusal, confidentiality, end-of-life treatment, perioperative do-not-resuscitate orders, potentially inappropriate treatment, conflicts of interest and resource allocation. The ABA example is a perioperative DNR discussion before urgent surgery.

Gather the relevant facts, clarify the options, elicit the patient's values, negotiate differences, and arrive at a documented decision. For DNR, that means a specific conversation about which interventions the patient accepts during anesthesia rather than assuming the order is suspended.

4. Communication with other professionals

You talk to a surgeon, nurse or colleague, often about a disagreement. In the ABA example you must tell a surgeon that an elective case should be postponed for new-onset atrial fibrillation. The outline asks for clear, professional communication, prioritizing what matters for the patient, active listening to the other person's concerns, and recognizing and resolving conflict.

State the concern and the patient-safety reason early, listen to the surgeon's constraints, and finish with a concrete shared plan.

5. Practice-based learning and improvement

You explain or apply quality improvement principles. The outline lists measuring current outcomes against benchmarks, designing a change with stakeholders, educating clinicians, implementing the change, and measuring outcomes afterwards. In the ABA example a colleague asks how to run a QI project in general terms.

A simple scaffold works: define the problem and measure the baseline, assemble the team, choose one change, test it in a small cycle, measure again, then spread or adjust.

The two technical stations

Interpretation of monitors and echocardiograms

You read simulated monitors and images, identify the clinical condition, and recommend treatment. The outline's monitor list includes ECG, arterial and central venous waveforms, pulmonary artery pressures, cardiac output, mixed venous saturation, pulse oximetry, capnography, airway pressure, flow and volume waveforms, flow-volume loops and temperature. It adds quantitative and qualitative neuromuscular blockade monitoring and fetal heart rate tracings, both marked as testing from 2026.

Echo and point-of-care ultrasound content includes ventricular function and wall motion, volume status, pericardial and pleural effusions, pneumothorax, pulmonary edema, pulmonary and air emboli, aortic dissection and basic valve lesions, using transthoracic POCUS windows, lung and gastric views, and 11 standard TEE views. Pulsed-wave and continuous-wave Doppler are excluded.

Application of ultrasound

You use a probe on a simulated patient to find anatomy and, where asked, demonstrate simulated needle placement. The outline lists vascular access (internal jugular, cubital fossa, radial, femoral), common blocks (interscalene, supraclavicular, infraclavicular, axillary, TAP, femoral, adductor canal, popliteal sciatic) and POCUS image acquisition. The ABA FAQ confirms that point-of-care ultrasound is tested in both technical stations.

Scheduled additions in the outline: ultrasound of airway structures, bladder volume assessment and airway blocks from 2027, and erector spinae, PECS, fascia iliaca and quadratus lumborum blocks from 2028.

The 2027 eighth station: unscored pilot

On Aug. 25, 2026 the ABA announced that every 2027 candidate will complete an eighth OSCE station as a pilot. Each candidate gets one of two scenarios: airway management or team-based skills. The ABA says pilot scores are for evaluation only and will not affect exam results, that the station will be clearly identified, and that it will share more material before the exams.

The current content outline already has an Airway Management section marked as testing from 2027. It includes airway examination and predictors of difficult mask ventilation and intubation, landmarks for airway blocks and an emergency surgical airway, navigation of the ASA Difficult Airway Algorithm, and techniques from video laryngoscopy and supraglottic airways to flexible scope intubation, lung isolation and cricothyroidotomy. The outline lists it among the technical skill topics and says technical stations may combine categories, so it is worth preparing whichever pilot scenario you draw.

Practical advice for the day

• Use the four minutes to plan the opening sentence and the two things you must not forget.
• Watch the task statement for limits ("you do not need to obtain formal consent"). Time spent outside the task scores nothing.
• Listen to the bell. At six minutes, start closing: summarize, check questions, confirm the plan.
• Speak to the standardized patient as you would to a real one. Jargon costs more here than in the SOE.

Practising the communication stations out loud is the most efficient OSCE preparation because they are five of the seven scored stations. Our practice options guide compares ways to do that without a partner.