Observed Clinical Activity (OCA) and MEQ – Passing the RANZCP Exam- Dr Sanil Rege

Posted on: February 27, 2019
Last Updated: October 20, 2020

Dr. Sanil Rege is a Consultant Psychiatrist and founder of Psych Scene, a platform to enhance psychiatry education and Vita Healthcare, providing high-quality mental health care services to the public. He is a Fellow of the Royal Australian and New Zealand College of Psychiatrists and Member of the Royal College of Psychiatrists (UK). His clinical and research interests include psychosis, depression, anxiety, post-traumatic stress disorders, and personality disorders.

Author Quotes :

The skills in the OCA are invaluable for your future, because that’s what you’ll be doing day in, day out, and I would suggest that you really do think about formulation management all the time.

We’ve got to look at the evidence in front of us and actually deduce things from that. That is true intelligence–so it’s not about knowing just the knowledge, it’s about being able to pull out relevant facts based on evidence.

The better decision maker has at his/her disposal, repertoires of possible actions (Herbert Simon)-and that’s what you need to do in your MEQs.

Summary :

The RANZCP MEQ and OCA are two exam domains that come closest to real-life practice. Mastering these components will reap the rewards in the future.


In this video, Dr. Sanil Rege covers the important principles in approaching the MEQ and OCA that are also applicable to practical clinical scenarios.

Without a solid foundation to approach clinical cases, real-life clinical psychiatric practice becomes difficult.

Moving on to discuss the 4 questions that matter, he covers each with an explanation of what is required at each stage.

Dr. Rege emphasizes the importance of understanding the resources available to you as a consultant, and to consider how different your decisions may be depending on factors such as patient choice, environment/situation, or when working in rural vs urban areas.

Take-home Messages : 

  1. Your aim is to become a better decision-maker.
  2. You need a biopsychosocial and cultural understanding of your formulation and management plan. (You can read more on formulation and management)
  3. Ask yourself what the problem is, not what the diagnosis.


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