The case for and against the objective structured clinical examination (OSCE) has generated many interesting letters in the Bulletin recently. The unequivocal and emphatic response by Mortimer & Lunn (Psychiatric Bulletin, December 2004, 28, 458) is welcome. It is clearly ‘here to stay’ (apology unnecessary, in my opinion).

The pros - examination of a broad range of scenarios, reducing the luck factor - outweigh, I feel, concerns about limited time and the fostering of ‘ fast psychiatry’ (Yak et al, Psychiatric Bulletin, July 2004, 28, 265-266). It is a useful addition to the examination format. However, concerns about the challenge of handling the long case format deserve a response.

The ability to deal with long cases should be a fundamental skill acquired during one's training. Surely it is never too early to acquire this skill when embarking on a career in psychiatry. We all recognise that examinations provide a major (for some essential) incentive to learn. Therefore, unlike Narula (Psychiatric Bulletin, February 2005, 29, 72-73), rather than review the long case format in the Part II examination, I would advocate the use of both the OSCE and long case formats for both parts of the examination. Obviously, this would lead to some logistical problems but would the College fear being accused of placing too much emphasis on clinical acumen?