Top 5 Common Mistakes in IME PESCI and How to Avoid Them

The Pre-Employment Structured Clinical Interview (PESCI) can be one of the most stressful steps for international medical graduates (IMGs) preparing to practise in Australia. It’s not just a test of medical knowledge—it’s about how well you communicate, manage patients, and adapt to the Australian healthcare setting.

Unfortunately, many talented IMGs fall short, not because they lack medical ability, but because of avoidable mistakes during the PESCI exam. Below, I’ve outlined the five most common pitfalls and how you can avoid them—so you can approach your exam with confidence.

1. Poor Time Management

The mistake: Many candidates spend too much time on one aspect of a case (for example, history-taking) and leave little time for examination, diagnosis, or management. This creates an incomplete impression, even if their medical reasoning is strong.

How to avoid it:

• Practise with a timer. Allocate clear minutes to each section of your consultation.

• Structure your approach. Use a repeatable framework—history, examination, differential diagnoses, management, safety netting.

• Simulate exam conditions. Mock sessions are the best way to train your brain to stay on track.

2. Weak Case Preparation

The mistake: Some IMGs revise theory but don’t practise with the style of cases that typically appear in PESCI. They feel caught off-guard when faced with a common Australian presentation like mental health, chronic disease management, or women’s health.

How to avoid it:

• Study past trends. Focus on common GP presentations in Australia.

• Don’t just read—role-play. Practise explaining investigations and management plans out loud.

• Get feedback. A tutor or study partner can point out blind spots you don’t notice yourself.

3. Ineffective Communication

The mistake: Speaking too technically, overlooking rapport-building, or failing to check patient understanding. PESCI examiners assess not only your medical accuracy but also your ability to connect with patients and colleagues.

How to avoid it:

• Use plain language. Avoid jargon—speak the way you would with a real patient.

• Show empathy. Simple phrases like “I understand this must be worrying for you” go a long way.

• Summarise and check. Ask, “Does that make sense to you?” to show you value patient understanding.

4. Neglecting Safety and Risk Management

The mistake: Forgetting to rule out red flags, not discussing follow-up, or failing to escalate when necessary. Examiners want to see that you can keep patients safe within the Australian system.

How to avoid it:

• Always think risk-first. Before finishing, ask yourself: Have I ruled out emergencies? Have I provided safety netting?

• Know referral pathways. Be familiar with when to involve specialists, emergency services, or mental health crisis teams.

• Practise documentation. In your responses, explain what you would record and why—it shows you’re systematic.

5. Lack of Exam-Specific Practice

The mistake: Relying only on self-study. PESCI is a unique assessment style—many excellent doctors fail simply because they haven’t practised under exam-style conditions.

How to avoid it:

• Book mock interviews. Real-time practice is the single most effective way to prepare.

• Get professional feedback. A tutor who understands the PESCI format can correct subtle issues before they cost you marks.

• Simulate pressure. The more you practise in timed, exam-like scenarios, the less anxiety you’ll feel on the real day.

Final Thoughts

The PESCI exam is not about proving you’re a good doctor—it’s about showing that you can adapt to Australian standards of practice. Avoiding these common mistakes requires more than just medical knowledge; it requires structured preparation, communication skills, and practice under exam conditions.

That’s where real exam-style tutoring makes the difference. Through guided mock sessions, tailored feedback, and practical strategies, you’ll build the confidence and skills to pass PESCI on your first attempt.

✅ Ready to prepare smarter? Book a tutoring session today and give yourself the best chance of success.