Exam Review - Written Exams

Our medical exams are weird. We sit 2 written papers, each containing 10 questions (with each question having 20 marks). The pass grade of the papers is based on how many questions you pass rather than your overall percentage, and across the 2 papers we have to pass approximately 13 questions to pass the exam overall. Each question has a variable pass mark (ranging from 10-13 out of 20) based on the difficultly of the question. As you can imagine, this makes gauging your performance on an exam extremely difficult – you could have a really high percentage, but due to the spread of the marks still fail the exam, or vice versa.

I found these papers easier than my first attempt of the summer exams, but that’s not saying much considering I had to retake that paper. Many people said Tuesday's paper was more difficult than Monday's paper, but I thought it was the other way around. I guess it just depends on what bits you’ve revised well! In the exam I estimated that I’d got about 9-13 marks out of 20 on every question, with a few higher, a few lower, but looking back on the exam I think that I’ve done worse than I initially thought (although I do have a tendency to concentrate on the answers I know I’ve got wrong and forget about all the answers I did answer correctly). There’s a chance that I could pass the exam, but I’ve resigned myself to the fact that I’ll be resitting. It’s not the end of the world, but it would be nice to pass…

There were some silly questions on the paper, which annoyed me. Eg. there was a question on the gate theory of pain which we were told in lectures was an out-dated theory and that it wouldn’t come up in the exam. There were also a lot of social science questions which were really ambiguously phased so you didn’t know which exact module the question was from which made them hard to answer. I put logical answers down, but whether they corresponded with the exact lecture slide points (and therefore, whether I get any points or not) is unlikely. Sometimes it just feels like exams are just lots of rote learning and jumping through hoops rather than displaying our understanding and knowledge of the subject matter, but I guess that’s the nature of most exams. It's still annoying though!

If I pass these exams then I get to go onto the clinical phase of the course after Christmas, which I’m really looking forwards to! This involves being mainly based out on placement doing rotations in different areas of the hospital or with GPs, learning on the wards and actually doing things rather than being sat in a lecture theatre. I know that the science basis is important, but this is what I joined medical school for and the job I want to do, and being sat in lectures/group work full time can get pretty boring! I really hope that I pass these exams. I’m trying not to get too excited about going into the clinical environment because to fail exams (and the re-sits), and having to go through this year (or possible back to the beginning) again would be so de-moralising.

Since the exams I haven’t really had much recovery time. After the last exam everyone else went out drinking, but I had to get a train back home as I was working a long shift the next day. In the last few days I’ve worked 2 locum shifts, done Christmas shopping (which I couldn’t ignore anymore after exams) and helped my sister with decorating her flat. Tomorrow I’m visiting my gran to help her de-clutter her house, but hopefully on Monday I’ll be able to have a proper chill day and a lie-in! I'm looking forwards to it.

Exam Review - OSCEs

My exams are finally over! My OSCE was on Thursday and the two written exams were on Monday and Tuesday. I’m locuming in the really quiet pharmacy until 11pm again tonight so I thought I’d write up a review on the exams whilst it’s still fresh in my mind, starting with the OSCEs.

Considering that I got an Excellent (>75% on every station) in the summer OSCEs, I thought that these OSCEs were going to be a walk in the park, but they weren’t. It didn’t help that we only had 2 weeks exam revision leave, and the OSCEs were timetabled before the written exams, so trying to balance OSCE and written exam revision was difficult. They gave us 3 anatomy stations, which I didn’t like as being grilled on anatomy isn’t my favourite thing, plus I thought OSCEs were supposed to be for testing practical skills rather than just asking us anatomy questions or pointing to muscles on models! The stations were as follows:

Cranial Nerves II-VI – 5 minute station

This was the first station and I was really nervous. I think I could have done slightly better, but I think that I did ok and I could answer the questions.

Clinical Anatomy - CVS Surface Anatomy – 5 minute station

I’m pretty certain that I’ve failed this station. The examiner phased his questions weirdly and kept skipping backwards and forwards through questions which got me confused and in a muddle. Consequently, I ran out of time to answer all the questions.

Clinical History Taking - Respiratory – 10 minute station

This one was fine. I feel like I’m pretty good at history taking and I couldn’t remember anything I’d forgotten to ask about afterwards.

Abdominal Examination – 5 minute station

This station was also fine. It was just a regular abdo examination. I was an idiot and went straight from patient details, consent etc to palpation, skipping out inspection, but half way through I remembered and asked the examiner if I could do it then and he let me thankfully!

Clinical History Taking - Male Urinary – 10 minute station

This history was slightly harder than the respiratory history as you had to include a sexual history in it, but I’m happy that I asked all the important questions and I had just said “thank you” and “any questions?” to the patient when the buzzer went – perfect timing!

Clinical Anatomy - Spinal Column – 5 minute station

This station was fine. The examiner was this lovely old man who filled out the marking sheet in front of my eyes so I know that there was only 2 questions which I got wrong out of quite a lot so I’m pretty certain that I’ve passed that station. The questions were mainly about features of the spine and the vertebrae and naming different things.

Clinical Anatomy - Lower Limb & Hip Joint – 5 minute station

This station was a bad one. My mind just went blank on some of the questions and I just couldn’t remember the name of some things. Additionally, the model they used to test us on the location of different muscles and nerves looked a bit different than the images I’ve used to revise lower limb, which also threw me slightly. We also had to demonstrate a Trendelberg's test and a Thomas's test which I think I did ok.

Focussed History Knee Pain – 5 minute station

This station wasn’t difficult, apart from the fact that despite being called a focused knee pain history, we actually had to complete a full history, but in 5 minutes which meant that timing was very rushed. I managed to ask everything apart from the ever important ICE (ideas, concerns and expectations). In retrospect I should have asked ICE sooner in the consultation and missed out some parts of social history instead, but in my normal history taking format I always like to methodically work through questions and ask ICE last so that’s just what I did for this station. Oh well, I think I’ll have still passed, especially as everyone I've spoken to didn't complete this station in time either.

Thyroid Gland Examination – 5 minute station

This station wasn’t difficult but I’ve still got a suspicion that I may have failed this station. We didn’t have to do a full thyroid examination, just the thyroid gland itself and the lymph nodes, and then answer a few questions. I’m not sure why I think I’ve failed this station as I think I included everything and could answer the questions, but I just have a feeling.

Respiratory Examination Chest – 5 minute station

This station was ok. We only had to do an anterior chest examination, which I think I did fine, but I then didn’t say what extras I would do (eg. check for oedema, spirometry etc) as I didn’t even think about it as we were just told to do an anterior chest exam, but in retrospect I think that I should probably have included it. We then had to answer some questions and percuss a box and describe the sound. I think I did ok on this bit, but there were some bits I didn’t explain very well.

We can fail up to 3 stations and still pass the exam. Overall I think it went ok, and I think that I’ve probably passed, but I’m not 100% confident.

Now that exams are over, I don’t really know what to do with myself! I keep feeling guilty and thinking that I should be doing revision. Why is it that the internet and everything else is so interesting during revision period, but now that I don’t have other things to do, they’ve lost all their interest? Buzzfeed’s 30 Greatest Animal Photobombs of 2013 and the like just aren’t as entertaining now…

Grumpy revision times

Why have I done this to myself? Lets be a doctor, I said. I'll be fine with extra studying and exams, I said. It doesn't matter that I'll be poor, over-worked and stressed for the foreseeable future, I said.

I could be enjoying my weekend right now: slow lazy mornings, brunch, walks in the crisp winter sun, socialising with friends.... But no, instead I'm stuck inside this never ending revision, panic, stress, exam induced nightmare. What I wouldn't give for a photographic memory.

I was feeling ok about these exams, a lot more prepared than for the summer exams, but now I'm convinced that I know nothing. I learn one obscure word, and out pops a previous one I've learnt. I think I've got one module nailed, but then I look at past exam questions and don't even recognise what it's talking about, let alone know the answer! BAH

I just want to pass these exams and be able to enjoy my Christmas break without re-sits hanging over my head and the holiday being taken up with revision. Is that too much to ask???

The Coffee Formula

I have a complicated relationship with coffee. I love it - it's tasty, smells great and has caffeine in it so what's not to love, but it doesn't always love me. I'm pretty caffeine sensitive and I have to be careful otherwise I get palpitations, light headed and an upset stomach. It also lasts a really long time in my system so if I have it past 4pm I have trouble sleeping at night.
Currently I'm in hardcore revision mode for my exams (which are in less than 2 weeks time, argh!) so the extra caffeine really comes in useful. It's a tricky balancing act to get the benefits from the caffeine but without counter acting it by getting side effects, and I think I've finally cracked it! By having one medium strength coffee just after my lunch I prevent the mid-afternoon slump and the caffeine effects mostly last into the evening, but without having too much caffeine and getting ill. I then just top up my caffeine occasionally with the odd cup of tea. This seems to be working so far :)

I'm feeling ok about the exams at the moment, but I am getting the odd period of overwhelming panic and stress. I'm trying not to get too stressed though as that was one of my downfalls in the summer, when I was so stressed that I couldn't concentrate properly on my revision and got loads of migraines. I currently feel a lot more prepared for these exams than I was for the summer exams, but this set of exams is also notoriously harder, so we'll have to see. My boyfriend has bought me a mini christmas tree for my desk to help motivate me to revise whenever I'm lacking concentration, as if I don't pass first time and have to do re-sits after Christmas, I won't be able to celebrate and enjoy Christmas properly!

(Photo taken by me)

Lots of neuro

As is the constant theme in the run up to exams, my life isn't really consisting of anything interesting outside of revision hell at the moment. I've currently got half an hour left until the FIFTEEN hour locum shift I've worked today is over. The morning/afternoon was pretty busy but this evening's been DEAD (as in, there's been one patient come in, in the last 4 and a half hours...) so I've taken advantage of this and got lots of uni work done. My brain's no longer concentrating though so I thought I'd update this to use up the last of the time until I can go home to bed. I'm looking forwards to bed so much!

This week was the last week of my radiology SSM. Instead of going to shadow people in the radiology department, we just had a short neuro imaging lecture and then we all we had to give a short presentation on "whatever we wanted, as long as it related to radiology" to the rest of the group as part of our final assessment. My presentation was pretty boring  and I'm not great at presentations (nerves cause me to forget how to talk coherently) so I'm not expecting a great mark for that. It doesn't count for much though, we basically just have to pass it. In the neuro lecture the radiologist got out a model skull to show us. I thought it was just a bog standard model of a skull, but NO it was actually a 3D printed skull showing the exact fractures a patient had sustained from a gunshot wound! I didn't even know that was possible!

I've also given in the last of my other bits of coursework for the term, so all I've got to concentrate on now is revision for exams (which are getting very close, very quickly). One of my downfalls last term was the fact that MSK was hard, the lectures were too long and detailed and I couldn't figure out a good way of writing up notes for it, so I just didn't... (a friend has since given me a copy of his very good notes which I am extremely grateful for). Neurology this term could very easily have gone the same way, but I've made a concerted effort to put a lot of time and energy into getting my head around it and making good notes. I'm almost up to date with it all now which I'm very pleased about as it's taken far longer than any of my other modules. Hopefully it'll pay off for the exams.

Where's Bernard's watch when you need it?

Hi.

Apologies again that I haven't updated in a while. Uni is very busy right now, with only 4 weeks-ish until exams. I know they warn you that medicine is a lot of work before you start uni, but I don't think you realise just how intense the course is until you're here doing it!
I'm home again this weekend for another locum shift. Trying to earn enough money whilst having enough time to revise sufficiently is a difficult balancing act.

Theres not that much going on at the moment that's interesting to write about. All we're basically doing at the moment is lectures, group work and lots of revision for exams. My year's all a bit stressed and tense at the moment with the thought of exams. We have lectures up until 2 weeks before  the exams, with OSCEs in the 2 weeks before the exams, so not a lot time to revise. The exams are on everything we've done from day 1 at med school (1 and a half's year's work) and we have a lot of lectures at the moment, so trying to keep up with group work/extra questions and writing up notes for all our current modules whilst also revising everything else is pretty difficult. I wrote up a work/revision timetable the other day and realised that I'm at least a few weeks short of the amount of time I ideally need, but everyone else seems to be in the same boat, and every year the majority of people pass the exam, so it must be possible!

It was my birthday recently which was really nice. My boyfriend went all out in making the weekend special. 4 of my friends surprised me by visiting and staying for the weekend. We went for a meal on the Friday night and on the Saturday we all went to Alton Towers which was really good (despite raining all day). Also, check out the birthday cake that my friend's sister made for me!

(photo taken by me)

Exam worries

Oops, it’s been a while since I’ve last posted. This term is just going really fast and I don’t really know where the time goes! It’s just over 6 weeks until my big scary exams. 6 weeks really doesn’t seem like much revision time at all, especially when these exams aren’t just on this term’s work, but on everything we’ve covered since the start of med school and we don’t finish this term’s teaching until 2 weeks before the exam! It doesn’t help that every weekend seems to be taken up by working locum shifts or with visiting parents or friends. I’m trying to do as much work as I can in all my free time, but it never feels like enough. I had a bit of a freak out a couple of weeks ago that I’d never be able to learn everything in the time, and that everyone else in my year is far smarter than I am, and I just felt really disheartened. I’m feeling a bit better now, but I still have occasional moments of self doubt and panic. I really, really don’t want to have to re-sit these exams (and I don’t even want to think about the possibility of repeating a year). Having to re-sit the summer exams was enormously stressful and took up a big chunk of my summer holiday, and I don’t want a repeat of that. If I pass these exams then I’ll get to enter the clinical phase of the course, which by all accounts sounds a bit more relaxed than the pre-clinical phase, and I wouldn’t have to sit another exam for a whole year! Additionally, we also had to chose a clinical partner a few weeks ago, which we’ll be placed with in clinical rotations, and I’d hate to mess mine about by failing these exams. So all in all, my stress levels are pretty high at the moment.

A little while ago I wrote about being offered a 15 hour locum shift that I turned down. I worked a 10 hour shift at that pharmacy a few weeks ago, and as it turned out to be a really quiet, nice pharmacy (I spent a lot of the shift just doing uni work it was that quiet), I’ve agreed to do a few 15 hour shifts, starting with one this Saturday. I was worried that it was going to be really busy for the whole of the 15 hours which is why I originally turned it down, but now that I know that the majority of the time will likely be really quiet, I don’t feel unsafe working it. I was correct in my previous post in saying that a pharmacy open such long hours in it’s location isn’t really necessary, but I found out it’s because there’s another pharmacy situated a few doors away from it. Regulations mean that new pharmacies opening close to existing pharmacies are only allowed to open if they’re 100 hour opening pharmacies. Pharmacy’s tend to be pretty profitable so I’m sure they’re still making money, even though they are paying a pharmacist and a dispenser to just sit there a lot of the time during the extended hours.

Wednesday, Thursday and Friday

My sincere apologies. I did mean to post my daily dairy at the end of each day this week, but the last few days have been so full that I’ve only got round to writing them up now. I may have forgotten a few details but I’ll still document the main points. This does serve as a useful demonstration of just how busy this term is though; at any given moment there are at least 5 things vying for my time and I never feel up to date with my uni work.

WEDNESDAY

7am – I wake up and get ready (smart clothes again as I’m in hospital for the morning)

8.30 – I get the bus to hospital and arrive at around 9.15

9.30 – My SSM in Diagnostic Imaging starts. I’m not sure about what to expect from this module, but the 2 people running it are really lovely, and a bit eccentric which makes it enjoyable. We start by having an overview of the basics of imaging techniques and then an introduction to the chest x-ray. I was worried that this module would be heavily physics focussed, but they only teach us the basics (which I can just about cope with) to give us an understanding of how the different imaging techniques work, and most of the information is clinically focussed. I learn a lot even in just these 2 intro sessions, and now feel as though I have a VERY basic grasp of what’s going on in a chest x-ray. The session also serves as anatomy revision, which is good for me as anatomy is definitely my weakest area.

11.00 – We split up into pairs. My surname is luckily next to my friend’s, so we’re paired together. Each pair gets allocated a different imaging speciality and is placed with a specialist clinician to be shown the equipment, and get an overview of what the speciality involves. My partner and I get put with a specialist in nuclear medicine who talks us through what nuclear medicine involves (mostly the diagnostics side) and then takes us around the department and shows us some of the fancy machines. I learn that some of the scanning techniques and images that you can get are far more advanced and impressive than I ever realised! It was a shame that we had our practical experience in nuclear medicine before we had the lecture on it, as I think I would have got even more out of it, but I still really enjoyed myself. I know that I don’t want to become a radiologist, but I still think it’s pretty fascinating, and the things that I’m learning will definitely benefit me in my future working life.

12.30 – We’re finished and I get the bus home. I’m meant to be in uni this afternoon, but towards the end of the morning I felt myself starting with a migraine, and I knew that I just needed to go home and sleep. When I get in I go straight to bed and sleep for a few hours and then feel much better. The afternoon lecture was for the module “Human Lifespan”, which isn’t really hardcore science, so it won’t be difficult for me to catch up. When I wake up I do some uni work for a bit (going over my respiratory anatomy notes) before my boyfriend comes home.

7.00 – We eat dinner of beef burritos and salad. I then want to go do some more work but my boyfriend pesters me until I agree to make a cake with him for a baking competition in his workplace. We make the cake (a butterscotch cake) and then watch some TV.

10.15 – I apply some strong cleaning product to our oven which still has burnt on grease all over it (from before we moved in) which I haven’t been able to remove from scrubbing. The cleaner needs to be left on overnight

10.30 – bedtime!

THURSDAY

8am – wake up. I’m not in uni this morning so I could have had a lie in (it was very tempting) but I needed to get up and do things.

9am – after breakfast and getting ready, I start by washing all the cleaning solution off the oven. The kit only supplied you with one pair of gloves to apply the solution (which I then threw away afterwards), so I now realise that I don’t have any gloves to wear to clean off the solution so I have to use my bare hands. This later results in all the skin peeling off my hands. The oven is very sparkly though and almost looks like new!

9.30 – I sit down and do a few hours of work – mostly going over lecture material and making notes and prepping for this afternoon’s session.

12.00 – I have an early “lunch” of cake as I realise that I don’t actually have any real lunch food in the house.

1.00 – Get the bus to uni

1.45 – Afternoon respiratory lectures. The lectures have a lot of physics and equations and histology, so they’re not the most fun. We then have groupwork going over some respiratory questions and case studies.

5.00 – Get the bus home. When I get in I sit down for half an hour and then put together some pasta with vegetables in a cream cheese sauce. I make enough so that there’s left-overs for myself and the boyfriend’s lunches tomorrow.

7.00 – After dinner I do some more work going over the respiratory we covered this afternoon whilst it’s still fresh in my head.

10.00 – I finish working for the evening and sit with the boyfriend and watch some tv for a bit before bed.

11.00 - bedtime

FRIDAY

6.45 – Wake up, eat breakfast and get ready

8.00 – I get the bus to uni

8.30 – I arrive at uni and do some reading in advance of our first lecture

9.00 – Our morning’s lectures/groupwork are on the urinary system. I don’t mind this module, but the material we cover this morning is pretty complicated and I’m feeling sleepy so in a break I grad a hazelnut latte to keep me going

12.30 – I eat lunch (leftover pasta) with some friends. I really should do some work in this time, but Friday’s are quite full on so instead I enjoy just relaxing and spending some time with friends.

1.45 – Our afternoon lectures/groupwork are on neurobiology. The brain is hard! There’s lots of anatomy in the first lecture which is complicated, but the second lecture is given by a clinician who pretty much just sums up some things and talks us through some case studies (with lots of pictures!) which is pretty interesting. The group work is very long and pretty hard, but it’s made better by the fact that 2 people from my group have brought in cake to keep us motivated!

5.00 – I finish uni for the day and walk quickly to the bus stop. I’m travelling (over an hour on public transport) to my boyfriend’s workplace to meet him there when he finishes work at 7pm. This involves getting a bus and 2 trains, and with Friday evening delays the journey takes a while and I only arrive just before 7. It’s also been raining heavily all evening and I’m wearing canvas shoes, so I’m soon soaked.

7.00 – I meet my boyfriend after work and walk to his car. We’re going home for the weekend as I’ve got a locum pharmacy shift back home and my boyfriend’s going to catch up with his family. I drive us home (a 2 and a half hour journey) as it’s good practice for me to drive long journeys as I only passed my driving test about 2 months ago. The journey involved lots of motorways, in the dark, in heavy rain, with lots of spray and busy traffic, so it was good practice of driving in adverse conditions!

9.50 – we arrive home at my house and catch up with my family over eating a late dinner (steak sandwiches).

10.45 – my boyfriend stays downstairs hanging out with my dad (I like that they get along well together) while I get my things ready for my shift tomorrow and then go to bed.