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???