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)

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.

Exam Results

I passed!!! I'm a quarter of my way to being a doctor :D

Exam Update

I had my re-sit exams on Friday and yesterday. I felt that Friday's one went pretty well and I came out of it happy. Yesterday's one however, was pretty hard so overall I'm not sure if I've passed. Many other people came out of yesterday's exam saying similar things so hopefully that means that the standards will be set slightly lower, but I don't know. There's nothing more I can do now though so I'm going to just try not to think about it until results day (19th July).

Now that the exams are over it's weird to have so much free time. I keep feeling guilty that I'm not revising! Last night we had a really nice night with our neighbours. We made some food, ate outside and then went for a walk to a local park. It was really enjoyable just to relax and enjoy some time with some friends. Today I'm just catching up with some housework etc. I'm going home over the next few days for a week to do some locum shifts and then back here for results, and we're also moving house.  I'm enjoying the warm weather we're having at the moment. It's so much easier to be productive when the weather's nice! At the end of the month I'm going on holiday to France with my boyfriend's family which I'm really looking forwards to :)

Revision

My first exam is tomorrow. I've been averaging about 9 hours revision a day, and yesterday I managed a revision high of 12 straight hours (even eating lunch whilst revising). Today I'm taking things a bit easier though as I don't want to be too tired for the exam tomorrow.

I read somewhere that "one thing you never regret is working hard" which is something I've tried to remember every time I've been tired or lacking in motivation. I don't think that I could have worked much harder for these re-sit exams, so at least I know I've done my best, even if I fail. I definitely know a lot more now than I did the first time I sat the exams, but whether it's enough or not I'm not sure.

Random thoughts

When I found out who else was doing resits, I wasn't surprised that some people also hadn't passed, but I was surprised to see some people in the resit group.

I also look at some people and think that they'll definitely pass resits, whereas I'm not so sure about others.

I wonder which category I fall into when people think of me?

OSCE success

We got all the marks back from our exams a few days ago, and although I failed the written exam, I got the top grade possible for my OSCEs! This means that I passed all 12 OSCE stations, with a mark of 75% + on all the stations! I didn't think that I'd done that well, especially since I ran out of time and didn't finish several of the stations. It's a nice morale boost though to know that I am capable at doing something well.

My revision for resits is going well I think. I've got a heavily laden revision timetable which I am managing to stick to so far, and I'm going to all the revision sessions available. Hopefully I've got enough time to learn enough to pass the resit exams, but if I do have to resit the year I'm trying to be optimistic about it. I wouldn't want to have to resit the year and leave all my friends, but at the end of the day it's only one year and it might be a good thing if it means that I get to learn all the basics really well which would set me up well for the rest of the course.

Results

The results came out, and as expected, my name wasn't on the pass list. Even though I was expecting it, it still hit me pretty hard. I passed the OSCEs but not the written exam. We don't find out our marks until tomorrow so I won't know until then how far away I was from the pass mark.

I've heard several times that it's rare to get through medical school without failing something, but to fail the first proper examination still seems like something a person capable of becoming a doctor shouldn't be doing. I calculated that approximately one fifth of the year failed, which makes me feel slightly better though.

I have to say that everyone is being so supportive. Several friends have offered to help me if they can. The uni are running revision days, have organised individual feedback meetings and have set up a special forum were we can ask questions to the module leads directly. A group of second years who also failed this exam are putting on revision sessions for us every weekday evening for the next two weeks and have offered us a specific second year mentor should we want it. On top of attending all of these revision sessions I'm planning on just getting up early and working really hard all day every day. There's 2 weeks until the resits, so hopefully if I make the time count I can pass the resit exams. I think that even if I weren't to do any revision I would still do better in the resits than the first time just because of how crap my brain was on the day of the exams, partly from the end of a migraine and partly from just being really worked up and stressed. I remember at one point in the exams, I couldn't even remember what the uterus was called or the name of the commonly used anti-depressant drug citalopram (something I see all the time as a Pharmacist)! I'm still going to work my ass off though.

Even though everyone's being so nice, it still feels really shameful to have failed this exam, especially after all of the hard work I did, and the good career I gave up, to get into med school. I haven't had the heart to tell my family yet. I don't want to disappoint them, but I'll have to tell them soon.

Low Expectations

Today is results day. However, I'm not overly nervous as I fully expect my name to be missing from the pass list. I submitted mitigation for the exams a few weeks ago and on Tuesday I had to go for a meeting with a big group of people to discuss the circumstances of my mitigation. I wouldn't have had to attend this meeting if I'd definitely passed my exams, as only people who've failed or are close to the pass mark (as by the time of the meeting the definitive pass mark hadn't yet been set) have to attend. So, purely from the fact that I had to attend this meeting I know that I've probably failed. I may have just scraped a pass but I'm not putting too much hope on that.

The meeting itself wasn't too bad. I fully expected to be grilled and have them rip my mitigation to shreds, but they were actually pretty nice and sympathetic. I submitted mitigation for my chronic migraines. I take medication which helps to decrease how frequently I get migraines, but unfortunately stress is one of the triggers for them and exams and stress go hand in hand. I get stressed because of exams, this causes a migraine which then means that I miss a day's revision which then means I get even more stressed which then causes more migraines, a viscous circle. Consequently I did get several migraines in the run up to, and the night before, exams which I did think probably affected my performance somewhat. The board agreed with this, but did point out that going on from this meeting I should probably actively do something to help decrease how stressed I get. Until the run up to exams I hadn't realised the full extent of stress = migraines, as I hadn't really been stressed so hadn't really got many migraines, but now I agree that I should probably try to do something to decrease my stress levels around exams. The question is, what though? I already try to eat healthily around exams, make sure I get enough sleep and take little breaks when I'm getting stressed. I'm going to see if the study skills department of the uni offer any courses, but other than that, does anyone have any good ideas of any strategies I can try?

Pharmacy and exams

Another reason why I'm glad I'm giving up Pharmacy to do Medicine (if I manage to pass med school that is....):

http://www.which.co.uk/news/2013/05/can-you-trust-your-local-pharmacys-advice-319886/

This report is flawed in many ways (the very small sample numbers, only looking at one source of advice instead of the wide range of services pharmacies offer etc.), but the results do ring true to a certain extent in my personal opinion. There are many excellent pharmacists and pharmacies out there giving an excellent service, but on several occasions I've been a customer in a pharmacy and have been given poor or no advice (when ideally I should have been given counselling considering I was a new patient taking a blood pressure lowering drug (I take it for migraine prophylaxis)), or overheard bad advice being given to other customers. I also know that I went to university with several people who I wouldn't trust to advise me on medical related matters, who are now working as pharmacists (this may be unfair and is only my opinion). Many people don't seem to respect pharmacists as much as they do other health care professionals ("glorified shop keeper"), which whilst unfair, I don't see changing significantly in the foreseeable future, especially with reports like the above.

(Note: I don't feel the same way about hospital pharmacists. Hospital pharmacists do further diplomas and training, and every hospital pharmacist I've ever known has had an excellent knowledge base and regularly prevent unsafe prescribing/make sure the best medication is prescribed to patients in hospitals).

On a different note, my second exam on Friday went better than Thursday's exam, but I still don't think that I've done enough to pass overall. I'm doing a little bit of revision everyday to prepare for resits, whilst also preparing for my OSCE exams next week. We found out the OSCE stations today which we're going to be examined on. Most of them seem ok, but there's a few I'm a bit unsure about. There's going to be one station on ECG which I presume will be to interpret an ECG but I really don't know what to expect from it. I also haven't had that much ECG practice, so I definitely need to do a lot of work for that one. There's also stations on infection control and male anatomy which I'm not too sure of what to expect and a station on mini mental state examination, which I know is quite straightforwards but we've never actually practiced it before! Luckily my boyfriend has agreed to be a practice patient all week (when he's not at work) as practicing on a real person is definitely more effective than just running through the motions by yourself.

Yet more revision

It's a lovely day, neighbours are having bbq's and multiple facebook updates have popped up showing friends out enjoying the sun, and so to at least try to enjoy some of the sun (and to escape my neighbour's dreadful singing) I revised in our back garden for a few hours this morning. It was very enjoyable, and I actually got quite a bit done, but unfortunately, our garden is north facing, so the garden's now totally in the shade, despite only being 3pm :(.

Garden revision (photo taken by me)

I think that I've finally found a way of revising Medicine which works well for me (I wish I could have figured this out sooner, given that it's only 3 days until my first exam, but better late than never right?). It's nothing special, I just type up condensed notes (still 30-50 pages per module....), then print them out and read over them a million times and highlight/memorise off by heart the most important bits. Previously I've tried flash cards, spider diagrams, revising my notes off the computer and other things, but this method seems to be by far the best. I don't know why I can learn far better when my notes are printed out rather than off the computer screen, but that's the way it is! Given that my revision up until recently hasn't been very effective I won't be surprised (I'll still be upset, but not surprised) if I fail the first take of the exams, but hopefully I'll be well prepared for the resists. I'm still going to try my very best to pass the exams on the first try though.

Good luck to everyone else working towards exams at the moment!

Losing My Mind

Ways in which revision ruins your life:

• Becoming fat. I even have fat feet as I discovered today.
• Diagnosing randomers in the street with conditions that I’ve been revising about recently (and then becoming really concerned for them in case they do actually have (highly unlikely) whatever it is you think they do, but they don’t know about it and then they might become really ill).
• Not caring about my physical appearance and living in the same tracksuit bottoms/PJs for a month.
• Taking half an hour out of revision time to help do the washing up seems like the most unreasonable thing ever and will the sole cause of me failing my exams, but watching an hour of Grand Designs during my “revision break” is fine.
• Spurting out medical information whenever my boyfriend/the tv/bus adverts/pretty much any outside stimulus mentions anything vaguely medically related and then getting really cross when I can’t remember a key bit of information (eg. specific blood test) about whatever it is I’m shouting about. This then equals a cross boyfriend because trying to remember medicine means that I’m not paying attention to what he’s saying or else I’m talking over the tv programme we’re watching.
• Becoming unreasonably aggravated and obsessive over the slightest noises disturbing your revision – how dare your neighbour do their washing at 11am on a weekday! How can they not prioritise your learning time over everything else?
• Developing bi-polar disorder - complete and utter stress one moment about not knowing anything at all and despair at never being able to learn even a third of the never ending pile of revision notes to a lackadaisical attitude towards the whole thing, believing that I’ll be fine, I’ve done lots of revision and I’m sure I’ll have that amazing revision day tomorrow where I’ll manage to revise half of the material for the exam and all of the knowledge will magically fall into my brain…