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 :)

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?

Mini Rant

I had a GP appointment this morning. This is how it went (as word for word accurate as I can remember):

Dr: Hello, what can I do for you?

Me: Hi, I’ve come in for my medication review for my migraines. Additionally, I’ve been having more migraines than normal recently, although that could be due to stress from exams recently.

Dr: Is that Propranolol you take? (Propranolol is a beta-blocker commonly used to lower blood pressure, but also used to prevent migraines)

Me: Yes

Dr: Do you take paracetamol too?

Me: Yes, but it doesn’t have much effect on my migraines.

Dr: Try taking paracetamol when you have a migraine. *Hands me my repeat prescription for my medications*. Anything else?

Me: Oh, so you think I should carry on with the Propranolol?

Dr: You don’t get any dizziness do you? (medication for lowering blood pressure can sometimes be too effective and lead to low blood pressure, which can give dizziness)

Me: No, I’m a Pharmacist though so I know what to look out for. (I slipped in the Pharmacist card (which I wouldn’t normally do) in the hope that it might prompt him to engage with me slightly)

Dr: Ugh, Pharmacist’s were the bane of my life in hospital with their green pen. I don’t know what their obsession with green pen is. *Doctor leads me to the door and ushers me out*

Me: Ok, goodbye…

I didn’t expect much from the consultation, but I was hoping to get a doctor’s opinion on whether I should try a different medication for the migraines, and to at least actually listen to what I was saying. I would also expect a doctor to find out how frequently I was getting migraines and perhaps offer some lifestyle advice or recommend a different pain killer, or prescribe sumatriptan (a common drug to take when a migraine occurs). He asked me about dizziness, but he didn’t bother to actually check my blood pressure, despite the fact that the blood pressure machine was sat on the desk less than 10cm away from me. Incidentally, I’ve not actually had my blood pressure checked by my GP once since I started on the Propranolol.

To then add insult to injury, on my way out I noticed a plaque hanging in the reception saying “...(name of the GP surgery).. Health Centre is a certified training centre for ..(my)… Medical School”. So not only is this doctor providing me with poor patient care, but one day in the future, he could also be my mentor.

Needless to say, I won’t be following his example for my OSCEs on Monday. There definitely wasn’t any empathy or ICE in his consultation!

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…

Update

Hi,

My apologies for not updating in a while. Time’s just ran away from me recently! Not too much has been happening lately though. We had a few weeks off for Easter which was nice. I didn’t do too much, just a bit of revision and some Pharmacy shifts. This is the last week of our term for this year (!), so we’re mostly just having revision/review lectures, rather than learning new material. This first year of university has gone so so fast!  My first exam is in just over 3 weeks time. Most of my revision notes are up to date, but I still have a lot of learning to do. I haven’t got the exam stress yet, but I’m sure it’ll hit soon. I really really hope that I manage to pass these exams ok.

We had some fresh lower limb specimens to learn from the other day. I didn’t really enjoy the session too much because of a few reasons. The specimens looked as though they came from elderly people, which made me think of my grandparents which was a bit disturbing. I also don’t find that I personally learn very well from plastinations/specimens, I learn better from sitting down and just reading over everything by myself. Additionally, because the room is quite crowded I can’t properly hear the demonstrator or see the specimen half of the time. When I came home after this session though, my boyfriend’s response when I told him that we’d had fresh specimens was “Aw, isn’t that sweet that someone’s last wish was that you’d learn lots from their body”. This made me think differently about the session, and feel a bit guilty that I’d complained a little bit and hadn’t found it that useful.

I’ve been enjoying the nice weather we’ve been having the last few days, though it does make it harder to sit down and revise! There’s always things going on when the weather’s nice and my boyfriend doesn’t always understand that sometimes I have to be boring and stay at home and work instead of going out and having fun.

Medical student syndrome

Tonight I noticed I had a rash under my chin and on my arms and I'm really achey, so I convinced myself that I had meningitis.

I've since realised that I was being an idiot; the rash is just a boring rash and I'm achey from going to the gym last night. Over the last term I've also thought at various times that I had anaemia, a congenital heart problem (because I sometimes get palpitations), GI cancer, hyper and hypo thyroidism and that I was pregnant. I wonder how many more medical conditions I'll diagnose myself with before the end of med school?

[EDIT] Hah, the day after I wrote this we had a lecture on meningitis!

Medicine, a secure career?

Recession proof degree subjects:
http://www.studentbeans.com/student-money/a/ten-recession-proof-degrees-subjects3828.html

Annndddd........ *drum role*, Medicine comes in second (below nursing) in careers least affected by the recession! People are always going to be ill I suppose! Apparently unemployment in medicine graduates is "virtually non-existent" at 0.1%. Although this year apparently nearly 300 medicine graduates are currently without F1 jobs (though this figure will probably decrease over the next few months with people not passing finals/not graduating and freeing up jobs and apparently foundation schools are being asked to take on more doctors to ensure that everyone ends up with a job http://www.foundationprogramme.nhs.uk/news/story/ukfpo-update-on-fp2013-oversubscription). Apparently in the future there will be a 2% decrease in the intake of medical students in the UK, in line with future workforce planning (http://careers.bmj.com/careers/advice/view-article.html?id=20010044) so hopefully there will always be jobs available for doctors (although I have heard that there are problems of shortages of consultant posts in some specialities).

As many people probably know, there's been a bit of a kerfuffle with FPAS F1 job allocations over the last week, with some candidate's SJTs needing remarking which has meant that all the job allocations that were given out last week no longer stand and all the jobs will be reallocated tomorrow. This must be so stressful for all final years (especially as they already had the stress of being the guinea pig year for the SJTs, and many of them either have their finals now or in the near future). I really feel for everyone in this situation and hope that not too many people are left disappointed.

We did a practice SJT question last week (although technically it was packaged as an aptitude/professionalism question as the med school aren't meant to be prepping us for the SJT...) and I got all the answers in the correct order! It's all a bit vague though and the middle answers seem as though they could be mixed around a bit depending on which way you interpreted the question. Who knows though, we might all prepare ourselves to take the SJT and they could change the assessments again for our year so I'm not getting too stressed about it yet.

My younger sister (of 2 years) is currently in the process of buying her first property! She's a nurse and can afford it, but I didn't think she'd be in the position to buy a place quite so soon. It puts everything in perspective though with regards to my own situation. If I hadn't gone back to uni to do Medicine, I would probably be in the position of looking at buying a property also. Now though, I'll be lucky if I'm house hunting in less than 5 years time. Currently I can barely afford to eat. It's a bit depressing. I know that in the future it'll totally be worth it, but sometimes it's just hard seeing all my peers enjoying their 20's and putting down roots whilst I'm still living off my overdraft and finding money just to pay for rent/bills/food a struggle some months. This should improve slightly next year when I don't have to pay the £3000 odd fees that I've had to do this year, but not substantially. Many people in my year come from quite wealthy families with parents who are paying all of their fees and living expenses, and even buying them a house to live in in some cases, but unfortunately I'm not in that position. Being a responsible adult is hard. I really hope that I don't fail med school after all of this!

The O&G workshop

I went to an obstetrics and gynaecology conference last weekend. I meant to write about it sooner but it’s been a busy week!

The workshop was a one day event for students run by several O&G registrars from the local hospitals. I wasn’t sure how good or useful the conference was going to be, but it ended up being both! The registrars were obviously trying to sell O&G as a career, but not from some underlying agenda but purely because they genuinely really enjoy O&G and think that it’s a great specialty to be in. I found it a bit hard to believe that it’s as good as they say it is from other things that I’ve heard, but I do believe that compared to many other specialties it’s a good one to be in.

My main concerns about O&G were about the working hours and the range of work that you do. I think that I would enjoy the obstetrics side more than the gynae side (particularly gynaeoncology), but they were saying that the split is approx 70:30 obs:gynae and the majority of the more complex gynae things and gynaeoncology is generally done by specific gynae specialists in tertiary hospitals. I also learnt that you can be an O&G generalist doing a bit of everything in a DGH (with a better work life balance), or specialize in a specific area and work in a bigger tertiary type hospital (but with a worse work life balance!).

They gave an example of one of their consultants who works Mon, Thur and Fri daytimes and a Tuesday nighttime, and because out of hours work counts for more than normal working hours, doing these 4 shifts counts as the consultant working full time! One of the registrars there was working LTFT (less than full time), working 60% of full time (which equates to 3 days work a week and just over half of the on call time) which I think would be a good option if I end up having children, although it does increase the specialty training length.

I love medicine! There’s so much variety and choice. My problem with deciding what specialty I want to do, is that there’s so many amazing options, that choosing just one is going to be hard! I have thought about a career O&G previously, enough to choose it as the specialty to base my patient case studies on that we’re doing in uni at the moment, but after the workshop I’m seriously considering it.

At the conference we also did several different workshops, and modesty out of the window, I was awesome at laproscopy! My friend and I were the only pair to manage to get all of the pasta tubes onto the string J. Too bad I don’t have surgical aspirations! I also got a freebie tourniquet! I was under the impression that you had to use disposable tourniquets in hospital though, so I don’t know if I can actually use it, but I still enjoy having it.

I also went to one of my friend’s engagement party the other day and we were looking through a wedding magazine. It made me really want to get engaged now and have a big sparkly diamond on my finger too! In all seriousness though, I have heard that it’s beneficial to get married before the end of med school because otherwise you’ll end up having your non married name as your professionally registered name and only be able to use your married name personally as it’s hard to get your doctor name changed. I don’t know how true this is though.