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.

Blah

So the exam today went dreadfully. The only thing that I know, is that I don’t know anything.

Loads of people were coming out of the exam saying that they’d done badly and won’t have passed many questions (the pass requirement for our exams is based on how many questions you pass, rather than your overall percentage), but you know that really they’ll have done really well. When I say it though, I mean it. There were things on the paper that I don’t even recall ever learning about, let alone have revised and could answer questions on them! All of the topics which I’m confident on didn’t come up, not one. Additionally, my brain was so fuzzy that I struggled coming up with basic information (such as what the uterus was called…). All in all, unless a miracle occurs and I get everything right in tomorrow’s paper (which lets face it, is highly unlikely), I’m going to be doing re-sits.

The thing is though, at this point I’m questioning if I’ll even be able to pass re-sits, even with the extra few weeks of revision time. I work hard but I just don’t seem to be able to retain the amount of information required. Not everyone’s cut out for medicine, and maybe I’m one of them? Throughout high school I was that annoying person who got close to 100% without having to really work for it, but since then I’ve slowly been losing my work ability. Things used to come really easilyy to me, but now I’ll work my butt off and still only be mediocre. Maybe I’m just dumbing down as I’m aging, or maybe it’s just that phenomenon of bringing together all these smart, type A personalities at med school, and unfortunately not everyone can be the best, someone has to be at the bottom of the pile.

Throughout my life my family haven’t put deliberate “you must do well or we’ll disown you” pressure on me, but a different type of pressure; the “you’re the smart one in the family, you work hard so we know you’ll do well’ pressure. The type of pressure that is worse because they’re just being nice but they’ve got such high expectations of you that to disappoint them would be worse than failing itself. Even my boyfriend’s the same. I love them, but I wish they’d just say “we understand that this is really hard and it won’t be the end of the world if you don’t succeed”. Everyone’s so proud of me going to med school, that to flunk out now would be horrible, but if I’m struggling at this stage, how will I make it over the next 3 years?

I’m sorry for this abundance of self-pity. As you can probably tell, I’m feeling pretty deflated after this morning’s exam and don’t really feel as though I can talk to anyone in real life about it. Hopefully tomorrow's exam won’t be quite so disastrous and then I can just put them out of my head and work towards OSCEs and resits.

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.