Hurrah!

I passed!

I’m completely happy with my results — no more than I deserved in the OSCE and I’m still a little bit stunned that I actually passed it, but a B in the written papers and I’m thrilled with that.

I am officially on my summer holidays.

I am done with the year from hell.

… Hi. I’m Sefkhet and I’m a third year medical student.

A reflection on second year exams.

This was originally written in longhand, while on a First Scotrail train from Edinburgh to Glasgow this afternoon. I’ve spent this week with my parents, sleeping and reading novels and cooking the odd meal and then sleeping some more. It’s been a good week and a much needed break, but I’m looking forward to sleeping in my own bed tonight.

In spite of warnings from the faculty that results might not be published until Tuesday, we’re all expecting them tomorrow and we’ve already had the obligatory This Is What You Must Do If You Fail email from our head of year. This is doing nothing for my blood pressure. I’d wanted to write about the exams and I’d wanted to do it before my memories became contaminated by the elation or the devastation of the results, but I couldn’t face doing it straight away. So, here we go.

For the written papers, this was honestly the longest and the hardest I’ve ever worked for any exam. I know I’ve said it before, but I don’t know what I’ve got left to give to a resit — my proper revision started on Easter Monday, and for the next seven weeks, my computer was turned off during the day and I worked from 9am until 11pm, most days (and five or six days where that 11pm quitting time turned into a 2am quitting time) with lunch and dinner breaks, with Sunday mornings and Tuesday evenings off, and with classes fitted in where they needed to be. It turns out that my extended family hadn’t been aware that my trip down to Englandshire marked the actual end of term, which resulted in a number of remarks being made about me having an easy life and not working hard enough. As you might imagine, that went down like a bag of hammers.

Paper 1 was the worse of the two. It was three hours on Block 7 (reproduction, growth, and development), Block 8 (musculoskeletal and neurological systems), and Block 9 (cardiovascular, respiratory, and renal systems). There were a handful of one mark questions that I really just couldn’t answer — the name of the deformity that results from a Colles’ fracture?! — and a horrible picture of the brain that I had to flat-out start inventing things about, and I’m not convinced that I got the answers they were looking for in the pregnancy hormones questions. There were a few places, too, where the marks available didn’t seem to match the quantity of information needed to answer properly — 4 marks for a full description of the ischaemic cascade?! They got a page and a half from me! And a ridiculous question about the renin-angiotensin-aldosterone system, which everyone in the room could have described the principal features of but which we all freaked out at when faced with an eight-mark fill-in-the-blanks paragraph. The most common question I heard as I left the exam hall was, “Do you think it’s okay that three of my blanks were angiotensin II?”. Overall, a few really odd things and certainly not an easy paper, but nothing like as nightmare-ish as I’d been expecting.

Paper 2 was on Block 10 (gastrointestinal system) and Block 11 (risks and responses, or ‘everything we didn’t have time to fit into the rest of the year’), with a wee bit of signal transduction thrown in just in case we should have thought we’d got away with that one when it didn’t turn up in Paper 1. This was an easier paper — still not easy, but I found it much more straightforward than Paper 1. The only thing that really threw me for a loop was a question that required me to start digging around for information that had long been buried in the furthest corners of my brain and not touched since second year biomed, stuff that I knew but that I definitely didn’t remember covering in this degree! I’ve since been told that it was in an FRS in the last teaching week that I skipped in favour of revising embryology, so that’ll be that.

Have I done enough to pass? God, I hope so.

As for the OSCE, I really don’t think I’ve done very well. I know there was stuff that I missed out and that I did in the wrong order. I missed out a few things that were really basic, especially on my first station, when I forgot to wash my hands and forgot to check my patient’s identity. Plus, I’ve totally cocked up the ethical communication skills station — I wasn’t expecting the actor to pull out a list of questions that he’d written down and wanted to ask me about the Access to Medical Records Act. I’ve been told over and over that it’s difficult to fail the second year OSCE and that hardly anybody ever does, and I know that I didn’t actually freeze in any of the stations and that I probably did most of what I was supposed to, even if it wasn’t that slick, so, again, I hope that I’ve done enough to pass. Fingers crossed.

Blog off

The exams are over, and I think they went OK.

On Friday, I went out with my classmates, wore real clothes (i.e., not jeans and hoodies) for the first time in a long time, had dinner, and danced the night away. Lots of smiling. Lots of hugging. Lots of relief. Because whatever happens next Monday, the important part for now is that it’s over and we’re all still standing. It’s been a hell of a year, and I couldn’t have done it without them.

This weekend, I’ve caught up on sleep and cooked and cleared away the piles of textbooks that were scattered across my floor like landmines. I’m packing now for a week in Englandshire, and I’m taking nothing with me but clothes and novels.

I’ll be back next Sunday. Take care.

It’s going to be a long afternoon of, “I’m Sefkhet and I’m a second year medical student. Is it OK if…”

In a little bit, I’m heading off to North Lanarkshire for my first OSCE.

I’m not nearly as nervous about this one as I was about the written papers (in spite of having sat perhaps a hundred written exams in my life and having never, ever sat an OSCE that counted for anything before today). I know what I’m doing, mostly, it’s just a question of remembering to do it in the right order, faking some sort of confidence, and keeping the shaking under enough control at least that I won’t drop my tendon hammer.

Oddly, I’m kind of looking forward to it. I’m not getting tested on how much scientific information I can fit into my head, I’m getting tested on how good I might be at actually being a doctor. This is the part that I love. The part where I get to see patients and talk and interact with them and maybe try to figure out a little bit of what might be wrong with them. It doesn’t matter that most of my patients today will have absolutely nothing at all wrong with them or that they’ll all be actors. This is what I live for.

Is it off-putting that there’s going to be an examiner there, waiting for me to forget to check for malar flush? Little bit. Or that I will at some point (more likely tomorrow, I think) have to get consent from a plastic bottom rather than a real live person? Yeah. But I can live with those things.

So.

Stethoscope… check.

Tendon hammer… check.

ID badge… check.

A hundred warnings to not forget the temperomandibular joint or tracheal deviation… check.

I’ll see you on the other side!

Full disclosure

I’m tired and stressed.

I’ve reached the point where there’s stuff that I really do need to cover (cholesterol and muscle contraction, for two), and then there is other stuff that I have gone over twice or three times and really should know and probably *do* know but am not actually convinced that I know it, and that is making me freak out.

Apart from the girl who does the evening shift in Starbucks and a five minute conversation with my mother every night, I have not actually had contact with people who aren’t medics since last Sunday morning. I am hoping like hell that church tomorrow morning will improve my mood.

I had a moment, earlier on. I was sitting in my carrel and it all just got too much and I had to go and sit out in the stairwell and have a cry to myself. In the last two months, I’ve had maybe four days and another five evenings where I haven’t done any work, but, besides that, I have been going flat-out since Easter Monday and I want this to be *over*.

And if I don’t pass…

There is nothing shameful about doing resits. There is nothing wrong with things not going exactly the way you planned them. Really, take it from someone who did medicine by the scenic route — cocking up my A-levels was one of the best things that ever happened to me.

But this year, I don’t know what I’ve got left to give. I don’t know if I can keep going for another nine weeks.

I just want to be a third year.

*is exhausted*

ARRRRRRRRRRRRRRRRRRGH.

I want this *beep* *beep* *beeping* exam to be OVER.

A commandment worth remembering

This week, I had the worst day I’ve had since I started revision.

I’ve had rubbish days and I’ve had unproductive days. There was the day when I tried to work in a study room in the QM, but that turns out to be a lot like working in a prison cell and it doesn’t really do much for someone who goes slightly crazy if she can’t see the sky from time to time. And the day when I had a complete meltdown over the conus medullaris, of all things. And the day when my study partners and I were sitting at the kitchen table, stressed out and stressing each other out and trying to learn things and really getting not a whole lot done. And the day of iron deficiency anaemia, when I came so very close to setting fire to Berne and Levy. Do you see where I’m going with this? The last five and a half weeks have not exactly been shiny and fluffy.

But this was different. Because in spite of all that, I’ve been happy. Mostly. I’m generally a happy person and I always try to look for a good side to everything, and I’m well aware that that might drive some people a little bit nuts, but it’s how I want to live my life and it certainly makes for a better experience than the alternative.

So, when I started staring at a folder full of notes and thinking dark thoughts and deciding that there was no possible way for me to pass this exam and wondering what kind of idiot I’d been to think I could do this and despairing over how slowly the work was going and how quickly the time was going…

It’s not like me.

I’d barely slept the previous night — going to bed very late (which was entirely my own fault) and then being woken up at dawn (for reasons that were unforeseen and totally unavoidable) combined to mean that I’d got maybe three and a half hours sleep, and looking at it from the other side of a good night’s rest, I know that I was cranky because of the sleep deprivation and the work was going slowly because of the sleep deprivation, and that the whole thing spiralled from there. I’m back to my normal, terrified-but-chirpy self now, but I know that I’m far from being the only student to have had those dark thoughts in the last few weeks and I read something today that I thought was worthy of sharing. It’s the conclusion to the new Hippocratic Oath:

“While I continue to keep this oath unviolated, may it be granted to me to enjoy life and the practice of the Art, respected by all, in all times.”

Eeeep

The good news is that our final piece of coursework came back and I don’t have any coursework resits, which means that I will be DONE as soon as my final OSCE is over. In fact, my aggregate coursework result will be an A or a B (never been too sure how the calculations work, and it depends on how well the critical appraisal grade is balanced out by the rest of them) so I’m very very pleased with that.

The other news, which was inevitable and therefore not bad, but is also not exactly inspiring me to jump up and down in glee, is that I have my final exam timetable:

Monday 1 June — 0930 — Paper 1 — Hunter Halls

Tuesday 2 June — 0930 — Paper 2 — Hunter Halls

Thursday 4 June — 1310 — OSCE 1 — Far Away Hospital

Friday 5 June — 0900 — OSCE 2 — Clinical Skills Suite

Eeep.

Yesterday, I took the day off — it was on my revision timetable as a day off, and now my house is clean and my freezer is filled with enough curry to feed a couple of medium-sized African nations for a fortnight. This morning was the final comm skills session of the year, and then back to work after lunch. It’s going to be a long, hard slog to the finish.

Can it be June, please?

I’m a person who enjoys the simple pleasures in life — clean sheets, good cups of coffee, the smell of a new book, hot showers, a big bowl of rice and daal, the occasional morning off… And at this time of year, I appreciate those things even more. I take an extra five minutes to brew the real coffee. I wait for the moment when my muscles unknot underneath glorious hot running water. I think my bed is the best place in the whole world. I love my Sunday mornings off and I cherish them the way some people cherish diamonds.

So, you can imagine that I was deeply unimpressed on Sunday when I was walking towards the subway and, without bothering with little things like asking permission, my brain started to recite the signs and symptoms of pulmonary thromboembolism.

“Piss off,” I said. “Are you crazy? You’re not supposed to be working until one o’clock this afternoon!”

“Right ventricular heave and increased JVP,” it replied.

It’s almost ridiculous to think that I could have forgotten what it was like, this time last year. I remember doing things. I remember all the nights of getting the last subway home, and living on pasta from Little Italy and coffee from Peckhams, and photocopying pages of immunology diagrams at midnight, and standing in the middle of the (empty) atrium and getting two verses into I Am What I Am before I realised exactly what I was doing. All of this, I remember. It’s the relentlessness of it all and the utter physical exhuastion that comes along for the ride, that’s the part I had forgotten.

I don’t think I’ve ever worked as hard as this, and definitely not for as long as this. I worked hard for my BSc finals, but it was a lot easier to ‘question spot’ for them and, anyway, a big chunk of my degree class was based on coursework. And twelve thousand words of dissertation on a month-long antibiotic resistance experiment that failed spectacularly is hard work, but it’s a different kind of hard work.

In some ways, it feels a little bit good. I’m plugging away and making inroads and there’s knowledge in my head now that I didn’t have three weeks ago, and if I pass this exam, it will be because I have worked my bloody arse off. I crawl into bed at night and crash, and, for seven hours, I sleep the sleep of the people who have totally earned their sleep. But in other ways, I’m just so tired. In my revision timetable, I have a day off scheduled for next week (except for PBL, I still have to get up and go to PBL) and it’s like this enormous shining beacon on the horizon.

Did you know that one of the symptoms of total sensory deprivation is a reversion to childlike emotional responses? That’s us. The highlight of our day is getting a tick on the list of PBLs that have yet to be revised. And scrumpling up a piece of paper with a long long pathway that we just learned and scribbled out from memory, and then throwing the piece of paper at the wall? That comes a close second.

26 days. And counting.

This incoherent mess of a ramble is brought to you by a day of gallstones and hypersensitivities and stomachs, and, you know, it being two o’clock in the morning.

*fumes, stamps feet*

Okay, third years? You have GOT to stop scaring us.

I’ll say before I start that the more senior medical students here are absolutely brilliant when it comes to helping out the more junior medical students. They’re lovely, friendly people who spend most of the year imparting wisdom and advice and general reassurance, and we appreciate it more than they’ll ever know.

Except, now? It’s just stressing us out. If someone says that they’ve only properly studied Block X and are currently working on Block Y — and, mind you, this is five and a half weeks away from our exams — then the appropriate response is not to start interrogating them on obscure details from Block Z. It doesn’t increase confidence or productivity, and it’s definitely not funny. In fact, it scares the shit out of us and distracts us from whatever we were doing at the time and pretty much guarantees that we’ll get nothing done for the next hour and a half as we proceed to have nervous breakdowns.

Enough.

And with that I return to my notes on brain injury.