Monthly Archives: May 2010

Going Gentle Into That Good Night

In many ways, we’re sheltered from the harsh realities of medicine during the first three years of medical school. As the final “bit” of my third year, I’ve chosen to do an SSM in Palliative Medicine. I think that when I’m finished, I’ll have fulfilled the objectives that were submitted when I chose it — which mostly revolve around an audit that I’m doing. But I think that the most important things I’m going to get out of this are much less quantifiable and are unlikely ever to appear on a list of learning outcomes.

I think that it’s going to break my heart and then put it back together. In the end.

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Posted by on May 26, 2010 in Blog, Medicine


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Well, that’s that.

It wasn’t so bad as I feared it might be and it seemed better than last year, but I repeat what I’ve said before about third year not being an easy ride (no matter what anyone else might tell you).


Paper 1

1. The aetiology, pathogenesis, pathology, and management of asthma and COPD.

2. The pathophysiology of TB, the natural history of HIV, and five ways to prevent the spread of each.

3. The management of peripheral vascular disease as it progresses from intermittent claudication to acute critical limb ischaemia.

4. A modified essay question on cervical cancer, including cervical intraepithelial neoplasia, staging, spread, management, the HPV vaccine, and the basic anatomy of the female reproductive system (it doesn’t bode well for me in, y’know, life, that I spent five minutes trying to work out which way around the woman went, or that I spent another five minutes saying, “but women haven’t got prostates!”).

5. A modified essay question that was split into two separate patients, one with psoriasis and one with epilepsy.

6. 60 EMQs — as expected, a hodgepodge of random things that included infectious disease, embryology, the muscles of the abdomen and thorax, differential diagnoses of dyspnoea and acute abdomen, immunology, and interpretation of LFTs.


Paper 2

1. The differential diagnosis for and management of severe depression, including assessment of suicide risk.

2. The genetics of breast cancer.

3. The clinical causes of eight abnormal blood films (microcytic hypochromic anaemia, normocytic normochromic anaemia, macrocytic anaemia, thrombocytopaenia, eosinophilia, neutrophilia, reticulocytosis, and atypical mononuclear cells).

4. A modified essay question on atrial fibrillation and congestive heart failure.

5. A modified essay question on the clinical features, pathophysiology, and management of rheumatoid arthritis.



I actually studied for the OSCE, this year. A lot of this involved making my flatmate pull strange faces as I tried to get a routine for the cranial nerves into my head, but still. I studied for it.

Day 1 is the one that takes place in the hospitals. It was difficult but was made less so by the volunteer patients, who were all lovely (and, personally, I owe many thanks to my first patient, who did much to put me at ease). This is also the day with a resuscitation station, during which I managed to almost strangle myself on the Ambubag cable, tripped and fell over, and, um, swore loudly, which provided amusement for my examiners and may have got a yellow card for me. We’ll see.

Day 2 was less difficult but still had its interesting moments, like having to give a “patient” an intramuscular injection without ever having been taught how to do so and having been assured that it wouldn’t be in the exam, but we’ve been told that our marks from that station won’t be counted.


We’ll get our results in the middle of June. I hope that I’ve done enough to pass, but, honestly, for now I’m just enjoying the sunshine and the sleep and the opportunity to be a normal human being again.


Posted by on May 22, 2010 in Blog, Medicine


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*deep breath*

It seems that I’ve disappeared into the revision vortex, a bit.

I’ve got my first written exam in a couple of hours and then the second one is tomorrow morning, followed by OSCEs on Wednesday and Thursday. So, here I sit, eating my bagel and drinking my coffee and praying for nice questions (and, please God, not too much synoptic stuff).

Fingers crossed.

It’ll be over soon, anyway.

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Posted by on May 17, 2010 in Blog, Medicine


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Two Weeks Out

I had a spectacularly unproductive day today.

Occasionally, there are moments of spiralling panic — have I retained any of the information that’s been being stuffed into my brain over the last six weeks, have I totally underestimated the synoptic element of this exam, what happens if I walk in and sit down and can’t answer anything?

I know that I’ve worked hard.

I know that I’ve got another two weeks, and that I’ll continue to work hard.

They always say that if you coped with the second year exams, you’ll be fine with the third year exams.


But I can’t quite get rid of those niggling doubts.

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Posted by on May 2, 2010 in Blog, Medicine


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