Tuesday, 9 April 2013

Post Finals Update

So posting here fell into a finals shaped hole. The good news is that I have emerged with a pass, the not so good news is that 3 days after they finished there was a big fire in our building and so we are out of the flat awaiting cleaning/redecoration/replacement of soft furnishings etc. I'll be posting about that experience at a later date. Suffice it to say, it was pretty traumatic and is still quite rubbish but I'm in one piece as are my darling wifelet and kittycat and we have absolutely beyond amazing friends who have carried us through all the nonsense. And as you'll know there is a lot of of nonsense when insurance companies get involved in anything.

Here is a canter through my exam period and the lessons I learned from it.

The good :
- Starting early. I knew I wouldn't be able to cram in the last few weeks like other folk so I planned around it. Our 4th and 5th years are one unit curriculum wise, so from the start of 4th year I began studying. This may sound ridiculous, but what I mean is that during each block I studied a couple of hours every evening, really getting into the speciality I was doing and making good notes that suit my revision style. This meant that for the most part revision was actually revision. A lot of folk took 4th year as a year off out-of-hours studying but it wouldn't have worked for me (it worked really well for a lot of them - there is no single right way to approach things). My studying didn't actually have quite the same intensity ramp up in the last few months - I just continued spending a couple of hours every evening, admittedly infused with more adrenaline! My need for rest however did ramp up - that was more that my condition is worse now than during 4th year. I spent a lot of time resting (to those of you who have the urge to say 'ooh, lucky' please don't - whilst I enjoy a duvet day as much as the next person, enforced rest that is isolating and restrictive on your other activities is not fun)

- Focusing on self care. Taking full days off as needed, eating sensible food (for which I have to thank my wifelet), letting myself have a good cry from time to time, keeping in touch with friends via text when I didn't have enough energy to see them and having a stop time every evening. The best self care was accidental - two of our dear friends got married in the middle of nowhere in between writtens and OSCEs and we went there for a few days. The change of scene and the fresh air were incredible - and because I did some work while there I didn't panic about not being at my desk (read - in my bed) at all.

- It was the first time I'd have my special exam arrangements in place and having a separate room to allow me to wiggle and pop and stretch to my heart's content without distracting folks plus extra sufficient time (this reference comes from the most amazing series of blog posts on access and education that I have completely lost track of - if you know of the link please comment!) to complete the exam at a speed my poorly fingers would allow.

- Having a study ethos rather than a study plan. In days gone by I've spent many hours making/colouring coding a detailed study plan, only to fall behind or change things up and having to do the whole thing again. This time around I came up with some principles to read when I was unsure of what to study or feeling panicked about what I hadn't covered yet :
1) I will never cover everything
2) Doing past papers is useful, because it is a guide about what kind of depth to go into and what kind of questions may be asked / what kind of answers are expected
3) Identify the major conditions and presentations within a subject and cover the relevant material about those well (for conditions outline definition/aetiology/pathophysiology/clinical features/diagnosis/management/prognosis and for presentations outline differential/key points from history and examination including red flags/investigations and management)
4) Regularly write a list of 5-10 things that you would hate to come up. As you go on this will get more specific (from 'ENT' or 'urology' to 'cerebellar examination' or 'TB pathophysiology'). Resist the urge to make the list longer.
5) Every time you think 'I know nothing about ...' list 10 thing you know about it. (e.g. ENT : thyroid related lumps move on swallowing, big tonsils/adenoids can cause sleep apnea in kids, grommets are tubes through the ear drum). Anything. It doesn't mean you don't need to study, but catastrophising isn't anyone's friend.

- Thinking 'I'm not the best, but I'm not the worst' on loop. Thinking that even if I failed, managing to complete the exams was a massive achievement in itself. Knowing people who passed last year and the level of study that they did and the level of knowledge that they had was very helpful. It gave me something concrete and reassuring to compare myself to. Very few people fail finals but everyone is terrified that it will be them.

The bad :
- No study leave meaning that we were on placement full time right up until the exams. As someone who will need to work part time due to fatigue etc, this was really tough. I think it would have been easier if those organising our placements had taken this into account, but I was being told right up until the end that spending time in the library and not on the wards was a waste of time. At that point it just isn't. Yes, you need to be seeing patients, but if you've had 2 hours of bedside teaching and then spent another few hours seeing several more patients, retreating to the library at the start of afternoon visiting is actually a pretty sensible way to consolidate what you've learned.

- Spending the first minute of every OSCE station having to rearrange furniture so I could fit in the room / get to the patient or task. I think for PACES or whatever I would ask for there to be someone who would go in the changeover gap between stations to sort that out for me. They knew there was a wheelie on the circuit, but noone had really given it much thought (understandably as they'd not been asked to). The worst was the first station where it was impossible for me to get to the patient without lifting furniture so I had to bum shuffle across the bed (patient was on a chair at the other side) to get to them - not the most dignified entrance but I passed the station.

- All of the admin nonsense that falls during exam time. We had to submit a big portfolio of case reports and essays and stuff a couple of weeks before, then there was the SJT nonsense and job ranking and all of these things. All necessary and unavoidable (except for the SJT saga) but still annoying. Also more DSA related nonsense (still don't have any of the equipment and the report when finally submitted 5 months late missed off half the stuff we'd discussed).

- We had 4 OSCEs spread over 2 weeks. They are utterly exhausting in a way that nothing else is. I finished one in serious doubt as to whether I would literally be able to make it home.

The rest :
- Practicing cardio exam on the cat "Skye I'm just feeling your radial pulse. Skye do you have a radial pulse? Skye do you have a radius?"
- Living in scrub bottoms, giant protest Tshirts and my polar bear dressing gown
- Eating mashed potato for 2 meals a day for nearly 3 weeks
- A certain person giving me the fright of my life by blogging good luck for exams a day early! (but otherwise being utterly angelic and wonderful - happy birthday!)
- Another friend getting up during their annual leave to go with me for the start of my written exams to keep me company because the wifelet was working
- Taking a study break to be fed radioactive cornflakes while inside a space ship (aka having a gastric emptying scan)
- Answering a full past paper question worth 20 marks entirely right gained entirely from knowledge I only had from watching ER
- Answering a question on the treatment of croup with "I don't know, but Anne of Green Gables used to swear by belladonna"


  1. Glad you've posted at last, and well done on getting through those finals. I don't know you, but saw something a while ago that was linked to your blog, and I always hold my breath a bit when you don't post for a while! You're a great inspiration.

  2. I just finished reading through all your posts. Really interesting stuff. I decided I wanted a career change into medicine about 6 months ago. I've been researching about the role ever since. I've been trying to find decent info on what it is like to be a disabled medical student / doctor, but all I ever find is the official stuff i.e. stuff institutions have to say because of DDA.
    It's nice to finally find something that goes into the practical nitty gritties of training.