A Memorable Year.

1 year ago today, I was thankful and nervous at the same time. Last year's exam was probably the largest hurdle of my degree. I didn't do as well as I had hoped in my exam, but still managed to pass. I was incredibly thankful to be able to pass as many of my friends had failed the exam. Some of which had to repeat the year. I made a promise to myself that the year 2012 will be my comeback year. I was determined to start on the right foot and to never make the same mistakes again.

This year zoomed by. I believe I made leaps and bounds in terms of knowledge and self-confidence whilst on the wards and in clinics. I still got to give lots of credit to my placement in Orthopaedics. I cannot be more thankful to my supervisor. Even my friends have noticed that after my Orthopaedics placement, I was a different medical student. I was no longer afraid to speak up. I was no longer afraid to participate and be proactive. I realized that if you don't ask, you will never know what will happen. The worst answer you can get when asking something is "No". What is there to lose...other than a hurt ego. So one tip for all of you is to be confident. Don't be afraid to ask for help. Again, the worst someone can say is "No". If the answer is "no", just shrug and move on and don't take it personally.

As you move through the degree, Medicine slowly dominates your life and you really got to make an effort to have a social life. As the months pass and you have some free time to reflect, you realize your friends start to drift away and it may get a bit lonely at times. Medicine needs a lot of dedication, but I cannot emphasize enough how important it is to relax and take some time out. Giving yourself a break does not necessarily mean you have to go take a vacation. Taking a break is different for everyone. It may involve going to do something you enjoy or meeting up with friends, or even just spending some time at home to relax and watch TV.  I didn't realize how important it is to take a break until this year when I have finally experienced a whole year of clinical placements, one after another. Work - Life balance. I know many people in my year who are taking a year out to do a BMedSci next year, not because they want to do research, but because they have burnt out.

To top off my memorable year, just earlier today I received confirmation that I have been accepted to present a my research poster at a national conference. Really unexpected as it's quite competitive, so I'm absolutely chuffed. What a way to finish up the year!

In general, I have made many new friends, matured as a person, and gained valuable skills for the future - I think this has probably been one of my most memorable year of my medical degree. Despite the many ups and downs throughout the year, looking back - overall it has been a very good year.

Got to thank those who have made my year so memorable and those who made my experiences so much better. Cheers to 2012, bring on 2013!

Happy New Year!

Request: Tips for Revising for Exams.

So I had a request to do a post on tips for revising for your year-end medical exam. To be honest, every person will have a different way of revising. The most ideal way to revise for exams is to start from day 1 of the course. After every lecture/day, gather all your notes together and make sure your notes have enough info for you. If not, look at your recommended reading and add info to your notes. Or after end of each day is to consolidate all the things you have learned and to go over it. Some people like to consolidate their knowledge on weekends as most lecture days go from 9-5pm and by the time you finish your day, your brain will be fried. If you stay on top of your notes, when it comes to exam time, you should know your material quite well and just need to commit things to memory and you will not be needing to learn anything "new".

What I just described is the ideal way...but realistically, the chances of that happening is quite slim, unless you're quire organized and on top of everything. For me, that method got tossed out 2 weeks into my course. What actually happens is that you take notes during your lectures/print out your lecture slides. If you're having a good week and have some spare time, your notes will go into a binder so your room stays relatively neat and that you will be able to find your notes. If your university only does 1 year-end exam, like mine, on average, medics begin studying between 4-6 weeks prior to exams. You would think that's ridiculously too far in advance, but the sheer amount of material you learn in one year...it just as ridiculous. I personally need 6 weeks to go through a whole year worth of material, but do keep in mind...I don't really look at my notes again until my 6 week revision period. So here I will list some tips on how to get on top of your revision period:

1) Make a revision schedule. Try and figure out how many days/weeks you will need to go over a topic (eg. 1 week for Paediatrics, 5 days for O&G). How much time to dedicate to each topic will depend on how well you know a topic/how confident you are with the topic. Always leave 1 week prior to exams for leeway/time to go over sample/past papers/revise stuff you don't know very well/last minute cram. I usually start thinking about making my revision schedule well in advance or else if you do one too late, you'll realize you have too little weeks left and too many topics. To avoid that, maybe think about your revision schedule when you come back from your last holiday before exams.

2) Find a study buddy! If you live with other medics, then that's sorted. If you don't, try finding a study buddy who has the same sort of revising method as you. It's a great way to make sure you don't miss out any topics and also a great way to test each  other's knowledge. Make sure this study buddy won't be a distraction though or else you won't accomplish much!

3) Rest! I cannot stress enough how important it is to get enough rest during your revision weeks. No point of pulling all-nighters when your brain can't even function anymore. Nothing will get absorbed. Your body will tell you when it is time to take a break (usually when you find yourself reading the same page over and over again and nothing is going in). Try and get a good nights sleep every day. Pretty basic stuff, but it is so easy to forget to just rest.

4) Use cue cards for memorizing things. Some people don't like cue cards, which is fair enough. In medicine we have to learn a lot of names that aren't even related to the condition such as drug names/some medical syndromes. Once you write it down, you can put it to the side. Also great for the last minute cram a day or two before exams.

5) Start early. At the same time I'm not saying start revising 10 weeks before exams. Obviously this is down to personal preference. I think I started too early for this year's exam, but it's not something I regret. It was extremely tiring and boring though. At the same time, last year I started too late and regretted it and it was extremely stressful. Because I started a bit too early (or maybe even perfect timing), I could sacrifice a day or two to take a break or to spend a few extra days on a topic such as Paediatrics. I originally allocated 10 days for Paediatrics, but actually ended up taking 2 weeks to go through all of Paediatrics, but because I started revising early, I was able to give up a few days and shift my other dates around for my other topics.

6) Use revision books to AID knowledge, not gain knowledge. There are some books called Crash Course or At a Glance, which are really good books which gives you a quick glance at a topic. These are good books to help you look up stuff quickly or to double check info, but these are books you should not base your revision around as it misses out fundamental/basic knowledge that you will get from a proper textbook/lectures.

To be honest, I think the key things for revision is to be organized, good time management, rest lots, and try not to stress out too much. Exams are extremely stressful and your anxiety levels go through the roof. Everyone will be feeling the same so don't think you're the odd one out. On top of revising, you might still have to go into placement as some unis only give you 1 week of revision (where nothing is timetabled), so you'll need to be able to balance going to placement and revising. If you aren't organized, your revision will get quite messy. At the same time, don't start skiving placements so you can revise because at the same time, you can learn/revise while on placement. Sometimes really useful tutorial sessions will be held and you can learn/revise during those sessions. To be honest, this whole revision business sounds a lot harder than it really is. You'll know what to do when it comes to revision.

Hope this helps!

I'm baaaaack!

Well it's certainly been awhile since my last post. Apologies. I've been revising for my exams. Finished exams  so I suddenly have a lot of free time. Quite weird. I've technically been studying for over 6 weeks for this exam which felt a lot longer as it just kept dragging on and on. It didn't help that the other years have already taken their exams/have left for winter holiday already. It's gutting when people are away back at home or on vacation and you're stuck in your room/library revising all day, every day.

Today I got my results from my exam and good news: PASSED! Managed to jump over another hurdle. Next hurdle: Finals. Scary! To be honest these exams meant a lot to me. I wasn't very happy with my performance in last year's exams and promised myself that I will never make the same mistake and study harder and work harder. I pretty much declared this year as a "comeback" year. I promised myself to go into placements and actively learn. So today when I went to get my results, I was very nervous. I was confident I had passed, but there's always that little bit of doubt in the back of your mind. The relief when I saw my results. Phew. I think I can officially say that this has been a successful comeback year. I have regained my motivation for Medicine and during the 2nd half of this year, I have regained a lot of confidence. I got to say - it's been a good year (despite the highs and lows).

Along with my results, I have received my schedule and placements for next year. Starting off in A&E, so it will be a very quick and hectic start! Should be very interesting though. Now that exams are over and that I've gotten my results - I can finally relax. Get back to normality. Do what I enjoy and meet up with friends. It was a tough exam period and I cannot wait to go back home. See my school friends. See my parents. Celebrating Christmas and New Year with the family. It will be nice. It will probably be my last proper winter holiday as next year I will be revising for finals as my final exams are after winter holidays. I will definitely have to make use and enjoy this winter holiday as much as I can this year. It's been a very tough road. Scarier thought: after next year's winter holiday, I will be working as a proper doctor in a hospital somewhere during winter holidays! Wow. It's getting close!

One step closer to being a doctor!

Anyways Merry Christmas to everyone and good luck with interviews!

Revision Time Again.

So exams are in 3 weeks. Truthfully, I'm not as nervous about these exams as I was last year. Last year was a disaster. It was horrible. Actually those exams last year could be deemed scarring. Worst experience ever. I have been constantly telling myself that nothing can be worse than last year's exam. This year, it is fairly obvious what we need to know for our exams and it has been clearly laid out for us. I think what's making revision difficult is that we still need to go to placements. We only get 1 week of revision. Consultants expect us to be on the wards 9am - 5pm and by the time you get home, you're exhausted. On average, you're looking at around about 3 hours of revision time. I am finding it quite difficult to juggle and obviously have to adapt my revision style to my placement schedule. I am quite used to staying up quite late to revise as I work best at night. On top of that, I am on my Neurology placement, which is an examinable topic for our exams, so I'm trying to learn and revise while on placement. Swear my brain feels like it can explode as I'm trying to do so much all at the same time.

The neurology ward in general has been interesting. We have got various different cases ranging from stroke to epilepsy to multiple sclerosis. If I had this placement at any other time in the year, I would enjoy it a lot as there are so many examination signs to see and the patient histories are really educational. As I've mentioned above, the brain is focused on revising so any time I catch a break, I am heading to the library or a quiet room to revise instead of spending time on the wards. Because we don't have OSCEs this year, I'm not too bothered about seeing signs, but it is certainly affecting the experience I am having on the placement. It is quite annoying as I find neurology quite fascinating...and challenging, but certainly something that does not bore me. It makes you think and it makes you think laterally as well. Anyways I'm going to keep this post short as I have to hit the books. Exam season is tough. I cannot wait for this to be over and bring on the new year.

Work hard. Play harder.

Close Call.

If you have read my previous post on exams...you would have noticed that this exam was very difficult and I was fairly convinced I had failed. From last day of exams to results...I had 7 days to ponder and scare myself/reassure myself. Easily the most anxious 7 days of my life. First day post exam - I swear I was brain dead. I couldn't do anything properly. At the same time - I was in a bit of a depressed state of mind. Also found it very difficult to sleep. Mind you, I'm not the type that worries about stuff. I literally am a happy-go-lucky/care-free person. I rarely worry about things.  Thank goodness I got to go to London for the weekend to watch a concert, which allowed me to get my mind off of exams and just to relax.

Results day - woke up at 8am...pretty much tossed around in bed for the next 4 hours as results aren't released until 2pm. Worst bit is that I have to go to the medical school to go see my results as for no reason the school does not post them online.

"Results are out...it ain't pretty." - the text message I received from my friend at 2:10pm. When I read the message, I felt my heart drop. As I got closer to the medical school, I could feel my heart racing. I then saw classmates standing outside the school. Some crying. Some cheering. Some looked in shock. I really didn't know what to expect. The short walk from the entrance to the notice board where our results are posted was probably the longest walk ever. Next comes the difficult bit. Finding your student number in a list of 280 other numbers. "Should I check the fail list first? Or just try to find my number in the pass list?" My gut went with looking through the pass list first. Thank goodness our numbers are in numerical order this year. Page after page....I finally found my number. I passed my exam! Then curiosity won me over and I took a look at the fail list. I was in shock. The phase director had failed 20% of the year (50+ students). Wow. She actually kept her word about it. I was disgusted by the number of students she had decided to fail. Ridiculous. As time passed, more of my friends came in to check their results as word had spread about results being out. One by one I saw students come through. Saw a couple people crying as they had failed their exams. Thinking about it - we were all top of the class students. Failure...is probably something we have never really experienced before, so for those who failed their medical exams it probably came as a shock. By the way - usually only 10-15 people fail their exams. In our last two years, my year had set the highest passing rate. The academic department was proud of our year. In 6 months, we went from the highest passing rate, to the highest failing rate. Obviously there is something wrong with the exam and not us.

Unfortunately a few of my close friends had failed their exams. I know a few people getting kicked out from the course from failing more than 3 times in the course. A couple of people had failed and had such a bad experience from these last 6 months, will be quitting medicine. It's really a shame that one phase director can put so many people off from medicine and possibly even change the future of so many students.  Lots of students had lost a lot of confidence because of these exams. These exams disgust me especially knowing the school had screwed up badly with these exams. Pass mark for our exams are usually at around 47-50%. This year our pass mark was around 40%. OBVIOUSLY something wrong with the exam if your pass mark is that low. I surely hope the school does something to resolve this as I think this is unacceptable. Yes I am angry at the school. Yes I am annoyed. Yes I know I passed, but knowing the pass mark was that low - I feel like I didn't pass my exam as it was not a fair exam and not a fair way to examine the knowledge I had gained in the last 6 months.

What I had experienced from these exams, I am a bit hesitant on even recommending the school to prospective students. It's really a shame how poorly this has been handled. Hopefully the school will regain my confidence in them in the new year.

Brain Torture.

As some of you know, I had exams about a week ago. Had 2 written papers and 1 practical (OSCE). It could easily be the hardest exam I have ever endured. I was mentally drained after each exam - I had never struggled so much in an exam. Our year had our exams re-written to a new format so we were going into the exam blind as we were told 3 days before our exam that the specimen papers that were put online are not representative of what we will be examined on. Instilling so much confidence into us (sarcasm). So pretty much we were all pooping ourselves prior to exams as we have no idea what to expect. We didn't even know what to study or how to study for this exam so the general consensus was "We are so screwed." It didn't help that we were told that the previous year 1 in 5 students had failed (20%). The scare tactics had been brutal and was pretty much messing with our confidence (quite unprofessional of the director to be honest). We were also told that the director was going to fail 20% of the year again so everyone was extremely scared. Horrible way to go into an exam.

Anyways the first paper I had was multiple choice and I swear once I finished the exam it felt like someone had continuously kicked my brain. I couldn't even think straight afterwards. The exam was 1.5 hours and the exam we took was definitely for a 2 hour time limit. I had BARELY just finished the exam. I was on my last question with only 10 minutes to spare. Didn't even get time to check. Mind you I'm not a slow exam taker...for the last 2 years I have finished my multiple choice papers in 30 minutes and the last two years my exam had 90 question and a 2 hour time limit. This year we had 60 questions with a 1.5 hour time limit. Each question was a massive paragraph to read. It was really frustrating as it takes just a minute to read the question. You seriously start to wonder if anyone had checked the exam paper and tried doing it to make sure it is possible to finish the paper in 1.5 hours. I had several friends who couldn't even finish this paper. Most people only did about 40ish questions out of 60. What a way to start the exam week.

Next day was the OSCE practical exam. 12 stations. 6 patient histories. 6 physical examinations. I was fairly confident going into this as I feel that I'm strong at doing practicals. Anyways the exam was 2 hours and it was so hectic and a lot more difficult than I had expected it to be. Should've known if I had based it on the previous day's exam. The instructions that were given in each station were long and very confusing. It would be like "Please do _____ examination on the patient BUT do not do _____, ______, _____, and _______; BUT remember to assess _______." Mind you the time you take to read the instructions is part of the time you're supposed to perform the physical examination so the longer you take to read, the less time you have to do the physical examination. You're already nervous and anxious, so when seeing such unclear instructions your brain gets all jumbled up. Personally I thought I did okay in the OSCE. Did however watch one examiner fail me in a patient history station for no reason. Everyone else in my circuit was complaining about the same examiner as he was giving everyone just half marks and was being very stingy/strict. Quit frustrating.

Final day was modified essay question paper. Obviously every one was petrified of this exam as based on how the last 2 days went - this exam will be ridiculously hard. Also because a lot of people couldn't finish the first paper, a lot of people were relying on this final paper to pull their mark up. This year we have to pass our written papers overall and pass the OSCE individually. For the first time in 2.5 years, people were studying prior to the exam. Usually we would all be standing around and being really relaxed. The air was so tense, it was ridiculous. My heart was thumping and I saw people being sick right before the exam. The nerves were through the roof. Got to the exam...and oh....my....goodness. We were asked really rare conditions which were probably mentioned in 1 slide of a random lecture. Again more people got up to be sick in the toilet. One girl passed out in the final 10 minutes of the exam. Some people threw the paper on the floor and just left in disgust. What an exam.

"Time is up. Can everyone please stop writing and close their papers."

I have never heard such a quiet exam hall after the exam. No one was celebrating as it was our last exam. No one was cheering. Every one looked shocked/disappointed/upset. People left the exam building in record time. The mood was quite solemn. No one was in the mood to do anything. Had lunch with friends and most of my friends had lost their appetite. To be honest, when I finished that last exam, it was the very first time I said to myself: "I am going to fail." I was already thinking how I was going to tell my parents. I was so convinced I had failed it was eating me up inside.

Medicine is not easy. Again confirming my belief you have to be mentally strong to study Medicine. It is mentally and physically grueling. You have to be determined. There will be several up and downs as I have faced in this new phase. Probably the worst 6 months of medical school I have ever endured. It was like going through Medicine Boot Camp. Medics certainly do have a crazy life. It is never a straight line. Never take it for granted you're in medicine - anything can happen.

5 More Days.

So yesterday it finally set in...the sense of impending doom - exam is just around the corner. It has been a very tough revision period. It was particularly hard to muster up some motivation as it is quite weird to have an exam so soon (as I just had an exam in May). I think I'm still recovering from May's exam - it was brutal/traumatizing. Horrible experience.

I've spent about 6 weeks revising now, and I feel like I haven't really learned anything, which is an unsettling feeling. Worst bit is that no matter how much I study/revise, I am not going to know everything. That's the thing with Medicine, it's just a bottomless pit of knowledge. Give me another month, I'd still find something to study. Went to look at specimen papers earlier today - had a semi-realization. No book will teach you how to pass a clinical year exam. It seriously is common sense. I mean I went through a whole paper and I was like "...nothing I've studied has been asked." Then I realized clinical questions is the application of knowledge. Take the basics and apply it to the question. No book will teach you how to diagnose. It is a matter of taking what you know and putting it together to form an answer...like a puzzle. After 2 years of medical sciences, you forget that Medicine isn't about 2+2 = 4. It's more abstract and requires critical thinking and pattern recognition. And then I kept flipping through the specimen and seriously some of the questions they ask really deserves a fat: "What...?" And then you look up the answer in a textbook and find the answer in tiny fonts as a footnote at the bottom of a page. Seriously think some questions are put into exams just so it's impossible to get 100%. If anyone ever gets 100% in our exams I will personally go to them and bow to them. Then again I forgot how disliked my year is in the medical school so I'm pretty sure there will be questions on the exam where you just want to pick up the paper and throw it at someone.

Anyways...looking forward to end of exams and at the same time I am scared out of my mind for this year's exam. Ugh. ALMOST THERE!

Practice Makes Perfect.

I was signed off from placement on Monday so I haven't been doing anything particularly interesting other than revising for exams. Met up with a friend on Thursday to do some physical examination practice on patients at the hospital. As you may recall in my first attachment back in the summer (doesn't seem that long ago...time flies) I was drilling Cardio an Respiratory Examinations. Well exams are in 2.5 weeks so I got to get drilling on the rest of the examinations.

So we went and practised Abdominal, Shoulder, and Knee exams. Got that down pretty quickly. Never really had trouble with those examinations to be honest. Then we practised Cranial Nerves, peripheral neuro, and hand examinations. We did these with each other as these exams have quite a lot of steps. Before practising, I was hopeless at Cranial Nerve exams. I was not slick at all and obviously needed some serious practice. After a few attempts, I have finally gotten it down and was starting to get slicker at it. Did the same with the other examinations and I could definitely see an improvement. I was starting to feel much more confident with my examination skills and a bit more confident for my OSCE exam. Have arranged another physical examination practice session for Monday so hopefully I'll continue to improve and get better at these things.

Today I finally reached the last system to revise (Gastrointestinal). It surely doesn't feel like the last unit as my binder is still full of notes and it just doesn't seem real that exams are so soon. It's really weird. Most of my friends and I agree that exams don't seem near and the panic still hasn't set in. Generally been feeling quite unmotivated so I constantly have to remind myself how close exams are which results in mini panic attacks/a kick up the ass. I guess it kind of works as I've been revising furiously for these last few days and really pushing to get ahead of my revision schedule to give myself an extra half week of revision for anything I'm unsure of. At the moment I have scheduled in 1 extra week prior to exams for random revision/going over sample questions. Hopefully if I work hard enough I can make it 1.5 weeks of extra revision time to actually properly learn Microbiology. I swear Microbiology is my new nemesis. It used to be histology, but because we don't do that as much anymore...Microbiology has quickly taken Histology's crown of being my nemesis. There are so many things to remember! And all the stains for the different bacteria. Mental.

Pharmacology comes close behind. Drug treatments for Cardiovascular disease and respiratory are fairly straight forward. The minute you get to Dermatology...oh wow. You start feeling like a walking BNF (British National Formulary - it is a book of drugs)...but more like a BNF written with fading ink. Put some new drugs into my brain...the old drugs fall out. Dermatology...endless amount of drugs. So many names as well! Half of them I can't really spell! I can picture myself writing drug names in my exam and writing the first few-ish letters and then squiggling the rest and making sure it looks like the drug I'm thinking of. Thank goodness spelling doesn't count in our exams! As long as the word is recognizable they will take it.

My Oxford Handbook of Clinical Medicine is also finally getting beat up. It had been in mint condition for 2 years and FINALLY it is getting used...and I am seriously using it to death. Also random note - think I might be getting tennis elbow as my desk isn't great to write on as it is fairly deep. That means my elbow is constantly resting on the hard surface and sometimes I can feel my hand go tingly and numb. Also my elbow is sore from resting on the hard surface. The things you sacrifice for exams. Sacrifice sleep, good food (yay for quick microwave food), social life, going out, sanity, blah blah blah, and now sacrificing joints! Prospective future for my body. YES!

I hate revision. I miss lounging around and being lazy.

Exam Preparation.

To be honest...I haven't really done anything in placement, hence, the lack of updates. As you probably noticed from previous posts, my exams are coming up which involves 2 written papers and 1 OSCE. It's my first year of taking OSCE and doing more clinical based papers, so I'm quite nervous as I don't know what to expect. Yesterday, I finally got an idea what the OSCE will be like though as the school held a mock OSCE session for the students.

Essentially, our OSCE will be 6 stations of patient histories, and 6 stations of physical examinations. Each station will be7-8 minutes long. Before going into the mock, I had an impression that it will be really difficult. To my delight, the mock turned out a lot easier than I thought. Obviously could have done better as I didn't study for it (haven't had time to) or really practice for it. All in all, it wasn't too bad. I do have to work on making my examinations more slick and quicker as I take too long examining the peripheries. For example in Cardiovascular examination, I spend too much time looking at the hands and face. I think I need to just quickly glance over the hands and really just scan it instead of really looking at every single detail. Obviously the most important part of the exam is to examine the chest and I felt that I spent less time on the chest than the peripheries. Again, I think this is down to practising more.

It was really nice getting feedback from people on how I did in the mock OSCE and I now know what to focus on. Prior to the mock, I wasn't too sure what I needed to work on so I will be making a trip to the hospital tomorrow with one goal in mind: get slick at examinations. It should be good and I'm quite determined to get this down as the OSCE is worth 70% of our mark. In terms of history taking, it has always been my "strong point" as I do enjoy talking and I feel that I have a really good logical system of asking questions. In a patient history you would ask Presenting Complaint, History of Presenting Complaint, Drug History, Family History, Social History. Once I get that in my head, I find that asking questions and getting info from the patients quite easy. During mock, I was also helping out and was a patient for a station. Some people don't have a system at all and you can tell as their questions are all over the place. It's nice to see the level of history taking other students are at as it gives me a good idea of how much I need to work on my history taking skills.

Other than that.....3.5 weeks until exams. Eep.

End of Placement 3.

What a placement. It actually went by a lot faster than I thought it would as I hated my first week of placements. In the end, it wasn't too bad. Definitely found out colorectal surgery is not for me. I can never seem to orientate myself in theatre especially during laparoscopic procedures. Everything looks the same! Just bowels here and there. Clinics were alright - completely understand why consultants hate it though. It's usually the same old things - over and over again. Only been to 2.5 clinics - and to be fair - it was starting to get repetitive and boring. I must admit, I am a bit embarrassed by the fact that I only turned up to ward rounds ONCE in the entire 4 weeks of placement. Oops. 7:30am ward rounds are too early - Note to self: don't get admitted as a patient to a hospital with 7:30am ward rounds - no wonder most of the patients we saw on ward round were cranky. You're ill/in pain and you're tired - 7:30 am a team of 5+ doctors (have seen teams of 10) crowd around your bed - doctor takes a feel/ask a few questions and then disappear. As a patient, that would really tick me off, but then again I'm not the most cheerful person in the morning.

What else have I learned on this placement? As previously mentioned in an earlier post - common sense takes you a long way. Oh and some consultants are actually human and love to talk about other stuff other than medicine. And again especially at busy hospitals - medical students are probably the least important things in the hospital - be prepared to get ignored/no one caring about you. That's reality and you just have to be proactive and be responsible for your own learning.

Next placement will be in endocrinology. Don't know what to expect; however, I don't even think I will have time to go into placement as exams are around the corner (December). Need to really study and start focusing. Can't tell you how stressed I am - it's mental. Like most students - I hate revising. The only thing that keeps me going is the future. I keep telling myself that once these exams are over I can slack off again and it'll be a year before my next exam. Can't wait as we just had our year-end exams in May - so it's only been 6ish months. The thought of 2nd year exams/revision still scares me - it was tough/a nightmare. At least this year's December exam will be more clinical (what I like) and not as science based. Still a bit lost as to what to study. Just hoping the best and hoping that I'm studying the right material as this year - we've hardly had any guidance. Eep.

Common Sense.

On tuesday at clinic my consultant looked me in the eyes and told me: "No matter how smart you are, in order to be a successful doctor, you must have common sense." Since then, I can't stop thinking about what he said.

So I've started revision for my December exams and as I'm studying up on management and treatments of conditions, "common sense" suddenly pops up. I realized I can know nothing about the disease, but if I know the symptoms from a history and use common sense - I can figure out how to manage a patient and treat. What my consultant told me on tuesday was really starting to click.

Clinical years of medicine is all about logic and common sense. A person can study all they want and flip through every textbook and know everything, but without common sense: they won't know how to apply their knowledge. It's all about going back to basics. Picking out key bits in a patient history and focusing on it. Unfortunately, in pre-clinical years of medical school - students tend to forget what is common sense. 2 years of pre-clinical almost trains your brain to just retain information and splurge at exams. Because questions in exams are structured in such a detailed manner such as where cells of something is asked - common sense can't really be used. It's either you know the answer or you don't. It's that straight forward. Now in clinical years, you can work your way through a history and physical examination. It's really difficult to describe but in high pressure situations, you got to stop, relax, and think. Think basic and work through all the clues and start piecing the puzzle. Lots of people have the tendency to just jump to the most ridiculous diagnosis as they panic and don't think how one symptom can lead to a sign.

It sounds easy, but as a medical student it is difficult to remember to just use common sense. 2 years of pre-clinical medical sciences in our brains - we can't help but panic and just dig/try to remember information/answers that we crammed for exams. There were times where I would get put on the spot with a question and I would panic. My consultant had told me off a few times for blanking out as all I need to do is just stop trying to dig for an answer but instead work it out. I guess the closest thing I can relate it to is that in maths we learned 2 + 2 = 4. By now we've all memorized it - don't put any thought into it whatsoever. It's kinda like that in medicine. We see 2 + 2 = 4 (symptom + symptom = disease x) - easy. Sometimes we don't know the answer so when we get 1238 + 236, we will panic. Our brains will go "I haven't memorized this!". Instead break it down and try and link them together to come to your answer.

Anyways I hope that made sense. But only now, after 2.5 years - it has clicked. Medicine is all about common sense. We can't memorize everything. At the end of the day we'll need to use our brain to solve/work out things. It won't all be 2 + 2. But as we encounter more problems, we learn more. The beauty of medicine - never ending knowledge.

The Key is to be Proactive

Have been in placements for about 10 weeks now and I have had many ups and downs as you have read in my previous posts. After looking back at my placements, I've realized that my best experiences had been when I am being proactive. Being active in learning and stepping out from my consultant's shadow. In my first placement in the summer, I put a lot of effort into taking patient histories and doing loads of physical examinations (cardio, resp, and abdo). 2nd placement...did a lot of ward rounds - definitely seen a lot. For comparison sake - first placement I took about 10 patient histories and have done 4 cardiac exams, 3 respiratory exams, and 3 abdo exams. 2nd placement: 1 patient history, 1 shortened peripheral nerve exam. Poor showing in the 2nd placement. Yesterday, I did a group revision session on cardiac, resp, and abdo examinations. I knew how to do those examinations quite well and knew what I was looking for and can easily explain positive findings. The minute we got into neuro and musculoskeletal (MSK) exams...I died a little inside. I didn't know what was going on. Okay well MSK was easy to follow as I'm quite familiar with joints and those tests...but neuro was painful. I obviously didn't know how to do these exams as well as the cardio, resp, and abdo exams and it just felt horrible how lopsided my learning has been. Thinking back - it was because I was really proactive in my first placement. I had put a lot of effort into seeing patients and doing examinations. These last 2 placements - I've been...how should we put it...lazy.

You might ask: why suddenly the realization? Yesterday I was in clinic in the afternoon and my consultant told me to go take patient histories of the new patients in clinic and to come back and present the histories to him. While presenting, my consultant would ask questions dealing with the presenting complaint and about the differential diagnosis. It really made me think and be on the ball. When I didn't know something - he would teach me what to look for in a history and I realized: "I'm actually learning and remembering this." Once clinic was over - I actually had a good time. I felt independent and a lot more confident in my history taking skills as I got to present my histories and then got quizzed on it. I also realized that I was quite rough with my history taking with my first patient but by the time I saw my 3rd patient - it was easy and straight forward. It was a great feeling and a great confidence boost.

Now I'm sitting about - pondering - actually no...stressing about exams (OSCE + 2 written papers in December). There's no way I can pull off taking good histories and performing examinations without practice. I need to be proactive and do what I did in my first placement. Make a schedule and follow it. Be involved and just take a step away from my consultant and tell him that I need to practice. There isn't much point following him - I've got a good idea what the specialty is about already. I need to see more physical signs and conditions to start seeing patterns and recognizing things quicker. 4 more weeks of placements - I need to get back on the wards and talk to patients!

Start of Clinical Years.

Finally got some free time to make a post. First want to thank those who are still following me on my blog as I really do appreciate it.

So I finished my 3 exams (MEQ, Multi-Station, and EMQ) on May 5. 3 torturous days as predicted. To be honest - The MEQ and EMQ exams weren't too bad as I adapted a new way of studying which is better suited for those two exams; however, I neglected the method needed for Multi-Station exam. Consequently, I did suffer a bit in my Multi-Station exam. It was horrible. I didn't exactly start at a great station either. I knew how to do the questions in my first station but the next 4 stations shattered my confidence. I did not study the things asked and it was a horrible feeling. With every station I lost more and more confidence and was starting to think pretty negatively. At one point I even asked myself if it was possible to get 0% on the exam. It was grim. After 2 hours of absolute shattered confidence and the horrible sinking feeling - I was hoping like no tomorrow that the EMQ would be much better. Thankfully - EMQ was quite okay and I didn't have too many difficulties with it.

Fast forward to May 19. Results day. My university requires us to go into the medical school to get our results so the journey to the school was long and nerve-racking. I don't think I have been so nervous before. To my relief I had passed and cue celebration. We still haven't received the breakdown marks of our 3 papers, and I'm looking forward to see how I did in the multi-station paper. Last year it was my best paper of the 3...I don't think that is the case this year. Who knows - maybe I've got some pretty amazing guessing skills.

Just the other day I got my first clinical year schedule and it looks really crammed and hectic but after looking at it again - it isn't too bad. The major downside of starting clinical years...is the lack of holidays. I guess they're trying to prepare us for the future? From what I've heard from upper years - this is the time when it hits you - you'll be a doctor in 3 years and it is quite a frightening thought. I swear the last 2 years FLEW by. Freshers week felt like it was only a few months ago.

Anyways just wanted to do a quick update and hopefully my next post will be soon. :)

5 Weeks.

Well okay not exactly 5 weeks but close enough. Anyone care to take a guess 5 weeks until what?

If you said exams...you are CORRECT! It has come to that time of the year that every medical student dreads - EXAMS. Well for my university...not sure about others...passing the year 100% relies on 3 exam papers which are done 3 days in a row. Stressful much?! I dread it so much. It can easily be the 3 worst days in my life. No matter how much you study you will not know everything on the paper. Unlike back in school - you study...you go to the exam...you know everything - easy. Medicine? Study like no end...think you've covered everything...get to exam day and first page of the exam - BAM - you have no bleeping clue about the question. It is BOUND to happen. Now as a 2nd year medical student we have to also know last year's material so technically we will be examined on 2 years worth of knowledge. Not like one year isn't hard enough eh?

I have started studying since end of February...now I am about 3/4 way through the material. Now thinking back...I don't think I remember really anything from what I studied in February (which was all of last year's material). Great. Oh and NEVER look at a specimen paper in the middle of revision just because you got curious or whatever. With no doubt you will most likely scare the crap out of yourself as you'll see questions in there that you have no clue about and then cue panic attack/major stress. I made that mistake a few days ago...and I nearly cracked, but I haven't actually studied the section that the question was aimed for, but still - it was not a pleasant feeling.

The only nice thing about only having 3 papers is that we can get it all done with in 3 days. Nice and short - just extremely torturous. At least now having already taken an exam last year, I know now what to expect in this year's exam and will be more prepared. Last year, I had absolutely no clue what the exam would be like. Armed with experience I think I am a bit more confident this year than I was last year. One major difference is that I started studying MUCH earlier than I did last year so I won't be rushing through revision and causing unnecessary stress.

5 weeks...jeez. I'm really scared. Haha. Instead of losing an hour sleep can we possibly increase the days to about 30 hours just until exam time? It would be very useful. Oh and to make matters worse, the SSC attachment I have been talking about...well my final report (2500 words) is due in a few days. Great...time to wave goodbye to good quality sleep and hello long hours of studying through the night!

That's It?

After some good banter after our critical analysis presentation for our SSC research attachment, we were told by our supervisor that we essentially will not go back in/see him until the LAST day of our attachment which is in 2.5 weeks. In the meantime we are supposed to do our final task: data analysis. I am absolutely ____ing my pants about this as I do not know anything about stats. Doh! This is definitely going to be a REALLY tough task and thank goodness we have 2.5 weeks to figure it out. At the same time when I found out we will not be going in for 2.5 weeks you would assume that I would be doing a victory dance the minute I left the building. Wrong. I was actually really bummed out. I hate to admit it, but I have THOROUGHLY enjoyed this attachment and I am having a really good time! I think it is because I have an amazing supervisor coupled with amazing group members as we get along extremely well. Once you get into med school and make medic friends you tend to talk about medicine with each other, but with my group members - we all play sports and we are quite athletic and to be honest - we NEVER talk about medicine when we are around each other. We actually have something interesting to talk about and it is quite nice. Such small things can make quite a big difference.

As well, we were promised at the beginning...okay not promised...more like notified that we will probably get to go to the gait lab to try out the equipment and test out what the volunteers will be going through in the trial. Because our supervisor has to leave for conferences and stuff, we apparently will not be going in. I was really excited about going to the gait lab and now seeing that we won't go in until the last day - we obviously will not be getting the opportunity to try out the machines. Boooooo. Super bummed.

So essentially our last day of attachment is 2.5 weeks away and that means we have already been at this attachment for 3 weeks now. It definitely does not feel like 3 weeks and I know earlier I was whining about doing a research attachment, but I loved it. I think the main reason is because of the tiny little things like a great supervisor and a great group really made things a lot more enjoyable. On top of that, my attachment is very clinical based and it was nice not being in a lab all day (actually we never went to the lab) and the hours were quite "slack". Definitely a good balance. Go in just enough to get a feel for the attachment, but at the same time we get enough free time to get some revision done for exams. When I looked at my calendar and looked at the last day of our attachment I said: "That's it?" Before embarking on this attachment I would NEVER think I would be saying this as I thought by the end of this I would be sick of the attachment and hate the attachment. I am soooooooooooooo wrong and I am happy to admit that it was wrong of me to have such a close-minded view of this attachment prior. Can't believe that this is it. Today was my last proper day of being at the attachment. The final session will be a quick presentation and then getting feedback. Wow. Time flies. Scary stuff.

Unnecessary Stress?

Lately I have been getting a bit stressed. And I do not know if I am giving myself unnecessary stress. I've been having a lot on my mind. As some of you know, I am a Canadian and an international student studying in the UK. Just for good back-up should I take the Canadian registry exam so if things go bad or for some reason I have to return home to work I can. I have done some research and some people say take the exam after 2nd year because all the sciences stuff will be fresh in your mind. Some say do it after 3rd year so you have a bit more knowledge about the clinical side of medicine. Then there are some who say after 5th year (aka after graduating from medical school) because I would be more mature to take the exam. There are pros and cons for each year but you know if I am considering taking the exam after 2nd year or 3rd year I should really get thinking. I really do not know what to do. I'm stuck. In a way I am a bit hesitant about taking the exam after 5th year as I am worried I'll forget all the sciences stuff. But on the other hand, 2nd year could be too soon as I need time to study and it is now November...well in a few days it will be November and I also have to study for my final exam in the summer. Might be giving myself too much work! So in a way 3rd year seems like a good time but is it really too early to be taking the exam?

Second, I have a strong passion for surgery. Ever since I had the opportunity to learn/discover about surgery I have been non-stop thinking "I want to be a surgeon". Also for my 2 week hospital placements to shadow surgeons/doctors, I was fortunate enough to be paired with a general surgeon and a paediatric surgeon. Compared to others I found surgery really interesting. Can't believe some people say it is boring and actually would do anything to avoid going to watch surgery. I have been criticized by people that I am thinking too early, but to be honest, it is never too early. I want to prepare myself and really try to find as early as possible what I want to specialize in and whether or not surgery is genuinely right for me. About three years ago I was first exposed to Orthopaedic surgery. I was hooked. I thought it was interesting and I really enjoy sports medicine. When I reached medical school, I have seen a lot of surgeons/doctors teasing orthopaedic surgeons which essentially put me right off. "The carpenter of the hospital." "Oh you hear the hammering and drilling sounds? Ah must be the orthopaedic surgeons working." It seems to be that orthopaedic surgeons don't get enough respect. I personally feel that they should get a lot more respect than they really do as they do help a lot of people's lives feel better. Yeah they might not always be saving a life like a neurosurgeon or a trauma surgeon, but they have their part in changing someone's life for the better. Anyways so after being put off from orthopaedics, I found that I had a huge interest in learning about the heart. So I thought about cardiothoracic surgery. Sounds great. Love the anatomy of the heart, get to save lots of lives, prevent people from dying, and great pathology. Oh wait....it is at risk of getting phased out by them interventional radiologists. Plus the other day I went to attend a talk by an Orthopaedic - Spinal surgeon who discussed about thinking about the future. Need to think if the specialty you want to go in will still be here in 10 years time. He listed cardiothoracic and vascular surgery will be at risk. Great. Hmm. I obviously want to do something that has a lot of potential and has plenty of time to develop and not be at risk of disappearing. I did pay a lot of money and study really hard to get into a UK university and I definitely don't want to spend a lot of hard work at training into a specialty which could diminish in a few years time. I like to be on my feet, and excited about the future. The new technologies for surgeons and a field that is developing.

So the other day after attending the spinal surgeon's careers talk, I gave orthopaedics another look. Like it is a field that is developing and we have an aging population. There will be higher demands for hip replacements, knee surgeries, etc. So yeah I'm now jumping back and forth. Deep inside me I feel like I will end up in orthopaedic surgery as I always tend to go back to my first choices. Orthopaedics clicked with me early on and yes pathology isn't huge...but I could do a sub specialty into something that may involve interesting pathology.

Some others I have thought about are surgical oncology and ...well that's as far I have gotten to for now. My mentor is a surgical oncologist and specializes in breast cancer and after having a brutal four hour lecture from him, it actually seems quite interesting. Cancer will be out there for a long time and I don't see it disappearing anytime soon. It is constantly developing. Huge research goes into it. LOTS of people are affected by it. Very interesting pathology. Quite enjoyed it last year when we had lectures on it.

So you're probably thinking:

1. Are you done ranting?
2. Ok so what's the big deal? It isn't like you're graduating next year.
3. ZzzZzzZzz

On top of what I mentioned earlier, to become a surgeon you need a CV that stands out from the rest. What did I do last summer? Relax aka did absolutely nothing. My classmates? Oh well they volunteered and worked at their GP surgeries, went to the hospital to shadow surgeons and doctors. Great....my CV is already looking real unique now...more like in a bad way. So now I'm on full blown motivated mode. To be honest I need to speak to someone about my future. At the moment we are in the midst of changing our mentoring program and we still do not have our new mentors. I don't know how much longer will I have to wait to get my new mentor and I don't know how much longer I can wait with so much in my head. I don't know who else to ask other than my mentor from last year as he seems quite knowledgeable. Maybe I should have a chat with him, but he is soooo busy I feel bad wasting his time when I am no longer his "mentee". Hopefully he'll have the answers. If not, time to search for someone to ask.

Sorry for the long post. Hope everyone is having a great time at uni still and enjoying medicine!

First Year Medicine - OFFICIALLY DONE.

Great news - I PASSED! Yay! I managed to pull a 4 as well so I was quite pleased when I saw my mark. Sadly my celebration with my other friends kind of abruptly stopped an hour later when we got a phone call from one of our good friends that he has failed and need to do resits. We were quite shocked as this guy worked and studied quite hard and it was shocking to see someone who worked so hard has failed. It was definitely a sobering thought and snapped us out of our "cloud 9" and really showed us that it could have been easily any of us who fails. I really felt bad for him as he does not deserve to fail due to all his work (he started studying PRIOR to Easter break). We all wish him the best of luck and pass his resits!!!

On a more happier note, I just got home from a massive party - Drink Medsoc Dry. It was amazing. Who can complain about 50p drinks?! Started drinking at about 7:45pm and decided to leave at 10:30pm. We decided to head to a club to have some real fun and went to a great club. Great music and it was PACKED. There were so many people there! Eventually more medics showed up at the same club and it was a lot of fun. Definitely had a great night with friends and it was a good "goodbye" as I am leaving tomorrow so I won't see my friends again until September.

All in all, what an amazing first year of medicine. It is a great subject and one I definitely enjoy. Medicine has a reputation that it is hard/difficult and I have generally thought it was quite okay. After exams I realized how tough the subject can get and definitely do NOT underestimate the exams. They can literally ask ANYTHING. Learned loads this year - especially on how to study and work throughout the year so next year when it comes to exam time I won't be pulling super late nights and almost to the point of cramming.

2nd year of Medicine - Bring it on.

1 day til Results.

I didn't think I would be nervous about results as we have been assured that about 5% of the class would fail, but I AM STILL NERVOUS. It is really hard to say how I have done in the exam and I have no clue what sort of mark I'll be getting. Back in high school, after an exam, I usually have a sense of how I did and can ball-park the mark that I will be getting. This time, I seriously have no clue at all. I have a feeling that everyone will be scoring around the same mark and 1% can make or break you pretty much - scary stuff.

I also don't understand why I have to physically go to the medical school to see my results...why can't we get our marks online like most schools? For the home students it isn't that bad as they can always go home, but I am stuck in England for 2 weeks with nothing to do waiting for results to come out and I can't go home in between. I also don't like crowding around a little pane of glass trying to find your student number and along the way see other people's marks as well...quite nerve-racking but I guess it gives you a bit of competition as you can see how your classmates have done.

Wish me luck for tomorrow and hopefully I get the mark I am aiming for and PASS. I really put a lot of work into studying for the exams and will be extremely disappointed if I end up with a 3 (or fail). Not trying to be stuck up or anything - please don't get me wrong - but for the amount of effort I put into studying - I hope my work pays off and get me a 4.

Will update again when I get my mark and hopefully be a very happy medical student. :)

Reality.

Yes finally done exams!

If I had to summarize my medicals exams in one word it would be: Reality.

As a medical student we are all used to being top of the class and breezing through exams. It is quite rare to not know how to do something, but wow talk about crashing into the reality wall. I had 3 exams in 3 days: MEQ, Multi-Station, and EMQ. Overall the exams were challenging but it was do-able. It was a good reality check that there will be times where you won't know how to do something and you are going to have to overcome the feeling. First day was definitely tough. I went back to my room and I just felt really dumb and my confidence level was pit bottom. It was definitely hard to pick myself back up but I was pretty determined to make it up by doing well in multi-station and EMQ. All in all I tried my best in all 3 papers and hope I did enough to pass! Results release on June 10 so I guess I'll be camping out at the medical school. I'll probably be a nervous wreck though.

On a lighter note: summer holiday has officially begun! Right after exams I went out with friends and just make up for the last 6ish weeks of complete "hermiting". Then went for a night out with the rest of my medical year - great celebration. Today, I finally got the time to go and play some field hockey in pretty nice weather. Was a bit cold, but it was sunny out and I watched the sunset. Very relaxing. And then in 4 months it'll be the official start of 2nd year of medicine! I'm also planning on going to freshers events as they are so amazing. It is also a chance for me to go to parties with a group of people who I know and have a lot more fun. Also the perfect chance to meet new people and hopefully make some new friends! Looking forward to it.

Final Lap.

So exactly 2 more weeks left until my first exam.

Thoughts?
Eek.

Feelings?
Nervous.

But if I was not nervous/anxious about exams I might question my motivation to study medicine. Nervousness is what kicks you into the next gear. You work 10x harder for your exam as you know it is important and you care!

I've gotten through quite a bit of material since my last post. I am starting to see the light at the end of the tunnel. I'm on one of the last chapters for the year and will very soon be going over my notes briefly for a refresher prior to exams. We finally got our exact exam schedule and I'm a bit iffy about it. Not loving the fact that my first exam will be "Modified Essay Questions" - which is more like one word answer questions. I would much prefer to have the Extended Matching Questions first as it is multiple choice and I guess a better way to "ease" into the exam. Despite seeing a specimen paper already - I still don't know what to expect from the exam. I have questioned myself several times about the amount of detail I've been studying in. I feel that my method of studying is very clinical based so I know the pathology of diseases quite well. But when it comes to the fine details of cell interactions and stuff, I may be a little bit screwed? I really hope the exam won't be that detailed.

I'm pretty determined to do well in this exam as I have put a lot of work into studying. I have high expectations.

Hopefully all will go well and you'll be seeing a happy post instead of a long rant in the near future.