All 4 entries tagged Finals
May 04, 2021
Apologies for radio-silence since my last blog which was just before my final exams of medical school. The last couple of weeks have passed by in a bit of a blur, a kaleidoscope of exams and anxious waiting for the results.
First of all, the exams. Written exams came first, with 2 papers of multiple-choice questions. I found quite a lot of the questions in these papers tricky – there is a definite step up from Phase II of the course to Phase III (final year). The patients in these questions have more complicated medical histories and the questions require you to think and reason why it can’t be one condition as much as it requires you to know what condition it might be. Overall, I found paper 2 the easier of the two, although I know most of the year found paper 1 easier. I think this is probably just dependent on what we’ve read over in the weeks before the exam. It’s always difficult to gauge how well an exam has gone after sitting it, so I simply tell myself, ‘once it’s done, it’s done’, and keep moving forward. I think I could drive myself crazy if I devoted too much time to going over each question in my mind and casting doubt over my answers. Besides, there was no time to sit on my laurels after completing the written papers as OSCEs were imminently upon me.
OSCE day arrived, and it was an equally daunting, intense, stressful and exhilarating experience. There were 10 ‘stations’ (clinical scenarios) to work through and I felt a definite lull in concentration towards the end. The OSCE scenarios are 7 minutes each and the station usually requires some sort of clinical examination and then you are asked questions by the examiner. It always surprises me that, no matter how much practice you get, there is still something that catches you off completely off guard! However, I think this is good practice for life as a qualified doctor – patients always surprise you, no matter how experienced you are. By the end of the OSCE, I could definitely feel my energy waning, but there was still (just) one exam to go – the OSLER.
I have practiced many of these during my placements but of course nothing compares to one under exam conditions, as the stakes are far higher. An OSLER is a ‘long-case’, where you have to take a full medical history (10 minutes), then discuss tests you want to do and how to manage the patient (10 minutes). The exam usually ends with a communication aspect – so explaining how to take a drug or what a certain test involves to the patient. We have to complete 4 OSLER cases for our finals, all on one day with a short break in between each case. This exam tests everything, from your clinical knowledge to your history taking and patient communication skills, as well as how well you can integrate your knowledge and put it all together. The written exams test what you know, the OSCEs test what you can do, and the OSLERs test how well you can function as a doctor, a healthcare professional. The OSLER day was very long but actually flew by because of how busy it is.
So that’s it – finals done! I then had a week wait until results…and I passed! It still hasn’t really sunk in, but I’ve passed medical school and will be starting my first doctor job come august. In my next blog I will go through some more details about applying for my GMC registration and what my first doctor jobs will be. Don’t miss it!
April 12, 2021
The past couple of weeks feel as though they have gone both very quickly and very slowly. I think that’s just a reflection on every day being almost exactly the same. I’m sure that you already know from my last blog, but I am currently in the midst of the revision block before my final exams in almost exactly 2 weeks. This is week 6 of 8, and I feel as though I have made startling progress so far. Mostly I have been going over things by myself, practicing my academic and clinical knowledge together to try and integrate things and bring all of the knowledge and skills we have acquired over the course into a homogenous whole. The university has also run some practice sessions for us which are similar to the actual final exams – one of these was the GP session I had last week. This session was run online by one of our GP tutors and involved taking a history from a simulated patient whilst the GP watched and then asked questions at the end. Doing a history online is quite…awkward! It is difficult to read a patient’s cues and facial expressions when you can’t see them. However, I think the session went relatively well and I had some good feedback from the tutor. It was also good practice because our final 'long case' exams this year will be online so getting used to talking via webcam is useful.
The last two weeks have also been exciting for a whole different set of reasons. As well as our final exams, we also have to be applying for doctor jobs if/when we finish the course and graduate. This process is complicated and starts at the beginning of final year and essentially you rank areas and then jobs in that area and then are scored based on your Medical School performance, amongst other things. I am delighted to say that I got into my first-choice deanery (West Midlands) which was essential to me as my partner can’t move due to work. This means that we can live together when I start work as a doctor and both commute into Birmingham. I am originally from Birmingham, did my History degree there, and now I’m going back! I don’t know which hospital I’ve been assigned to yet, but I’m not really too fussed – the jobs are essentially the same and I was just keen to be going home and around family and friends for what I’m sure will be a busy and exciting two years of the Foundation Programme. I’m excited to be returning to the second city to start my career as a doctor. Coming to a Birmingham hospital near you! (If I pass my finals that is…)
This week we had a clinical skills practice session at the George Eliot Hospital. I have spoken of my fondness for the George Eliot (or 'the Eliot' as some call it) previously, as the clinical education staff are fantastic and really go above and beyond to make sure we have a good experience. For this session, the clinical education department had set out all the equipment so we can practice our skills on things that come up in practical OSCE exams. These skills include things such as taking blood samples, doing an ECG, catherization, feeding tubes, airway procedures and delivering drugs via various methods. Going over the skills was really good practice and actually reminds us of how much we’ve covered over the course – our training is very broad based to enable us to be pretty competent at a huge array of things. I particularly struggle with catheterisation as there are a lot of steps to remember to make sure infection is not introduced, so having the chance to practice was super helpful. Knowing that a job is waiting for me at the other end is a big morale and motivation booster. Not long to go now.
May 15, 2015
Last week was one of the most stressful weeks of my academic life, but I can now say that clinical finals are over!
My exams were on Tuesday afternoon and Thursday afternoon. I had wanted to get them over with as quickly as possible, so of course I ended up in the last possible session! The morning before each exam went so slowly, and I sat in the house trying to relax but watching the clock from waking up at 6am to leaving the house at 12.
Arriving at the hospital before the exams, it was obvious that everyone was nervous. There were sandwiches and cakes for us, but they didn't get touched until afterwards. After a briefing, we were led to a corridor where we all sat outside our individually allocated room. A bell rang, and we entered the room.
From then we had 15 minutes to take a history and examine a patient, which is quite tight on time. The 30 seconds it took for the examiners to introduce themselves and shake my hand seemed to take forever, but the rest of the time flew by. After that another bell went, and we left the room to think for 15 minutes and produce a management plan. Then it's back into the room for 15 minutes of presenting the patient and getting grilled.
Everyone says that these exams are like your driving test, with, “inspection, palpation, percussion, auscultation,” (or lookin’, touchin’, hittin’ and listenin as I remember it), as the equivalent of, “mirror, signal, manoeuvre.” The examiners aren’t expecting a perfect display of skills. They just want to know that you are safe and that you know the limits of your own practice.
Having said that, as lots of people will remember from their driving tests, when under pressure it isn’t always that easy to perform as well as you’d like! After 2 cases, I felt physically and mentally drained. It wasn't like any exam that I've had before. Although I now know that I did enough to pass, at the time I felt like I could only remember about 60% of the stuff that I’d revised.
The thing that was most interesting in the exams was that most of the patients had clinical signs to find. We spend hours as students trying to seek out just such patients, but so many of them are well in the community that the only times they attend hospital are for the occasional clinic and to help out with exams! A lot of us saw some signs for the first time in finals, and it took a lot of effort not to be too enthusiastic and excited about them during the exam!
Over 4 days 170 students saw 4 patients each. That's a lot of patients, and I think it's incredibly kind of these people to give up a whole day of their time to let us talk to them and prod and poke them to show that we will make safe doctors. I imagine that it's almost as tiring for them as it is for us, but they continue to come and help year on year. It's a timely and important reminder of the respect and trust that people have in the medical profession.
April 29, 2015
2 weeks to go until clinical finals, and I’ve got cabin fever. I spend the days either endlessly reading and re reading my notes, or for a bit of light relief I head to hospital and try and find some patients who are willing to talk to me and let me examine then, and who haven’t already been seen by 6 students that day. At this time of the year, that’s a difficult task.
The university have arranged various lectures and mock exams for us, which have been really helpful. They have the same format as our finals exams, which is that we go and see a patient, take a 10 minute history, do a 5 minute examination and then present our findings, a differential diagnosis list, a list of investigations that we’d like to do, and a management plan. It can be quite gruelling, and I’ve found out that the best plan is to approach each case using the same framework. At least then if/when I freak out I have a basic plan to fall back on!
At the moment most of us spend half the time thinking that we wish we’d sat finals a month ago, because then at least it would be over, and the other half thinking that we’ll never know enough and that 2 weeks isn’t long enough. I’ve been dealing with this rollercoaster of emotions by ploughing through my Easter chocolate in record time, and regularly shouting at my notes. It does seem to help, but my housemate expressed some concerns about me last week. I’m also physically attached to my pocket copy of Kumar and Clarke (the bible), and I suffer separation anxiety when I have to leave it somewhere.
It is nice to see things coming together though. Until recently I wondered if I’d actually learnt anything whilst I’ve been at medical school. I know that sounds ridiculous, but as a graduate in a biological subject you already have quite a lot of anatomy, biology and physiology knowledge. Revising for finals and seeing patients has made me realise just how much I have learnt. Practicing medicine needs a whole new skill set and a different way of thinking to studying pure science, and that is what this course has taught me. I’m far from perfect, but I’ve come on such a long way that for the first time I feel more excited than scared about starting my first job now. Bring on August.