There’s Light at the End of the Tunnel – or is that the Approaching Train?

As we are now in our final year, we have been experiencing the joys of final exams over the past month or so. If the truth be told, the exam season actually kicked off at the beginning of December with the Situational Judgement Test, and we had the Warwick Safe Prescribing Assessment (SPA) exam at the beginning of January (plus the odd mock exam here and there) but it really got underway in earnest with OSCEs (structured clinical exams) on 12 February. With just a month separating the OSCEs and our last scheduled exam in the first sit (this is the national Prescribing Safety Assessment), it’s been a tough old run and most of us just want a few days to sleep and hibernate.

After the written component of our assessment (SAQs and MCQs), our cohort was assessed via the OSLER (Objective Structured Long Examination Record) method. There was a very famous Canadian physician called Dr William Osler (he of the eponymous nodes) and I have often wondered if there is a connection between him and the rather clunky acronym for our exams. Maybe I’ll make it my mission to find out when we’re all done – that is, if I still have the energy!

We haven’t got our results from any exam yet aside from the SPA, so these could be my famous last words, but all in all I found the OSLER process quite manageable. We each were assigned a full day and a half day of OSLERs. I was in a group of people who started our OSLERs very late in the week and thus most of my cohort had had their full day before I did. Of course nobody shared specifics of their cases with anyone else, but I was told that the time does pass quite quickly during the day when you’re actually doing it – and I found that to be the case as well. All of the patients whom I examined were really nice and friendly, and it seemed like they really wanted each student to pass and do well. I am always grateful to patients who give up their time to help us medical students learn and be assessed – they seem to enjoy themselves and it must be great fun to watch students come through all day. I might get tired of being examined repeatedly, but none of them seemed to mind that much. Maybe there was more variation in exam technique than I realised!

Recently our allocations to the Foundation Programme were released. This is the region of the country – known as the deanery – in which we will be doctors for the next two years. This was really exciting for everyone, as it’s a combination of a few things – both our educational performance ranking (for which we get 50 points out of 100) and the results of the SJT exam sat back in December (for which we get the remaining 50 points). Our combined score decides our ranking against all of the other 7,000-odd applicants from all over the country (and even the world, as there is a sizeable international component) and this in turn dictates which of the programmes we are allocated to. It’s very exciting to ponder the next step of our lives, and it’s really hard to believe that in a few short months, we will be sent to all corners of the country to start the next phase of our careers!

John

Joshua Galvin : 13 Mar 2018 10:24 |  Tags: John Mbchb Student Warwick Wms |  Comments (0) |  Close comments |  Report a problem

In the Thick of It

We are in the middle of our final exams period, and, as expected, it is quite full-on. These are basically several sets of comprehensive examinations covering everything that we have learned at medical school since starting on the course, and so the topics are understandably really vast. It’s so difficult to even begin to prepare for these exams and I think that everyone has basically just been reading and covering anything and everything that they can, and practicing our examinations all the time, in the hopes that any work is good and useful work – and by and large it seems to be.

By now we have already had our OSCEs (Objective Structured Clinical Examinations) and sat our written papers, and we just have our OSLERs (long cases) to go – more on those below! In previous phases, our exams have consisted of fifteen OSCE stations, and 180 marks each for SAQ (short-answer) and MCQ (multiple-choice) papers. But this time we only had 10 OSCE stations and 150 marks for the MCQ paper (although the SAQ paper was the same 180 marks). It has been really tiring so far, and I’m glad that we have the rest of the week to relax/recover from these exams, especially the written ones – as looking after our mental health is a very high priority at this stage.

Without giving away any information on the actual content of the exams, I can say that the people setting them up did a very good job to ensure that they have all been very comprehensive and that many aspects of the Specialist Clinical Placement blocks that we had in Phase III were covered adequately. We weren’t tested on everything, of course, but there was a sufficient amount represented from various different aspects of our medical syllabus to feel like it wasn’t too concentrated in any one area. Whilst OSCEs seemed to cover more adequately the clinical side of medicine (these are the common, everyday tasks that F1s and beyond will have to do in hospital), the written papers tested our book knowledge about lots of different conditions, as is expected.

It seems like we are all old pros at sitting written papers and at doing OSCEs, since we’ve all done a few rounds of each, but the OSLERs (Objective Structure Long Examination Record) are a new kettle of fish for all of us. We’ve had several practice OSLERs (some more realistic than others) since clinicals started at the beginning of 2016, but this is of course a different scenario – among other things, we are being examined with a real, live patient instead of an actor. And there are other components to the OSLERs as well that we’ve not yet encountered before in the exam setting – having a mini-viva where we are asked about the presenting condition, having to explain a medical procedure to the patient, etc. – so it will be interesting to see how it goes. Hopefully the next time I post, I will be on the other side from all of these exams – wish me luck!

Joshua Galvin : 22 Feb 2018 15:23 |  Tags: John Mbchb Student Warwick Wms |  Comments (0) |  Close comments |  Report a problem

Before the End, the Beginning

Next week marks the start of our finals-exams period, and with it comes the usual mix of emotions. Because so much is riding on the next few weeks, I’m nervous and anxious (I think there’d be something wrong if I weren’t), but I’m also pretty excited and looking forward to seeing what it’ll be like. We’ve put so much effort into the past few weeks, months and, yes, years that it will be interesting to see what sorts of topics we are examined on, and how it comes about. I’m looking forward to applying my knowledge.

On the one hand, it’s daunting because the scope of material we can be asked about is just so broad: the body of knowledge that a medical student is expected to have upon graduation is truly vast. I don’t quite know what I was expecting, but there is just so much to know! On the other hand, we have spent years accumulating knowledge, building upon it and putting it into practice. This in itself is really important to bear in mind when coming up to exams: sometimes it feels like we’ve not learned a lot, but in reality we all know a lot more than we realise or give ourselves credit for. And yet on another hand, I think that by this point most people just want exams to be behind us. We want them to start but, more importantly, we also want them to end.

Our first round of exams this time is the OSCE segment. This stands for Objective Structured Clinical Examination. Normally we have our written exams first, but it’s swapped round for finals – I don’t know why. For this exam (as in Phase II), OSCEs take place on one day. The entire cohort is split in two; half the cohort is assigned to a morning slot and half the cohort gets an afternoon slot. We are split into groups of about 12 students and each of these cycles through a set of ten stations (with a couple of rest stations built in) – and of course several cycles run concurrently. Once the morning group are done, they are sequestered in a room until the afternoon group starts – the purpose of this is to avoid anyone from the morning group sharing information about stations with anyone from the afternoon group. The set-up of doing all stations in one shot is actually fantastic if not exhausting – in our first year, OSCEs were three or four stations spread over four days and everyone was very tired of it by the end of the last day. This way, at least they will all be out of the way at once and we can focus on the written component, which is coming up next week.

One key element to our education process that often gets overlooked is that we as students need to pay due attention to our own mental health as individuals. Since this is such an all-consuming point in a pretty demanding course, it is really easy to let the little things slip – exercise, eating well, taking breaks, etc. We all want to do so well (or even just make it through) that we focus perhaps too much on revision to the exclusion of much else. I’ve started forcing myself to go swimming again a couple of times per week, if nothing else just to make sure I have an outlet for my energy and that I sleep better at night. So far, it seems to be paying off!

John

Joshua Galvin : 12 Feb 2018 09:34 |  Tags: John Mbchb Student Warwick Wms |  Comments (0) |  Close comments |  Report a problem

Final Exams Approaching…

As final exams are approaching, our cohort is getting really stuck into the revision block now and, as expected, it seems like there's never enough time to do what we want and need to do. At least that's how I seem to feel these days - and from what I gather, most other people feel the same. I have a list as long as my arm of things that I need to cover before exams (which are looming ever closer...) and of course it seems like it's growing every day. I'm pretty used to this state of being, however - we've been through this a couple of times before with Phase I and Phase II exams. The only thing that's a little more daunting this time round than previous times is the sheer volume of information - it's really difficult to find time to cover everything!

The med school have been quite good about setting up revision sessions for us, though. We have had several tutorials at our base hospitals and also have some clinical-skills sessions set up as well in the next couple of weeks. These are useful (well, some are more useful than others...) because they allow us to focus our knowledge and highlight where there might be gaps and where we need to pay more attention. It's also very helpful to have several sessions packed into one day so that we can minimise the time spent traveling back and forth to hospital or other places. Every second counts these days!

I think the most important challenge to us as final-year medical students these days is more just keeping engaged and motivated; our exams (well, those we've not had yet) last a month, and remaining energised to stay engaged is going to be the biggest challenge for all of us. There is a level of stress and tension which I think we've not experienced so far. I think we all just need to find the right way of dealing with it.

This morning as I was walking into hospital after parking up (and preparing for another long day of revision), I happened upon a group of ten or so first-year students who were coming in for their Friday-morning 8:00 am lecture. I remember these lectures well - of the 26 Fridays we had in our first year, we had 8:00 am lectures on 24 (not that I counted!). It was so exciting to see them talking and laughing amongst themselves, and ready to spend another day in hospital learning and growing as medical students. That was exactly the kind of inspiration I needed: after feeling a bit worn down and anxious and every other emotion under the sun, reminding myself of what it was like to be a first-year student again (and excited about EVERYTHING to do with medicine) was enough to light the fire under me - for a few days at least!

John

Joshua Galvin : 05 Feb 2018 09:12 |  Tags: John Mbchb Student Warwick Wms |  Comments (0) |  Close comments |  Report a problem

Revision as far as the eye can see

At the end of 2017, we completed our year of Specialist Clinical Placements, which for us was marked by the end of the Psychiatry block, which I actually enjoyed far more than I thought I would. It wasn’t until we’d got to the end of the year, though, that we’d realised how quickly it had flown by! Forty-eight weeks of fifty (with just two weeks off in August) is really hard going, no matter who you are. I always had more time off than that when I was working. At least over Christmas, most of us had some time to relax and some good excuses to be a little lazy. I had the chance to spend some time out of the UK for a couple of weeks, and I’m really glad that I did – it helped me appreciate the West Midlands much more when I got back, and I really needed a change of perspective.

Our final exams start in just over a month, and it’s really difficult to believe that they’re almost upon us. I don’t quite know what to expect. I’ve sat Phase I and Phase II exams (of course) and they’ve been… tough but not impossible. Phase I was relatively straightforward as the content was (mostly) presented to us throughout the course of the year; the pace and the volume was a huge struggle, but it was obviously not entirely insurmountable. I personally found Phase II exams to be a lot more unexpected in content and nature than Phase I, but thankfully they’re behind me and my cohort now. I think (and truly hope) that as long as each of us has kept up with our work throughout the year and has maintained a consistent stream of work over each block, we should hopefully be OK when it comes time to put pen to paper for the Phase III exams.

We have already sat the Safe Prescribing Assessment, a Warwick requirement to graduate (although not, as I understand it, a GMC requirement). Now it’s just a matter of waiting for results and dealing with the consequences, whatever they may be. The prescribing exam tests our ability to interpret instructions given to us by using the British National Formulary (a huge compendium manual covering basically every single drug available to be legally prescribed by healthcare professionals in the UK) and transcribing them onto mock drug kardexes (they resemble drug charts for patients in hospital) and discharge letters. It sounds straightforward but it’s a lot more complicated than one would initially expect. I know that many people, including me, found the exam really tricky.

It’s really important that we med students also look after our physical and mental health. It’s really easy to get in the habit of burying our nose in a book for 12-15 hours per day. But I have been forcing myself to do things like swim and take walks around the neighbourhood. I find it much more efficient to work after I’ve cleared my head, and swimming also helps me sleep better at night so that I’m less sluggish during the day. Is it a winning formula? I’ll know the answer to that in a couple of short months!

John

Joshua Galvin : 16 Jan 2018 12:11 |  Tags: John Mbchb Student Warwick Wms |  Comments (0) |  Close comments |  Report a problem