Post-Exam Rambling

Just realized one thing I haven't mentioned here - my exams are over!! :D As I said earlier, this exam was kinda shocking when we had our first paper.. I know it wouldn't concern most people, but I would just jot down some notes for record.

Note: This is merely a record for the uninspiring albeit memory-stimulating exams I had. If you have the least of interest in my studies, perhaps you shall stop at this point for the time being, and consider some other blogs, news or online articles. :) My blogroll and linkroll on the left might interest you.



5 June 2006 - CRL Paper 2
If I were to sum this paper with one word, it would be a "nightmare".

In this paper, basically we are given 100 multiple-choice questions in a duration of 2 hours. Well, some might think that MCQ is nothing, but I can assure you, it is something. In fact, at the end of the paper, most of us came out of the exam hall feeling dazed all over. We could had had a fever for having overworked our tiny brains, regurgitating more facts than it would like to hold.

The fact is, the multiple choice questions are not at all easy to answer. There are some questions which rely entirely on good memories, which unfortunately isn't my forte. It's not that I can't memorise at all, I used to memorise stuff too (duh..) when I was in primary school, with quite some "accomplished" skill. The thing is just that, as I grew to be more fond of concepts than details, I always have this kind of reluctance to rote memorise things which are simply meant to be memorised. It's like, who would have thought that phrenic nerve supplies the centre part of diaphragm and mediastinal pleura, instead of centre part and peripheral part of diaphragm, if not because of memory? (I got this question right by luck, anyway...)

Apart from the memory works, the conceptual questions aren't close to a breeze. Given that we have approximately 72 seconds for each question, it is not hard to appreciate the fact that we have less than ample time to analyze each question carefully and thoughtfully, let alone recheck the answers when we are done. By the way, those questions are not exactly tricky, but they are just hard to answer... There are some vague uncertainties where lecture notes (which I rely solely upon) are insufficient, and will only be obvious to people who have garnered clinical experience.

Just an example... Everyone knows it off the top of their heads that "an FER > 80 indicates restrictive lung disease, normal people's FER is around 80, while FER < 80 indicates obstructive lung disease". But there is this question which gives us an FER of 75 - how can one know for sure, whether this indicates "slight" obstructive lung disease, or a normal lung?! I would like to think that if you haven't read enough Kumar and Clark or worked for some time in a hospital, you wouldn't have much idea.

To sum it up, the MCQ paper is hard, really hard. I would be lucky to be able to score even 70 out of 100. But I will never know, anyway, because it is a closed paper and we will not be able to know our exact scores for this component.


6 June 2006 - ICM OSCE Interview
I guess anyone who knows me well enough would know that ICM interview is one of my most feared subjects in medicine.

Introduction to Clinical Medicine, or ICM for short, is a beginner's crash course to becoming a doctor. It actually endeavours to teach us to be a good communicator... Haha, well, I can't see much point - if you are not empathic, you won't turn into an empathic person by just reading the marking scheme which allocates a mark or two for being empathic. But I guess this kind of "empathic is important" preaching has to be done anyway, lest there will be more and more mean doctors.

Besides learning to be a good communicator, ICM's main point is to teach us what doctors do and why they do what they do (I know I am rambling incoherently know, but it's 2am now so paiseh larr.. :P). During our biweekly ICM lessons, we learn to inspect patient's hearts and lungs, circulation system etc, in addition to interviewing our patients about a medical condition (which in our semester is focused on heart and lung problems).

Alright, back to the ICM OSCE interview.. Basically in this day 2 of the exam, we had an interview with a simulated patient (a fancy word which means the same as actor / actress) for 9 minutes, and we are marked based on our performance in that short duration. In this 9 minutes, we are supposed to know our patients' every slightest detail - from how often he / she has the chest pain to how she is going with his / her family members. Miss one detail? Points deducted!

* Browser hanged, 3 precious paragraphs lost.. Grrhh... :P

Basically, I was saying that ICM is prone to subjectivity and bias since it depends on so many external factors. Good acting skill is of utmost importance, in addition to the basic communication skill. Luck is crucial. Besides, empathy should be feigned with finesse, and checklist approach employed under the disguise of non-checklist questioning style. Talking about checklist approach, I still don't get it today - we have been told since day-1 that "checklist approach should not be used", but how many of us actually got through the interview without having a mental checklist of all the keypoints we ought to find out from the patient?

Anyway, after all the apprehension and nerves, the actual ICM interview turned out to be alright. I would not say I performed very well, since there are so many weaknesses I could nitpick now in retrospection. However, with regard to my actual communication skill, I must say that I have done my best, and I shall leave it to the examiner to judge how much I deserved.


7 June 2006 - HP3 Exam
HP3 is supposed to be fascinating, if not because of some rotten eggs. Well, talk about the exams first, I will leave the rotten eggs to another blog post.

Health Practice is supposed to be an intellectually stimulating subject, since it enlightens us about the way population health policy operates - the principle is like: if you dedicate your time in saving one patient at a time, the most you can do is to save one patient's life. However, if you spend effort in promoting public health, say, about quitting smoking, you can actually save more people's lives with less cost. That, is the principle of public health we were learning all along.

In this semester, we had some sorts of lectures about epidemiology (which was dodgy) which is supposed to be about learning how statistics is employed in medical context, e.g. risks, prognosis, diagnosis etc. We also learnt to read academic papers from journals, and to "appraise" (which is a fancy word for "evaluate") the papers.

Eerm, I shall stop giving summaries and remarks about all our courses, if not I will not end my article at all... :P I am getting sleepy now, and it's time to get some sleep... Just a final note, for the HP exam, it's alright actually, not as hard as I had imagined beforehand. Apart from a few inevitable (yet lame) memorisation questions, most of the questions are answerable.


(... to be continued)