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Monday, June 13, 2005

Now that I've flown down to earth again, and have been lazing my ass off the past few days, I decided to jot down whatever from one of the more traumatic periods of my life - the clinical finals, before I forget.

It's not that the exams were a breeze. Oh, I admit, it was tough. But it was do-able. It doesn't help with ar-sey examiners, but I survived that, somewhat sizzled but largely unscathed. Neither was the limitless scope of what we were supposed to know, but I handled it. It doesn't help that the fear factor was the biggest of all time. I have never been as nervous before in my life - together with physical symptoms of nausea and palpitations and hand tremoring (without the aid of caffeine!). Not even national/international sports competitions compare to this. Either that, or I'm getting really unaccustomed to it.

Now a little detail about Part A - Medicine/Surgery. It consists of 4 mixed stations of med/surg, each roughly 10 mins long, and after 40 mins, that will decide whether you pass this section or not. I got 2 med and 2 surg cases. Fairly straightforward ones, I thought - one diabetic patient and what I'm supposed to do for her (erm... everything?? and which Dr Cottee was unrelentless in digging the answers out of me), a barndoor COPD with full chest examination, inguinal hernia (which I got blasted by Mr Sharma for), and Dupytren's contracture which turned into a combined case of RA (I had to switch my mind back to medicine, since it was fixed to surgery for the last 2 cases). I enjoyed the patients immensely as they were so lovely. The examiners didn't try to put me at east (Then again, it just wasn't their job to do so). They grilled me instead, but I thought I would pass.

Part B was a different story. It is the specialty day, where we are examined on O&G, Paeds and Psychiatry (don't know why we need to do it again even after being tested on it upteen times for term exams and written finals). As usual, the inertia of starting to revise for it for great, and I only started on all 3 a week or two into the exams. But once I got into it, I didn't want to get back to medicine and surgery coz it was actually quite enjoyable! =p But anyway, back to the examination. I had all 3 sections in the afternoon, each an hour apart. I had O&G first, and I think i aced it. At least the history-taking was slick and questions were all answered for competently - about abnormal cervical smears. I was feeling good at that point. Coz that was a definite pass, I thought.

Next up was Paeds. It went downhill from then on. The history-taking was quite alright, but it all went to bits when I gave the wrong diagnosis, and I was relentlessly quizzed about the differential diagnoses and the exact management for those, and what I expected to find, exactly, on the EEG. Gah... that didn't go well.

The last one for the day was the Psych case. I had a really lovely patient whom I'd built a rapport with outside the room while waiting to be called in. The history taking took me by surprise (how do we do a personal history?? I was expecting a past psychiatric history or something about mood symptoms, etc!! and therefore that wasn't well taken at all...), but the MSE about abnormal perception didn't go too bad. But in both bits, I ran out of time. When the examiners grilled me, it wasn't well. I was trying to explain about 2nd/3rd person hallucinations and which one is more common (3rd), and how in this patient, it was the 2nd person. Then they asked me to demonstrate it. I was like 'huh? demonstrate what? how to be a loony person?!' then I got killed about NICE guidelines regarding the treatment of schizophrenia, etc. My gosh, I came out of there thinking I had f***ed up this bit so much that paeds and O&G wouldn't be able to cover it enough to let me pass this part. That day went badly. I called Dee, and she put me straight about not giving up, and gave me a virtual shake to wake me up. Heh., thanks Dee. And I thought, yeah, since I already had 2 days down, I might as well finish up the 3rd day and see where that put it. If I failed, it wouldn't be because I had tried.

Part C was on professional development and clinical skills. This didn't go too badly at all. 6 stations, OSCE-style, and I think I did most of them well, esp the breaking bad news about non-Hodkin's lymphoma and aiding in her accepting an alternative treatment instead of TCM. I didn't 1-2 of those stations well, coz there wasn't enough time to finish talking! Gah..

George's is good that the suspense if not so long - the results came out the next day. Well, I thought it was better than putting the results up at the end of each day (like NUS, for example).

But anyway, the end result of that all, I passed. I know people who have failed. Some were expected, some weren't. This whole period was a pressure cooker. I have never felt like this before when studying for 'O' or 'A' levels. One person fainted, and had to redo Part A at the end of the day. A couple turn hyserical/crying halfway through part A.

Ok, more later abt the partying after, coz i have to go out now. =p