Medical School Examination

So today is my exam on obstetric/gyanecology/neonatal/paeds medicine senior posting. It is always fun to write on the paper the word "senior". haha. Now i am already a senior. have to admit that. 

Whatever whatever. So today is my first final year posting exam. I am so glad that the question was not that hard after all. Even though there is some question that o could not answer. Not because the question is difficult, but because it was too easy.

Do you ever encounter with this kind of situation when you study so hard on difficult thing, then suddenly an easy question came out and you don't know what to answer. I do. I study hard on a lot of thing, on the management of ovarian cancer, management of pv bleeding, management of abnormal deliveries, PIH, Pre Eclampsia, but then a question directly asking me the classification of ovarian cancer, i could not answer it. I did answer it because i know the FIGO staging have that kind of classification which is similar to other cancer no matter what cancer it is. 

To make myself remember until death i would mention it here clearly in bold

Stage 1 Growth limited to ovaries either one or both ovaries

Stage II Growth involving ovaries with pelvic extension

Stage III Growth involving one or both ovaries with peritoneal implants outside pelvis or positive retroperitoneal or inguinal nodes)

Stage IV Distant metastasize

Why! Why i remember cervical carcinoma and uterine carcinoma FIGO class but not ovary. I was totally blank this morning. Hopefully, i get mark from other questions. 

For problem based question, no problem since i can diagnosed every condition given but maybe the details is not that accurate. 

I love the feeling after exams. Feeling of relieve. 

Next exam is on wednesday OSCE, and saturday Short Case and Long Case. I guess i have to practice speaking starting from today as preparation for short and long case. huhu. 

Unique Medical Exam

A Neurosurgeon mention to my colleague and she mention it to me that Medical exam is the toughest exam in the world. Why? 

According to him, there is no other exams that involves presenting skill, showmanship, spontaneous thinking, written and practical exam. 

To think about it. Maybe it is true. I can see that other course in the university only have viva (oral exam) maybe two to three times and they can prepare for that for maybe a weeek, or at least prepared. I don't know. When i compare my pre-clinical years 1st and 2nd year which is much similar to other course way of exam, it is much easier i think. let me brief something regarding examination in Medical School. This is standard for all medical school in at least Malaysia. 

First and Second Year

The exam during this two pre-clinical years was pretty much the same with other course. We have monthly exam (similar to midsemester exam but more frequent obviously). Monthly exam will consist of question from the current module you are in. For example, you are in Haematology Module then the question will be regarding haematology. Usually in my school, monthly exam is consist of MEQ, maybe around 12 - 16 MEQ question. For those who did not know, MEQ is structured question where every question consist of 5 marks and you have to state 5 points for each question asked to get the full marks. At least 5 points or facts. 

When it came to end of year exam, there will be MEQ, MCQ (multipple choice question a,b,c,d), and Essay. This applied to all module you've learned for that particular year. So there will be around 2-3 weeks exams. One week for Neuro module, one week for musculoskeletal and etc. depend on how many module in that year usually 4-5  module. Plus, there is also practical examination which is OSPE and OSCE and the famous VIVA. 

Essay is where we use to score a lot of marks because it is free to write and just write everything and somehow you will get mark, somehow. 

OSPE is an Objective Structured Practical Examination. Usually there will be 10-20 stations. Each stations consist of a specimen (eg: microscopic slide, cadaver, or any pathological specimen) and a set of question. It usually contains 3-4 question in one set. 4 minutes is given for each question and you have to examne the specimen and answer question provided. 

OSCE is an Objective Structured Clinical Examination. It is the same as OSPE but the questions are more to clinical. For example, a station with BP set and a patient, and you are asked to take blood pressure, or maybe check pulse, or maybe ask history. 

Viva is vary from medical school to medical school. Some medical school use viva for those who want to get distinction but in my medical school, viva is compulsory to everyone. As usual, viva is an oral exams like in primary or secondary school. You have to sit in front of lecturer and they will bombard you with question. You have to answer everything or say "I'm Sorry prof, i am not sure". Haha, schematic answer. 

Third, fourth and fifth year (clinical year)

So this is where we really get into business. The real part in Medical exam. 

Clinical year exam is somehow different. It consist of MCQ, MEQ, and Essay, and also OSCE, Short case and Long Case. 

MEQ and Essay are the same thing as pre-clinical years. 

MCQ is different in clinical years as it no longer consist of a,b,c,d multiple choice questions but it consist of TRUE/FALSE questions. The unique thing is if you got one answer wrong, one mark will be deducted. Thus, it is safe to not answer rather than relying on your luck. They said they don't want a doctor to 'tembak-tembak' on the answer so mark deduction system is necessary. So, usually one set of MCQ consist of 150 true/false facts that you need to answer. 

OSCE in clinical years is a little different because you are not seeing patient anymore. Just a picture of x-ray, lab result, and etc, and you have to intepret it. 

Short case and long case is the main part of the exam.

Short case is where there will be stations with patient in it. And for each stations, you need to spend 10 minutes either examine the patient, ask history, and etc. Usually you have to examine the patient in front of examiner (consultant or prof) and present your result to them. Short case is much easier because you are guided by the examiner. For example, a patient with shortness of breath - examine the respiratory system, then you need to examine the respiratory system and present your result to the examiner within that 10 minutes spend in that station. 

Long case is the hardest part but the easier part to score. In Long case, a patient is given to you. You need to spend 1 hour with the patient, asking history and examine the patient and work yourself to the diagnosis. Important thing is you know the diagnosis if not, chances to failed is high. After one hour, you will meet your examiner and present the patient's history and physical examination finding to your lecturer. It also include investigation you want to order and how will you manage the patient. You will spend 20 minutes discussing the patient problem with your examiner. The difficult part is to get your way out from trapping question given by the examiner. The only thing to remember is to not to dig your own grave during this part of exam. If you did not know, say i don't know rather than pretending to know everything. 

Professional Exam

Professional exam usually twice or three times along the five year course of study. Usually on 3rd, 4th or 5th year. Or some medical school had their pro exam on 2nd, 3rd and 5th year of study. 

In Professional exam, all will be in one. All in one. MEQ, MCQ, OSPE, OSCE, Essay, Short Case, Long Case in one exam. The most important pro exam is in the 5th year of study because that one will determine whether you can become a doctor or not. Final year pro exam or Pro Exam 2 in my medical school, will consist of everything that you learn from first year. So you need to revise all the five year knowledge that you acquired. 

My Pro Exam 1 is on 3rd year and i already passed it. It compile only what i study from first to third year. My next pro exam is next year. I am so nervous for it. 

Other than exam

Other than exam, obviously, we have to do assigment ( other course said) or for us we use to call it Case report where we need to prepare case reports for patient we clerk in hospital. We also have 30 clerksheet where you need to clerk and prepare 30 cases clerksheeet for every posting you do. Luckily final year do not have to this. 

Posting = 2 month of one subject For example ONG posting = 2 months in Obstetric and gynaecology ward and lecture. 

Log Book. Every medical student know this. Log book is a book consist of everything that we need to know and need to do through out the posting. Every work we do must be dully certified by doctor or consultant in the hospital. Log book will consist of clinical procedure you need to do, clinic attendance, OT attendance, Labour room attendace, bedside teaching attendaceetc.

Attitude. I dont know why but in my medical school, attitude is taken seriously. Lecturer have absolute power to kick you out or make you stunted in your current year of study just by judging your attitude. 

So i guess this is all about the exam. maybe i would tell more regarding how medical student study. Lot of people think that we only sit down in library or room reading book, without knowing that we had to attend more lecture and bed side and do clinical works other than just study. 

It is fun. it is tiring. It is stressful. It is time consuming. But it worth it. But sometimes people did not understand.