So sick

I am so tired of the revision routine, I think I could write a thesis on it, my colleagues and I have done it so many times. The five Phases of Revision:

Keenness: Unattainably high goals are set with naïve confidence.
Denial: The exams are easy; they want most people to pass. Then you sit next to a few people retaking.
Fear: Everyone knows more than you do, there’s too much to cover and you have not left enough time.
Irrational: You are convinced you will fail.
Ambivalence: You just want it to end and cannot revise anymore.


I just finished the clinical exam for Paeds. The wait to start was a mild form of torture. The exams always start late for some reason. The different characters are very amusing: ‘overconfident -who-knows-nothing-boy/girl’, ‘person whose uncle is a janitor/security guard/ secretary in the medical school who knows the exam questions’, ‘person who actually knows everything’ (you want their brain) and ‘secret reviser’ boys who are adamant they have been down the pub/watched sport the whole time.


We were discussing the merits of the OSCE examination. It tests for theoretical, practical knowledge, communication skills and logical thinking but is it really any better than long cases? OSCEs have a wider scope in terms of material they can cover whilst long cases are more limted. I think OSCEs are designed to pass the most people possible and make sure all trainee doctors go through a ‘check list’ approach to medicine. Long cases test your knowledge in more detail and benefit those who know the topics inside out, while OSCEs are geared towards more candidates passing especially at undergraduate level. There is no correlation between attendance and performance during clinical attachments and performance in the OSCE in my opinion. Long cases are very much pot luck depending the type of examiner you have. I was shocked to read on one membership OSCE exam guideline that they are not looking for outstanding candidates, merely a certain standard in all candidates. What happened to doing your best?

So we finally went in and went through rounds of stations. It did not go well. The second written station threw me off because I ran out of time and wasn’t expecting that much detail to be in the question. Another practical station with an examiner I had met on attachment and I could tell from her facial expression she was not impressed. The written stations were weird because the questions are always phrased awkwardly. I prefer direct questions e.g name causes of jaundice in neonates rather than which 4 points would you look for in a neonate who is irritable and feeding less? The options are endless as must be their mark scheme. So I don’t think I gained many marks on that. At least it is over, well almost the clinical examination and written paper is to come.