Wednesday, 23 July 2014

Medical School: A Survival Guide - Part 3

Ah, summer. What a wonderful time of year. Everything is green and smells nice and you can't stop sweating because why the fuck is it so hot? I'm boiling all the time. C'mon, Scotland, sort yourself out. You're meant to be able to freeze the balls off a brass...statue...of...balls? Nope, lost that one.
ball pit plastic balls photograph
Balls.
Sadly for any of those unlucky enough to have ended up in higher education, summer also means waiting for the results from those oh-so-special exams that you did a couple of months ago; and ain't waiting for news on whether or not you still have a future just dandy. Now almost every single one of us will have sat an exam in the past (unless you're lucky enough to be of the special few who only need to remember how to put your helmet on and not to bite your tongue. Hey, silver linings), so I'll try and focus specifically on what new horrifying additions medicine adds to the formula and, for the third time, why you should never ever ever study this awful cesspool of a course.

Chapter 3 - Exams


There's a spectrum that all of the people in the world fall onto: on one side there are those who see the word exam, think "meh", and continue about their business balancing a chair on two legs and flicking balls of paper at passers by. On the other there are those who's faces contort into a mask of unimaginable Lovecraftian terror, promptly fear pee on everything in a three metre radius and jump through the nearest window onto a carefully placed pile of escape-pillows outside. I fall somewhere in the middle of this; neither laid back nor tearing my hair out with angst. On this Kinsey scale of exam worry I'm what you might call bi-stressful.

exam writing paper photograph
I was stress-curious until I had a thing with a Biology paper back in '11. 
If there was ever proof of the existence of a God - an uncaring, cruel, sadistic God - then exams would be it. What terrible human being could have decided one day that the best way of testing a person's knowledge of years of work, experience and studying would be to sit them down in a room completely unfit for the purposes of adequate recall and force them to answer poorly written questions on their subject of choice? It's like someone deciding to assess your sword fighting skills seconds after you've woken up in a bakery that's...on fire or something.

minecraft bread sword crafting screenshot
At long last, Minecraft logic pays off!
That said, you can probably get away with exams for some subjects; with, say, maths, you know what kind of problems you should be able to do and you know you'll get tested on them. With medicine, oh so special flower that it is, you're learning at least 4 or 5 different systems a year, all of which people will have dedicated their entire careers to mastering; which they then ever so kindly condense into 2-hour long lectures for you. The amount of information thrust down your throat is staggering, and it barely even scratches the surface. Do you know how many kinds of horrible, cancerous lump you can get on your face? Do you?! I know of almost a good dozen, and I would still be laughed down within seconds for not knowing shit about malignant face diseases by a dermatologist coming down off a paint thinner bender.

male doctor stressed angry headache
Granted, they don't have much else to do.
With sickeningly long lists of drugs, diseases and organisms to memorise and enough Latin to rival Cicero, revision becomes less a matter of systematically going back through the year's coursework to review it and more grabbing random sheets of paper and screaming at them until the information you need dribbles off the page onto the floor to mingle with your tears and the tips of the fingers that you've likely chewed off in panic. Your chances of covering all of the course material are nil, so revision is based primarily on preparing yourself for the most likely questions while covering your back with core principles that you can bounce guesswork off. Yes, that's right, your doctor likely passed medical school by picking something that sounded about right based on woefully thin basic knowledge and a high Luck stat.

smiling doctor with patient
"I have no fucking clue what's wrong with you, but I'll give you 10 to 1 odds that it's cancer."
Oh, did I also mention that the material covered in each year's exams stacks like the worst Accuracy-lowering Pokémon move ever? So the second year exam covers first year as well; third year covers first and second, and so on until you die. Even if you might have known something two years ago, chances are you've forgotten it by the time it comes up in the 4th year exams and you're back to playing "Pick the Smartest Sounding Word" again. Sure, I guess you could somehow overcome the minor hurdle that is the unfathomable workload and maybe even feel pretty prepared for what's coming. Well to that, good sir, I say a 'pah' and a 'hah' with much exclamation at the end! If you think that's how medical school works, you'd best change your name to Arya Stark cause your innocence is about to get raped. Raped real good.

multiple choice exam paper photograph
Brain rape. It's the good kind.
There are two types of question in most British medical school exams: the classic Multiple Choice Questions (herein known as MCQs) and the unadultered evil of Extended Matching Item (EMI) questions. MCQs give you one question like:

A 14 year old girl comes to your clinic complaining of a leg pain. On further questioning, she reveals that her mother has been physically abusing her, but she doesn't want anyone else to know about it. Which of the following would be the most appropriate action?

And you'd be given a choice of around 4/5 answers to choose from, like so:

A) Urgent Referral to Social Services
B) Discuss the Situation with the Mother
C) Tell them to Stop Telling Lies
D) Politely Suggest That They Stop Complaining About It
E) Insist That Women Don't Physically Abuse Children and Suggest That it Could be her Father Instead

The answer is, of course, D.
girl broken leg photograph
The correct medical term is "Nut Up or Shut Up".
Pretty straight forward; you can usually narrow down the obvious bad answers (the "stop lying" one did actually turn up in our last exam) and pick out the red herrings to give yourself a 50:50 chance for a correct answer, even if your knowledge isn't great on the subject.

EMIs are a whole different beast, however. The aim of these is to make your life a sodding misery by ramping up the answer choices to as many as 12 and giving you up to 3 questions on that one set based on a similar theme. If one were about, for example, the previously mentioned face cancers though, our curriculum didn't teach us about that many pus manglers so the person writing the question (who, did I mention, is usually a consultant in that field?) has to fill in the spaces with stuff that could be right to a student, but totally isn't to their highly attuned senses. I imagine them sitting on a leather Winchester with a glass of port, guffawing at the diabolical use of vague symptoms, double negatives and unnecessarily circuitous language in the figurative shit-stain of a question they've just dreamed up. I wouldn't be surprised to see this next year:

unfair extended matching item EMI question
I) Suck my 6-figure-salary dick

You might get the right answer eventually, but the questions themselves can be so impenetrable that the mark really wasn't worth the time spent answering it or changing your underwear after shitting yourself the first time you read it.

All in all, medical school exams are sadism at their worst; that is surrounded by the smell of fear, lacking in butt plugs of any kind, and while being watched by a bored-looking lecturer holding a Chinese-English dictionary. Is it bad then that I find the moment when I remember why I enjoy medicine at all is during exams? It could be the intellectual challenge, or maybe it's the base thrill of panic that comes from realising how stupid you still are. Whatever it is, there is no sweeter feeling than when you step out of the final exam on a Friday afternoon, knowing that whatever happens, you won't have to go through that shit again at least for a while.

shawshank redemption andy dufresne escape rain gif
"...and came out with a degree on the other side."
Then you fail and have to do resits all summer.

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