Final exams of medical school – 4th year OSCEs

November 22-23, 2014

As you may recall from my last post, we had our Surgical Specialties (orthopaedics and ophthalmology) exam on Nov 13. Following that, we had a week to prepare for our final exams of medical school – the dreaded OSCEs!

These are a set of clinical exams that test all the skills we’ve learned and honed throughout medical school. A variety of skills may be tested, including history taking and examination, clinical reasoning, basic/advanced life saving, investigation interpretation and response, procedural skills (venepuncture, blood gases, etc) and more.

We were told ahead of time that we would be rotation through 8 stations, each with 2 minutes perusal (to read your stem and collect your thoughts). 6 of the stations were 8 minutes long and the other 2 stations were broken down to 2×4 minute stations with related tasks.

Needless to say, we were stressed. We were incredibly stressed! The entirety of our medical school could be tested in 1.5 hours. Not only was there so much to know, but 2 of the most important rotations (paediatrics and obstetrics & gynaecology) we had completed first in the year, which seemed like so long ago.

My OSCEs took place on the morning of Saturday, November 22nd. The group of us sat in nervous anticipation waiting to start, trying to pass the time by chatting with our colleagues or doing some last minute reading.

I was allocated to the green team with 7 other students and we were soon escorted to our first stations. Facing away from the wall, the buzzers soon went off, signaling the start of our OSCEs. Everyone turned to the walls to read the stem (taped to the wall) of our first station.

Once the OSCEs started, they passed by in a whirl. Time flew and you were in and out of each station in what felt to be a blink of an eye. There was no time to rehash or even think about how you did in the last station because you were too busy giving it your all in the next. In less than 1.5 hours, it was over. The wonderful ladies coordinating the exam for my green team gave us big smiles and congratulated us before ushering us out to join up with the rest of the group.

The room was a buzz with students discussing the stations and their performance. Lots of happy smiles to have one last hurdle behind our backs, however, not without some caution that our performance in one or more stations may have been lacking. The director of the MBBS program shook our hands on the way out and asked everyone how the OSCEs went for them, a nice comforting gesture!

And since I might forget what my stations were in a few months time, I am going to record them here.

In no particular order unless specified.

1) This was my first station, which was a 2×4 minutes. Was given an ECG to report, which was SVT. Then also given some bloods to interpret (hypochromic microcytic anemia, likely due to iron deficiency). After interpreting the bloods, we were given pathology forms to request the blood tests we thought appropriate. This was almost a ‘gimme’ station as it was very similar to previous years, however, I was so nervous it definitely took away from my performance!

2) My second station was an 8 minute one. A few weeks prior to our OSCEs, we were asked to submit a clinical & procedural skills log – a report of the things we accomplished and to what level. At this station, the examiner looked through my log and asked me questions seemingly to verify our stated level of competency. I was asked a number of questions, including, “Talk me through how to do an IV cannulation. What complications could arise? How do you do an ECG? What gets printed out on the tracing? What are leads V1-V6 called? If you walked into a room and someone was unconscious, what would you do? And how do you do chest compressions? How do you perform ophthalmoscopy?” Nothing the examiner asked was out of my comfort zone and I just continued to answer his questions until the bell rang.

3) A young male fainted while gardening. Tasks are to take a history, examine and manage. Was greeted by the examiner as I came into the room playing the role of a nurse, with an unwell patient on the bed. Turned out he was in anaphylactic shock and required acute resus and further management once he was stable.

4) An expected death in a patient with advanced bowel cancer. Had to do a death certification, talk to the spouse and write up the paperwork.

5) Preadmission talk to a patient for an anaesthestic assessment. The main finding in his history is a mechanical valve on warfarin therapy. Would need heparin bridging and antibiotics.

6) Giving a distraught lady the results of her hysteroscopy D&C, which was thankfully not cancerous but endometrial hyperplasia. Talk to her about the risks of endometrial cancer and treatment options for endometrial hyperplasia.

7) Taking a history and presenting a mental state exam of a patient experiencing acute psychosis, likely schizophrenia.

8) My last station, another 2×4 minutes. First task was to interpret a chest x-ray which demonstrated lobar pneumonia and then to write up the medication chart.

Overall, the OSCEs went well. At every station, I can still to this day, think about things I forgot to say, things I should’ve done and things I could’ve done better. I just hoped that the examiners felt I performed well enough to pass overall!

Mom is in Australia!

November 17, 2014

Mom arrived safe and sound to Brisbane! No issues with flights and no lost luggage, win win!

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Unfortunately for her, we are right in the midst of studying for our OSCEs and couldn’t be as carefree as we would want. In anticipation of this, she took our suggestion of flying to Perth (after getting over her jet lag) to spend time with family for a week. So off she went to Perth 2 days later on November 19! Hope you have fun mom!

Last 4 weeks of medical school – Orthopaedic Surgery

October 20 – November 13, 2014

Ending medical school with a specialty I had been dreading… Orthopaedic surgery. Crazy hours, macho surgeons, and an intense knowledge of anatomy required were only some of the things I had been warned about.

Needless to say, I found none of the above true and in fact, extremely enjoyed my ortho term. There were 5 other students in my group and we were based at a smaller hospital especially known for elective hip and knee replacements. We were split into smaller groups of 1-2 students and assigned to an ortho surgery team. There were 3 doctors on my team, a consultant, a senior registrar and an intern – and I was very appreciative of each person, in particular, our consultant.

He started every face to face encounter throughout the day (even after coming back from lunch) with a smile on his face and the words, “So, did you do any reading? What did you learn? Why don’t you tell me all about it?” In response to our answers, he would ask us questions and provide us with more teaching. He was always kind and non judgmental, even if you didn’t know the easiest answers. His continuous interest and support in our learning was the push students (like myself) sometimes needed to really become interested in what we learning. Although the registrar had a different style of teaching, he was the same. There was never any time we spent with our team, whether that be in clinic, in theatre, or even on coffee break, that we didn’t gain more knowledge.

Even though I am not interested in pursuing surgery, for the first time in a long time, I felt useful and wanted in theatre. The team would encourage us to come to theatre and rather than leave us to watch silently and awkwardly in a corner (the bane of medical students’ existence sometimes), we were always asked to scrub in and assist. Even if we weren’t assisting, the team would continuously ask questions and teach during the surgeries, which was great.

I really thought Orthopaedic surgery would be my least favourite rotation, especially with less interest in surgery and my subpar anatomy – but I have to say, these last 4 weeks of medical school have only bettered the two. I’m looking forward to my surgical terms next year when I’m finally working and I have to say my anatomy is heaps better now!

My last rotation ended with 2 MCQ exams on Nov 13 (a day earlier due to the G20 public holiday) – one 50 question ophthalmology exam and another 50 question Orthopaedic exam. Despite walking out of the exam with the trembling thought of, “Oh my god, that was so much harder than I anticipated,” I’m happy to say that our results have seen been released and I got an excellent mark – so stoked!

We didn’t have time to lament awaiting our surg exam results though, as we had OSCEs to study for, which I will talk about in my next post 🙂

Blog absence

Hello friends!

Over a month since I last blogged, sorry I’ve slacked! There’s been a lot of stress studying and preparing for final exams, followed by a lot of fun and excitement. I’m looking forward to updating my blog these coming days… please stay tuned! 🙂