Friday, March 17, 2006

Day FIVE - (a second helping of) Multiple Choice Questions

gosh - i was afraid of today, and my fears weren't exactly unwarranted. it was a tougher paper than yesterday and previous days, albeit only slightly tougher - it was still a rankler.

apparently the negative marking system is supposed to encourage you to be certain about your answers and discourage you from answering if you're uncertain - therefore mimicking real life as a doctor when you're frequently supposed to make on-the-spot decisions, sometimes on very small and apparently technical details. certainty and accuracy are certainly virtues in medicine - they're trying to hammer in this philosophy via the negative marking system (where your marks are deducted if you answer wrongly, but you can choose not to answer if you're unsure).

i think it's appropriate here to state that i don't like the negative marking system any more than the next guy, because i think it's hard for me and it's such a technical process requiring knowledge of sometimes obscure minutiae.

however, there is much to be said for this system in place, chief among which is the fact that you cannot run away from a lack of knowledge, and it certainly does separate among the levels fairly accurately.

but NO! people are trying to circumvent the system, by not truly respecting the philosophical basis of the negative marking system. they're hammering blindly sometimes and hoping to get statistics on their side so that they can pass or score.

if you're on the verge of failing for not knowing, i suppose it's almost acceptable to do guesswork. but if you're already having a good strong pass with lots of statements that you're sure of, why:
A. take the risk of getting a statement wrong and having effectively 2 marks deducted?
B. take the risk of having 2 marks deducted and then causing a good strong pass to turn into a good pass?

sheesh - setting MCQ sample questions aren't easy. i could only come up with two statements. it's double-or-nothing, i guess!

Thursday, March 16, 2006

Day FOUR - Multiple Choice Questions

we are taking our final professional exams with around 12 people from various unaccredited medical schools. an unscientific poll was conducted via very informal and indirect means, and established that they ranged from India to Taiwan, with exotic names.

i've got absolutely nothing against foreign medical grads - they want to do medicine, and they pursue their dream quite doggedly. obviously that's admirable.

what's not admirable is the way they approach an important qualifying examination, and the skills and knowledge that they bring into this. i'm not so sure anymore that they are good enough to qualify - i'm thinking now that their system doesn't prepare them for anything much. that's a political story however, so not today.

there was this girl sitting right behind me, and today we had 60 multiple choice questions in a true/false format. there is one trigger statement, and 5 statements that follow it. you're to indicate on the answer sheet whether the 5 statements are true or false. each right answer is given one mark, and each wrong answer gets one mark deducted. you can choose not to answer if you don't know. so the maximum marks per question is 5, and the minimum is 0. if you answer 4 statements rightly and 1 wrongly, you get 4-1 = 3 marks.

not that difficult to understand - but they invigilators were kept busy instructing them 2 MINUTES BEFORE the exam began, and ALL THROUGHOUT the exam.

come on you fools - if you spent so much money going overseas to pursue the Asian dream of being a doctor and you now have to take one last exam to finally pass, couldn't you take one measly day off your life and FIND OUT THE EXACT FORMAT OF THE EXAMINATION?

gah.

Wednesday, March 15, 2006

Day THREE - (more) Patient Management Problems

the hospital that i study in has two examination halls. there is a big one, and a smaller one. apparently they are changing our seating arrangements daily, just in case any of us are planning on cheating.

so today, i got shunted to the smaller hall. there's nothing wrong with that, except that the invigilators are younger and much much more attractive over in the bigger hall - and they seem to take some pleasure in dressing up a little more extravagantly than usual, because it's the final exams and all.

at least when you're lost for answers, you can always take a good look at dimples and their nice shoes for some inspiration. but then again, i did better today than any other day - so i suppose aesthetic deprivation does have its merits.

Tuesday, March 14, 2006

Day TWO - Patient Management Problems

today we had two hours of Patient Management Problems, where they give you 5 triggers with specific time limits, that asks questions as you chart the patient's progress from admission till discharge.

apparently we weren't supposed to know what discipline was coming out with questions today - it could be medicine, obgyn, surgery, paediatrics, psychiatry, orthopaedics. not narrowing it down is apparently the faculty ruling - but i think it's an unnecessary ruling because c'mon, it's not as if when you're working you don't know exactly which discipline you are in?

in ObGyn, they had to fit both an obstetric AND a gynaecology question into those 5 triggers, in the same patient - thus implying that the woman in question is an unnaturally unlucky one. it can go like this -

TRIGGER ONE - 25 year old woman presents with symptoms of uterine fibroids. how would you proceed in management?

TRIGGER TWO - the same woman, now 30 years old, has been married for 3 years and is infertile. obtain a history and physical examination, and what investigation would you want to do, and how would you proceed in the management?

TRIGGER THREE - she had a couple of IVFs and was successful, but at the 30th week of the pregnancy she went into labour (10 weeks early). how would you manage her and her baby?

TRIGGER FOUR - 20 years later she has reached menopause, and is suffering from too many symptoms. what sort of HRT will you recommend, and why?

TRIGGER FIVE - at age 65, she developed symptoms of endometrial cancer. how would you proceed?

yes i know, super bad luck. some women just get it really bad.

Monday, March 13, 2006

Day ONE - Data Interpretation

on Day One, we get 20 different stations from all the departments in medicine - internal medicine, surgery, obgyn, paediatrics, opthalmology, ENT, forensics and such.

there may be the results of a blood count that needs to be interpreted, or an X-ray or CT scan, pictures from operations and laryngoscopies and the like. we have 5 minutes to answer questions about the trigger, and then we move on to the next station.

the best part is that it's only 5 minutes, and there isn't a lot of time left over for you to waste away.

the worst part is when you're stuck behind someone who is slow and takes his time putting his paper in the envelope (only when the bell is rung) and forces you to stand away from him because moving closer would be tantamount to "cheating" AND in front of someone who is always in a huge hurry and she cannot wait to jump out of her seat and try to get to the station that you have just vacated but cannot vacate fully because the guy in front is still at his station, and all the time she is breathing down your neck. phew.

i think i passed this paper.

The Examination

today was a very pressuring day. woke up at 10am and went out to breakfast at mcdonald's (it's the only thing i'll ever eat there), and stayed there until 5.30pm. i tell you, it's the only way i can get myself to not nap in the evening - thank God the cycle is broken! and the night wasn't exactly peaceful either, with so much to cover and so little time left.

but an hour ago, suddenly, i felt totally at peace. so calm and ready. so prepared.

God, help me build a hope that will endure and surpass all trials and tribulations.

Wednesday, March 08, 2006

heading for anarchy

unfortunately, that's what my final exams are all about - anarchy. albeit controlled, civilised and with a certain charm, but anarchy in every other way.

there is no telling what kind of questions we will get asked during our theory paper, and no telling what kind of patients and diseases will show up during the clinicals.

yes of course we'll get the widespread and common diseases like diabetes and cancers, but then again we're also getting the likes of internuclear ophthalmoplegia and periventricular leukomalacia.

the first sounds like a fancy nuclear bomb, the second just sounds hopeless.

gosh - anarchy. God let me bring order into my life.