Friday, June 26, 2009

Exam Stress

I have barely 3 months left till my dreaded final exams. I need to utilise these precious 3 months to the maximum in order to drill as much information as possible into my head(pray that it doesn't disintegrate) and patch up weak areas eg: neurology, ECG intepretation and other diagnostic imaging such as CT scan and MRI scan. I am currently in a study group comprising of two other fellow students and we have had several VIVA sessions together (which have proven to be useful) where we tackle the problems and present it to one another under examination conditions. We've also had a few practical clinical examinations supervised by an intern/resident/registrar where we see patients and are given approximately 15 minutes to take a history, perform a physical examination and present our findings. Plus come up with a possible diagnosis. This area is probably a lot more difficult than VIVA as it involves practical skills, possessing a sharp eye in detecting abnormalities and trying to figure out the probable illnesses. It is more likely for students to fail this examination due to improper technique thus not eliciting the correct signs, poor communication skills with the patient and poor summary of our findings.

Apart from having a mini study group (it is best to not have a group that big otherwise it will prove ineffective as not everyone will be able to have the opportunity to practice)there have been organised tutorials at POW hospital by enthusiastic registrars/interns and consultants willing to lend a helping hand to the 6th years in preparation for the exams. Like there is a surgical viva tutorial every friday which just commenced recently conducted by Dr Shing Wong who is a lower gastrointestinal surgeon as well as the examination head and coordinator of the POW clinical school. I have been under him during my lower gastrointestinal surgical term and I must say that this guy has very high standards. He expects students to be dilligent, have a good background and knowledge of the common surgical diseases and to be precise and confident during the exams. If he is your examiner at POW, the chances of you failing is as high as 60%. So even if you manage to scrape through his station, it probably means that you will get a distinction in the other stations.

Anyway, he conducts his viva session by randomly picking students and throwing a VIVA question at them in which they have to basically rattle on for about 5 minutes on their approach to assessment and management of a patient in a particular clinical setting. Furthermore, the student has to present his case in front of all his other colleagues which further adds more tension. I was lucky today in that I didn't get picked but I can be assured that my turn will surely come if I continue attending his VIVA sessions. The students he picked were all good in my opinion, they demonstrated good knowledge and a focused sequential approach. The examiner can choose to ask you questions during the VIVA to test whether or not you do understand what you are saying and not literally regurgitating everything you've memorised from the textbook or divert the scenario to another clinical problem. But Dr Shing Wong told us that due to lack of time most examiners will allow students to talk non-stop for about 5 minutes before asking the vital questions. He advised us that it is best to display AS MUCH KNOWLEDGE AS POSSIBLE and not hesitate or keep information that may actually prove useful and show that you have superior knowledge in that area. The whole idea is to IMPRESS the examiner and demonstrate that you are capable of handling the situation as if it were in real life. I thought that the students today did really well and would probably have done even better if given more time.

Apart from preparing for exams, I am currently in my endocrinology term where it is mainly outpatient based with the majority of the cases being diabetic. I am lucky in the sense that my next two terms are all selective postings (respiratory and gastrointestinal) with no formal assessments or presentations. I'm always contemplating on ways to spend as minimal time as possible at my attachment (except for important tutorials, lectures and teaching sessions) to stay at home and study (due to the scarce amount of time left) and even if i go to the hospital it would be to search for patients in other wards (cardiology, neurology, rheumatology) to practice my examination skills and to recognise the physical signs present in them. Not that I am being a bad student, in fact a lot of my colleagues are doing the same thing as you are now given a choice: Either go to hospital and be a pro-active student in the posting you are allocated to OR spend your time wisely in preparing for exams. Of course, I choose the latter...I mean which student wouldn't when you are already so close to the end of your course?

Oh, I found this rather cute picture on google which typically represents the detrimental effects of exam stress physically and psychologically. Click on the picture to enlarge.


  1. i trust you will know what to do that will be in your best interest. anyway you have been working hard consistently so you should not have any doubts about yourself. i am confident you will pass. i have faith in you.just continue what you have been doing & you will pass.

  2. Good and informative blog post thanks for sharing it.

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