Friday, October 10, 2008

If at first you don't succeed...


In a recent post, I said, "Third year was great because we were full-time in the hospital, getting practical experience". Unfortunately, it turns out that third year wasn't so great for me...

(I'll stretch this tale across two posts in the interests of readability.)

Remember the long case? I said, "My long case exam...went well, I think." I knew there was room for improvement, but I thought I'd done more than enough to pass. Especially after talking with other people after their long cases and hearing their horror stories.

Unfortunately the examiners didn't agree with me. I was shocked and devastated to receive an email in late August telling me I'd failed the long case.

The re-sit was scheduled for late September, two days after our written exams (more on those in my next post). So instead of focusing solely on study during that month, I also had to practise more bloody long cases! I didn't want to tell anyone I'd failed, because I was so humiliated, but I had to tell some of my colleagues so that they could find patients for me on their rotations. Very frustrating.

I presented a few long cases to doctors from my clinical school, who all praised me and couldn't find fault. However, this time I was determined to take the history quicker than last time, and ensure I left enough time to ask the patient any last-minute questions after the examination.

On the day of the re-sit, I was told to arrive at the hospital (not my clinical school) at 1pm. Being the middle of the day, there was no parking, so I had to park far away in a 2-hour zone. I assumed that I'd start the exam at about 1:30pm, and be back to the car by about 3:30pm. Instead, I was made to wait OVER 2 HOURS before starting my exam! I had nothing to read, nothing to do. I just sat there getting more and more stressed out. My car was parked too far away for me to move it, so I had the prospect of a parking ticket on my mind too.

One of the staff members felt bad, so when she came to tell me that I'd be starting the exam in about 5 minutes, she also mentioned that the patient had an aphasia, and that the examiners would take this into account. It was nice of her to warn me, but of course this increased my stress level exponentially!

The patient was a lovely man in his 80s, who'd recently undergone heart surgery to replace two valves. His expressive aphasia (and also some incoordination) were a result of strokes suffered during the surgery. That meant that the aphasia was new, and the patient wasn't used to it. My plans for a quicker history went out the window, because I had to ask him to repeat a lot of things.

Also, the patient couldn't tell me about ANY of his medications. I was praying that the examiners also didn't get this information from him. AND I felt like a monster because I made the patient cry when asking about his social situation. He was going to have to go into a home because he couldn't look after himself anymore. I felt so bad for him.

The examination was rushed but OK, and I used my 20 minutes of writing time effectively, I think.

The presentation was as good as last time - which, considering I failed last time, isn't saying much! The examiners were nice enough. The time went very quickly.

When I came out of the examination at about 4:45pm, I was completely drained. I left the hospital and called my Mum, and sobbed down the phone for a good 5 minutes. It was after 5pm when I reached the car, and amazingly there was no parking ticket! It then took me ages to drive home in peak hour.

This story has a happy ending though! I passed the re-sit. Woohoo!!

More on how third year made me its bitch in the next post...

4 comments:

chinaski said...

Well done on passing despite having a dysphasic patient - that's kinda unfair of them to give you somebody who can't clearly communicate. And, if it's any consolation, RACP long cases provide a list of current medications, because patients rarely remember meds accurately (and it's therefore a waste of time to try to squeeze blood from a stone).

Miss-G- said...

Jeez matey you must have some damn good karma coming your way by now! What a horrible day! But you know, I can think of at least 6.5 med students who would have crumbled under stress like that, and you didn't. You felt it but you went ahead anyway. Speaks volumes of you. And congrats for passing!

KT said...

Thanks for the comments my online medical friends! :)

Chinaski, I didn't realise that about the list of medications. I was disappointed that he couldn't tell me his meds, because I've actually gotten quite good at deciphering drug classes from brand names/clinical context!

Miss-G-, yes I do have some good karma due, but not just yet... Have a read of my next post...

Liz said...

OMG that sounds so horrible and unfair. How can you get a patient like that when other people got a retired nurse etc? The long case can be such an unfair exam. I'm so sorry that you had to go through that :(