Friday, October 10, 2008

Try, try again

If you haven't read my previous post, do that first.

In late September we had our Barrier exams, marking the end of third year. They consisted of three 80-question multiple choice papers, held over two days.

Third year focuses on the clinical application of what we learnt during first and second year - diagnosis, differential diagnosis, management, side effects of treatment, etc. It was expected that the third year exams would reflect this clinical focus.

I studied very hard for these exams (despite having the long case in the back of my mind). I had a strict study schedule, which I stuck to. I did a lot of past papers and other exams, and was pleased with how I went.

So I was feeling quite good about these exams - certainly much better than I felt last year!

The first paper on day 1 was a doozy. Instead of the clinical focus, there were obscure anatomy, physiology, histology, and pathology questions. It felt like we were being tested on the minutaie of first and second year, instead of the practical stuff we'd focused on in third year. It was a massive shock. Still, I took my time with the first paper, and tried my best.

I had lunch with some friends (including Yay), and we said that it was impossible to know how we'd gone in the exam, because there was too much guessing of answers. Like everyone else, we were quite frustrated.

The other two papers were more of the same: long clinical scenarios that take ages to read through, followed by obscure questions about Na+ channels and cell types, for example.

My final analysis:
  • I knew about 20% of the answers

  • I guessed about 20% of the answers

  • For the other 60%, I could narrow down the five possible answers to two possible answers, but then I had to guess between the two.
That was far too much guessing for my liking, but I figured that because everyone else found the exam to be awful, I had a chance of getting through it.

Unfortunately that wasn't the case. The results came through at the end of last week - I failed. AGAIN.

I was in Mudgee for the long weekend, doing wine tasting with (non-med) friends. A fellow med student sent me a text on Friday, saying that the results were out. My earliest chance to get online was Saturday evening, after a day of wine tasting. I checked my email in a room by myself. I covered my eyes as the page loaded, then peered through my fingers to see "Not Satisfactory". I was numb. I didn't get upset; I just sighed, shut down my computer, and sat there for a while. Eventually my friends came looking for me, and that's when I got upset - telling them that I'd failed again.

Luckily we were heading out to dinner and I didn't have time to dwell on it. In fact the rest of the weekend was wonderful, and I refused to let the news ruin it. (Alcohol definitely helped!)

I called my Mum when I returned to Sydney. She was in tears - very upset. I've slowly told other friends and family, because it will be impossible to hide this from anyone.

That's because the implications of failing the third year Barrier are significant:
  • I'm not allowed to start fourth year with my colleagues next Monday

  • I have to re-sit the exams in the last week of November

  • Assuming I pass the re-sit (big assumption?), I can start fourth year in December/January with my elective term - this means I don't miss out on Vietnam

  • After the elective term, I rejoin my colleagues for rotations 2, 3, and 4

  • While my colleagues are doing their pre-internship term (PrINT) at the end of 2009, I have to do rotation 1 (which I'm missing this year)

  • When my colleagues commence their internship in January 2010, I have to complete my PrINT term

  • I have to join the June 2010 intake of interns.
So what it boils down to is that I'm going to be six months behind most of my colleagues. And that's assuming I pass the re-sit.

I'm so frustrated, because I truly think that I could have done no study and ended up with the same result. What a waste of time doing all that study!

And if I fail the re-sit? That means repeating third year. To be honest, I don't think I have it in me. I'm not one of those people who always wanted to be a doctor, who would do anything to get into medicine. I love it and I want to be a doctor, but the prospect of repeating a year at age 34 does not interest me in the slightest. So this re-sit in November is very, very important.

I find myself wondering whether I'm cut out for this career. Maybe I don't want it enough - maybe that's why I'm struggling (even though I didn't think I was struggling this year!). And it's not going to get any easier! My non-med friends are always full of praise, saying that I'm such an inspiration, changing my career and pursuing my dream. That's really lovely, but I feel like a bit of a fraud. I feel as though I'm letting my family and friends down - all these people who have supported me in my return to student life.

I've had great support from my family and friends, and also from my third year PBL tutor, who is amazing. She's offered to help me with any revision I need to do. I'm meeting with the head honchos of my clinical school on Monday, and I'm already on the back foot, anticipating what they'll say to me. They're nice people and they mean well, but I suspect tears will be shed during that meeting.

So, for the next seven weeks I'll be studying yet again. I have the time to focus on specific areas, such as physiology and anatomy. I'm working on a study plan this weekend.

I'm so jealous of my colleagues who are starting fourth year on Monday, but I'm trying not to think about it. From now until the end of November, it's all about me. And let's hope I don't need to make a difficult decision about my future...


Miss-G- said...

My Dad failed first year (back in the day when it was four years). Later he failed the obstetrics exams too which put him back a year but was successful the second time around.

I don't think you'll fail the resit and in the far off parallel universe that has absolutely no bearing on reality whatsoever, if you did, it would merely mean you'd be in my year ;) With me!

You've really taken hit after hit in this course and when you have that meeting I would demand to know why the exam wasn't management focused, that's so unfair. Anyway whatever happens I am cheering for you all the way and personally I think the world needs docs like you.

The Girl said...

MissG is right - that exam sounded extremely unfair. Med school screws people over so badly, and I am so sorry that this happened to you.
From the sound of it, I doubt you will be alone.

KT said...

Thanks :)

I know I'm catastrophising a bit, but I am feeling sorry for myself. Miss-G-, this is why my Facebook status said that I needed a hug earlier in the week!

chinaski said...

You have every right to feel sorry for yourself, and no reason to feel as though you have disappointed anyone. Third year is a bloody draining time - and to receive not one kick to the head, but two - and to still be standing, despite that - says a lot about you.

I know what you mean by feeling like a fraud. I, too, often have the feeling as though I am not ridiculously passionate about the career I've set myself on (unlike some of my unhinged colleagues) - not a good thing when you are looking down the barrel of horrendous exams. I am sure I will feel like chucking it in if I fall at my post grad exam hurdles, too. Then I remind myself that I am not insane, and that I just prioritise things differently. Medicine doesn't come first, second and third in my life - so of course, when it delivers a body blow like this, it's natural to question why on earth we put ourselves through this trauma in the first place.

chinaski said...

Two upsides (with subclauses!) spring to mind:

1. Fourth year sucks anyway. I wouldn't be in a hurry to get there if I were you (wisdom of hindsight!).

2. Starting internship in June means:
a) You have time to have a meaningful break before disappearing into the abyss of work, and
b) You can fly under the radar - starting later means you can be anonymous in a new hospital, without being stigmatised as "one of the new (stupid) interns", and
c) Potentially, you can pick and choose where you work. Most hospitals have openings mid year when they realise they don't have enough staff.

KT said...

Chinaski, you're a mindreader - I was going to ask you about life as a June-intake intern!

The extended break will be much-appreciated. :)

I was concerned about being labeled as a "new (stupid) intern" though, due to starting later than everyone else, i.e. will people wonder why I'm in the June intake? I guess there are several reasons for starting later, e.g. time off for childbirth, etc. And it's not really anyone's business why I'm starting late, right?

Dragonfly said...

*Hugs*. Sorry to hear about that.
I had no idea that you could start internship in June, but that could be good...all your classmates can go before and be the guinea pigs and report back to you.
And good that you still get your elective as well.
Personally I think that exams have nothing to do with how good a doctor you will be, and it sounds like you have that covered already :-)

chinaski said...

There are new JMOs popping up all the time for rostering reasons, as well as those who start later for personal reasons. Nobody really thinks or cares about why they don't start at the beginning of the year - too busy to worry about the medical school record of a doctor. That's all in the past by the time you start.

You will be a "new stupid intern", though. We all were. It's a rite of passage! ;)

KT said...

Ah yes, that's a given!

Anonymous said...

I just wanted to say *thank you* for being so bloody honest!!!! It is a very difficult thing to do and I've learnt this year, a quality many med students lack :)

As a second year sitting their barrier tmw, my stomach is churning right now. I KNOW that I will fail the exams. I'm not trying to be pessimistic or despondent, just realistic. My preparation has been almost nil to date due to a whole variety of reasons. I have really only gotten my act together in terms of life and med school the past 3 weeks.

It sucks. It really does and I know why I am in this situation.

My thoughts are with you, and even though I don't know you--it seems that many of the qualities of your character that come through your writings *will* make you a person I would want as my doctor and colleague one day!

Kudos to you for trying and trying. I'm sure most people don't want to be the person who inspires or who perseveres despites massive challenges. You are one of these people! It's not easy but it definitely highlights that you do want this :)

zeph said...

Seriously, of all our colleagues, I would choose you to be there with me any day; as a fellow intern or as my doctor.

So they are putting you through your own personal hell to prove yourself, but they're not measuring the things that make a caring and compassionate doctor. It seems the further we get through this course the lower my opinion of it goes, and the more you inspire me. I know I would have crumbled long ago! I'll be thinking of you tomorrow.

Liz said...

Oh KT.... I'm so sorry. I had no idea. This post made me cry. I feel so horrible because I know that you've worked hard and that the passing point was this arbitrary mark chosen and someone who got one point above it passed and someone who got one point below it failed. It's unfair. Many people i've spoken to said that they passed by only a couple of points. Does that make them smarter than you or mean that they deserve it or want it more?? No way. Don't give up!! You've come so far and you are NOT going to fail the resit, and then you'll only have 1 year left. You can do it!
Also, i know how you feel about feeling that you've let people down. I know it's hard to change how you feel, but remember that this is your path and the people that you love will support you no matter what. People know that medical school is hard; they know that they might not have even been able to get into it. I'm sure your family and friends don't feel let down.

If there is anything i can do, please let me know. If it makes you feel better, i heard this rumor that the subdean from Northern Clinical School took this exam and failed it. What kind of exam is that???

KT said...

Thanks so much to everyone who's commented - I'm feeling much more positive, one week after getting my results. I won't give up!

Good luck to the second years for the Barrier this week. Fourth years, have fun on your rotations!

Su said...

Hi, I've been reading your blog for awhile and just wanted to say I'm really sorry to hear you failed your exam. I think I can emphasise with you though, having failed my first year of Med! I went through a lot of soul-searching when it happened because there were a lot of non-Med related factors which were involved. But I'm now at the end of fifth year (of a 6th year course), so I guess what I want to say is that failing isn't the end of the world and that if you still want to be a doctor, don't let it deter you! Good luck with your resits :).