[update] 2013 MD2 mark breakdown released

Today the mark breakdowns for us in MD2 for our PCP2 subject (the main one this year) were released. As I had expected, it was the OSCEs which brought my mark down. However, it is good to see the individual breakdown to analyze where I did well and where I did things badly.

For the MCQ, there was not much of an issue. I scored above average; just one point less than in the final progress test actually (both were out of 80).

For the SAQ, my score as a percentage was not as high, but it was still above average and just one point from the "H1" standard.

Now the OSCEs. Overall, I did worse than average, but this was a mixed picture:

There were two stations where I had actually scored above average. Now this is actually the first time I scored any OSCE stations above the average, so I was happy about this fact. These were the respiratory exam (COPD) and iron deficiency anemia (bowel cancer) stations.

There was one station where I had scored within a point of the average. This was the surgical abdominal exam (acute cholecystitis) station. After the exam I realized that I forgot to assess for rebound tenderness. I would have remembered if it was appendicitis signs but forgot for cholecystitis! Ah well.

Then for the other two stations, I scored below the average. Perhaps that is an understatement though - I scored below the "cut scores" (aka pass marks) for both of these. These were the headache history (SAH) and weight loss (T1DM) stations. Actually this is worse than I had expected to score. However, I do think that I have a tendency of narrowing in a diagnosis and not asking enough things to rule out other diagnoses, or in the weight loss station case, not even thinking of T1DM as a possibility in that station! I also don't know if I am particularly good at getting the "rapport" or "global" types of marks in the OSCEs for history taking. It is something that I need to work on for the future.

Overall, it seems like I have improved slightly on the OSCEs this time around compared to last time, although I have not tested to see if it is statistically significant. Last time my exams were worse than my history stations on average, but this year it seems to have reversed into the other direction. It seems like I will need to work on history taking in general for next year.

Anyway, scoring worse overall this year (by about 3-4 points) was mainly because the OSCEs were worth more this year and SAQ/MCQs were worth less overall. Actually scoring some OSCE stations above average for a change this time was a promising trend, but two history stations below the "cut scores" is a bit concerning. I will have to improve this into the future. Hoping for a turn-around like the Australian cricket team this summer. So far they have been quite spectacular!

[update] 2013 MD2 - results release, year in review and looking ahead

Today the final results were released for MD2. I did not do as well as I would have liked to, but I have passed quite comfortably. We have not received our OSCE marks yet, but it is most likely the OSCEs are where I have lost marks again this year. Ah well. At least it seems like I won't have to sit any supplementaries or repeat this year!

I guess maybe a reason why I would have liked a better result was because I did a lot better in the progress test. For the final progress test, I received a score of 70/80, which is a major improvement from the first one I posted at the start of the year! That said, the progress test is only testing on MCQs, and I think it is in the OSCEs where I have not scored that well.

In terms of knowledge and MCQs, I think that practicing BMJ onExamination questions was very useful in gaining knowledge. There is a free subscription through the medical school. Being interactive, it can facilitate learning more than reading over lecture notes or books. The other thing for exams is because the university repeats many questions, well... fill in the rest of the sentence yourself.

Generally speaking, this has been an interesting year, in the clinical environment and learning about things which are directly related to clinical management which build upon our basic sciences in first year.

There were a few highlights for me this year in medicine personally. There was once a patient who we were examining in a bedside tutorial, and everyone in our tutorial group took turns to listen to his heart. When it was my turn, he jokingly asked me: "are you too young to do medicine? How old are you? 12?" I laughed a bit at this, and said to him "Yeah, I'm probably the youngest in the tutorial group. Just switch around the two digits." The ironic thing is that back in the times of undergraduate entry, my age would be average for the first clinical year. It was only "young" because this was a graduate entry course!

There were quite a few times where doctors and other staff at the hospital asked us medical students what courses we did before medicine or what other life experiences we may have had prior to doing this. Although there was the occasional person who did something quite different, usually the answer from most students would be science or biomedicine/biomedical science. This was exemplified once when a dermatologist was taking one of our lectures. He asked everyone to introduce themselves with their names and what they did before medicine. Almost everyone in the lecture theater systematically said their name and indicated that they previously did biomedicine, biomedical science or science! It was quite humorous and ironic indeed!

Another thing which was the highlight in the hospital was when I was following the ward round of the Director of General Medicine. One of the patients did not feel like eating their food that morning, and the professor noticed the full bowl of food on the table. I was very surprised when I saw her spending the time and effort to spoon up the contents of the bowl and help feed the patient herself! Very remarkable!

Another highlight was that I was part of the winning team for the Inter-Clinical School Quizbowl Championship. In fact, this was a total accident! I was planning to attend the final of the competition so that I could eat some free pizza and learn some medicine from the quiz answers. I wasn't part of the team which was supposed to represent St Vincent's, but one of the team members was having a rural GP placement and unable to attend the final. One of the other team members suggested that I take their place. I was quite nervous when we were sitting there waiting during the first round since we played in the second and third rounds that night, and even more so when taking the position ready to answer the questions. But I managed to get the first question of that second round right, and quickly got settled and got a few random questions right in that round, making a contribution to the team. It's funny what happens sometimes when you least expect it!

Looking ahead to next year, I am not that keen on some of those rotations, although some others might be interesting. I start off with the mental health rotation, then aged care, then GP. Semester 2 will consist of women's and children's health. I am not looking forward to the first two so much, but the later few should be better.

It has been just over three years since I first made this blog. I am already halfway through medicine! Time has gone by very quickly!

The blog post graph still has this annoying glitch which displays some years incorrectly, so I have corrected them in the diagram above. Although my blog views are higher than I would have ever imagined when I started the blog, I have lost readers recently. This would have been unexpected for me at the start of this year since I thought that people would be more interested in clinical medicine over preclinical medicine. However, the requirement to protect the confidentiality of patients precludes us from sharing too many of the interesting events which sometimes occur on the wards. I have erred on the safer side in not posting too much where confidentiality can be impaired, and thus I have not made as many posts this year compared to last year.

Perhaps another factor is because I have made some more posts about politics this year due to the election, and the "Scrap the cap" campaign issues. I have a feeling that many of you are not so interested in politics. But politics is quite important and as the scrap the cap campaign has highlighted, policies have quite a significant impact on our future not only in medicine but also in life in general. As such, I will continue posting on these matters whenever I feel it is necessary. However, given the electoral cycle, it is unlikely that I will post as much on these matters next year.

Regardless of all these factors mentioned, I guess I have to lift my game to make my blog more engaging to everyone in the future to get back to where I was before!

Finally, to everyone who enjoys reading my blog and commenting, thank you very much for your continued reading. I hope you continue to enjoy reading my blog into the future!

[update] 2013 MD2 OSCE done! Available for GAMSAT/VCE tuition.

Today I did my last exam for the year, the OSCE. We had two examination and three history stations.

I now realize a few things which I forgot to do during the stations. Also, there was a weight loss station, where the correct diagnosis was apparently type 1 diabetes. I did not get that diagnosis right, and many people I talked to didn't either. Some people did, but others had answers ranging from hyperthyroidism to cancer.

Ah well. I hope that I did better than in last year's OSCE. For now, all the exams are done. I should be able to tutor people now. Keep in mind that it will be more convenient for me to tutor in Monash on the holidays than Melbourne. For more information, see the GAMSAT Science 100 + VCE tutor page at the top of the blog.

I will do a longer post about this year after the results come out. In the past I made some annual posts on the anniversary of my blog creation, but it is more logical to make them at the end after results come out and not have repetition.

[update] OSCE marks released

Probably a week ago now, the OSCE results were released. I couldn't post here though since I was in China.

This time, I got two scores just about on the average (within 0.5 sd), one score about 1 sd below, and one score just on the pass mark at about 2 sd below the average (knee exam). Even though they said they'd only give feedback for failed stations, they gave me feedback for that station. I wish we could have feedback for all stations though.

Apparently for the content marks of that station I got 22/24, but my overall mark was 27/40. I guess that means my "non-content" marks were only 5/16... I am surprised they are worth so much, although it is said that most communication is non-verbal. I wonder if I lost most marks for "non-content" things on other stations too.

Anyway, it seems like I did better than the last OSCE (when one was >1 sd below and one station was below the pass mark; >2 sd below). I haven't done a statistical test though. I hope by the next OSCE time my skills can become at least at the average. There should be more opportunities to practice next year since we are in the hospitals.

[update] OSCE complete! MD1 complete! (hopefully). Available for GAMSAT + VCE tuition now.

Today I completed my OSCE! I thought they went OK, although for one of the stations I had to stop to think a bit for some of the questions.

This time I remembered to wash my hands for both my clinical exams though, so that's good. And I didn't run out of time for the history stations either, unlike last time, and I think I answered the questions at the end of the history station better.

It's good having the previous experience behind me too, so I'm more used to the OSCE format now. Hopefully it can be as comfortable as written exams (which I'm quite used to now) in the future.

So all exams for MD1 are completed for me now. I don't think I'll need to sit any supplementary exams. So if that is the case (hopefully so I don't have to travel back from overseas), then I will be on a break from the MD until February next year.

Oh and just a reminder since my exams are all over now: I will be available to tutor for the GAMSAT or VCE for most days in the holidays now. Except for between 5-22 December when I'll be away from Melbourne.

[update] 2 years on. FBS exams done. OSCE next week. GAMSAT Tutoring available after Tuesday.

I've noticed it's now been two years since I made my first blog post on this blog. I have learned a lot in the past year. I'll make a longer reflective post after my OSCE on Tuesday.

Last week we had our FBS exams. The first one had no MCQ and was all short/long response. I had to write non-stop for the whole exam and had no time to recheck. That seemed to be a common and recurring theme among others I've talked to. I didn't really like it.

The second exam was all MCQ/EMQ (extended matching questions), and the questions were quite "clinical" in their nature. I liked this one a lot better, but I know I got a few wrong there too.

Anyway, my OSCE is on Tuesday. There will be two history stations and two examination stations, assessing anything they taught us in PCP1 this year. After that, I will be able to tutor for the GAMSAT on most days in the summer holiday, but I will be away from Melbourne on 5-22 December.

[update] MD1 Midyear OSCE results released.

This morning, the midyear OSCE results were released for first year.

For the Abdominal pain history station, I got 29/40 (72.5%). The pass mark was 26/40. For the cardiovascular clinical exam station, I got 27/40 (67.5%). The pass mark was 29/40, so I didn't pass that station. Ah well. It seems like I've been invited to get more practice.

Anyway. As I have been saying before, I haven't been practicing that much in this subject, because the main subject is the science subject this year. I wonder if these marks get entered directly into our end of year result, or are scaled first. If they aren't scaled first, then it would seem possible for people to "fail" all their stations but still "pass" overall (ie get at least 50%). The handbook doesn't seem to specify the requirement of passing each station at the end of year to pass overall. https://handbook.unimelb.edu.au/view/2012/MEDS90002

The midyear test result for FBS still isn't out yet though.

[update] Midyear exam and OSCE done.

Yesterday and today, I completed my midyear OSCE and written exam. It was a struggle to prepare without having a swotvac/cram week. That said, the exams were not worth a large proportion of our final mark, so the timing isn't too unforgivable on the university's part.

For the OSCE yesterday, it was my first ever OSCE. I did a lot of things properly, but there were some things which I forgot to do. For instance, I forgot to wash my hands until almost the end of my clinical examination (oops) and didn't remember to make the actor lie down before palpating the carotids (to avoid the tensing up of the sternocleidomastoid muscle).

For history taking, I was reasonably comfortable talking to the actor about her abdominal pain, but forgot to ask about smoking and alcohol history, and I didn't list the symptoms of common bile duct obstruction apart from jaundice and pain properly (pale stools, dark urine, itch).

Ah well. As long as I don't make the same mistakes again, it's OK. After all, this was my first OSCE, and it wasn't worth too much.

With the written exam for FBS, it was quite difficult. I was reasonably confident with more than half of the questions, but there was a significant number of questions which I was unsure about or almost clueless about.

That said, others in the course that I have spoken to have also found the test to be difficult. Maybe the end of year exams won't be hard in comparison then, given that the class average for the subject was above 70% last year. I guess that way is good. I think it's better to have harder tests before the final so that we don't get false confidence before the final exams.

Anyway. That concludes all my exams this semester. There's two more days left for med this semester, which will include some revision lectures scheduled after the midyear exam. Such a strange thing to do.

For those reading still with exams to do, study well and I wish you all the best for them.

[update] Unimelb MD1 midyear exam and OSCE week + Unimelb undergrad second week of exams.

On the coming week on Tuesday and Wednesday, I have my OSCE and midyear exam. They are not worth a high proportion of their respective subjects of PCP1 and FBS, since they are year long subjects.

However, this will be the first time I will be assessed in an OSCE. This will be something new to me, unlike the many multiple choice tests which I have completed throughout my life. I'm wondering how well I'll do, and how hard they're going to mark for that. The main subject this year in terms of credit points is the FBS subject though, so I haven't been putting as much effort into PCP in comparison.

For FBS, there has been some level of bafflement among students because they put some revision lectures for the semester after the test instead of before it. Now that is a strange thing to do. Ah well. It's not something which can be changed this year, so we'll just have to deal with it.

The coming week is also the second week of exams for undergraduate students at UniMelb, and is part of the exam period of some other unis too. If you have an exam this week, I wish you well in your preparation and exam.