Chapter end (9)

Part IX.
Word came to pass.
Took me some time to get my result using the enrollment/result email service. I submitted a request at around 3pm but it was still too early, and then again at 12.20am after coming home. I checked my portal email lots of times and decided that if it didn't come by 3am, I'd go to bed first.

I was woken up by my friend's phone alarm. Went to the bathroom while letting my laptop turn on. Then logged on to Student Portal. And got my results.

Really thanking God for this great journey that I've been on. Last night, I've decided that whatever the result is, it actually isn't as meaningful as the adventure itself, because it is during the long, sometimes arduous process that I've learned about what God desires out of my life.

Well, He came through and fulfilled His word! I achieved the highest excellence prophesied to me. And really, I found the journey (the process) to be more meaningful than the result itself (the single point in time). And you know what, this story is really more about Him than me. Seriously.

That's the close of this semester's chapter. Next up, Sem4 Neuroscience.

Picture credit: Daniel Mencák

Final 1 Hour (8)

Part VIII. CRL Practical, 1 hour, 50-MCQ, 15%.
Never Stop.

We learn from out mistakes. Agree? Well, after my last exam paper, here are three things I just learned:
1. When talking about lymph nodes, Bronchopulmonary = Hilar
2. The neutrophil's job
3. Coagulative necrosis - not fibrosis!

Also, as always, the prac exam has a few questions where the wording makes it ambiguous (at least to me). One thing I remember:

"The muscle associated with the structure pointed by the white arrow..."

It's as if the "muscle" and the "structure" are completely different, or somewhat different, or somehow related. I couldn't tell (so that's my problem). In the end I decided that the structure was part of the muscle, and made my answer choice.

I ended with about 18 spare minutes. Whew. What I feared the most were those long, PBL-style questions where you're told the patient's symptoms, history, body temperature, heart rate, etc., and give a diagnostic answer. And this is an MCQ test! Anyway, we didn't get any of that in the Prac paper, so it's a relief.

Last thoughts, despite the extra revision time that we had before this paper, I still don't feel the "readiness" feeling that I used to have before this. Could be a bad sign that I'm not preparing myself well enough. Or, could mean how much more I'm denying self-reliance, taking instead the understanding-that-is-higher-than-ours. And that's what I wish.

Big Surprise (7)

Part VII. HP3 OSCE, 7 minutes, 20%.
What should have been the last.

I totally did not expect it. The patient presented with cough. For the first 30 seconds while reading the case intro, before going into the consulting room, the word cough didn't ring a bell loud enough in my head. I expected sudden onset, central crushing chest pain (angina or full blown AMI), where I can then ask about the risk factors, etc. Heart attack is, in fact, the global #1 killer.

Thankfully, I have on the night before done a read-through of all the presenting symptoms in the ICM book, and sort of made links between their associated features. Cough goes with sputum (phlegm, kahak), haemoptysis, chest pain, breathlessness, wheeze, smoking, and fever. I reckon I did well with the cough, phlegm and coughing up blood. The ICM video on these were very interesting to me (thanks to Syarul), and all I did in the exam was copycat-ing the doctors and the way that they asked questions to find out more about the symptom.

What stressed me out was that I missed asking about chest pain and breathlessness! I realised this during the 3-hour lock-in after finishing my session, when I checked my workbook and found out that they are also associated features with cough. Surprisingly there's no feedback session with the doctor and patient this time around.

The reassuring thing for me is this thing posted online on LMS by our coordinator just 2 days ago:

On the whole I was impressed with the performance in this examination and the communication skills and interviewing skills were of a high standard.

Normally the OSCE (interview) is the last of our exams - which I see as the "pinnacle" where we utilise our medical knowledge to care for a person - but that's just me sometimes being over-dramatic. Our Prac Exam got the last slot this time.
OSCE=Objective Structured Clinical Examination, ICM=Introduction to Clinical Medicine
AMI=acute myocardial infarction, LMS=Learning Management System
Were you looking for something else?

So happy ~~ (6)

Part VI. HP3 Exam, 2 hours, 6-SAQ, 50%.
The most enjoyable.

Of all the papers I sat for this sem, I found this one to be the most encouraging. In fact, it's also the best Health Practice paper I've done in 1.5 years. You know, when you have such confidence while answering the exam questions?

I knew I wasn't alone and helpless. Because of the word in my ears.