I've just spent 2 and a half hours guessing the answers to 125 multiple choice questions. I actually knew the answer to about 10 of them! now I have to hope that I'm good at guessing.
It's a stupid exam anyway. Why the medical school think giving the same 125 questions to years 1 to 5 is a good idea is beyond me. The questions are also rather ridiculous, many of them involve picking the best answer, but most of the time there are a few answers which seem perfectly fine but you have to guess which one is considered 'most' right. I don't like the concept, its all about luck, most of the questions are so obscure you couldn't learn them by reading books, or talking to patients or even being taught by consultants, the ones you know are just random tit-bits of knowledge that you pick up from god knows where.
I'm useless at remembering questions after the exam which is probably a good thing as I don't really want to think about it but here is one I do remember:
You are the F1 doctor on the ward, a 60yr old male patient who has just been
diagnosed with inoperable lung cancer due to smoking 40 a day is in hospital and
about to begin chemotherapy. The patient has developed pneumonia and as a result
has just cardiac arrested, you arrive to find the ward sister bag and masking
the patient.
Which of the following is the best course of action:
a) Cease resuscitation effort
b) Contact the family to discuss their wishes
c) Ask the advice of the ward sister
d) Commence full resuscitation
e) Bleep the patient's consultant to ask them what you should do
Answers on a postcard, I went for commencing full resuscitation but I don't know if that's right or not. You need more information to answer so many of these stupid questions.
Anyway, at least its over with, I can forget about it till whenever results come out. Lets just hope that I'm not in the shitest few percent of my year who'll fail and will have to resit the stupidest exam in the world!
9 comments:
full resus definately - certainly a position which can be defended medico-legally I reckon too
Whoa. Sounds like a tough exam.
Still, you have it better than some; I just finished a 60-question exam that grilled us on excruciatingly minute details of pharmacology. I'd do your test any day rather than having to sit down and crack my head over whether enalaprilat is the inactive precursor of enalapril in the renin-angiotensin cycle.
I'd love to be linked on your blog..i'll do the same for you. just let me know....
theanonymousmedicalstudent.blogspot.com
that's weird that all 5 years get the exam! especially for the first years, lol.
nice insight into a student life of a medic student here
jooni - Thats good, at least I got one mark then! Thank fuck its not negatively marked or i'd end up with negative marks.
angry medic - Yeah, you have a point, I'd pick PBL of traditional any day of the week. I think i'd have shot myself by now had I had to study everything in minute depth.
the anonymous medical student - Sounds good, i'll sort it out later.
mo - Yes, its very weird, and a bit pointless in my opinion. Although I don't think i'm allowed an opinion anymore because i've complained too much about so many things. And thanks :)
I'd go for your answer, although I do like the thought of phoning the patient's family!
I have no medical training (OK, well I worked on a pharmacy counter for a while so I have a minimal amount of knowledge) but surely the question is stupid? SO you, a brand new doctor, just happen to stumble on a nurse doing the baggy-and-squeezy thing? How fortunate. Wouldn't the nurse have already called for the resus team? Therefore you would be one of many people responding to a call for full resus anyway?
He's corrupted me. I never used to care about this stuff.
The real life answer is:
1. Ask if this person has a DNR status
2. Discover they don't.
3. Swear under your breath because you are aware that this is a pointless exercise
4. Ask someone to call the Crash Team
5. Assess patient and if commence CPR
6. Ask someone to call patients family
7. Await Crash team.
8. Mentally curse crash team for still not having arrived. Meanwhile someone drags over the resus trolley.
9. Attach leads and discover asystolic rhythm
10. Crash team arrive. At this point one of two things happen
a) Pragmatic team leader: Attempt resus for 10mins whilst reviews notes. Ends resus attempt. Tidies all equipment away and tucks patient into bed. You (the F1) or team leader talk to family for 20mins.
b) ER wannabe team leader: Arrest continues for 45minutes. Eventually cardiac output is established but the poor man has no blood pressure and no respiratory effort. ITU team arrive and argue about whether he is a candidate. Agree he is and take him to ITU, where he dies 20minutes later.
Unfortunately, I suppose reality doesn't feature heavily in exams ;)
JD
Answer.
Commence resuscitation.
descover hypercalcaemia
shit the gonks
realise its your fault
be all 'well, he did have cancer'
relise that chemo was for curative intent. go home
go back to work
be more vigilant for the next time
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