Monday, 16 April 2007

Children Down, Vaginas To Go.

I didn't think 'one down, one to go' was quite right for this post.

My paediatrics OSCE is done, to be honest I'm disappointed in myself, I know I should have done better, it was a relatively fair exam, I just didn't fulfil my true potential. Its worse when that happens. I could just about cope if it was a horrible exam or if I didn't know anything but when you know the stuff but it all just goes a bit tits up, its fucking annoying.

I hope the uni won't get mad at me for explaining the stations (they shouldn't because everyone has done the exam by now)

PAEDIATRICS: (excuse the dodgy numbering, its the order I did them in)

Station 3 - Scenario: Young boy admitted previous night with exacerbation of asthma, comment on his vitals and examine him.

So, I looked at his vitals, but I wasn't exactly sure what comment on them meant so I just remarked that they had improved and took a few guesses at normal ranges of peak flow for children. Then disaster struck, I flunked the respiratory exam, Fuck knows why, I've done it a million tomes, maybe it was nerves, maybe I'm just stupid but I completely fucked it up, I did stuff in completely the wrong order, I forgot to even bother to do most of the stuff and the stuff I did do was rushed and messed up. What a waste, a fair and easy station but I flunked it.

Rest Station - Great, 5 minutes to reflect on my disastrous first station, just what I needed, I took a drink and a jammy dodger before carrying on.

Station 4 -
Scenario: Mother attends GP because she is worried about her 7year old daughter who is putting on weight. Take a history.

Probably my best station, my history was good, I almost froze at a couple of points but I bought myself some time with open questions and managed to cover as much as I possibly could in 5 minutes, which again is ridiculously little time to take a decent history. (even GPs have longer than that) I addressed the mothers concern, I even summarised, and started to make a plan before the buzzer went.

Station 5 - Scenario: Mother has just a baby which has been diagnosed with Downs syndrome. She would like some more information on the condition. Discuss it with her.

A strange and somewhat unexpected station although it was fair I suppose. I could have talked about the signs and symptoms of Downs, even discussed the genetics in depth but I was much less sure of this station. I managed to waffle a lot and managed to elicit and address most of the mother's concerns but I'm not sure I did what was expected of me. Goodness knows how I did in this station, hopefully my blagging was enough.

Station 6 - Scenario: 2 brothers have impetigo, calculate their doses of antibiotics using BNF

Another fair, if rather unexpected station, I don't think I did too badly here either but I couldn't for the life of me think of some contra-indications for penicillin, obviously I got allergy but apparently they were after renal impairment. I got half way there by waffling about metabolism. I also tried to give one of the children, a baby the wrong dose until I used my eyes to bother to actually read the BNF.

Station 7 -Scenario: 14yr old boy in a+e after mother became increasingly worried about symptoms of paranoia. Viva station.

Ah yes, the obligatory child psych station, I don't if I shafted this station big time or if I just misread the examiner. I mean, its a waffle-y topic at the best of times and I answered her questions but I was ridiculously vague and waffled like never before. I still don't know what I was actually supposed to say but hopefully I did ok, psych isn't my strong point but I had a vague idea about schizophrenia and I tried to satisfy the examiner.

Station 1 - Scenario: Young girl in clinic complaining of facial weakness, examine her cranial nerves.

My heart sank at this station, for 2 reasons, a) I hadn't really expected this to come up as it came up in neuro last term, I hadn't revised it but I had vague idea., and b) All 12 cranial nerves in 5 minutes? In fact, more like 4 minutes with traveling between stations and a bit of admin work. Are they having a fucking laugh? Oh well, I launched in saying "I'd also do this, and that and t'other" Whilst trying to be quick but rushing made me forget things, I got into a muddle and ended up having no idea what nerve I was up to. 5 Minutes is just too short, if it had been a 10 minute station I could have gone thorough it all slowly, systematically and properly. I was also bamboozled at the presence of orange quarters on this station, I didn't know whether to eat them or to use them to test taste and smell. In the end I chose the latter, although I could have done with refreshments at that time. I fucked up my diagnosis at the end too but he said I did ok so we'll see.

Station 2 - Scenario: mother accompanies child to a+e, child has a mark/rash on his bottom. Take a history

Now I thought this was a bit of a silly station, I mean it would have been ok as a viva or discussion but as a history it didn't make much sense. It was ok, I managed to deal with the mothers worry about the possibility of meningitis and asked her about the possibility of non-accidental injury (NAI) It turned out that the child had recently stayed with its father who had a new girlfriend. But just as I was discussing the NAI aspect of the case the buzzer went and that station ended. 5 minutes just isn't enough.

And that was the end of that, time flies when you're (hmmm, not too sure about that). In summary, my histories were good but 5 minutes is way too short to get anywhere, my examinations were crap and overall I should have done a lot better. Bring on obs and gynae tomorrow, hopefully I'll make up for today's semi-disaster.


medstudentitis said...

I'm SURE it went better than you thought. OSCEs are hard to judge. Some examiners are just stone faced and some put checkmarks on the sheet after you've left the room (which annoys me to no end). I'm sure you did fine. Good luck with the next one!

j00ni said...

Hmm, I was thinking. If you shift the comma of this post's heading one place to the right it makes a rather poetic description of labour.

Exam pressure is getting the better of me

HospitalPhoenix said...

Wow, that sounds like a tough exam! I'm sure you did fine.

Best of luck with the O&G (I am not going to mention ladies body parts!)

Cal said...

I can't believe you have such challenging stations and yet only get five poxy minutes for them!


We have five minute stations, but we have longer stations for some of the longer stuff...

5 mins is ridiculous.

And I couldn't even do cranial nerves in 24hrs let alone 5 mins... it's just a pet hate of mine.

Stupid cranial nerves.