On Tuesday, I had my very first oral exam. It was terrifying. I sat down with a plastic surgeon (just my luck...) and talked about lots and lots of different things, ranging from melanoma to lung cancer, cholecystitis to upper GI bleeding, colon cancer to breast cancer, and a lot of random surgical stuff in between. It's hard to know what they want to hear; given such an open ended opportunity after being told to "tell me about melanoma" means that I could go any direction with that topic - but where did the surgeon want me to go??? Details about specifics, or broad overview, or just the concepts of pathophysiology and treatment? That was the worst part of it. Oh, and she asked me a LOT of specific number questions ("If the primary superficial sclerosing melanoma lesion is on the face and is less than 1 mm in size, what does that indicate? What treatment would you suggest? What is the prognosis? How clean must your margins be?"). I talked to a few friends who took the orals the same day as I did, and I have heard that they went through the basics, the principles, the concepts...not the specific details and cut-off numbers. This surgeon was FULL of number questions...Like what is the necessary FEV1 in order to attempt a lobectomy versus a pneumonectomy? I'm not good with numbers on a good day, so on exam day you know I'll mess it up. But I gave broad concepts, and my numbers were mostly spot on (or nearly spot on...). It was rough. I did ok though, certainly not a fail, but I always feel like I'm a failure if I don't get 100% of every question asked correct. Maybe I'm a little too hard on myself...but I just expect me to be perfect and I don't accept anything less. That's a hard thing for me to overcome; no one in this world is perfect, so I have to accept that I cannot know everything, and it's ok to get a few things incorrect...Being a perfectionist, it's hard to accept that.
I also had my first OSCE or Clinical Exam. I had 2 standardized patients to take a full H&P on, perform an exam, speak with the patient about possible diagnoses and tests we'd need to run, and write a note documenting the encounter. My first standardized patient had diverticulitis, the other one had acute cholecystitis. I scored noticeably higher than average on my clinical exams. I'm always happy to do well on the Clinical Exams, as that is what my future will be full of.
I'm happy to have that done and over with. Only my shelf exam to take next week and I'll be finished with my first clerkship, 10 weeks of 3rd year will be complete! Seriously: Where Has The Time Gone?!?
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