OSCE Exams!

This was an abbreviation I had seen so much of during my research into studying medicine at university. Now, this was going to be my main assessment for second year!

An OSCE is essentially similar to the MMI stations that you will (have) sit to get into uni. The stations are made up of a number of sections and each OSCE will have a certain number of stations in total. For my exam, there were three stations with each being divided into three sections.

Each station would test an aspect of the content that had been taught in both years 1 and 2. It would involve a history or an examination on a patient with a presenting complaint, so like chest pain or breathlessness. It would then be followed with an interpretation task. So this could be looking at an x-ray (to test anatomy), processing lab data (to test practicals and lecture content) or interpreting graphical data. Finally, would have to explain something to the patient (ie. what they have, how to use an inhaler etc) or activate them to change their lifestyle (ie. stop smoking, stop drinking alcohol etc). The station could also have a clinical skill which we would’ve learnt In our clinical encounters, like dipsticking urine or doing a manual blood pressure.

But there were three of these stations to break it up (eg. One on chest pain, one on breathlessness and one on abdominal pain).

The examiner would sit there with a clipboard and tick as you were talking and working with the patient. The patient was an actor pretending to have the condition, or real patients who had what they were actually describing (eg. Psoriasis).

The whole exam lasted an hour. (Each station was 20 minutes)

It was great how the exams were so practical and you actually felt like a medical professional whilst speaking to the actor patients. It was very pressurising, like any exam, as the trick was to look both confident and friendly. In these examinations, you're being tested on both your person skills as well as your knowledge!

I got my results about a month later and was over the moon with a pass! Roll on Year 3...

Summary of Year 1

Let's do an overall summary of Year 1...

• I arrived at university and met my flatmates. I had to make all new friends from my course and my student accommodation, who thankfully remained by my side throughout the whole year!
• I did house viewings and decided on my accommodation flat for next year!
• I learnt soooo much! From anatomy, to law, to sociology, to ethics, to histology, to biomedicine to biochemistry! There has been so much content on each individual system in the body which you can't help but feel excited to turn up to lectures.
• I have handled a lot of cadaver specimens and have been exposed prematurely to death. I have also taken part in shadowing a pathologist during a post mortem.
• I have taken part in clinical shadowing at GPs, where I did some clinical skills and did individual home visits. Here, I learnt how important communication is when it comes to talking to patients.
• I have also shadowed doctors at Southmead Hospital and have been taught by both patients and the teaching fellows about body systems and some clinical skills - such as taking blood pressure, blood glucose levels, auscultation and palpation.
• I completed an essay project, as well as an art project. This is based on medicine being both a science and an art.
• I have worked as HCA as part of the course, where I worked four shifts of 7 hours and one 12 hour shift.
• I loved being a HCA so much, I then went on to apply for a job as a healthcare assistant in Bristol. I went for the interview and then received my job offer. I then attended the training and now awaiting some shifts to sign up to!
• I have completed my exams, January and Summer and passed to progress into Year 2!

I can't believe how much I feel I know ever since starting just less than a year ago!

Year 1 has been filled with some very exciting moments and I have enjoyed every second of university life. You are so independent and have so much fun which is incomparable to any other experience I have ever had! I would say I would love to do it again, but I'm really excited to go into Year 2!

I hope all of your exams go well and you receive the results you both want and deserve. Have a great summer, and I will speak to you in September if not before!

...and the results are in...

Guess who is 20% a qualified doctor??? ME!!!

Yup, somehow, I passed my exams! I feel like it was a huge reward for all of the hardwork that I put in towards the end of the year (from the beginning of May up to the exams) even with the circumstances going on.

I will use this chance to say about the grading with medicine as well! I'm not sure if I mentioned it in the last posts so I'll say here, medicine does not have the standard first, 2:1, 2:2, third etc. scale which is used to measure and assess other courses.

So you will hear that a lot, "Did you get a first or a second in your exam?" around the university. But medicine is simply a pass or fail. This then determines your next progression into the following year. So because of this, I have completed Year 1 and will progress to Year 2 next year!

I'm progressing into Year 2!

Thank you to everyone that supported me, especially the past month. I am truly grateful for everything.

Summer Exams

Preparing for the exams has awful and sadly not because of the stress of exams. Whilst at university, I was informed by my friends at home that a close dear friend of mine had passed away at his university. This came as a great shock to me and I wasn't prepared to process such news as devastating as this. I was fortunate enough to attend his funeral and speak my eulogy that aimed to portray his fun and exciting character that I miss dearly. His funeral was the 6th June, whereas my first exam was the 5th June and my second exam was the 7th June. So sandwiched between the two examinations, I had to travel home promptly within the time to ensure I would make his funeral.

...

But the main question - what were the exams like?

Short answer: Difficult! Haha.

It's nothing like A-Level testing. The exam MCQs give you five possible answers to a question that could be a one line to a whole paragraph describing a patient's history. You guarantee that you will find yourself deciding between two answers and then it's pot luck if you aren't confident to the answer!

The exams were also weighted massively on the delivery of teaching. The majority of the exam was on physiology and function, closely followed by anatomy and then broken up into questions on the sociological, behavioural and ethical aspects of the course.

Here is an example of a medical MCQ! (And how I would approach such question in an exam situation)

Which cranial nerve is responsible for the abduction of the eye?
a) CN II
b) CN III
c) CN IV
d) CN V
e) CN VI

So... the breakdown on this question. You could either work out each individual cranial nerve and what it supplies, but I found it was always quicker to just dissect what the exam question is both asking for and looking for.

I'd begin with a quick sketch of the eye...

A small sketched diagram I would draw next to the question that I've annotated. The line on the left represents the nose, showing that this eye would be the left eye.

On the sketch, I would quickly drawn on the eye movements and the name of the muscles that are responsible for this. I would have learnt this mainly from my anatomy sessions when I located these muscles on cadavers and learnt their functions. Then, in the neuro case, I would've elaborated on each individual cranial nerve and what motor supplies they have.

I would then draw the names of the eye movements:

Another small diagram showing the names of movements of the left eye.

This is important because I need to be able to understand what movement I am trying to identify. In this case, abduction is the lateral movement (meaning the eyeball moves away in a direction away from the nose). Comparing the diagrams, it is clear that lateral rectus is the muscle responsible for abduction of the eyeball.

Then, I would just have to either remember from my revision that the lateral rectus muscle is innervated by CN VI. Or, I could've looked at the answers in turn. Cranial nerve six, CN VI, is actually called the abducens nerve. So this would've saved me time if I had remembered the common name of this cranial nerve! Or I could've worked down the functions and remember that CN II is the optic nerve which provides sensory information of sight etc. Or, remembered that CN VI is the only cranial nerve to supply the lateral rectus muscle ... which causes eye abduction!

It may not make sense now, but you'll be laughing how easy this is to understand when you complete your first months of medical school - trust me!

If you are looking for my opinion of the exams, I would say they were very difficult. They were quite confusing and used a lot of application! I know in the example, I gave an MCQ which would be structured similar to how the teaching would be delivered. But there were a lot of questions on symptoms and a list of possible conditions which we had touched on throughout the year.

I found the second paper a lot harder than the first. Obviously, the circumstance of my friend's funeral being present during my revision time didn't help either, but I will confirm that I did apply for extenuating circumstances. Results day will tell me more!

Good luck to everyone else who has exams at this time!

Preparation for Exams

At the moment, I still attend university in the week because we are still learning content. We are still learning about the Neuro system (which involves the brain, central nervous system and peripheral nervous system) and the Endocrine system (which involves the glands and hormones around the body). As mentioned before, this content is being delivered through lectures, facilitation sessions (because we are doing CBL), laboratory sessions and the clinical placements at the hospital and the GP.

How the majority of my days were spent throughout May!

Between these hours at university, I have been finding the time to balance revising for my exams. I have two exams this year which are both written multiple choice exams. Whereas in my January exams, if you can remember, I had to complete a written examination of MCQs (multiple choice questions) but also a 'spot' function exam (which involves cadaver specimens with pins labelling structures we should identify / explain their function fully) - but in my summer exams, I just have two written papers! Both of these exams are MCQs, 80 of them, which will test all aspects of the course from the beginning (Yes! ... from September 2017!)

So, I had to revise all of the ethics, all of the behaviour and social sciences (including sociology), some of the law content and the biomedical parts. Alongside this, I had to revise anatomy, histology and the function of each of the structures I could identify from a variety of photographs.

The worst part about revising for these exams is that I love working from past papers! They were my 'go to' resource which helped consolidate my knowledge. But unfortunately, I have no bank of past paper questions to go by! Some of our lectures though did give a small example of what a multiple choice question concerned with the lecture would look like, so I did stick all of those into a document that I printed and made an attempt at.

I did find quite a few online MCQ flashcard applications which had pre-made Year 1 medical questions which were composed by other medical students. Obviously, there were a lot of questions I didn't know because they weren't part of my curriculum. Therefore, I broke up the content and searched for questions on those individually. For example, looking up quiz MCQs on 'Anatomy of the Thorax' or 'Histology Images of Epithelial Cells'.

My exams are in the beginning of June which is very late in comparison with my friends. My friends finish their exams mostly in the middle of May, where they will be heading home for summer. So, I will be revising in the flat alone! Some of my friends from other universities studying other courses had a few exams at the end of April and were done for the summer! I'm very jealous.

To revise, I found the best way to learn anatomy was to study myself! I drew on my body quite a lot, highlighting different areas which were important to remember. For example, remembering the palmar arches in the hand, and whether it is the radial or ulnar artery which supplies them mostly individually.

With all of the other notes I had typed up based on attending my labs and lectures, I practised writing them out by hand in a notebook. It was quite good practice to consolidate my learning in this way, as I was reading my notes and then testing whether I could reproduce the information on a blank page. If I made an error, I could learn from such mistake.

I drew on my arm to try and get an idea where the structures were located on myself.

This was also during the period of the heatwave that hit England! You can imagine how horrible it was to sit in the library as the scorching sun shone through the window and burnt your arm. It was more of a killer getting invited to join mates in pub gardens when you know you should be studying hard!

Caffeine overload! To stay awake, I found myself turning to Red Bull and coffee for the boost I needed!

I did give in though, I cooked a barbecue for my flatmates and we sat on the field drinking ciders and soaking up the sunshine while it was here!

Barbecuing on the downs!

Assignments.... science vs. arts!

At the beginning of the year, I remember laughing with my flatmates how great it is that we don't get as many essays compared to other subjects. One of my flatmates who does biology is always complaining about another essay or report she has to do.

But, we were set an awful essay on discussing *something* and its impact on human health and wellbeing. The *something* had to be appropriate and from a certain list we were given (ie. diet, exercise, loneliness etc). I decided to do how owning a dog affects human health and wellbeing, which I thought initially would be very interesting. Was it? Of course not. For every paper that said owning a dog lowers your blood pressure, there was a study that proved that wasn't the case.

My essay based on the impact of owning a dog on human health and wellbeing. One of the hardest parts of writing this essay was actually trying to reference using the Vancouver method as opposed to Harvard, which is what I'm used to!

It was very complicated and repetitive, but I ploughed through. I lost out on a really good night, but I guess it was my fault for leaving it until the week it was due. Literature reviews and breaking down medical scientific journals is a talent that I really don't think I have compared to my friends.

My uni though is trying to promote this concept of medicine being both an art and a science. Therefore, we have also been set an art assignment. We have to base this on a clinical encounter that we have had or observed.

I have decided to create a reflective piece based on a patient that I met whilst doing a home visit in my GP placement. She has polycystic kidney disease, and her poor kidney function led to her having a kidney transplant. I was very shocked to learn that unless cancerous or posting a serious threat to life, they keep the kidneys inside you! I always thought they removed it during a transplant, but no!

The patient told me about how she believes it's the medication that is keeping her going. So I have based my art project solely on the amazing concept of a renal transplant, but also the dependence on medication to stay alive.

The plan for my art piece: an anatomical representation of the abdomen with the transplanted kidney (from the posterior abdominal muscles, to the bladder, major blood vessels, two PKD-affected kidneys, a transplanted kidney, to the liver, the stomach and the spleen). This will be moulded out of clay, dried over the holiday and fired in a kiln in the final week and ready for the deadline of the 20th April. Surrounding my clay piece will be the tablets a renal patient will be taking to prevent rejection or any infection post-operation. I have researched these drugs online, and through the use of NHS renal transplant information leaflets which are given to patients before or after their transplant operation.

The beginning base for my anatomical representation of the abdomen, crafted out of clay. On the paper is my rough plan of how I plan to lay out the structures.

I will keep you updated on how this turns out!

Villiers Park - How did it help?

So I have been part of the Villiers Park scholarship programme since Year 10. I feel that being a Villiers Park scholar definitely set me up for my path into Medicine by providing me with the information and support I needed.

As part of the programme, everyone is assigned a learning mentor that will provide this information and support that I have mentioned before. Through one-on-one mentoring sessions, I would meet with my mentor to discuss my recent activities. I would explain to my mentor how stressful I’m finding things, how I’m worried I’m not going to get the grades and how I cannot find a balance. And by talking and development plans of actions, I knew I could cope for another two-three weeks before the next session. Everyone on the programme found the mentoring sessions as an opportunity to vent about our struggles but find solutions to them, whether it be crafting the perfect personal statement or researching different university choices.

The masterclasses allowed all of us to come together as one group and work towards given goals. But the objective wasn’t the task itself, but the personal and interpersonal skills we developed through it. As shown in our last Year 13 residential in March, we could confidently deliver a presentation better than we could in Year 10 residential. Through Villiers Park, we learnt about how to conduct research, how to process the findings and then present to an audience. These are skills important not just for university, but possibly for most of our jobs and careers in the future. I felt I developed and learned more specialised skills through Villiers Park moreso than I did in our normal PSHE lessons at school.

Villiers Park has helped with our career advice, university choices and personal statement construction. I feel my mentor sessions and the masterclasses provided helped me on track to making me a strong candidate for the degree I wanted to read at university, being Medicine. I was also a member of "MedSoc" which was our Medicine Society. Here, I heard guest speakers (such as paramedics and junior doctors etc) who pass on any advice. We also had interview preparation and help, where we learnt how to address our interviewer, how the MMIs are structured and even advice on current medical affairs and how to approach the ethics in medicine.

There was an opportunity as well for a one-week residential in Foxton that specialises in a subject we feel passionate about – whether it’s engineering, biology, English, politics or computing! I attended the course on Cell Biology and Cancer where I learnt about the different stages of cancer (from a genetic mutation in transcription to metastasis around the whole body). On the course I learnt even more skills, but this sparked my interest for oncology which then initiated my project in the EPQ (which was based on the biochemistry and physiology of cancer). These courses can be assessed by following this link: CLICK HERE. I would certainly recommend a biology/medical fuelled course as this will be of great interest and look super attractive on your personal statement to universities!

If you're still not persuaded to get involved, take a look at these photos:

Personal Statement

You will need to construct a personal statement which sells you to the university. It should advertise you as a person, should be written by you and should make the admissions team reading it go “Wow. Give this person a place!”. You have 4,000 characters to sell yourself, so what should you include?

Firstly, check the university course website. Most universities may post personal requirements that they are looking for. For example, some universities might be looking for a confident resilient individual that has strong communication skills. You want to read across your chosen universities’ websites and refine what you should include. Sometimes there will be an overlap, but you want to sound as appealing to the universities as possible!  Merge all the personal qualities from your chosen universities and construct one personal statement. It is the only one you’ll write and all five universities will receive the same statement.

Don’t fixate TOO much on Medicine in your personal statement. You are applying to five universities, but only a maximum of FOUR of these can be Medicine. Therefore, one university has to be non-Medicine. So this could be Biomedical Sciences, Biochemsitry, Human Anatomy etc. If you apply to Art, they are most likely going to reject you as your personal statement will all be about Medicine!

What should you include?

• Show don’t tell – If the university is looking for a “confident resilient individual that has strong communication skills”, you could use these words but with caution. Don’t use the string of words exactly how they’re written in the prospectus. So instead, show the admissions team what makes you that individual. Maybe you were a head boy? A peer mentor? An adviser for younger pupils? Don’t just say “I work well in a team”, give examples of team led activities you’ve taken part in. 
• All your experience journal entries! Mention BRIEFLY what you did, but what you learnt from it. Don’t dwell too much on certain aspects as interviewers may take them as opportunities for you to elaborate on certain points. I’ll give an example later. Say what you’ve learnt and how it changed you as a person. 
• Your most perfect English, spelling and grammar. Make sure you use spell check! 
• Be passionate without using the word. Do not say “I am very passionate about medicine” because it’s extremely cliché. You want you just put across your passion and strong interests without saying it. 
• Don’t say any cliché terms – it is a complete waste of characters and you only have 4,000 of them so use them wisely. You haven’t wanted to study medicine since you were a child, so don’t waste the energy to type it.  
• Take on board all feedback you receive. Hand your personal statement to anyone that you can! I handed my personal statement to my Villiers Park mentor, two teachers, two doctors and a nurse! I had conflicting feedback, three against three on different parts. One person would say they love one bit where another person would say “Scrap it!”. Personally, it all comes down to you. If you think it should stay, then keep it. If it should go, remove it. You don’t have to take all feedback and act on it – it’s YOUR personal statement. 
• Use short snappy words if you can. Don’t waste characters as “next” uses less characters than “in addition to this”. Remember, conserve those 4,000 characters wisely. 
• Avoid cliché terms like “I am passionate for Medicine”, “I really love Medicine”, “I was born a doctor!” 
• All your own work – do not plagiarise! You will be found and caught out on it. This will affect your opportunity of reading medicine.

Make sure you apply to medical school before the deadline! Then it’s a waiting game….waiting for the university to reply to your application! 

Experience Journal

Document everything you do! The reason I have found this document fairly easy to put together is all because I documented every experience I did. Villiers Park gave me a template that worked perfectly in crafting my personal statement and discussing in interviews.

So an experience journal, how will that help? I would recommend buying a small notebook that you’ll keep from Year 12 all the way to the end of Year 13. All you got to do is plan something you’ll do, like work experience or an extra-curricular activity and then write a short description about it.

For every experience or work you do, answer the following questions:

• What is the date/time I did it?
• What exactly did I do?
• Where was it?
• What did I learn?
• How did this fuel my passion for Medicine?
• How has it changed me/led me to do?

You wouldn’t believe it, but universities only really care about the final three bullet points of that template. You could go complete work experience in India and observe a baby being delivered. But what did you actually benefit from that? If you can’t explain, you clearly didn’t develop yourself. This is to deal with opportunity that is separate from all medical candidates. Some candidates have family working at the NHS so can get readily available work experience. Some candidates can fundraise the money to go to India to undergo medical shadowing and support. Some candidates live in rural areas where there are no surrounding hospitals or surgeries in reach to volunteer or work at. So they’re primarily interested on what you have learnt, how this has fuelled your passion for studying medicine and how it has changed you (whether you did something else after that experience or learnt something).

Make sure you fill this out closer to when you have completed or doing the experience. The purpose of this is to make sure every detail is retained for later recall in your personal statement building or interview practice.

If you write this, you’ve basically got the skeleton to your personal statement and the answers to those questions in your interviews.