Exam Weak (Yes, that's intentional!)

So, the Christmas holiday is over and we have returned back to university to complete the next term. All my friends have some exams, but they are sitting them and then going back home. Me on the other hand, I'm here for the start of the term. After my exams, I start my shifts as a health care assistant for a week before everyone returns and lectures begin. As I write this, I sit alone at the kitchen table in my empty flat with a tea.

January has come and Christmas seems a lifetime ago. The pleasant happy season feeling has somehow dissolved into fear and anxiety for the exams. The majority of the Christmas holiday involved sitting at my desk day-and-night reading the same notes over and over again - with the occasional glass of mulled wine and a 'drag and drop' quiz on "Muscles of the Upper Back".

This is my dog, who did make it challenging to revise at times when he would lay across my notes...

How did I revise? Well, I began by reviewing the learning outcomes. In A-Level, I lived by the course specification and read it like the Bible. I had it printed in my Biology folder, annotated around each outcome with slight more detail than what was presented. At university, you don't get an 'as guided' list of learning outcomes that I am used to. You get a long list of fairly broad learning outcomes, that you definitely couldn't annotate with 'slight more' detail. Farewell to the days of "Candidates should be able to explain the role of the diaphragm in inspiration" to "Define what health is, from different perceptions of Lay definitions to agreed definitions from health professionals." as an example.

The first exam was an anatomy exam. There were basically specimens positioned at different stations with a sheet of paper in front, asking us a question and to select the most appropriate from five answers (in a multiple choice way). You had a minute per station and roughly 80 to complete, so the exam was approximately an hour and a half long (counting the rest stations). In the anatomy practicals, it was very independent and self-led, which is why I was dreading the anatomy exam more than anything else. I felt that I was quite familiar with the 'majority' of body locations. So, if you asked me to draw out the gastrointestinal system, I probably could. I could point out the major organs, as well as the accessory organs. I could explain some of their functions, and even small extra detail like how the major duodenal papilla is where the pancreatic duct enters the duodenum. But I can not explain this using cadaveric specimens. Therefore, I decided over Christmas to completely redo my notes and update them with not just pretty coloured diagrams from an Anatomy Atlas, but to also incorporate images of cadaveric specimens that are readily available online.

I'm definitely more of a visual and creative learner, so I made this model of the cranial nerves and incorporated the cranial foramen names so I could revise both of these at the same time.

Personally, I feel this paid off. But I don't want to jinx it to be honest, because I really hope my hard work over Christmas pays off for anatomy. It took a lot of blood, sweat and tears - and I still can't point out where those tears come from because I can't identify the lacrimal gland. I believe this would be quite a handy skill to grasp before you come to medical school, or as a good skill to practise whilst "you've got nothing to do" while at university. Look up some cadaveric specimens online, or possibly use an Anatomy Atlas which includes labelled photographs of cadavers, as this will help you identify structures more easily. For example, learning that the trachea obviously has the C-shaped cartilage rings that keep it open and that the oesophagus has a thinner wall and isn't 'as open'. This means when you are given both and asked to identify which is the trachea, you'll be able to identify the 'open' structure and which one feels like it contains the slightly "soft/hard" cartilage rings (you're able to feel the difference!).

But in the exam, you're testing on a few parts of anatomy PER question. Let me give you an example. You have a table at this station, with the pelvic girdle of a male situated in the centre. The pubic symphysis (the joint which joins the two hip bones at the front) has been represented by a solidified clear resin with a pin pierced through it. You look down at the sheet of paper accompanying this stand and see the question: "The structure being identified here is classified as what type of joint?" with a list of different types of joints: from primary cartilaginous joint, to secondary cartilaginous joint and named synovial joint types. But that is an example of how the one question actually asks quite a few: "What is this structure?", "What type of joint is it?", and you could even argue that it asks "Where is this joint?" and "What's the movement at this joint?" as it could help determine the type of joint this is classified as. Or you were given a radiography image, where you would have to quickly identify how the X-ray was taken (ie. from the side? from the front?), what is in the image, what structures are available, what does the white represent (ie. could be bone, could be fat) and then finally what is the answer to the question being asked? This is a lot to do in the short period of time at this station before you move to the next. However, it was just like in the MMIs that if you messed up one question and did not have a clue at this station, that dreaded buzzer declaring the end of the minute was a sign to suck up and move on, put it in the past and pray the next station provides better hope.

When the exam finished, my friends and I hit the nearby pub to discuss our answers over a coffee and large breakfast. The coffee helped us recover from the nervy-sleepless night before the exam, but to wake us up in preparation to go home and revise for the written exam tomorrow...

The written exam tested us on the behavioural, sociological, ethical and biochemical side of medicine. The paper consisted of multiple choice questions again, but this time asking questions that directly link to the lectures and tutorials we have had. I found this paper more difficult, mainly because I had stupidly spent my whole time allocated to revising anatomy. I was tested on genetic transcription, consent, what imaging should be requested for a patient presenting a certain condition, manipulating data from a graph I had to plot, what is epidemiology and so much more.

I will use this opportunity to describe how exams at university differ to how you may be used to it! GCSEs and A-Levels, you sit in rows of desks, are given the paper, started at the same time and then all finish at the same time. This is different to university! In university, you all start at the same time, but you can leave the exam hall when you've finished - just like what you've seen in the films! The only exception is that you cannot leave in the first half an hour of an exam or the last fifteen minutes, but as soon as you're finished (and hopefully proof read your answers), you can put your hand up, get permission from an invigilator and then you can leave!

I get my results in the first week of February, so who knows how I did. If I'm perfectly honest with you, I'm proud of how I did and know that I couldn't have tried any harder. I redone all of my notes in preparation for my anatomy exam and hope I see the result I really worked hard for. But you can never tell. We all have (especially me!) worked so so so hard for an exam, only to be devastated when opening that results sheet. I'll give you an update when the time comes, ay?