Wow, I apologise for the unexplained hiatus I took. 2 months! This post is going to be an unofficial breakdown on the summer exams here in Bristol med school and how I found them (they’re finally over for me, now let’s hope I’ve passed </3).
Systems of the Body #1: Anatomy & Histology Spot Test (May 30th)
Structure: 60 MCQ questions (40 anatomy + 20 histology); 45 seconds per station (hence 45 mins long). The anatomy questions are 50:50 between pathology and identifying structures.
What: In Term 2, we began the Systems unit – for first year, we learn about the cardiovascular system and the musculoskeletal system. Each system integrates both the anatomy DR sessions, histology practicals, and the of course, the abundant lectures. Students tend to prefer Systems over MCBoM, because this is actual information we may need to retain as doctors in the future since it’s much more focused on pathology and we begin distinguishing the normal from abnormal. And for this same reason is why students buckle down and revise that little bit more than the January exams, because it’s the real deal.
- DO NOT NEGLECT HISTOLOGY. In Term 1, students saw histology as a bit of a joke, thus neglecting it partially or completely, and got away with relying on knowledge retained from the histology lectures in LT 1.4 those few weeks ago. Sorry, but this ain’t gonna work for Systems! I highly recommend going over the virtual microscope slides (no need to remember the names of each slide – they label it in the exam), identifying what things are and functions of certain cells/structures. All you need to know is in the lecture and the VM, so don’t get all worked up with histology, but do not neglect it. People came out of these exams saying “The frikken histology stuff though, not even funny how much I guessed…”
- LOOK THROUGH THE RADIOGRAPHY SLIDES. Again, be efficient with your time and don’t dwell extensively on them, but they definitely come up – it’s the only kind of pathology you’re seeing in first year, so whatever slides they use to teach the clinical stuff, focus on those. They won’t give you a random tiny fracture in the 4th metacarpal bone to identify. Sometimes you’d like to rely on your anatomy knowledge of where things are, but there are just things the radiography slides have that can trip you up if you haven’t seen it before.
- KNOW OBVIOUS SIGNS OF CERTAIN PATHOLOGIES. Okay, really obvious. But, if the case scenario starts talking about a 63 year-old man complaining of pain radiating to his back, you can almost guarantee the answer will be coarctation of the aorta without having to read the rest of the scenario. Or if there’s an image of splinter haemorrhages or Osler nodes, it’s bacterial infective endocarditis. If you attempt to remember the hundreds of other causes of back pain or splinter haemorrhages, or research the extensive pathophysiology of pericarditis, it’s a waste of your time at this point – to pass the exam, just key points.
- NEVER LOOK BACK. It’s so easy to think back 7 stations to that question on the umbilical cord when you’re looking at the brachial plexus, and be tempted to change your answer. Stop! Don’t do that. I was a victim of that in the January exams. Completely derails your focus on what’s currently in front of you. Trust yourself, because knowledge is lingering in that brain of yours and don’t question your instinctive answers.
Final remarks: Dare I say, the most fun exam, since approximately 60 of us are crammed into the DR, madly stressing under the same sky of glaring white lights that illuminate the bags under our eyes. It’s kind of teamwork in the most independent way. I remember seeing some questions that no way came up in the red booklet, like “What does the umbilical cord contain” and then permutations of 1 artery 2 veins/2 arteries 1 vein etc. – don’t freak out about it. Chances are, if you’ve done your revision and this has not come up in the statements, your course mates will feeling equally baffled. And, there will definitely be specimens you’ve never seen before, like how I saw a hand with Dupuytren’s contracture; not a difficult question, but very interesting to see.
MCBoM Element 5-9: Written Paper (May 31st)
Structure: 120 best of five questions (mind you, different from MCQs – all could be correct but one answer better than the other); 3 hours.
What: Basically, anything could come up based on all the hundreds of lectures you had since the beginning of Term 2. Also, some random questions pertaining to the various practicals, eBiolabs and STAN sessions could come up.
- DO WEIGHTED REVISION. What does this mean? The number of questions per element depends entirely on how much content there was in that unit and how much lecture time was dedicated to it. So, I tended to focus a bit more on Element 8 (clearly not enough, judging by the amount of guesswork done on all the hospital acquired infection stuff…).
- START EARLY. Even before all the CVS & MS stuff. Just because the amount of content will make your head implode if you begin two weeks before the exam. Just take it slow and let everything pass your eyes at least once through.
Final remarks: Back in high school I was one of those annoying kids who learned everything on the syllabus and beyond. In med school, that ain’t gonna happen. We’ve all gone from “I’m going to get top in my class!” to “I pray I get 50%”, because if you’re attempting to learn ALL the lectures from Element 5-9, you’re crazy. And no, not crazy in the smart way. Be efficient with your time – 12 hours revision per day will do more harm than good. All I can say for this exam is, just do it + repetition.
Systems of the Body #1: Written Paper (June 1st)
Structure: 60 best of five questions; 1.5 hours.
What: Basically all the theory you learned in Systems that isn’t anatomy or histology.
- CUT THE WAFFLE. You know when you’re listening to Mediasite, and then the lecturer begins droning on about their current research project (ahem stem cells)? Yeah, don’t even bother understanding that stuff – no way they can test us on information they can’t even validate yet. Maybe during summer if you’re really keen on their expertise, but for exam purposes, skip that portion of the lecture.
- DRUGS DRUGS DRUGS. There are some lecturers who highlight exactly which ones to remember, and then there are ones who give a list longer than your arm. This is where you really have to listen to the lecturers – which one do they mention a lot? For example, the calcium channel blockers do end in -dipine (well, one subset of them), but the one selective for the heart is verapamil. As for learning side-effects, just know the more outstanding ones – like, one of our questions was “Which of the following drugs has a side-effect of rhabdomyolysis?” and a string of foreign words were listed, but the only drug ever mentioned to have that special adverse effect were the fibrates. Just little things like that.
Final remarks: I did a lot of idiotic things. For example, on the exam, they wrote “osteoprotegerin” and my mind threw a tantrum because for goodness sake I swear I have never seen that in my life why would the examiners do th- oh. OH. It’s…the same thing…as OPG… Also, there was quite a bit on skin and joint infection stuff which I completely neglected (when in doubt, choose S. aureus). And I spent crazy long revising what cytokines and pro-inflammatory mediators were seen in rheumatoid arthritis and osteoarthritis, but none of that came up.
Take all of this with a pinch of salt (because we are the last year in the MB16 program of Bristol; starting next year is the fabulous new MB21). Everybody is vastly different in their revision style and approach to learning, so let me just say: I’m not smart. Honestly. I rely a lot on being hardworking. If you’re one of those who naturally assimilate information from just listening to the lecture once through and have the ability to formulate an intellectual question to ask afterwards as well as retain it in a few weeks, amazing! You are awesome. But I’m definitely not one of those people. So, that’s the direction & perspective I took on these exams; it’s just a little something to be aware of.