September 23, 2010


     If one were to survey med students regarding what motivates them to do well on their exams, I'll bet that 'fear of failure' would rank high on the list.  I know it does for me.  About 2 weeks ago, we took our first mock practical exam in gross anatomy to 'let us know where we were at'.  I guess I should explain how a practical works.  There's a large room where we dissect the cadavers.  The faculty go around and 'tag' structures with a metal pin through a muscle like the 'flexor carpi ulnaris', or a piece of brightly colored string around an artery such as the 'deltoid branch of the thoracoacromial trunk', or an arrow on a radiograph (x-ray, CT, MRI) pointing to the 'greater tubercle'.  Armed with a clipboard, an answer sheet, and a four-leafed clover, we are expected to walk up to a station, observe the structure and write it down.  A bell goes off in 45 seconds and then you repeat.  The 45 seconds of observation go way too quickly but then there are rest stations where the 45 seconds last an eternity.  That goes on for 50 structures.
    So my first practice practical result?  A whopping 10.  And that's on a scale from 0 to 100.  That's right, I had 45 X's on my answer sheet and only 5 checkmarks.  Nothing to write home about unless it's to apologize for being clueless.  Granted, this practical was executed by the pedagogues (student assistants who aced the class in years past and often want to be surgeons) and they admitted that it was much harder than the real one would be (the highest grade I heard was a 50).  But still, a 10?  That doesn't exactly instill confidence.  A week after that one, there was a second mock practical only 3 days before the real exam.  That means if you bomb this one, you only have the weekend to learn the stuff.  I had, shall we say, studied with a bit more enthusiasm.  And this isn't a trivial amount of information.  To give you an idea of the volume, here's the material for Block I, excepting the cadaver.  They tend to frown upon taking body parts home.

This time, I got a 70.  And then I started asking around how others did.  Scores were still in the 50s so I was psyched.  Real practical rolled around on Monday, and they posted the answer key that evening.  We have a carbonless copy of our answers so we can self grade.  Since it's not multiple choice, there is some subjectiveness to what answers they'll accept or reject.  Depending on their degree of mercy, I got somewhere around 80 give or take some points.  And the written part, somehow I managed an 86, a high pass grade only 2 questions shy of honors.
     And I'm left wondering, what could happen if I was actually a diligent student and applied myself?  Knowing myself, I'm pretty sure I'll never know the answer to that question.

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