Friday 7 November 2014

24 Oct 2014 - liberation day

14 months of hardcore studying and many moments of insanity later, the fellowship exam is finally over. It sounds strange, but I really hope that was the hardest academic exam I will have to complete in this lifetime.

The journey was a rocky one. I started out thinking that I could sit the exam in March/May, but in December my term allocations for the year were changed and that was no longer possible. I was upset and frustrated by this, but eventually came to terms with the fact that a few more months of study was probably beneficial anyway.

Though I had done random bits of work-related reading, the actual studying started in August 2013. Each phase of the study was difficult for its own reasons

- The first few months were tough because it felt like a sea of information which all merged into each other, trying to stick to a "timetable" was not easy
- The month of Dec/Jan were a particular challenge as I felt like the goalpost had been moved to Aug/Oct
- The next few months were spent trying to make sure all of the major topics were covered, a laborious and arduous process
- Leading up to the written, it was hard to know what topics to go over again vs. learning new obscure topics.. probably the most trying period for time management
- After the written keeping the motivation up to study for the clinicals was near impossible and I had to have a few weeks off for a mental break
- The last few weeks before the clinical exam were gruelling. mentally I was overwhelmed by the enormity of the situation and also with the prospect of having to do the exam again - I had an intense desire not to have to put my life on hold anymore, a pretty strong motivator for passing.

It definitely helped lots having a study buddy, both for study related reasons and for the mental support as we took turns going mad. It definitely did not help that I had nights 2 days before the written and 2 weeks before the clinicals - but that is the nature of our work.

Looking back, the single most challenging part of the exam was the last two months between the written and clinicals. Doing cases with different people and getting different feedback was incredibly tiring and I often felt devastated, as if there was no way I could see any light at the end of the tunnel.  I was told by various people that my performance was suboptimal in terms of diction, grammar, presentation style and body language. Almost everything I did was criticised at some point and that was very trying, especially so close to the exam. So many people said that the exam is a performance and that I was not good at the type of acting the exam required.

At the peak of my demoralised state, one consultant told me just to be who I am. I found that single comment gave me the strength to rise above all the other negative comments - I felt that someone out there was on the same page as me, that I just want to be the down-to-earth unpretentious person I am - screw the exam! So in the end that is what I did, and I got through.

I cannot describe the feeling of numbness as I was holding the fateful envelope. Many candidates walked away to find a quiet corner, but I just opened the envelope on the spot. My mind was completely blank as my eyes scanned the page for the fateful word - successful or unsuccessful. The weight of the moment didn't register till much much later, and at the time I felt intensely emotional with disappointment for my friends who were unsuccessful. At the celebration drinks, the examiners were dressed in their formal academic gear and lined up to shake our hands and congratulate us. That felt totally surreal as well - did I really just finish the fellowship exam?

The understanding of the exam also changes throughout the year of study. At first one is studying to learn the topics and answer the questions, and it seems exam focused. Then one realises that the topics are actually what we need to practise good medicine, so that the things you want to learn are the things you actually need. At the very end, when the exam is finished, you realise that this is just the foundation upon which you will build your practice for the rest of your career.

One of my favourite quotes by Winston Churchill:
Now this is not the end
It is not even the beginning of the end. 
But it is, perhaps, the end of the beginning. 

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