Hobbit’s Guide to Exams

Ah, it’s that time of the year again.

Sweaty palms, palpitations, a flash of exhilaration when you see his face, or maybe crushing despair.

No, I’m not talking about Choi Siwon, Justin Bieber or even Pornsark Sukhumvit… I’m taking about Examinations. The favourite thing to love/hate by all Singaporeans. We can’t live with it, we can’t live without it. We are well trained since primary school to take examinations, in fact, we love it so much that we now have multiple smaller exams to train and prepare us for the big one. As part of a self-selection process, those who excel in the academics (i.e. Chao muggers who get pristine As) end up in Medicine, where even more exams take place to delight the heart of any kiasu parent.

From M1 to M5, there are end-of-posting tests, MBBS part I, part II, part III. Then whichever sub-speciality you choose, more exams to take, part I, part IIa, IIb, IIIx, Vz etc. In fact, because of the higher fail rates, some doctors have to retake these exams several times. Isn’t it a strange observation that these exams are rather expensive, and can be held overseas; and some doctors are so dead-set on passing them that they would fly all over to re-take the exams anywhere? So maybe there must be a set percentage of failures per year so that there’ll be returning customers? After all, the overseas colleges charge a fee, the organising committee charge a fee, and our own Singapore JCST charge a fee, even if the exam is not held here! But, this is a groundless comment, just my own flight of fancy. Of course, there are some strange doctors out there who have too much time and money on their hands, and are known to have sat for all the available sub-specialty exams available. These are the Professional Examinees. One famous example is Prof Chee Yam Cheng who passed Part 1 of MRCP, FRCS and MRCOG just for kicks. Then he became a hospital administrator, which does not require even a MBBS. Talk about irony. (Prof, in case you are wondering, I am the short squirt who is walking around your hospital with hairy feet and without a tie, and I am NOT one of the housekeeping staff)

The Hobbit is a simple doctor – I don’t have those fancy letters after my name. But I do know many people, oh the great and powerful, who have achieved greatness and success in their chosen fields. Let me put together some pearls of wisdom, and share this guide to passing the examination with you (without having to pay S$23.99 or subscribe to my blog; as many enterprising American residents have done to guarantee plus double-confirm “Success in ABSITE”.)

In studying:

1. Use short simple textbooks (preferably with lots of colourful pictures- for example, do you remember the full text of Lord of the Rings? No right? You only remember the spiffy quotes like, “You shall not pass!” (sorry. Bad example.). One such textbook is “The Black Book of Clinical Examination” by Tey Hong Liang and Erle Lim, two of the most pre-eminent examination sadists of our times.

2. Avoid using seniors’ notes (nice for revision purposes, but a bit silly to use this as your main textbook. Especially if said senior is now a part-time GP with interest in cosmesis- do you really, really want to use his notes from 2000?)

3. Start early – this is no problem for most of you medical students, because mugging is in your blood. Unlike the Wizarding World, we are very proud of our Mugger blood. But there are a few brilliant, talented ones- eh, whose talents probably lie NOT in studying- who continue to be very active in sports and the Arts. Trust me, MBBS or MRCS or MRCP – hard to wing it last minute and squeeze years of learning into 1 week of hard core revision. Can be done, but rather stressful. I do not recommend it.). For postgraduate exams, it is important that you can start early with examination sadists/gurus to get into the scheme of things from the onset. Long ago, the ultimate exam guru were folks like Prof Ng Han Seong and Prof Rajasoorya. Now there are still folks like Erle Lim who can destroy your ego and confidence in 47 seconds. Better now than in the exam later.

Exam technique:

1. Spot questions (seniors have traditionally handed down a TYS- ten year series- where examination questions are committed to their formidable memories all throughout that 3h of essay, and then transcribed and circulated for future batches. Worthwhile to look through and know what are the common perennial topics- “What are the structures in the T1 plane? Course of facial nerve? Classical signs in SLE and scleroderma? Signs of chronic liver disease?”)

2. Train for the right arena – If essay- bring in nice pens with smooth action and ink that doesn’t smudge. If MCQs- if the past 15 answers were D, something is wrong. If oral exam- practise to talk well. More on this later.

3. Know thy enemy, know thyself (There are a few feared examiners locally, and the myth and legend surrounding them has grown over the years, as they become more senior and their own seniors and peers who know them personally have either gone into private practice or passed on. I have heard that medical students nowadays practice presentation to a life-size poster of Prof W, so that they can get used to the sense of panic and fear in case they encounter him in real exam. Bollocks. Everyone started out as medical students, and everyone has made novice mistakes sometime in their career. Yes we should respect these bastions and giants of our field, but to fear them like some tyrannical dictator is not necessary.

The clinical examination:

This merits a separate section because most of the failures are from this component, rather than the written. At the speciality examination, most sub-specs have a viva component as well, and it takes a different kind of skill set. No point knowing all the textbooks and journals in the world but cannot articulate your thoughts.

1. Dress well – For the men, that means shirt +/- tie; cufflinks may be excessive. Ladies- while looking sexy and helpless works in some fields- probably not in ours, but there have been cases. There was this one girl with- her skirt, her erm, chest- never mind- stories for another time. Conservative is always good. Leave the fashion statements of purple hair, shaven heads, multiple piercings and rings for personal time please. I have nothing against that- I dye my feet hair blue sometimes. I just like the colour. And I’ve got piercings in places you probably don’t want to know about. For both: An ironed, spotless white coat (splotches of curry or other more personal fluids are a definite no-no.

2. Speak well – If English is not your first language there is a natural disadvantage. For those with Singlish as a first language/mother tongue – Singlish is not such a great idea in the exams, “This 60 year-old auntie say that she got stomach pain, and then hor, she like, went to see her doctor, and then like, took something and then she was ok lor.” But please don’t put up an accent; it is a touch incongruous for Student 127 Tan Ah Hock to have perfect Queen’s English. It would also be pretentious for student 128 Aloysius Amadeus Tan A.K. to have perfect Queen’s English. *names above are fictitious. Any resemblance to real persons, living or dead, are purely coincidental* For those with serious stutters or confidence issues, can get lessons from speech therapists, toastmasters, etc.

3. Carry yourself well – You know how in a Beauty Competition, every contestant looks gorgeous – dressing sometimes irrelevant as they are skimpily dressed, those who speak well score better than those who messed up the Q&A (“Australia? You spell wrong, it is A-U-S-T-R-I-A!”). But the winner is some graceful creature who has this lovely, indefinable air about them- great composure, great stage presence, great charisma. Now that, my dear boys and girls, is what will make you shine in the clinical exam. Trust me, your seasoned examiners, and your seasoned patients (don’t forget, some of them are veteran patients returning year after year, you know, the ones that hold a glass of water in hand and know how to hold water in their mouth, THEN swallow; or the ones who know to breathe in-out-hold their breaths and lean forward JUST SO for you to hear that elusive murmur) – they know when you know what you are doing; or not.

My final tip for you, our minds work best by remembering no more than three things. You do notice that I have classified my advice accordingly. The long-standing success of trilogies stand as evidence to this observation ☺

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