Exams are stressful. Exams that must be retaken – a thousand times more so. I could have asked a hundred people who went through the same thing before me, and none of them would have adequately prepared me for the Internal Medicine examination in my second final year. I prepared well for it, learning all the theory I could and practicing my postures for the oral exam. What I did not prepare for, however, was the panic attack that would hit during the examination.
My patient was not co-operative; he had requested to NOT be in the exams as he felt too sickly but, as he was in an academic hospital, he found himself nonetheless being prodded and poked by students. He was furious at the doctors and, at me. As I tried desperately to remind him that my future was in his hands and I needed his co-operation to pass the exams, flashbacks from the last Internal Medicine exam intruded, and I started hyperventilating. “This cannot seriously be happening again! I cannot fail this God-forsaken block again!” Such were my thoughts while sweat dripped down my forehead and time moved.
In that moment, try as I did, I could not empathize with the patient whose wishes were being disregarded for the sake of learning and exams, whose pain meant less than the signs his illness produced. I could not empathize with him because my survival instinct had taken over. I had listened to my patient despite my better judgement the previous year and failed as a result. I used this reasoning as an excuse to continue my evaluation, despite the patient’s protests and my own panicking.
See my previous post: how I failed my final year of Medicine https://blackandgoldblog.com/2020/07/06/failed-the-year-my-journey-through-medicine/
I was not ready after the 20 minutes had lapsed. When the specialist examiners entered the consultation room, I had barely come up with a diagnosis. The patient was even more indignant, my anxiety had now reached intolerable levels, and the examiners waited on me to blow them away. I did not. For some reason though, I made it. Call it a miracle or a mistake, whatever it was, I passed my exams. When the wise say God works in mysterious ways, perhaps this is what they mean.
Integrated Primary Care (IPC)
The IPC exam was markedly less stressful. Perhaps I was better prepared – both emotionally and knowledge-wise. Perhaps the long-term stakes were not as high, or perhaps I just knew I would make it. Where the previous year it had given me the more anxiety of the two, this time I knew it would not be my downfall. That counts for something, doesn’t it? After all, this is the block that shredded my self-esteem as a black student.
Sunday Times article on racial/political issues surrounding IPC exams https://www.timeslive.co.za/sunday-times/news/2017-12-02-wits-medical-students-cry-racism-over-failure-rate2/
MG article on racial/political issues surrounding IPC exams https://mg.co.za/article/2017-12-01-00-wits-med-school-hit-by-racism-claim/
What I learnt from both exams
It took a while to get over failing and to believe in myself again, the process was long and ugly, and there are still days of self-doubt. However, here we are, not wallowing in our inadequacies, living the life of victors every day, irrespective of our continued struggles. What I learnt the most from this is, let the negative experiences fuel you to do and be better. They will affect you, even more than the positive experiences, but use them to grow, and to believe in yourself even more.
Another experience I hadn’t anticipated, was retaking exams I had previously done well in (because the university still believes that failing two modules renders you an unsafe doctor and you must start over, to get the basic principles). Some of the exams went by smoothly, because I enjoyed them the first time. Others, however, reminded me of the ease with which one can fail a block one had previously passed.
The Paediatric module, for instance, was a nightmare. It was work-intensive, with calls every four days, working as interns while still being expected to study and work on research assignments. The exam itself was no child’s play. The one child cried from the moment I entered the consultation room to the end of my examination. I somehow still passed that exam, albeit barely. The idea, however, that I could have failed that exam when I passed it the previous year with a B symbol, scares me to this day.
Perhaps the rule that people who fail two exams should repeat the whole year is something to be re-assessed, or perhaps my fear and bias prevent me from being objective in this topic. Irrespective, this year has left a permanent mark on my life – the PTSD, the anxieties, the panic attacks, the fear, will forever be remembered. However, they will not always be remembered negatively. I will remember how I struggled and panicked through exams, and still made it to graduation that year.
Exams will forever remain stressful and evoke anxiety. Nevertheless, we come out of the experience stronger and better, and the fruit of our labour is sweet as honey. I will never fully understand why I had to repeat the year after a relatively smooth ride through medical school, and the scars of failure do not magically disappear when the results finally say ‘completed requirements for degree’ at the end of the year. However, victory tastes a little sweeter and you savor it a little longer after a fall.