Thursday, November 15, 2007

So close, yet so far away.

Tomorrow is our last day of this neuro/psych/hell on Earth course.

Part of me is internally throwing a ticker tape parade and part of me wants to crawl under my covers and cry. My school is... I don't know, effed up. It does this thing at the end of every unit that is unlike any assessment I've ever heard of anywhere. We'll call it Leaping Thrice. A Leaping Thrice Exam. It's a two day extrvaganza of brutal humiliation.

It's not so much a cumulative exam, which... I guess I should be grateful for... but I'm not because the Leaping Thrice is kind of worse. Instead of a global assessment it's more like, here, let me give you something inane and esoteric, have you implement logic within the framework of the course's curriculum to decipher this random ass thing you've never heard of, have you pontificate in writing for three hours on the topic, and then defend said pontification. Orally. Aloud. In front of experts.

They expect us to draw from our font of knowledge that has presumably accrued over the past few months, which is just too bad because more often than not, my font is drier than... I don't know what, chalk in a desert? It's so dry I can't come up with metaphors anymore.

Anyway, Leaping Thrice.

The first day we get a clinical case and lots of questions about it. We have three hours to type out our answers and hand them in. You think three hours sounds like a lot don't you? You wonder if you have enough knowledge in your head to fill three hours on ANY topic, save the life and times of Britney Spears which is not exactly medically medical stuff (unless we're talking psych case history here). You think, three hours, are they just trying to accommodate the older members of our class who type really slow? (Sorry.)

Well let me tell ya. You think WRONG my friend.

It is unnerving how fast those three hours go. Particularly when you end up so crunched for time you compose sentences like, "I think the next step would be to image the brain. Then give drugs," in response to questions that are in the vein of, "What laboratory tests might you order to elucidate the diagnosis? Describe how these tests provide insight into the clinical situation, what you expect to find and how this will aid you in choosing the salient diagnosis from your differential. Further, indicate what medications you would prescribe given the various potential findings and describe the purported mechanisms of each. Discuss how their sites of action contribute to the ostensible side effects." True story.

So anyway, you are given the case. You have three hours with a computer to word vomit every medical term you've ever learned in a desperate attempt to sound competent. After you're done, you hand in an essay that butchers the English language and then receive the second part of the clinical case.

Immediately upon reading the second part you take a few moments to mentally berate yourself for the diagnoses you not only completely missed, but supported with flimsy arguments that may or may not include physiological processes not found in nature. Once you are through, you have the whole night to research the topics relevant to the case (assuming you can figure out what those topics ARE...). This research is the second leap.

The next day, for the third leap, you are assigned an oral exam with a faculty member during which you spend half an hour trying to backpedal and justify the answers you fabricated the day before, as well as answer fresh new questions designed to determine just how pitiful your preparations overnight really were.

The whole process is a great way to foster confidence in the future physicians of America and is not at all damaging to the psyche. Especially when you bomb the whole thing and have to wonder what in the bloody hell you've been doing with yourself for the past few months and why you're paying thousands upon thousands of dollars for this kind of torture. Mmhmm, yes. Bring on the patients.

For some reason this particular course is the only one that opts OUT of the oral exams which... is really too bad in my opinion. I am MUCH better at extemporaneously bs-ing aloud than on paper (I know, I know, does this negate my credibility as a blogger?). On paper all this crazy (read: unintelligible) stuff comes out because my science side and English-y side are fiercely battling one another for representation. Or maybe because I am just crazy. (Read: unintelligible).

When I don't know the answer in the oral I can usually coyly side-step things and ask the right questions to get the examiner to point me in a better direction (manipulation, I think this is called...), but I have no such luck when I try and sway the written, inanimate questions. When I'm befuddled during the essay part I just stretch and reach for words I haven't seen since the vocabulary tests of middle school. You know, words like "befuddled." Words that are completely unnecessary yet hopefully distracting enough to throw the grader off my heinously inept scientific argument.

So anyway. In lieu of the oral, our third leap tomorrow is going to be another three hour essay session. Oy.

We're almost done though. Freedom is within our reach! At least, freedom for a few hours until we all have to start writing the 7-10pg health systems paper due on Monday (yeah, I thought I left papers behind in undergrad too...).

I can't wait for Thanksgiving.

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