Do you have a dumb question that you're kind of embarrassed to ask in the main thread? Is there something you're just not sure about?
This is your opportunity to ask questions. No question too simple or too silly.
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Notes -
I went blind again. Before anyone panics, it was for less than an hour, and I'm fine now.
I was previously diagnosed with a condition known as central serous chorio-retinopathy, where fluid leaks out of the vessels below the retina and makes it bulge out. It is usually due to corticosteroid consumption, which I've never done, but also due to prolonged and severe stress. Guess what I'm experiencing?
This isn't the first time. In keeping with a now-obvious pattern, it happened to me before a high-stakes exam. Once before the PLAB 1, again before the MSRA. And now, the MRCPsych Paper A looms ahead of me.
My stimulants might contribute (they're stimulating the sympathetic nervous system too), even if I take very reasonable doses. Unfortunately, my ADHD is not an affectation, I can't study without my meds, let alone pass exams. Especially exams that require months on end of grinding and memorization, when is rather be doing anything else.
So yeah, same choice as usual: lie flat, or keep fighting. I'm inclined to do the latter unless the attacks become so severe that I'm at great risk of permanent visual damage. I did see a doctor once, and it was decided that a waitful watching system was appropriate, instead of jumping to options like intravitreal injections or lasers. It's been a year and a half since then, and this attack was mild, so I suppose it wasn't the worst advice.
Anyone else have a few dangling Damocletian swords above them? Aimed at their eyeballs? Alternatively, what's the best way for me to manage my stress, when giving up or foregoing my meds isn't an option I'm willing to consider?
(I'm going to order myself some green tea. It helped in the past.)
First of all, sorry to hear that and all the best with the tests.
Secondly, about:
I’m curious about these medical exams and studying. Are there some candidates you’ve met that can just ace them without studying, based solely on general medical knowledge and above average recollection from both medical school and hands-on training in the years before their specialist qualification? Or is it like some legal qualifications, where even a towering intellect needs to rote memorize that the answer is a section 37 part 3 form and not a part 4 and that a certain period is 13 working days and not 12?
Thank you.
I don't think that it is possible to pass just about any medical exam with zero studying, in the literal sense. But I definitely know or have heard of people who can get by with much less of it in the way of "total hours of effort". The very best young doctors I know (in terms of academic performance and successful entry into difficult specialties) were both very smart and very hardworking.
There are people who have retained far more than I did from med school, which definitely came in handy for them. I wasn't the most motivated of candidates back then (because my performance didn't matter as long as I passed, and I only ever failed one minor exam in the last decade), but I put far more effort into career-defining or gatekeeping exams later.
For example, the very first exam a foreign doctor needs to clear to get a license to practice in the UK is the first PLAB exam. It was always oriented around a UK curriculum, but now is/will be entirely subsumed into the same British end-of-medschool exam that is the UKMLA. A British med student would have a very significant innate advantage simply because that's their default curriculum, whereas a foreign grad would need to learn additional information about UK guidelines (holding all else equal, which I will happily grant isn't true, British med students are very good on average).
Once the PLABs were done, I had to give another exam called the MSRA, where the advantages for the locals diminish. The exam has roughly the same core topics as the PLAB/UKMLA, but will drill much harder into the nitty-gritty details. These details aren't comprehensively covered in med school, so that's when your own effort begins to come through.
The next step is usually the membership exams of one of the Royal Colleges. In my case, the MRCPsychs. At that point you are well beyond "innate" or general knowledge. Almost everything is new.
Not all RC exams are made alike:
Something like the MRCPsych Paper A heavily rewards rote memorization. There's no exam where it isn't important, but some others will test your practical and critical thinking skills harder than others.
You would have to be God to derive medicine from first principles. For mere humans, no matter how smart, there's no choice but to resort to empiricism and knowing what works. Medicine, for all its scientific underpinnings, remains a deeply empirical and at times atheoretical field.
For example, why do antipsychotics increase the risk of pneumonia? Nobody knows. Why do clozapine and olanzapine cause the most weight gain (within antipsychotics)? Fuck knows. There is no logical chain that leads from the pharmacology of clozapine to it causing more weight gain than ziprasidone. We only know these things through observation.
The exam questions reflect this reality. They do not ask you to model the interaction of dopamine antagonists with hypothalamic appetite centers. They ask: "Which of the following drugs is most associated with weight gain?" This is not a test of your reasoning. It is a test of your internal lookup table. You either pass the herblore skill check or you don't.
And that is a good question. It's information that is in some way relevant to clinical practice.
Freud's nonsense isn't. Neither is Monkey Business. I don't know why I need to learn the name of the dude who invented modern antipsychotics, or why I'm being asked that. Yet those make up an unfortunate amount of the syllabus.
Sure, but I would classify this closer to the ‘classical’ examination than the rote legal memory check where, you FOOL, you forgot that it was actually a class 5(a)i notice and not a class 5(b)i one even though you actually! In the sense that I would imagine that smart and well-read psychiatry students would probably know that antipsychotics increase the risk of pneumonia and so on. Even moreso for Freud’s ‘nonsense’.
I... uh... didn't know that until I opened my revision notes to look for examples. You are welcome to update on how smart or well-read a psychiatry student I am. In all fairness, that knowledge is irrelevant in clinical use, I've never seen or heard of a psychiatrist not prescribing because of pneumonia risk from an antipsychotic.
But, in general, my main source of frustration is irrelevant information gumming up the syllabus rather than the fact that a lot of memorization is involved. If what I have to memorize a lot of facts to be a good psychiatrist, then that's just what I need to do. But I don't enjoy, and in fact, hate quite a bit of what I'm forced to learn. Physics majors aren't grilled on their knowledge of Aristotlian mechanics, nor are chemists asked to produce the schematics of the alembic necessary for transmuting lead to gold. It's all so tiresome.
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