Adrenaline Rush: Grand OSCE 2015

“Med School provides perhaps the best substantiation for Charles Darwin’s theory of natural selection. For here we see in its cruelest form the survival of the fittest. Not the smartest, as one should expect. But the fittest to cope with the inhuman pressures, the demands made not only on the brain but on the psyche…”

 – Erich Segal’s “Doctors”

Where have the months gone by? It’s the last week (hopefully) of LU V, my fifth year in the college and my third year of Medicine Proper. I’ve been so caught up with everything that I have utterly failed to continue chronicling the magical journey that is Med School.

But, as the last bits of adrenaline drain from my body, it seems only right to write this obligatory blog post not only to vent out my feelings after one of the most challenging experiences of  my life, but also for it to serve as a sort of tribute to the amazing year that was.

~

So, the Grand OSCE is held at the end of the year and is somewhat a rite of passage for the third year medical students of the UPCM wherein, before they are deployed to the hospital as full-fledged clerks, they must manifest the clinical skills they have learned during their “bridging” year. That is what ICC (Intergrated Clinical Clerk) year is all about, after all – bridging the gap between the classroom and the hospital, the textbooks and the clinical picture. The Grand OSCE is composed of multiple stations, representing each department, where we are expected to manifest what we have learned.

By the cruel dealings of fate, my block was among this year’s first takers – FIRST BLOOD! That meant less time to study and to practice and to memorize! Of course, we had the entire year to learn, but come on, students are notoriously known for their short-term memory! It’s so hard to remember stuff when you’re trying to learn something new at the same time. Our brains can only take so much! And to make things worse, the Grand OSCE was scheduled in the middle of Hell Week, wherein we were also to take several final exams and the dreaded Comprehensive Exam (we had that yesterday and that was a whole other experience!).

Yesterday, the day before the exam, I could already feel the panic. I slaved through OSCE reviewers and desperately tried to come up with ways to remember details – how to do this, how to report that, how to do both things at the same time, what to look for, what to use, when to use/administer, etc. There was one point wherein I got so overwhelmed with stuff that I just had to keep everything away, close my eyes, and just cry. Cry and pray. The stress is VERY real. I was that afraid.

Reggie, Sha and I spent the evening of Tuesday reviewing and practicing. I realized that I was at a struggle for words – I know right, big irony there. I’ve always thought I was ‘word smart’ as per the multiple-intelligence theory was concerned.  One thing I really didn’t like doing was annotating – that is, explaining what I was doing as I did it. I felt like it was such a big confusing factor. You’re trying your best to do the skill, but you get so side-tracked trying to explain that you end up lost and a bit confused.

The adrenaline came a bit too soon, I think, and I couldn’t sleep! I was reviewing up to 3:30AM and was repeatedly staring at my reviewers until I realized I wasn’t going to get anything from them anymore. My real problem? The stress. The nerves. I had to relax. So, I played a few of my favorite songs and tried to do breathing exercises. I fixed my battle gear – stethoscope, clipboard, BP app, penlight, measuring tape, and my all-mighty ballpen – and went to sleep.

~

I woke up at 6:30AM, with a single thought repeatedly looping inside my head: OSCE day na. OSCE day na. OSCE day na. Tachycardia. Tachypnea. And gosh, my stomach! I felt like vomiting! Forget about having breakfast! And woah! Look what decided to act up today of all days? Yep, my wrist!

The last few minutes before we began the Grand OSCE was killer. We were all throwing random information, mentioning stuff about this and that, in our futile attempt to squeeze in high-yield stuff before we went into battle.

Experience from the previous OSCE has made me realize that the first station is always the sacrificial one. I’d lose it on the first station due to nerves and eventually get back my exposure come the succeeding ones. The Grand OSCE turns out to be an exception. It went pretty well, thanks to the Ortho consultant who was not only very nice but also chose to guide and teach me every step of the way. He wasn’t the only one who was nice! I highly appreciated the consultants who chose to make the OSCE as a real learning experience for us by pointing our areas of improvement and by guiding us along the right train of thought, knowing that with just a few probing, we’ll eventually get to the right path.

Of course, there are exceptions. As much as I want to say that I easily did my parents proud by doing well in the Pedia and Surgery station, I think I did not. I think I made a lot of mistakes in that vaccination station. The fact that the consultants were not really saying much during the entire process did not help much. I couldn’t tell whether I was doing okay or not. My Surgery station went a bit loco because of three things: 1) my nerves; 2) my painful wrist; and 3) yung pata na makunat. My needle wouldn’t bite! Gaaaaah. I was super annoyed at the fact that I practiced that simple interrupted suture multiple times and am fairly confident in my ability to do it, only to struggle with it come the OSCE just because of the annoying pata. So much for that. And probably because of that annoyance, I was totally in panic mode for the Breast Exam. I missed a freakin’ mass. Gah. Oh well, I guess I have the elective period to perfect that skill. I hope and pray that I did enough to pass both.

Two words sum up my common mistake for a couple of stations: HAND HYGIENE.

I think the panic was really showing in my manner, stance and way of speaking. Practically all the consultants had to take a minute to smile at me and ask me to relax. Not that it did much, of course, since I was still drowning in adrenaline. What did help was their subtle affirmative remarks – those “good”, “don’t worry, you did very well”, “very good”, “excellent, that’s right” sentences go a long way for my self-esteem. Of course, my panic was also the reason behind my babbling – as the struggle for words became harder and harder, I just mention the first things that come into mind. I hope I didn’t make too much of a fool of myself! Haha! In my ORL station, I actually forgot to put on the head mirror at first! The patient practically laughed at me when I realized my mistake and she told me, “Relax ka lang kasi.”

Over-all, I think it went a lot better than I expected. Maybe it was really a test of grit. Nerves are your number one enemy during these kinds of experiences. Because if you did your part throughout the entire year and made an effort to really learn what was expected of you, the knowledge is really there, somewhere, and when the time comes, it really just shows. Even the words come out quite unexpectedly.

To end this rant, I would like to thank our consultants, residents and most especially, patients. More than a parameter for me to be graded based on my knowledge, skills, and (yes) grit, I think of the Grand OSCE as a big learning experience, one that I am truly very thankful for.

“The most fundamental principle of Medicine is love.”

– Paracelsus’s “The Great Art of Surgery”

Thank God it’s over! Pedia and NeuroPsych finals on Friday, and it’s break time for me! I hope I don’t have to repeat OSCE stations. *crossed fingers* 

Clerkship Block 4 post-Grand OSCE lunch! :) Here's to the year that was and the year that will be! || Ang tanda na natin, I realize...
Clerkship Block 4 post-Grand OSCE lunch! :) Here’s to the year that was and the year that will be! || Ang tanda na natin, I realize… || photo c/o Gienah
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