Practical Magic

Today, I will be taking (what I fervently hope is) my last practical exam on the island of Dominica. It’s also the last practical of basic sciences, so you know they’re making it hardcore. Here’s the setup: 4 rooms – two task rooms, one scenario room and one ‘Harvey’ room. In the task rooms, I may be instructed to perform, for example, a pelvic exam (on a model) or test pupillary reflexes (there are about 29 ‘tasks’). In the scenario room, they’ll give me a little vignette (e.g., ‘Patient comes in with a headache. Please show how you would examine the patient.’) and I must choose which tasks to perform (and justify them during the question period). In the Harvey room, I must inspect, palpate and auscultate Harvey (the cardiac simulator), describe the type of heart problem he’s having and diagnose him. No matter what I’m asked to do, I must do it competently and confidently AND leave at least 30 seconds for the followup questions, which could be on practically anything (‘what drug would you use to treat this?’ ‘what syndrome presents with this symptom?’). Even though I’ve been practicing pretty regularly, I’m a bit nervous. Some tasks I feel fairly confident performing, but what if I get something like fundoscopy and can’t see the fundus?!** Or, what if I have to perform the entire respiratory exam* in 5 minutes and 30 seconds?! Eeeeee!

I guess I just need to keep my mnemonics in mind.

Inspection

Auscultation

Percussion

Palpation

For musculoskeletal tasks:

Tone

Power

Reflexes

Sensation

Let’s hope I can competently and confidently IAPP and TPRS my way to an A today.

*If I do get the respiratory exam, they won’t make us do diaphragmatic expansion and they probably won’t make us auscultate the anterior thorax. But still! 5 minutes and 30 seconds is not a lot of time…

**aaaaaand I got fundoscopy as a task. Still couldn’t see the fundus. But I described papilledema well, I think (I hope). I also had thyroid exam as a task, angina for my scenario and ventricular septal defect for the Harvey case. :::sigh::: One down, two exams to go. Wish me luck!