Test time for mere mortals

Heartbeat: I suppose it was as much fun climbing into a tumbrel, as it was for me getting into my little car on the morning …

Heartbeat: I suppose it was as much fun climbing into a tumbrel, as it was for me getting into my little car on the morning of my first final exam. At this stage, fatalism was the only realistic attitude.

The initial part of the exam consisted of written papers. There were two in medicine and one each in surgery and obstetrics and gynaecology.

Physicians, of course, are twice as smart as surgeons or obstetricians, they tend to take themselves twice as seriously, and they may even charge twice as much as lesser doctors.

However, at this stage of our lives, written exams were no big deal. We had lived with them seemingly forever. Everybody knows the feeling you get as you wait for the papers to be distributed. I don't remember cogitating at all on the usual pre-exam advice. The only bit I ever knowingly heeded was to make sure I had at least two pens.

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A lot of the conventional advice from schooldays onwards verged on the asinine. Read the paper slowly and carefully! Be sure to write legibly! Highlight the important points! Allow a reasonable time for each question! Teach your grandmother to suck eggs! It should be a song, with a chorus about making sure that you had a full night's sleep before exams.

These were not multiple choice exams, they were essays. Occasionally a question was divided into parts. Give a brief description of A. B. etc., but mostly a lot of writing lay ahead. Most of us grabbed the paper, read it briefly, and off we went. You had no time to wonder why some of the hotly fancied questions were absent, or that some seemed overly difficult.

You wrote and you wrote until eventually, in no time at all, your answer book(s) was snatched away from you, with yourself still trying to write in mid-air. This was meant to give an impression of further vast untapped reserves of knowledge and frustrated brilliance.

There was no time to talk after Medicine 1. A quick lunch and then straight back in the afternoon for Medicine 2. Surgery was the following day and then obstetrics the day after. There was last minute revision, but by then we were on automatic pilot.

Three days and the written exams were over; we now faced the clinics and oral exams, spread over the ensuing fortnight.

I felt great relief at finishing the written exams, coupled with the realisation that I had read enough. I never indulged in exam post-mortems. "Did you put down so and so as a cause of jaundice?" Oh Jesus, that's me gone. Life was hard enough, let the dice lay. The three sisters of Greek mythology, Atropos, Clotho and Lachesis, had us firmly by the short and curlys.

In passing, I have always noted that the Fates tend to reserve their most unpleasant twists for those mortals who bound out of the examination hall and announce to the world that the exam was easy. The most confident expression allowed was that it wasn't too bad. If you kept your head down, maybe the Gods would ignore you.

With hindsight, the immense amount of reading and teaching we had undergone would have made it unlikely that we could not have produced passable answers to the written questions. Those worries were over and I remember only a sore hand from writing, and trepidation about the ultimate clinical phase.

The most dangerous shoals of our long passage lay ahead.

This was something unique to the medical faculty - the clinical examinations and the consequential oral exams. There were many imponderables here. Would your patient be a good historian or would you have to painfully extract every piece of relevant information? On the other hand, would you get some verbose patient, who plied you with inconsequential and indeed misleading information? Would the physical signs be easy to elicit and demonstrate to the satisfaction of the examiners? Would you be able to tie the whole story and physical examination into a credible working diagnosis?

Finally, would we be lucky with the examiners? They patrolled in pairs, sometimes the hard man and the soft man, sometimes two nice ones, sometimes, most dreaded combination, two right bastards. Seneca said that "time heals what reason cannot". Maybe I have not had enough time, and certainly I can think of no reason why certain examiners can be loosed on a defenceless and apprehensive student population.

If the object of the exercise is to extract knowledge from the student, then terror and bullying have no part to play.

To this day, I feel shame that some examiners treat students in this fashion, but they existed then and they exist now.

We students, frightened out of our wits by the folklore and mythology of previous student classes, knew what to expect and realised that this was the luck of the draw.

You had no idea who would pull back the curtains around the bed and say, "Well Mr Neligan, what have we here?" You had no idea, but in the next week you would find out. The time for closure of our undergraduate career had arrived. One more week without mishap and we were free.

It was our most dangerous week in our passage through medical school. Incidentally, if all goes well, we'll all be celebrating next week.

• Dr Maurice Neligan is a cardiac surgeon