Yes, of course I recommend sitting nine hours worth of exam in a room with no crosswind on the most humid two days of the year; why do you ask?
Last week on Tuesday evening, I told the collected Internet that I was knocking off and going for a run and an early night — “this is going to go however it goes now”, I said. I’m sure the Internet was relieved. I had been using my last little bit of annual leave to study for the exam I was about to take, and while stuck in front of my laptop I had been intermittently making fun of the more ridiculous of my practice questions for the benefit of Twitter.
For example.
The correct answer suggested that I have the authority to quarantine dogs in Uruguay. By the power vested in me by the medical receiving page.
In the middle of all this, a friend who is not a doctor confessed himself to be curious as to why I was still being obliged to sit exams. The short version of the answer and to put it in a broader context is that for the time being this is just what I do as CPD. The longer answer is that medicine, after medical school, always requires some form of specialist qualification, which is what this is, and then sometimes, later, a subspecialist qualification too. I’m sitting my membership exams for the Royal College of Physicians, with what I did last week being the second of three parts. You may remember that I’ve moaned and mumbled about this sort of thing before, and that was Part 1. If I wanted to be a surgeon or a paediatrician or a GP, for instance, they all have their own college and so their own kind of exam.
A few people had warned me that I would feel as if I’d been hit on the head with a hammer, afterwards.
There are 270 questions split into three papers that are spread over nine hours across a day and a half. The questions all have a wee story, which is called a stem, normally about twice the length of that story about the Uruguayan dog, and then five options, of which a single option is “best”, to be selected and changed and then changed back using a 2B pencil and an inadequate eraser. My question paper, which they don’t mark, thank God, is full of circles, arrows, sums, and manic scribbles. A bit of sensible reasoning through of logic, a lot of notes-to-self, and the odd piece of exam-induced snark: “prob talking to an obstetrician before I do anything with the 38 wk pregnant woman tbh”.
You would think that this would all be old hat. It is a broadly similar format to Part 1 — the stories are slightly longer and the material is more clinically relevant, more about my actual job, although slanted heavily towards the weird and wonderful, and less about my ability to remember specific trinucleotide repeats on specific chromosomes, but generally familiar territory. And it’s not like I did Part 1 just the one time.
Except: in Part 1, you don’t have to come back the next day.
At the end of the second paper and a rudimentary debriefing over dinner (“I don’t even know where I’d start. Did you know what a rupture of thingummy of the sinus of Valsalva is? Are those prawns?”), I took myself off for a swim where I got to cool down (have I mentioned that it was hot?) and do nothing more complicated than count laps and ponder whether it would be appropriate to sit the third paper in the pool.
Back in on Thursday morning, and by the two hundred and sixty ninth question my eyes had crossed and even the invigilators looked like they were flagging. After a day and a half of mostly sitting in a chair, I was exactly as knackered as I would have been if I’d done four days of medical receiving. But, except maybe the candidates, nobody in that exam had anything as mundane as a troponin negative chest pain.
It’s done, anyway, and now I’ve got a few weeks grace before I’ll know how it really went.
The lessons learned from the experience are:
- If you can, don’t sit an exam in the two days of the year when humidity comes to Glasgow.
- I have rarely felt more ancient than the morning after, when, having spent my week sitting a postgraduate exam, I had a work experience kid in clinic who was waiting for the results of his Highers.
- Don’t forget to cuidado con el perro.
The Road Less Travelled 
I just googled cuidado con el perro, and every single instance in the top fifty or so included an image of a dog. I have no Spanish, but I’m amazed that it would occur even to a hypothetical pedestrian that ignoring such a sign was a viable course of action.
On the other hand, in one of my home states in the US, some lad just put a rocket on his head before igniting it; and another jumped into an alligator lake, with predictable results. So ignoring a “cuidado con el perro” sign in a country far from home is perhaps more credible than I allow.
Best wishes for a most favourable outcome on these exams, and may they be the last for a very, very long time.
Frankly, I was more amazed that having ignored such a sign this hypothetical pedestrian’s first instinct was to call a hospital back at home and ask switchboard to be put through to the receiving medic, rather than, for example, to go to a hospital. They do have hospitals in Uruguay.
There will be a further part to do if I pass this one.
I don’t know whether to laugh or cry on your behalf. This is HORRIFICALLY like the story problems which so tripped me up in mathematics! However, sadly, there were dogs, but they never did anything so interesting as live in Montevideo or bite through two layers of clothes…