Aug 13, 2010

Medical Licensing Examination, Step 1

The United States has a cool name for it, USMLE or United States Medical Licensing Examination. I wished Taiwan has something as cool, but they just simply call it Medical Board Exam, or 醫師國考. Unlike its American twin it's much simpler with only 2 steps. Step 1 consists of basic medical sciences in 2 separate papers: paper 1 for anatomy, histology, microbiology, immunology, parasitology, biostatistics and public health; paper 2 is physiology, pharmacology, pathology and biochemistry. Step 2 concerns clinical knowledge with 4 papers roughly divided according to the Big 4 - internal med., surgery, pediatrics, and gynecology/obstetrician, with several canapes in between such as radiology, urology, rehabilitation medicine etc. It's not a fun exam but one has to pass it to begin your physician license.


The major challenge for me is taking the test in Chinese. The last time I had any major exams in Chinese was in Primary 6, and even though I'm Chinese educated my brain is, sadly, programmed in 26 alphabets. I learned all my basic medical sciences in English too.
With the language fear haunting me, and my decision spending 2 weeks in Medcamp, I started preparing for the exam as early as my winter break. It may sound boring but I started with anatomy and physiology - which I didn't regret because it laid foundations to all my subsequent studies. As the semester progresses into summer I found less and less time for my exam preparations until it got abandoned altogether before my finals. I didn't do well for my semester this time round.
After an insane Medcamp, the countdown starts - 2 weeks. Groups of us huddled around our PBL classrooms and begun our tedious 14-hour workday. If exams are the killer of fun in education, then studying is the electric chair, or the guillotine. My study drive eroded slowly as the exams draw nearer - afternoon breaks got longer, napping time gets longer, and then comes tea time, chocolate time, walkabout time, surfing time, and daydreaming time. I think I might have attention deficit disorder because at the end  of 2 weeks I can't even sit without nudging for 30 seconds.
The sympathetic nervous system kicks in, stress levels skyrockets, and REM sleep (or restful sleep) got shorter. Everybody turns on their "exam mode" - not talking anymore, taking showers at 3am, wearing singlet and shorts to school, not eating, or eating the same food over and over.
Like most other examinations past-year questions became the golden standard, the Systeme Internationale. Those who obtain a pass loses motivation to study further; those who fail are too broken in spirit to continue further.
Then we seek spiritual support - from whatever religion and spiritual source there is. I personally paid my visits to Jesus Christ of a Taipei Presbyterian Church, a Taoist temple, great Buddha, our silent mentor, and the Goddess of Hell (sounds creepy eh? In Buddhism she's actually a very noble Goddess).
With the blink of an eye 31st July is here. I was jerked awake at 5am to see all 3 of my roommates grilling their books under the lamplight. I had 2 straight nights of very light sleep and was feeling groggy. I summed up all the stress hormones I had in my body, top it up with black coffee, and headed to the examination center - a high school about 3km away.
The Taiwanese summer and the smallish classrooms that were our exam centers don't make the experience a pleasant one. I was melting from the heat, suffocated by the humidity, and starving - because I dare not eat too much in fear of sleepiness - I have a problem with sugar spikes and neurons shutting down, so I had a cinnamon bun for lunch and went back watching others with their carbs and proteins.
As quickly as it started it ended. My instincts tell me I shouldn't have problems passing, but my brain kept dissecting and analyzing questions. It's useless to sleep with a disobedient mind, and my roommates were already in celebratory mood - 2 of them being sleepless for at least 3 days, I can't really tell.
That evening after packing up for home and washing my jeans and hoodie (a task ignored for 3 months), I slept the deepest sleep ever. In my dreams I became dean of medical school, abolished all kinds of exams, and students gave me a standing ovation.

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