Last week contained fourteen hours’ worth of exams – our comprehensive “end of block assessment” for the systems of the heart, lung, kidney, and blood. Plus anatomy and many other things I didn’t know. The Friday portion of the exam was a three-hour multiple choice exam of boards-style questions. For those of you that aren’t medical people, boards questions are notoriously difficult and are representative of the test all graduating medical students must pass to match into a residency program. An example:
“A 25-year-old male medical student presents with night sweats, fever, weight loss, and a five-day history of caffeine abuse. On examination, he is visibly anxious with a blood pressure of 210/120. Given this patient’s diagnosis, which of the following statements is NOT correct?
A) The second polynomial derivative of the Frank-Starling curve is a straight line.
B) The patient later failed his exam.
C) If a woodchuck could chuck wood he could chuck quite a lot of wood.
D) This answer is not incorrectly not the wrong answer.
E) His prognosis is poor.
F) Vitamin B12 is absorbed somehow, but you never learned how or where.”
Now multiply that by 150 questions. That was my Friday.
By the time this part of the exam rolled around, we had already suffered through an anatomy practical (which I described earlier this year), a pathology practical, a “grab bag” section, and a six-hour essay exam. Yes, really. Fourteen hours.
As you can imagine, most of us were pretty burnt out. No one looked great. As 8AM passed and the first question came up, quiet fell over the room. Alas, it would not last.
At around 8:20, the first student began to stress eat. You should know that we take these exams in a large, open room full of chalkboards and those heavy black lab tables. It turns out these features both reflect and amplify sound, especially when you are trying to concentrate. You can hear everything.
CHOMP. CHOMP. CHOMP. CHOMP. CHOMP.
Just as the torment ended, a bag of pita chips rustled in another corner as a second student broke the incipient silence. A third student reached into her bag and opened a bag of lettuce. Just lettuce.
Someone else chewed with his or her mouth open. I do not know who. 98 students wished fervently for duct tape.
The munching was contagious. Someone else decided 9:50 in the morning was the perfect time to unleash their full bacon, egg and cheese sandwich they had bought two hours earlier. The smell of old omelette wafted across the room.
At ten, a classmate stood up, grabbed his charger, and walked out of the room. I looked at my own test. I was on question 14. I normally like this classmate. As I watched him leave the room I found myself wishing that the next time he uses the foam hand sanitizer, it explodes and covers him in antiseptic goo. (As someone who has experienced this firsthand, I promise you it’s worse than other kinds of ill wishes, like falling down stairs or self-immolating.)
Around question 50, I had to pee. I stood up and walked to the door. A large man (okay, most people to me are large) wearing glasses stood up behind me and followed me outside. “I have to chaperone you to the bathroom,” he said apologetically. We were one step short of reinstating the hall pass. The large man stood guard (thankfully outside the bathroom) while I peed. I wondered how long it would take before the chaperone felt compelled to run in, afraid I was frantically Wikipedia-ing “what is the first-line pharmacologic treatment for failure?”
I didn’t want to wait around to find out.
I sat back down at my desk, chaperone-free, to continue the test. At this point, a full two and a half hours in, the resolve of many began to waver. A friend nearby broke out a bag of fruit snacks. Fruit snacks are a bad sign. Another classmate leaned back in his chair, thinking hard. Leaned far back. Too far back. Classmate tumbled over backward and lay supine for a few seconds before collecting himself. A third classmate stood up in full view of everyone and did jumping jacks.
An hour later I had finished and began going through my answers. I made it through four of five of the 79 questions I had “marked” – I mark questions where I don’t know the answer, and usually I get about ⅔ of these wrong anyway – before another classmate broke out another bag of granola. CHOMP. CHOMP. CHOMP.
I hit “END SECTION” and submitted my exam. It was 10:45. To the bar!