Tuesday, April 9, 2013
The dummy medical student’s guide to the oral examination (viva)
The medical viva exams can be interesting, amusing, out- rightly funny, ridiculous, frightening , horrible, terrible or digustlng….all depends on which side of the table you are on. If you happen to be on the ‘unprivileged’ wrong side of the table (read’ examinee’’), then you really need some special tricks up your sleeves to survive some of the more ominous examiners. There is of course a very simple way to ace your viva exams….study….but studying beyond a point is really ‘uncool’ right? So that’s why you need a lot of plan Bs. Coming up are some golden tips I have learnt from some masters of the viva exams (These are a breed of special creatures who often end up either flunking most of their exams, but somehow come through the viva smelling like roses…while the more educated ones end up smelling like assorted varieties of excrement….human or bull) 1.Empty your bowels, bladders and any other area bodily waste depots before the viva. It helps you relax better. The only bull-shit that you want to extrude should be from your mouth. 2.Dress well, shave/ cut your hair, brush your teeth, take a shower, use a comb, use a deodorant and an anti-perspirant…..I know that doing all these things on a daily basis is very cumbersome and asking too much from a medical student, but what the heck? You’ve got to do most of these things at least once in a blue moon, so you may as well do it on the day of the exam. Subjecting the unsuspecting examiners to the full glorious panorama of your appearance, and bodily odours combine with the over-activity of your autonomic nervous system may just unfavorably tilt that gentle balance between a ‘pass’ and a ‘fail’. I call it the ‘whiff between the cup and the lip!’. Almost every other examiner has this fetish for a white coat, so always wear a well washed and ironed white coat …if you can find something like that in your cupboard. If not steal it from the nerd in the next room who lives in a stupid utopian world where apparently medical school requires discipline, hardwork and white coats . Start with a greeting and a smile….you can even try commending the examiners choice of dress, even if the examiner is dressed like a mutated cross between Govinda , Bappi Lahiri and Lady Gaga. 3.Act knowledgeable – This is the key…from the examiner’s side the logic goes a bit like – “If he looks like an idiot, talks like an idiot and moves like an idiot…he must be an idiot”. So try not to be your true self as much as possible. Wearing a spectacle helps often. Most medical students these days spend more time on the internet and video games than medical texts. So there’s a good chance that you are already blessed by myopia ……If not you can always go for a zero- power spectacle. For every question hesitate a bit, filling the gaps with a few ‘hmms’ and intelligent-looking head nods – the up-down type, not the side-to-side ones (Imagine you are Manmohan Singh giving a press conference., but don’t get too much into the role coz you may end up remaining absolutely mute even if a Richter 9 earthquake strikes the examination hall) . Of course you also have to follow up the ‘hmms’ and ‘err’ with some kind of legible words, otherwise the examiner will identify that you are ‘borderline’ dumb (which you probably are…. but then not getting caught is what we’re talking about right?Capisce?) 4.Learn a few big words and try to introduce those words into whatever answers you are giving. For example for a dermatology viva – learn a few terms like ‘Dermatitis cruris pustulosa et atrophicans’ and always say this instead of saying something simple like ‘epilating folliculitis’ ,even though they essentially mean the same thing. So if you are asked to talk about say acne…you could say something like “ Acne is a very common disease, the lesions are similar to Dermatitis cruris pustulosa et atrophicans, but there are differences, for example Dermatitis cruris pustulosa et atrophicans looks different, because Dermatitis cruris pustulosa et atrophicans is somewhat different and acne is not exactly like Dermatitis cruris pustulosa et atrophicans. Sometimes Dermatitis cruris pustulosa et atrophicans and Acne can occur in the same person and sometimes Dermatitis cruris pustulosa et atrophicans and acne can occur in different persons also” 5.Steer the examiner towards what you know……the whole funda of the exam as far as you are concerned is to get the examiner to hear what you know not know what you don’t know. So the moment you get a question on some area you know even vaguely, wax eloquently till kingdom comes and if you get a question not even remotely near the little bit you have studied, still try to connect it to the part you know. For example, imagine that the only thing you’re really comfortable with in dermatology is ‘acne’ and the nutty examiner ends up asking some totally stupid question like “ Tell me the etiopathogenesis of psoriasis” ;your answer should proceed on the lines of something like: “Psoriasis is a very common disease- it affects the skin – there is inflammation in the skin- there are lot of conditions with inflammation in the skin – one of the commonest of this is acne – acne is characterized by a block in the sebaceous apparatus …blah , blah, blah”……..rant and rave like a possessed madman for about 3-5 minutes (incorporate all the minute, irrelevant and outright ridiculous details regarding acne that you know) …. at the end of this severe verbal diarrhea, most examiners end up forgetting that the original question was about psoriasis and not acne…and they also end up believing that they’ve just met a future Nobel prize winner in acne . Incidentally make it a point to speak as slowly and clearly as possible, when you’re talking about something you know and speak fast and unintelligibly, like unadulterated gibberish, when you’re in unfamiliar turf 6.Last ditch salvage attempts if things go horribly wrong – cry, bawl,howl, wail (Kind of more effective if you are a girl, but worth trying across genders)..tell the examiner that the previous day you had a life threatening bout of fungal infection of the left groin (be specific and inventive..the old ‘I had fever’ kinda things are too lame nowdays. Don’t say that even if you actually had a fever)…..the sympathy thing sometimes works if the examiner is a bigger idiot than you. 7.Learn to answer some of the trick questions which usually come up when things are not looking so good for you– The examiner may ask you things like “ How much time do you spend daily of facebook and twitter”…don’t jump and shoot something like “Less than 16 hours hours Sir” or complain of invasion of privacy.The best answer would be something on the lines of “ ‘Facebook’…duh….what is that sir?” or “Facebook…is that a medical book? Who’s the author?” DISCLAIMER: All the previous mentioned skill sets have been tried and tested by professionals, I urge you not to try out these stunts in the exam hall if you can do something more simpler, sensible and much more effective….like STUDYING. On a more serious note, it is rightly said that ‘assessment drives learning’. If the assessment process is not valid or reliable, the whole learning process also becomes undone. Medical teachers need to ask realistic and relevant questions – sampled over a wide range of topics within the subject, with the majority of questions being of a moderate difficulty. They should also try to ensure that the marking is realistic. Giving marks too liberally or too stingily really doesn’t serve any purpose. On the other side student have to understand that medicine is a really difficult course and examiners can have their own special peculiarities and idiosyncrasies. You can’ t realistically go around expecting to score a 100% on each exam and neither can you go on cribbing about each exam/ examiner. If you consistently put in really good effort, you will definitely get good scores.