Sunday, August 5, 2007

i faced the dreaded OSCEs!

hopefully i'll wrangle a pass somehow. over here i'm not quite sure if failing one station means an overall fail even if we pass the rest but i'm really quite hopeful i'll make it. failing this means failing this rotation in ortho and means having to forgo my electives next year so i'll really be quite devastated!

i'm pretty certain i passed 4 out of 5 stations, the 2nd station being a very big dubious question mark. our OSCEs this time round concentrated on clinical examination in ortho, namely the knee, hip, spine, hand and shoulder exams.

spine station was easy, PID/DDD no questions asked. patient (all patients are actors by the way) was perfect, giving positive signs and cues without my even asking at points. but managed to piss examiner off with my bowstringing test, apparently the examiners don't quite concur?

hip station was horrible. the patient complained on hip pain. and i have not a clue on how to do a hip exam. thank goodness my tutor was in the room and greeted me cheerily when i entered. as usual, i managed to bumble the exam by starting on the pathological side first (a BIG no no - always examine the normal side first!). patient wasn't as helpful, but very obliging. tutor even went," oh just skip that part" when i was spouting my usual drivel about wanting to fully expose the patient, saving me time. BUT i forgot Thomas' test (which is very very VERY impt in hip exam) and i almost forgot to measure limb lengths until my tutor pointedly asked," ditzy, are there any more tests you wish to perform?" TWICE. and he had to discreetly point at the measuring tape too. OMG. if he wasn't my tutor, i think i wouldn't have half a hope in hell of passing this station. this is definitely one dubious station. i hurriedly diagnosed the patient as having secondary osteoarthritis likely due to his fall on his buttocks many many years ago. geee.

shoulder exam was mostly alright, except i misdiagnosed the patient as having an impingement syndrome rather than a partial rotator cuff tear. hope that didn't count too substantially!

hand station was fine, carpal tunnel syndrome with split sign on ring finger. positive tinel's easily faked by patient, but she gave positive phalen's in BOTH hands. eh? nevermind. the prof was super sweet and let me off real quick after i cursorily tested for intact radial and ulnar nerves. i quite adore her!

knee exam is usually my best station, but this time, i bungled it up. didn't test range of motion, didn't test fixed flexion, forgot my sequence, didn't test fot collateral ligaments. luckily tester was a fairly nice and jovial prof who hinted broadly at my missing tests, but i didn't have time to complete the examination.


well, 4 out of 5 isn't too bad! hopefully my overall score will pull me through.

it's really funny. i usually have no love for ortho, but when i was studying for this OSCEs, the unbridled thought of : oh, i LOVE ortho! came to mind, for no rhyme or reason. strange. maybe i really do love ortho after all!

it'll be sad to leave this posting, i had fun for the most part. but there's still more OSCEs to come at the whopping end of rotation test in 2 weeks time with long and short cases to go. hmmmmm.

Thursday, August 2, 2007

i'm nearing the end of orthopaedics! it's been surprising, but i do appreciate the straightforward nature of it all.

the standing in clinics though, is wreaking havoc on my poor back. i have paravertebral muscle spasms! i really need to learn to change my horrible posture.

meantime, tomorrow we're off to the cerebral palsy association. it makes me sad to see CP kids. they're really, awfully, terribly sad, especially the quadriplegic ones. there was this quadriplegic CP kid i remember seeing in paeds who was abandoned by his family. no one even came to visit him. i remember standing by his bed watching him and trying not to cry whilst he rasped for breath, his stridor audible through the ward.

CP. so important to know to pass paediatrics and MBBS, so devastating to the kids and family (depending on which type it is - some are near normal!)

but i believe all these children are in God's hands, as am i.