The bigger picture

My first station of the exam was cardiovascular, and naturally I was quite nervous.

I walked in to find the examiner singing away with a 5 year old boy, who was very enthusiastic. He asked me to “examine the cardiovascular system”, and I got started with my examination. I was focused on getting the diagnosis as quickly as possible. At the end, I presented the child as a boy with a VSD.

The examiner looked at me quizzically and asked if there was anything I thought I might have missed. I turned back and took another look at the boy, and immediately noticed that he had trisomy 21. I looked back with horror to the examiner and told him what I now saw, and how it might change the diagnosis. I was angry at myself for missing one of the most classic paediatric conditions (especially in the cardiovascular station!), and couldn’t stop agonising about it for the next few stations (and when I got home).

In hindsight, I should have just taken a deep breath and moved on. The examiner gave me 12/12.

Key learning points:

  1. Don’t rush into the examination. Step back and take time to think about the overall presentation.
  2. Don’t agonise about how you think the station went – just move on and focus on the next station.
Filed in War Stories
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