Do you ever just get to the point where you are completely aware that you could know a lot more than you do for an exam, but you have just had enough of studying for it? I'm at that point right now. Occasionally the fear will drive me onwards to learn some other facet of treatment (or at least write it out once or twice) but there is just so damn much to learn and I have a very finite brain.
I am at the end of my medicine rotation and have my exams on Thursday - I have one long case and two short cases to perform and present to two examiners. The examiners are both lovely doctors, so I feel very lucky. It has been a nice, supportive hospital for this rotation and we have a fairly standard set of patients (elderly, COPD, CCF, CRF, stroke, pneumonia, pleural effusion, or multiples of what I have just mentioned) but there is just enough of an interesting smattering of neurology patients for the exam to have a curveball or two in it.
I was surprised at how much I enjoyed the rotation - I expected to like it, but not as much as I did. I love problem-solving, analysis, talking to patients and putting symptoms together to try to work out the process that is happening (and simplistic diagnoses frustrate me - I think that if a case is too simple, then you are not looking hard enough) so being in the hospital and around the patients and the excellent doctors was a treat.
I have seen how incredibly stressful and taxing physician training is, and know that it probably isn't for me, as much as I enjoyed this rotation. You see, I like knowing things about a specific area (such as psychiatry) and learning about things that apply to it. Physicians have to know EVERYTHING, and as interesting as that is, I don't think I have the stamina.
Even now, as I am studying for the long and short cases, it scares me how much there is to know and how much I won't know when I go for the exams. When I went and did long and short cases on patients who had been seen by the physician candidates for the hospital I am at, the patients would often tell me that the physician trainees hadn't gotten their diagnosis right, either. To me, this is more of a reflection on the massive breadth and depth of knowledge required to see and diagnose a patient on the spot, than on the quality of the exam candidates.
My supervising physician told me that I had an excellent level of knowledge but that I need to focus on management, and I agree. The problem is that there is just so much to learn, and I am just one girl with only so many hours in my day.
My hospital has the reputation for choosing sensible examination patients for their student exams. I will be happy if it is something that presents regularly (common things occuring commonly). 'Tis the season for pneumonia and URTIs, and I'm happy with almost anything respiratory, so fingers crossed.
Now back to study. My brain has stopped overflowing for the moment, and the (decaf) coffee is calling me.