Waking to a hint of bacon frying as the morning sun slanted shadows on the croquet lawn outside. It was the day of the clinical examinations at the MSc in Sports Medicine at Trinity College Dublin. One of the perks of being an examiner is to stay in the beautifully appointed guest rooms overlooking a leafy quadrangle in this historic city centre campus, breakfast prepared by the housekeeper, before ambling over to the examiners meeting in the anatomy department.
Today the long cases. Last night we met the candidates at the OSCE component of the exam but this was the main event. It was a tough examination; tricky cases with definite but difficult clinical signs. The candidates were bright and able and no one struggled. I was impressed. We all know the tired and threadbare examiner’s apology that no one likes to fail a candidate. It is true but, today it was never in question. These candidates were at the top of their game, well able to sort the pieces of these complicated medical jigsaws and I learned a lot. Competent, confident, and so cool under pressure, it was such a pleasure to share their day. And, very humbling.
I doubt if I was ever as good when I was in their shoes. I never enjoyed examinations. In hindsight I was probably over nervous and a little underprepared- but, more in the context of exam technique than bookwork. Looking from the other side, I sometimes wish I knew then, what I have learned from watching others. It is not about knowledge, it is about being able to work things out under pressure- a skill that can only come from practice. Were I to do it all again, I would gather a group of friends and run through clinical examination technique so often that it became second nature. A hour or so working as a group would be so much better than yet another week in the library. Like sport- it’s specific training for the day of competition that is important. And, specific preparation is about clinical examination. And, dare I say, I would also encourage people to enjoy their exams (easy to say at this stage in a career). But, having invested so much time in preparation, exams should be a wonderful opportunity to show how much you know. If you have done the work you really should be looking forward to them. (yes, I know it sounds a little daft and you would have had difficulty convincing me too).
These folk were superb. No surprise, as they had been schooled by the indomitable Moira O’Brien, a pioneer in education in sport and exercise medicine and, her erstwhile lieutenant and successor Nick Mahony together with departmental stalwart of almost 40 years, Bernard Donne. This is an old style course with intensive teaching and continuous assessment by written and practical examination. Exemplary dedication and commitment to personalised education. These students earned their day in the sun.
There was an unscheduled delay to compound the tension while the candidates waited to see if any would be called for a viva. At the examiners final meeting we discovered a mistake in the results sheet. An understandable glitch in data entry. There had been an error. In inserting the marks for one of the OSCE stations – a zero was missing in the percentage entry of one candidate’s result. It should have been 100%. Unusual, unexpected, unprecedented. Yes, they really were that good.
Domhnall MacAuley is primary care editor, BMJ