Do you remember that I said fourth year would be busy? Well it certainly was. To cut to the chase, I passed fourth year and am currently on elective but it was challenging on an academic, personal and financial level, so much so I still can't actually believe it all came out well in the end. Placements were on the whole, fantastic. There were a few iffy moments including a GP facilitator that really didn't like me (when presenting the case of a 6 year old mute child complaining of bleeding from the ear, he marked me down for not including malignant melanoma in my list of differentials) and a surgeon whose sexually inappropriate names for his instruments left me feeling really uncomfortable in his presence. On the whole though, placements have been brilliant. My SSUs went well and culminated in me ambushing an unsuspecting group from my year and teaching them to sing a simple round to prove to them that singing positively affects mental health. I surprised myself by not dissolving into a teary mess on my oncology and palliative care weeks and actually really enjoyed them. I will admit to shedding some tears at the funeral of one of my long term patients I'd known for the year and shadowed all his appointments. He was an amazing man, so strong and determined to fight his cancer to the end. He always had a smile and a joke for me and really made me feel like family. His funeral was packed to the rafters with people, a testament to how popular he was and being a devout football fan he had 'you'll never walk alone' as his final song. All his work colleagues started singing along, though through their tears it sounded more like howling and I couldn't hold back the tears anymore.
On a personal level, my bald spots all grew back, and though I have new indents on my nails indicating there is still an autoimmune process going on in my body, I haven't found anymore new ones. Yet. Investigations for that showed I have thyroid auto antibodies, so I'm waiting for thyroid symptoms and having regular blood tests. The scary c word was treated successfully thank goodness. Unfortunately, my Dad was taken into hospital with a suspected stroke which turned out to not be a stroke but neurology cannot work out what is going on. As they explained it to him, it's like half his nerves have just decided not to work. All their tests are coming back as normal, so they've decided it's not common or bad, so they've discharged him from follow up which I'm not terribly happy with as he's had the symptoms since Christmas now and they aren't improving. The same weekend Dad was taken in to hospital a close relative of mine attempted suicide and was thankfully unsuccessful but we had no idea they were in such a bad place.
To top it off, the week of my final exams mr was deployed on tour to the hot sandy place with a three month window in which he might be back at least six months later. Suffice to say, I failed my final exam. By 0.9 points. Grrr. Our final exams are similar to what I sat at the end of second year. They are ISCEs and are 6 stations over three days with each station being 45 minutes long. We have 10 minutes to take a history, 10 to do a relevant examination, 5 minutes to put our thoughts together and 20 minutes to present the patient, differential diagnoses, investigations, management plan and answer knowledge questions. Each station is marked on 10 areas with each graded out of 5. I went to Phase 2 ISCEs which is 6 new stations in one day. You have to get the pass mark plus enough extra points to make up the difference between your phase 1 mark and the pass mark, so luckily I didn't have much to do. I had passed everything else, so the ISCE was the final hurdle to getting in to fifth year. Had I failed, I would have had to resit fourth year, which I wouldn't have been able to afford as I had splurged my savings treating myself to an overseas elective which I wouldn't have been allowed to go on. I had worked part time during fourth year as a driver for the local out of hours GP service, but money was still tight due to not having a job in third year. Despite everything riding on it, I actually walked into phase 2 ISCEs with a smile on my face and really enjoyed them. The results came out a few days before I was due to fly and I don't think I've ever been so relieved in my life. To have come so close and fail by such a tiny amount was heartbreaking. Thankfully the exam gods smiled on me, and oh boy am I looking forward to a fifth year with less drama!