Monday, May 13, 2013

Tips on Surviving Your Professional Exam (Clinical)

Salam a'laik.

Its been awhile isn't it? For quickie, Alhamdulillah i've passed my MBBS this April.

Well, this post is merely dedicated to my fellow juniors, who are going for the next PRO Exam 2014. Everybody in MBBS know that this exam is the final, which decides whether you can be a doctor sooner or later.

Being a doctor sooner doesn't mean that it is the best, but it is definitely what everybody hopes for. We think medical school is hellish, so lets  end it soon! Isn't t? In the contrary, i am scared to end the title as a 'student' and further up my career into real one. Not merely just dream anymore.  Little that we think, the world ahead is much more brutal and needy.

So this post is about learning issues, what i hope i would done earlier as a 5th year/final student. I was going to write it in study week actually, but i need to pass first, for my tips to be a bit, credible. And this tips are about SURVIVING, or PASSING. so if u want tips for excellence, better contact fellow seniors who pass with an A. :)

So let go straight to the tips. it gonna be lame, I've heard it repeatedly, but hey, here lies the truth.

1. Do notes. NOTES NOTES NOTES. Precise but concise.
Nope, i don't ask you to stay up and write your own books. Do short note, neatly and keep it separate with your jot-down note during bedside to avoid mess.

 Exam questions, the long case or short case will be about, what the disease is? (definition. always started with for example X is a clinical syndrome/x-linked/clinical condition/etc. it is like an opening statement.) how it occurred? (pathophysiology) To whom? What age? What risk factors? (bit epidemiology) How it manifest? (sign and symptoms), how to investigate? (all the test, and what lies behind it? For example Why do CRP? Why check C4/C3? How anemia of this and that look on blood film? etc) how to manage (divide the management well into acute, start with ABC, or DABC, and chronic) know your drugs, and if it is surgical, get a glimpse of how it is done,where, under GA? local?Look up for youtube videos.

I dont know how to stress to you how it'll become SUPERHANDY in your final. You'll not have enough time to look back into your textbook, and by organizing your note this way, it'll make your life hell lot easier. IT IS SUPER HANDY.

Im suggesting to choose a book as your companion for each subject, and learn about the book as if you are learning about your future imam/makmum. Lol. what i am saying is familiarize with the book. Know it so well that you'll know what pageto turn when you need to read something.

Im going to suggest you some good books, (it isn't necessary anyway). Membantu memahamkan.
  • The yellow xpress short case book.
  • The yellow books on Excellence clinical exam of medicine, and for surgery and peadiatrics. most essential questions are listed already.
  • Surgical express or i called it mini bailey
  •  Murtagh (good book for differentials)
  • Peadiatric protocol 

2. Know your physical examination. ALL OF IT.
Know the basic, list down 5 causes. Jot it in your notebook. The question will be like "what is rhonci?" "at what phase you heard it?" what are the condition produces rhonchi? any other condition? more? what else?" Examiners DIG basic questions.

Do it so well, as our lecturer said, let it be your reflect. If you are not good, do it over and over again with a friend who is good. If you have performance anxiety, please  find a way to overcome it.

I have performance anxiety, a bit of sociophobia when it comes to performing PE in front of my colleagues and doctors. I HATE IT. And i do nothing, nothing to improve myself and at the very end im struggling. It hurts me a lot more that i think it could. You'll think that u are inadequate, you'll be inferior to others and your self esteem is nowhere to be found. ANd im telling you to CHANGE early.

3. Organise your presenting skills.
Start scribbling in order when clerking patient. Demographic data first, the chief complain. As u go along you'll find out that different specialty requires slightly different style of presenting the cases. For example in medicine you'll need to put risk factor known/proven related to case in the very beginning otherwise you'll irritate the examiner. Remember the 4Cs as Dr Kamariah taught, Chief Complain,Causes, Complication, Current Condition

The vital keys in history is, why patient come to the hospital aka the chief complain.
What did he experiences? (and inserting some relevant negative finding as well. Plus complication. It is simple. if a person who regularly bleed, you might wanna ask any risk factor, or anything that may contribute to that like coagulopathy or any NSAIDS abuse?Did he lose weight? As a complication, did he had anemia? Since admission how is he doing? Worse or better?)

Another example would be in case of fits, you wanna rule out space occupying lesion, any electrolyte imbalance, so what question should u ask? Post fits, as a complication, what u should ask? 

The way you present in 5th year is slightly different in 4th year. History is obtained in order to sort out what you think did patient had? And you had to show that you are actually thinking, not casually asking for the sake of completion. Next, how do you confirm?

Chronic case like SLE, RA, nephrotic syndrome, etc requires slightly different style of presenting. Either it is by chronological or by current complain, u need to know what is the best way to tell your examiner what you think your patient had.

Learn to avoid using short terms. PE for pulmonary embolism or pre-eclampsia?

4. Study
Either in groups or alone, you choose.

I survived, alhamdulillah, being alone. I had the helps from my friends, of course. It speeds things up and you'll need less energy to think and less time consuming as well. Imagine, at that time you'll need to study for ortho, surgery, medicine, psychiatry, some short posting special cases as well, O&G, peadiatrics and so on. The something come up like "what are the drugs that will improve the prognosis in heart failure?" it easier to ask friends, rather than to search from the jungles of books and note you had in front of you.

Read CPGs, malaysian CPG, ad GOLD for TB, or GINA for asthma. Ask the lecturer what is appropriate. CPG published>5 years is considered old and invalid, Dr Ng once said.

5. Kita Merancang, Allah yang menentukan.
Dean always said, it'll be the most unfair exam ever. and im telling that it is ****** TRUE. Truth hurts to some. You'll find that some of your colleagues got complicated cases, some got simpler one. Lets not envy each other. Whether you'll pass at that time, it has been decided by God. You do your job, and let your heart be at ease.

I find it helpful to read seniors' note on their experiences during PRO, and the questions are about the same.

Personally, and honestly i think that PRO Exam wasn't that hard. It is the feeling of anxiety and worry that make your life miserable. I think questions during bedside are harder. IM DEAD SERIOUS. lol they asked you basic questions. Inhale, clear up your mind and answer what you know.

Build good relationship with your God, family, teachers and friends. Prayers make life smoother.

1 year, it wouldn't be that much of time. it'll pass before your eyes. So be prepared guys.

Any other questions please put in comment section, i would love to entertain questions if any. Thanks for reading.


  1. Hai doctor. Im going to sit for EPR exam soon. As i was told the EPR questions wil b quite similar to Msia medical uni Final year PRO exams. is there any past year questions or question bank that i get access to? Any sources? It wil be a great favour for me. Thank u so much

    1. Hi. Im sorry i dont have resources as mentioned. U may try contacting your friends who is sudying here

    2. Thank u so much for ur kind reply. It was great blog. Very encouraging. I wil try my best to get contact with my friends. All the very best for ur future upcomings, doctor

    3. I wish u well as well. Medical world is an interesting and colourful world, make sure to fuel it with passion and courage.

      All the best!

  2. Salam' alaik Doctor. I'm a final year medical student & I'm sitting for Pro Exam in 13th November. I am really really freaking out and feel so lost. There's just too much to study and I keep on forgetting those that I've read. Any tips that you can share with me Dr? Thank you

  3. Is it okay to post part of this on my website basically post a hyperlink to this webpage?
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  4. Hi am lina from indonesia..Anybody who h friend going to sit for epr pls ctc me at need friend for study since am foreigner here everything looks blur..tq very much doctors...


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