How exams work at UIWSOM

I survived final exams at UIWSOM. This was a GRUELING week. The closest thing that I can compare it to was when I prepared for and took my written and oral comprehensives last year when I was finished with my PhD coursework. And to be honest, that still paled in comparison to what I just went through… What follows is a description of how exam week is for the OMS-1 year at UIWSOM. I’ll give as many details as I can, but I cannot discuss particular topics or questions that were on our exams.

So briefly, at UIWSOM, our classes are given in a block system and each block lasts between 3 to 10 weeks. This first block was Essentials of Biomedical Sciences and EMT. Within each block, we have Small Group (SIGS), Clinical Skills & OMT (DOCS), Large Group (LGS), and Gross Anatomy/Histology/Embryology (STRX). The grade for SIGS is based on your attendance and participation in the case studies. Essentially, you only have to have a pulse, be professional, make an intelligible comment now and again, and you’ll pass the course. The grades in the other three activities are based on exams. This is what I will. Now describe.

For LGS, we take an exam called the “CE” or Cumulative Evaluation. This exam covers anything that was said in LGS, SIGS, DOCS, and STRX. Where UIWSOM is different than most medical schools, maybe all U.S. medical schools, is that our exams are not multiple choice. Our exams are written exams, so you really must know your business on a deeper level. There is only so much bullshitting that you can do to pass the exams.

The CE was on Monday of this week. The class was broken up into smaller groups so that we could take the exam in different rooms in Building 2. Check in for the exam started at 0715 and was complete by 0755. If you arrived after that time, you likely would not get to take the exam. The exam was broken up into three blocks of 14 essay questions each. Block 1 went from 0800-0945; this was followed by a 15-minute break. The second block went from 1000-1145 and was followed by a 30-minute lunch. The final block was from 1215-1400. If you finished early, you could leave but we were not allowed to hang out in the building nor were we to discuss the exam with one another. The exam was taken on the ExamN lockdown browser.

The next day, Tuesday, we took the DOCS exam. The exam was divided into two parts. The first was the History & Physical exam and this was taken in the CIELO Patient Simulation Center with mock patients. The second part was taken in the OMT lab with one of the OMT professors as the rater. For this part of the exam, we were matched with a student and took turns being the patient.

The History & Physical part of the OSCE started at 1230. The class was broken up into groups of 10 to 12 students and each group of students had to arrive at the CIELO, check in, and then the check in staff gave us a number that corresponded with our exam room. At the appointed time, we were escorted to the exam room, and we had a few minutes to read the prompt on the door. The prompt was a scenario that gave some basic information about the encounter and what we were to do. After reading the prompt, a buzzer went off and I knocked on the door. The mock patient said “Enter” and I entered and started what I was supposed to do. Once I’d finished gathering information and examining my patient (we were allotted 16 minutes), we had eight minutes to type up a SOAP (Subjective, Objective, Assessment, & Plan) note. After the SOAP note was completed, we waited until we were escorted to the OMT lab for the OMT portion of the exam.

The OMT station was a timed, 12-minute station. The instructor who was also the rater, gave us each a red folder that contained information regarding the type of OMT exam and/or treatment that we were to perform. Once a buzzer went off, if you were playing the role of the physician, you instructed your patient to disrobe and then you started the exam. As you were doing the exam, you had to verbalize what you were doing and why, verbalize key anatomical landmarks, state what you were looking for, name the somatic dysfunction if applicable, etc. At times, the rater would ask a clarifying question, but they did not otherwise communicate. It was really kind of an odd feeling because me and my partner were standing there in front of her as she sat at a computer typing notes on our performance of the exam. We were not to communicate in any way, as you might imagine. Once the exam was done, the rater would ask, “Is there anything else that you would like to add?” If nothing, we were done. We dressed and exited the OMT lab.

The final exam, arguably the most mentally taxing, was the anatomy or STRX exam. We had that today and again, the class was broken up into two groups for the exam. My exam time was at 1230. When I arrived at Building 4, I checked in and then our group was broken up into two groups. One group proceeded to the lab for the visual lab practical and the other group proceeded to the large group lecture room for the microscopic anatomy portion of the exam. Each portion of the exam consisted of 40 questions, and we had 90 seconds to write an answer for each question before a buzzer would sound for us to rotate to the next station.

The exam started at 12:45 and ended at 1510. When I got to the last six questions of the microscopic anatomy, I was mentally DRAINED. Few of the questions were straight up “identify this” questions. No, everything was a 3rd or a 4th order question. Like they would show a basophile and ask what does this cell type do and when is it activated? Or If I cut off this blood vessel, what collateral can supply this tissue? You had to really know your stuff.

UIWSOM does not give letter or numerical grades; the idea is to cut down on competition in the class. Everything is graded Pass, Pass with Recommendations, or Fail during the OMS-1 and 2 years. In the OMS-3 year, you can Pass with Honors, Pass, Pass with Recommendations, or Fail. I feel that I did well enough to pass everything, probably pass with recommendations, but at this point, that is all I care about. I need to make some modifications to my study strategies for this next block, Musculoskeletal & Integument, that starts on Monday. For example, I need to go back to making flashcards; I got away from them because they were time consuming but in retrospect, they really do help with my memory and retention. I am also NOT doing a study group. Study groups are good when you have a good group but sometimes, you just don’t mesh well with the people that you are studying with, or you find that the effort that you put out is not equal within the group. I found that my study group slowed me down. Finally, I now understand the depth that we are expected to go into so that will help when I answer the lecture objectives and make my flashcards. I’m going to rest tonight, and tomorrow, I’ll prepare my poster for the AMA Research Challenge. Saturday, I’ll start getting ready for the new block that starts on Monday. Seven weeks of MSK and Integument!