Neuro – Conclusion

Updated: Nov 29, 2020

So the first rotation of third year has come and gone. Psychiatry is on que, and starts on Monday. In the last week or so I was starting to feel pretty confident about my Neuro exam, meaning as good as I could possibly feel for only having done it for 3 weeks.  I was still forgetting to do certain things, but instead of forgetting to do something huge like all the reflexes I would miss something somewhat minor like vibratory sense. Of course like most things in life, just as I was starting to feel good about doing it, it ended.


This rotation of course was not going to end without a barrage of tests and exams in order to nationally prove that I got something out of it. The first of the tribulations was the Standardized patient exam. In a nutshell there are these fake exam rooms in the med school equipped with video cameras and lord knows what other kind of monitoring devices. They stick us in there with a fake patient, the school actually hires actors to act sick, and they train them extensively in order to know everything about the disease they pretend to have in order to answer all our questions about their symptoms. I learned for example that there are some 87 different physical symptoms a standardized patient can fake.  


We are given a ridiculous 15 minutes to perform a full history and “focused” neuro exam, not anywhere close to enough time, or what is given in the real world. We then come out of the room prompted by a passive aggressive series of dings only to find a computer waiting for us to type out a full history and findings, exam findings, possible diagnoses, and treatment assessments. This little gem gets a whooping ten minutes to complete; it’s a good thing I paid attention in typing class in high school.


In all the gripe the standardized patient exam is kind of fun, the patients present pretty classically, so its not too hard to figure out, whats kind of weird is that Tulane uses the SPs to teach stuff during second year, meaning I learned to do a rectal exam because they paid some guy to let me stick my finger up his butt. So sometimes they employ the same SPs to do these exams, and I have to pretend every time like I am meeting them for the first time.


The second leg of exiting a rotation is the feared Shelf exam. Shelf exams are the standardized exams given out by the national board of medical examiners; they have them for every class in the first two years, and every clinical clerkship in the last two years. It is the school’s discretion to decide if they want to us them, or just give their own final. I think I only took 3 or 4 of them in the first two years, the clinical years employ the shelf after every rotation however.  


There were really no big surprises on the exam, except that it was maybe the most wordy exam I’ve ever taken, there were four questions per page because they rambled on for 2 paragraphs before getting to the point. I feel like at this point taking scary national exams is becoming more of a knee jerk, study for a week, sit at an uncomfortable desk for a couple of hours. If I had test anxiety I feel like I would be anxious all the time because I do it so much.


  All in all I feel like I really liked Neuro, before going in I would say it was in my top three choices for possible careers. The unfortunate thing is that it still pretty much holds the same position, I don’t love it, or hate it anymore than I did before, which is weird because I was hoping I would feel something about it. My only worry now is that I have become such a drone of putting one foot in front of the other, and jumping through the hoops of testing, grades, and what not that I won’t be able to take the necessary steps back to look at the big picture of what do I want to do when I grow up.


I’m just really hoping the following rotations will have some kind of effect on me, be in good or bad.

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