Orthopaedics exam experience

Finally some good fucking news

Had ortho just now. I had professor György Szabó, like almost everyone does. Ms. Worldwide had the exam before me, and she was called 09:20. Her exam finished at approx. 09:45. She had the sciatica and chronic osteomyelitis topics, and it went very well for her.

I was called soon after. The co-examiner was sitting next to prof. Szabó. We say good morning and I introduce myself. I was sitting in the same room as Ms. Worldwide was when she had her exam, which he notices as soon as he sees my camera feed. I can tell that he’s confused, and he asks me whether I have some kind of custom background on or something, but I explain to him that Ms. Worldwide is my girlfriend and that I’m in the same room as she was. He asks to see my ID, but didn’t ask to see my room.

He then starts to ask whether I’m nervous (which I was. A lot). He asks me what would be the worst that can happen. I tell him that I could get good topics but forget everything and fail, so that I have to repeat the exam later. “So what?”, he says. “What kind of doctor do you want to be?”. “A cardiologist”, I reply. “So when you’re a famous cardiologist in Norway, do you think anyone will ask you about your orthopaedics exam as a fourth year student? Even if you fail, how long do you think that’ll bother you?”

He also asked me whether I thought that he’d ever failed as a student. I answered no, but replied that he had, multiple times. He told me that he failed his A chance in anatomy, and only passed on the B chance after “Promising the examiner that he would never become a surgeon”. “Of course I promised him!”, he told me, and laughed. He tells me that there’s nothing to worry about and that we’re just going to have a friendly conversation between colleagues.

He shows me that the topics are spread out on the table, and tells me that he will point to each one once and I will say stop to choose that topic. I had to do that twice. He asked me whether I was happy with the topics, to which I reply “no”, but he tells me that he will help me, and that it will be fine.

55. Rehabilitation following limb amputation, ortheses, orthopedic shoes

Something to note is that when he read the name of the topic he just said “Rehabilitation after limb amputation. Orthopaedic shoes”. So he skipped the “orthoses” part.

I start talking about how limb amputation was performed more commonly some time ago, before oncological advances allowed for the use of limb-sparing surgery for bone cancer, but that limb amputation is still sometimes performed today.

I explain how it’s very energetically “expensive” to use a prosthesis, and that training strength and balance is important. I explain the concept of stump conditioning. He asks me how long I think it takes for the swelling to go down, whether it’s days, weeks, or months. “Weeks or months”, I say. “What does the patient do while waiting for stump conditioning. Do they have to lie in bed and wait?”. I reply that they could use crutches or wheelchair in the meantime. “Crutches are good, but wheelchair is not. Why?” “Because then they don’t use the healthy leg”. “Yes”, he replies. “What else can they do in the meantime?”, he asks.

I try to think but can’t think of anything. He mentions that there are temporary prosthesis, which I didn’t know. He asks me about where amputations are performed, and where it is “best” to perform them”. I say that they’re performed at the level of the knee, which he says is wrong. I say they’re performed above the knee, but he tells me that that’s not the best place to amputate. “Below the knee”, I say, which is correct.

He asks me about amputation of the upper limb, and where it’s best to perform. I say “below the elbow”, but he disagrees. He asks me how functional a upper limb prosthesis should be. “As functional as possible”, I say. He asks me how functional I think they are. “Not fully functional”. “Exactly”, he says. “There are some million-dollar prosthesis which are connected to the brain and allow for finger movement, but almost nobody gets those. Why would normal people get a prosthesis then?”. I can’t really think of anything. If not for function, then what?

He asks me about people look at people with amputated limbs in the store. “Peculiarly”, I say. “Exactly. So what does that tell you about another function of the prosthesis”. I don’t really get what he’s getting at, but after some time of thinking he tells me that prosthetics are also important for cosmetic reasons, and for the patient’s own psychology.

He ends the topic by telling me that there are three important components of rehabilitation after limb amputation. “Function, cosmetics, and psychology”. “Let’s skip the orthopaedic shoes and go straight to the next question. This topic was a 3.”

42. Scoliosis with known etiology, treatment of

I start mentioning the causes of neuromuscular, congenital, post-traumatic, etc. I then start to compare neuromuscular to idiopathic scoliosis, saying that neuromuscular often involves pelvic deformities, etc. He stops me and asks me why I’m talking about idiopathic scoliosis, when my topic is about secondary scoliosis.

He asks me about a medical synonym for idiopathic. He freeze and start to get really nervous that I’m going to fail at this topic, as he’s seemed displeased with what I’ve said so far. However, he notices that I’m getting nervous and reassures me by saying “There’s no reason to be nervous! We’re just having a friendly chat as colleagues! Don’t think of this as an exam”. He helps me by saying “You’re going to be a cardiologists. Think about idiopathic diseases in cardiology. Think about essential.” “Do you mean primary?” “Yes!”, he says. “Primary, idiopathic, essential; it’s all the same. Idiopathic means that we’re idiots and don’t know what causes it. But this topic is about secondary scoliosis, scoliosis with known causes, so you shouldn’t talk about idiopathic scoliosis.

He obviously didn’t really need to tell me that, and I wanted to tell him that I was just trying to compare secondary and idiopathic scoliosis, but I didn’t get to tell him before he started to ask me other questions.

“What is the treatment of congenital scoliosis?”. “Surgical resection of the abnormal vertebrae”, I say. “Hmm”, he replies. “So when would you do the surgery? The baby is born yesterday. Do you do the surgery now?” “No”, I reply. “When would you do the surgery then?”

I stop and think, but he says “The child is now one year old and has begun to walk. Do you do the surgery now?” “I don’t really know exactly when you would do the surgery”. I don’t really remember how we got there, but eventually he arrived at the conclusion that would only do surgery if the scoliosis is severe and conservative treatment is insufficient. He asks me “What if I’m a stubborn father. My child has severe scoliosis, but I accept how he looks. How would you convince me to do the surgery?” I tell him that severe scoliosis involves a high risk for cardiopulmonary complications, and that surgery is important to prevent it. He is satisfied with this answer.

Last words

He tells me that the second topic was also a three, so the total will be 3. He asks me whether I am satisfied, to which I reply “Yes, of course”. I thank him, he wishes me a nice day, and I leave the video call.

I don’t know if this post got it across properly, but prof. Szabó is literally the nicest and kindest examiner I’ve ever had. Literally. I was so nervous for the exam but during the exam I was much less nervous, thanks to him calming me down before and during the exam. He also only seemed interested in the very basics. My exam took only around 20 minutes. I wish all examiners at POTE were like this.

Some words of advice for those having the ortho exam: Talk about your topic in this order: epidemiology, etiology, clinical features, diagnosis, and treatment. He really appreciates it if you follow this order. I think that applies to most subjects, actually. Make it a habit.

Unfortunately my fantasy of him only giving out topics which have been covered in the lectures didn’t turn out to be true, but it didn’t matter much. I’m sure that if you draw one of the topics which were covered in the lecture and you mention only what was said in the lecture, you’ll be okay.

Anyway.

Oral exam failing streak: broken ✔

Insides: dead ✔

Urology: Monday 😩