u/Outrageous_Buy_1316

I’m a 2nd year med student and honestly I feel a bit lost academically right now.

Growing up, I was always the “smart” kid. I did well in school, especially biology (chem and physics humbled me a bit lol). Getting into med school was probably the proudest achievement of my life. I knew I wouldn’t suddenly be the best anymore because everyone here was high-achieving too, but I still expected to at least be up there.

Instead, I’ve realised I’m… pretty average? Usually around the mean. Meanwhile people around me are getting merits/distinctions. Last year I worked insanely hard just to get a merit, only to then realise there was an even higher grade above it 😭

This year I basically sacrificed my social/personal life to focus on studying (not that I had much of one anyway). I’m naturally introverted, I genuinely enjoy staying home, eating good food, watching movies/TV, and relaxing. I thought not having loads of hobbies or nights out would give me more time and maybe an advantage academically.

My main revision method is making Anki cards from lectures/outcomes. I’m VERY good at memorisation. Anatomy, cranial nerves, pathways, muscle actions etc. I can grind those out really well. But I struggle more with application-style questions and SBAs. Those “50/50” questions genuinely stress me out and can ruin my mood during exams.

We just had our final written exam yesterday. Weirdly, I came out feeling awful about it. I thought I was well prepared, especially because OSCEs were what I was most worried about this year. But the written paper felt so obscure? It felt like they tested random tiny details mentioned once in a lecture instead of the concepts they constantly emphasised. The straightforward memory questions were fine for me, but the application-heavy questions really threw me off. I guess also topics that I didn't revise because they were genuinely boring or not "high yield" also did come, but cmon weve all been there at some point lol

Then afterwards I spoke to friends and they all seemed way more confident about answers I was unsure on. Some of the questions felt like:

• year 1 content I’d forgotten
• things I’d literally never heard before
• or pure 50/50 guesses

And now I’m spiralling a bit because I wanted to do well this year so I’d feel prepared going into clinical years.

I think what’s bothering me most is that I’m starting to wonder if hard work alone just isn’t enough for me to actually excel in med school. Like maybe I’m just not naturally good at the type of thinking med school exams reward.

The scary part is that Year 3 onwards is supposed to become even more case/application-based, and then there’s the UKMLA, which everyone says is full of “best answer” style questions. So now I’m questioning whether my revision technique is actually effective at all.

For people further along in medicine:

• Did anyone else go from being top of their class to feeling average in med school?
• How did you transition from memorisation-heavy studying to clinical/application thinking?
• What revision methods actually helped for AKTs/UKMLA style exams?
• And how do you know if your study method is working when you walk into exams feeling prepared but walk out confused?

Also for context, I’m Asian, so there’s definitely some pressure tied to achievement/family expectations too. And honestly, being seen as “smart” has always been a part of my identity, so struggling with this has hit harder than I expected.

Sorry for the long rant. Just needed to get this out somewhere.

I genuinely don’t believe OSCEs are a true measure of a person’s clinical ability. While it’s great we have come a long way from the old surgeon grilling each med student on something different to a standardized exam, a huge reason people fail them is because most students don’t actually know what they’re being marked against. At least for early years at my university the lack of support is astounding

At least at my uni, we’re taught clinical skills like history taking, counselling, examinations etc., but we’re never really given a proper checklist of what examiners specifically want us to hit. Compare that to written exams where expectations are much clearer, there are mark schemes, example videos, and a defined structure.

With OSCEs, we’re told to learn entire examinations, but then in the actual station they deliberately cut parts out because it “won’t fit” into a 5–8 minute station. Instead, they interrupt you halfway through to ask random questions at the end under pressure. So what’s the point of AKTs and learning full examinations properly if we’re never actually assessed on performing the complete exam?

The stations which last 8 minutes were often split into mini-stations within stations. So instead of assessing clinical ability, it starts feeling like a game where success depends on being able to balance time while also think about the question and what not. Now granted that GPs do this on a daily basis but it just seems u fair to those students who like to take their time thinking of an answer and writing down whatever is going on in their brain which isn’t possible when you have a tiny clock in front of you counting down each second while you realise every mark is slipping away. This is my opinion does not test whether or not you are a good clinician.

What also baffles me is the lack of transition time between stations. We literally had no break between finishing one station and moving to the next. Sometimes you have to rush across the hall, sit down out of breath, and immediately start reading the next prompt without even 30 seconds to reset mentally. Adding one minute between stations would barely increase the overall exam time but would massively improve fairness and performance consistency.

I understand OSCEs are supposed to standardise assessment, but right now they feel more like an exercise in time management, memorising buzzwords, and gaming station structure than actually assessing whether someone would be safe and competent with patients.

Curious if other med students feel the same or if this is just my experience. Not looking to pick a fight or anything, please correct me if I’m wrong in any department or you have had different experiences because my OSCEs so far have been traumatic to say the least.

Basically the title, we have our Year 2 OSCES in a week and I was wondering whats the best approach/structure to go through to hit as many marks as you can, as our med school doesnt really have a structure like history taking so you dont really know where the marks are and I am struggling to see whether my approach is right or not?

For example: A patient has been diagnosed with high BP, talk to them and give them lifestyle advice. So my approach would be along the lines of:

- What do you know about HTN? Then explain HTN

- ICE (Ideas, Concerns, Expectations)

- Then tell them that there are a variety of lifestyle factors that can affect your high bp and make sure you have a good QoL

- Then I talk about how Diet, exercise, smoking and alcohol affect HTN and also ask them about how each of these domains are for them

- After doing that I ask them what their goal is (i.e. what are you looking to change, where do you want to be in 6 months)

- Then I talk about if they have ever tried doing said change before (e.g. more home cooked meals, reducing smoking) and why or why not it worked and what resources did they use to change that.

- Then i say smth along the lines of: Having set a goal is good but sometimes we dont manage to hit those goals so its important that we take small steps to reaching there, so what would be something short term you would like to achieve (say having 2 home cooked meals a week or reducing cigarette smoking 1 day a week)

- Then i end with saying how would you notice said changes are working and the patient would say smth, and then i would finish the consultation by saying if we can book a follow-up appointment to check how you are getting along and any blood tests if needed to check changes

So that's my lifestyle advice structure, not really sure if it's good so would appreciate feedback, I use the GRINs Model (Goals, resources, Increments, Noticing) so idk if anyone else does thats what our med school taught us

I also am not sure how to go about explaining a diagnosis, like talk to xyz about their diagnosis of Crohn's. What I fins hard is how to explain it simply (and if i even rmbr what Crohn's is) and to actually discuss this in 8 minutes if I have the knowledge to even discuss lol

Sorry for the long post, would be much appreciated