Failed the year – my journey through medicine

 “Failed the year – refer to faculty”

These are the words that assaulted and violated my sanity in my final year of medical school. Technically, these are the words that rendered it my first final year. I was preparing for graduation, for internship, for a monthly salary and for two wonderful years at the coast. Mostly though, I was preparing to not have anxiety attacks every 6 weeks (this owing to having life-changing examinations, seven in total throughout the year) because of all the dangerous, unhealthy habits medical school develops in us (I would have said we develop these habits in medical school, but the choice is not ours). The mental toxicity these examinations cause is unrivaled.

So, there I stood, face to computer screen, reading the words as the screen went from crystal clear to blurry. It was not due to my eyes filling with tears, as one would imagine. It happened because my brain could not, would not, register what my eyes had been seeing. I mean, it just was impossible. My lowest score in first year was 60% (when the pass mark was still 50%). In second year I went up to 69%, exempt from exams for the remainder of my medical school theory career (because from second year, an average test score of 60 or more meant one had proven oneself capable and smart, and further examination [i.e. actual final exams] was unnecessary). The next year my year mark was 72%. In fourth year the report card noted 75%. I was a Golden Key invitee for all those years. So how would my brain justify what my eyes were seeing? What sense did any part of that phrase make?

What’s even worse, my final year marks – of the blocks I had already been examined in – left only a little to be desired. My scores ranged from 69 to 79 percent. How do I bring myself to understand failing because of two bad days? Two LIFE-ALTERING bad examinations?

The first block I failed, Internal Medicine, was horrific. Too horrific that I could not bring myself to meet up with the head of the department (as was expected of me) to find out what marks I received. The oral exam had me dealing with a discordant patient, who was picked for our exams because he had ‘good signs’ to illicit. Apart from the fact that the exams are there to prepare us for internship (where patients do not have signs on their forehead revealing what system is worrying them, unlike in the exam), we are told that the history guides us towards which system to examine. What, then, was I expected to do when my patient said his problem was only gastrointestinal but was placed in the neurology station? My brain understands that I failed to illicit the ‘good signs’ of cerebellar dysfunction, thus deserve the poor outcome. The rest of me, however, cannot come to terms with having been expected to examine a system that didn’t bother my patient, and failing because I listened to the patient, not the sign on the headstand. I loved Internal Medicine in my sixth year, more than in my fifth year of studying. That is what I found most ironic about failing my first block of final year.

The Integrated Primary Care (IPC) block deserves its own chapter. For now – the crux of it. My overall mark was 75%. I failed because the oral exam hit me with a bulldozer and my anxiety issues did nothing to help. 54% is what I walked out with – 6% less than I needed to make it through. I had been oblivious to how badly I did prior to receiving the results. So much so that when I searched for them on the Wednesday afternoon (a week after the exam), I expected no less than a 75% – I was confident I aced it and only modestly said I received a young A symbol. As the results came through and the phrase “FAILED THE YEAR – REFER TO FACULTY” showed up instead of the distinction I anticipated, my brain refused. I said to myself, alone in my room, ‘this is wrong. I’ll refresh again in a few seconds. Impossible.’ I refreshed, and refreshed, and refreshed. Then came the, ‘I will go to the head tomorrow and he’ll see the grave error which was made. We’ll laugh about it, after he apologizes.’ I slept peacefully that night. Had I known that that would be my last peaceful sleep for the rest of the year, I would have savoured it a tad bit more.

I awoke the next morning, went on to class and endured the cheers of my peers as they sang songs of victory at defeating the mighty IPC block. Some spoke of how they thought they’d fail but passed, others whispered about how those who failed should have studied harder. Both kinds pierced every fibre of my heart, for different reasons. I studied hard, and I thought I would pass, but Wits medical school said I had failed. The Utopian ideas I’d had the previous night melted under the Parktown sun and, the realization came that it may be possible I failed the year. Thoughts raced through my mind and I decided to skip the rest of the day and go visit the IPC department.

“Black students form the majority of the students who failed IPC. We have to believe there is an inherent weakness in either how they study or how they take exams.” I had been in his office for perhaps 20 minutes, trying to understand how I thought I passed but failed the exam and, consequently, the year. The head of the department felt it alright to tell me, a black student, that I am weak. I was defeated, no, destroyed. Because from that moment, those words haunted me day and night. I was one of the black students in question. I was weak. I failed. All my previous successes had been nullified by this one statement, made by this one man, this white man who felt comfortable enough to tell me, a black woman, that my melanin weakened my intellect.

Politics aside, the point was this – I failed. For the first time in my varsity career, I failed. Golden key did not matter. Exemption from exams did not matter. 75% aggregates did not matter. I failed. No graduation, no internship. No ridiculous salary, no beach. Just 7 more examinations to look forward to in 2018. 7 more six-week anxiety attacks. I failed. Oh dear.

Life had just hit me with the scariest lemon I hadn’t prepared for, and I was salty. You could not tell me anything that would soothe me, help me or heal me. I was bitter. I was furious. I was not about to make lemonade. And the real kicker – you could not tell at all. I perfected the fake smile, the ‘I’m okay, really’ line, the YEY GRADUATION cheer. I kept my failure a secret for as long as I could. I was the best actress I’d ever come across. And that was near fatal.