6-Ever Fail a Test?

I Want to Be a Doctor

Welcome to the I want to be a doctor podcast where insider information about what it takes to become a physician is available for anyone. I'm Dr. Robin Dickinson, a board-certified family physician and I will give honest answers to your questions. Today's question is from a 7th grader who asks: Did you ever fail a test?''

Yes I did!

When I was in medical school, I failed every anatomy exam. Yup, every single one. The only reason I passed anatomy was that I worked very hard in lab and did beautifully detailed dissections. Anytime we were offered an extra assignment or extra credit, I did it.

People who know me are surprised that I almost failed anatomy. I’m a really good doctor and take truly excellent care of my patients. I teach at a medical school. How could I have done so poorly on the exams?

Because exams don’t always say how well you’ll do in real life. Anatomy was really hard for me. I have really terrible spatial reasoning. When my son was about nine, he suggested he get out of the car and direct me when I was trying to parallel park. And yes, my parking improved dramatically when my nine year old starting helping. I always struggled with those puzzles where you have to flip something over in your mind. Back when we used paper maps, I would always have the turn the map upside down if that matched the direction we were going because I could read upside down but I couldn’t turn the directions around in my head.

So that also meant that trying to remember which blood vessel or nerve passes over or under something was really hard for me, especially if something was turned around in a different direction. And anatomy in medical school is totally different than anatomy before medical school.

Half the exam was in the cadaver lab where it was all about turning things around in our head.

Cadaver lab has been phased out of many medical schools. But when I was in school, we had teams of about 8 students who worked together to completely dissect a cadaver.

So what is a cadaver? People would decide before they died that they wanted to donate their body. After they died, their body was preserved and then we would carefully dissect it over the course of the entire semester. One of the other cadavers in the room I was working in was donated by a doctor who had gone to our medical school and dissected a cadaver in that very room. When he died, he donated his body to a new generation of medical students. The person I worked on was an old lady whose hands were exactly the same size as mine. I have short, fat fingers. I know this for sure because every surgery I’ve ever scrubbed into, if the scrub nurse hasn’t met me before, they’ll comment on my short fat fingers. It’s their job to make sure our gloves fit and I always had to size up and then pull the fingers up so they bunched around my hand. So it’s unusual to find someone with hands just like mine. It made me feel a little more connected to her that we had the same size hands. She appeared to be quite elderly and in overall good health when she died.

I was very good at dissecting. I grew up sewing, knitting, spinning, weaving, cooking, and doing other hand work. I was meticulous and detailed. I did a prosection--that was a special dissection used for demonstration for the other students--that got one of the highest scores in the class.

But the cadaver lab was also my downfall. I did great during the written part of the test. I knew how to memorize, draw diagrams, and answer questions. But the half in the cadaver lab was torture! They would drape the body with sheets so only one small section would show and then have strings and pins labelling various blood vessels, nerves, bony features, and so forth. They would often turn the cadaver in a funny position so we would first have to figure out which part of the body we were in.

I often had NO IDEA whether I was looking at an arm or a leg, the front or the back. So of course, not even knowing where I was in the body, I couldn’t answer the question. Even if we were being tested on something obvious, like inside the abdomen, everything goes under and over everything else and it just looked like a tangle to me.

So that is how I failed every exam and still passed anatomy and went on to be a good doctor.

My spatial struggles also caused a challenge for me in my surgery rotation. But I ended up honoring surgery. That means getting the highest grade possible. And I got some wonderful reviews from the surgeons I worked with. The difference between anatomy and surgery was that in anatomy, half the exam was being able to name the anatomy in a cadaver. In surgery, I would get quizzed by the surgeon during a surgery. “What nerve is this? What vessel is this?” And I would almost always answer, “I don’t know but I’ll look it up” I remember one particular surgery in which I said that multiple times. Finally the surgeon laughed at me and said, “You’re going to be looking up a lot tonight!” I said enthusiastically, “Yes I am!”

But the surgeons didn’t really mind that I struggled with the anatomy. I came early and knew everything going on with my patients, spending extra time to look up anything I didn’t understand and asking for help to learn more. I stayed late to assist on surgeries. Anytime someone was needed to help with something, I volunteered. I got a reputation for my beautiful stitches (all those embroidered pillowcases when I was a child paid off, thanks mom!) I asked good questions and was genuinely interested in the answers. Patients liked me so much that they would mention me by name when they reviewed the doctors who had seen them while in the hospital. I had a good attitude, matched my tone to the tone in the OR (so in a serious and quiet OR I’d be serious and quiet but if the surgeon asked me to tell a good joke or story to entertain during a wait, I’d pick a good one); one time a patient asked if someone would sing a particular song to them while they were going under anesthesia and, having grown up singing with my sister, I happily obliged. I took any teasing from the surgeons in good spirits. By the end of the rotation despite the fact that I nearly passed out during the first two surgeries and never did figure out the anatomy, I was allowed into almost any surgery to assist and was truly sad when the rotation ended.

If there is something you struggle with, don’t let it define you. I did eventually get much better at anatomy because I learned ways to study that work better. And in the next episode, I’ll answer a question about how to study according to science.

But more importantly, I was a good doctor long before I triumphed over anatomy. My other skills were far more important when it came to actually caring for my patients.

Whatever you struggle with, you can find the right fit for yourself. One of my good friends was never comfortable talking with patients. He didn’t know how to ask the questions that elicited the information he needed, he couldn’t explain things in a way that made sense ordinary people, and he got regular complaints for what patients described as a cold and uncaring bedside manner. He actually did care. He just didn’t know how to show it. He ended up becoming a really talented pathologist.

Pathologists are sometimes called the doctor’s doctor. They are underappreciated by patients because you never talk to them or see them. But doctors call pathologists all the time. We rely on them to tell us what a biopsy, blood sample, or other test shows. They tell us what kind of specimen to obtain and how to prepare it. They tell us what test to do next to figure out what’s going on. And he is a really good pathologist.

No one is good at everything. I’m not good at everything. You’re not good at everything. That’s okay. My only regret with anatomy is that I could have learned the information better if I’d understood more about the science of learning. But we’ll talk more about that next week.

That's it for today. Subscribe, share with your friends and mentors; and remember to live the life that is right for you with your personality interests and values.

Please send your questions to me at [e-mail]. That's podcast at d-o-c Robin like the bird school dot com.

Show notes are available on the podcast website linked below.

This episode was sponsored by Dr. Robin's School the first pre-medical curriculum for kids, and recorded in beautiful, downtown Englewood, Colorado.