Hektoen International

A Journal of Medical Humanities

Medical school final exams: playing the odds

Howard Fischer
Uppsala, Sweden


Five men toasting, as if after completing exams
Five men toast around a table. Unknown photographer. between circa 1890 and circa 1910. Nordic Museum NMA.0057916. Via Wikimedia

I had finished eighteen months of clinical rotations at an American hospital and was back at my medical school in Belgium to take final exams. I checked in to a small hotel in the center of town and settled in for two weeks of last-minute cramming. I was going to take five exams, each three to four days apart.

The first two exams were in internal medicine and pediatrics, where I would have to take a patient’s history, perform a physical examination, and offer a diagnosis, or at least some diagnostic possibilities. Neurology was an oral exam, often with a request to demonstrate certain reflexes. The fourth and fifth exams were in surgery and obstetrics/gynecology. For each of these, one had to hand in a case report written about a patient seen during the respective rotation. This would then be followed by an oral exam.

I navigated the first four examinations successfully. There were probably eight or nine students present for the last exam in obstetrics/gynecology. The professor determined the order in which we would be examined based on how far one had to travel to get home that night. Since I had just a few blocks to walk to my hotel, I was called last, as my trip would only take a few minutes.

It was common knowledge that this professor would often ask students about their eventual plans in medicine, and then ask questions somehow relating his field and the branch of medicine the student wanted to enter. I wanted to be a dermatologist. I also did not think I could study all of the subject matter in my cram period. Therefore, I had prepared and memorized a ten-page summary of normal and pathological skin changes in pregnancy. My luck held. He asked me about skin changes in pregnancy and told me to stop after I had talked for five minutes, telling me that it was apparent that I knew this material.

Since I was the last student examined, the professor invited me to his office where he poured each of us a glass of wine, followed by a small Dutch cigar. I do not remember what we talked about, other than that he congratulated me. It was a perfect last contact with my medical school.




HOWARD FISCHER, MD, was a professor of pediatrics at Wayne State University School of Medicine, Detroit, Michigan. When he returned to the US he learned how difficult it was to enter a dermatology residency.


Summer 2021  |  Sections  |  Education

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