I haven’t written a personal blog post in a while, and this topic has been on my mind for a bit. I started writing this at the end of last year and continued writing it in the middle of 2018 - and I have been meaning to share it ever since. It took me a lot of courage to share this. I had to sit with these words for a while before I could post this.
My university isn't recognised by the medical council, and therefore I would need to sit for the Examination for Provisional Registration (EPR) (previously known as Medical Qualifying Exam (MQE)) and pass the EPR (part I and part II) before starting my housemanship. I needed to pass Part I: OBA first before proceeding on to Part II: OSCE.
Earlier on, we were being informed that upon returning home, we can register with any of the three universities (UM, UKM, USM) in order to sit for their medical final exams and will then have the choice to attend the final year classes or lectures, in order to familiarize ourselves with the Malaysian system.
Unfortunately this was not the case, the previous procedure got cancelled by the Malaysian Medical Council (MMC). After waiting for a year in a limbo, I was told to sit for an EPR exam, which fee costs RM7,000. Without any syllabus, guidance and format, I was unable to successfully pass the exams after taking it three times.
I woke up one morning to receive an email from the medical council, and it was my exam result. My eyes glazed over at the start of the paragraph, and jumped to the next.
I just stared at the word “FAIL” for a considerable amount of time. My mind went blank, and my eyes started to tear up. I was on the edge of crying my eyes out. But I managed to pull myself together.
The worst thing about hearing bad news is having to swallow that lump that is growing at the back your throat, holding back your tears and telling yourself that it's okay. I had to convince myself that I’m going to be fine. I’m just completely devastated and very disappointed with myself. I was having a hard time digesting this one. This easily went to my list of the top 3 most painful thing I’ve had to go through in my life. The other two things you might ask? Well, I dont think I am ready (or will I ever be ready) to share, so I’m going to let those two posts sit in my drafts. At least for now.
My brain is still processing, what went wrong? It hit me bad, like an existential crisis. How does one cope with repetitive failures? How does one keep their sanity and maintain a positive outlook on life during hard times?
I was really upset with myself, it was unacceptable. I already knew the exam pattern - 120 questions are in the form of one-best answer (OBA) type of question where all 5 answers are right, but you need to choose the best option. I studied really hard for this exam, I revised and reviewed all the diseases.. system by system. I used study materials for USMLE, PLAB and past exam papers of local universities, did a lot of question banks that has one best answer (OBA) format and did many case-based questions. Did most of the questions from PLAB 1700 MCQs by Dr Khalid Saifullah, and this question type is the closest to the EPR. I have studied well and answered well in the EPR exam but was disappointed to find out I failed time and time again.
I kept on questioning myself, where did things go wrong? Was it my study technique? Was it because I didnt study properly? Perhaps this is not meant for me? I cannot begin to tell you how guilty I feel everyday for putting financial burden on my parents, you have no idea how expensive the exam fee is.
After the results came out, I spent most of my days in bed and did a lot of thinking. How do I face everyone when they ask about my result? What are my excuses this time? For all that I know, sooner or later everyone’s gonna find out and I dont know how to deal with this suppressed emotions just yet.
At that time I just wanted to be left alone and I dont want to listen and hear anything coming from anyone. Especially when I cant even convince or comfort myself. I dont want to hear what I dont want to hear. Dont tell me to not to be sad and cheer up, I just needed some time and space, and heal at my own pace.
But it’s difficult when you’re staying with a big family in a small house, where theres constant engagements and conversations happen with family members all the time. I had to put on a mask and pretend that everything’s fine. I had to force myself to engage and communicate with family and friends who approached me because I dont want to be rude or hurt them by not socializing. I dont want them to know that I was going through a hard time because I am afraid of being misunderstood. People tend to compare my hardship and struggle to others and that doesnt make me feel any better.
Weeks have passed and I am slowly recovering and slowly accepting the situation that I was in. I’ve started to understand myself more and trying to adapt to the pain that my mind and heart refused to accept.
I generally felt okay with myself until we had back to back cousins’ wedding every weekend for a month. Throughout that whole weekend for a month, I met so many family members, relatives and friends who asked me the same question every single time:
“When are you starting your housemanship?”
“Why is it taking so long for you to start working?”
“If you’re not working right now then what are you doing at the moment?”
“My daughter graduated later than how come she already started her housemanship?
“You both graduated in the same year and my son is starting his MO soon, what about you?”
“Have you done your exam?”
“Have you gotten your result?”
“When is your next exam?”
“Are you sure you still want to work as a doctor?”
“No need to work as a doctor, just do whatever you’re doing right now since you’re good at it.”
Now imagine having these same repetitive questions by different individuals throughout that whole month - that 4 weekends.
I got overwhelmed, and the anxiety I went through after I had gotten my exam relapsed. Actually no, that was a lie. It got worse. My mind was a complete mess, I just wanted to scream and go somewhere where I cant be found.
It was also the month where most of my friends were almost done or already done with their housemanship. Some of them have already started applying for MRCP/MRCS/MRCOG/MRCPCH. The good news were shared and posted all over Instagram. I know I shouldnt feel this way and compare their journeys to mine but I cant help myself when I’m in this vulnerable state. I felt alone and left behind. We all graduated in the same year, but they’re already becoming medical officers and I’m barely starting my housemanship journey. I know different people have different pace or timeline in life but I was just too upset for any positivity and optimistism.
I deactivated my social media accounts, ignored phone calls, replied blueticked messages only after a couple of days/weeks, avoided hanging out with a few friends and didnt go to any weddings. I had to come out with lame excuses for all of them. Most of the times, I keep myself occupied in my own room. I feel bad for ditching others but I felt relief when I’m alone in my own space. I needed some time off for myself. I need some space from everything.
But when I was alone with my thoughts, I started to question and doubt myself again. I even questioned myself what am I going to do with my life? Only 7/50 candidates passed the exam and 2 of them were my friends. I couldn’t help but think, if my friends can pass the exam, why can’t I? I’ve been overthinking and kept on replaying failed scenarios in my head. I isolated myself from everyone, stayed in bed doing nothing, just staring at the ceiling or watch Grey’s Anatomy. I cried every night feeling upset and worthless before I go to sleep. I became a light sleeper, so that made going back to sleep an even bigger challenge. I was having difficulty sleeping and my mind wouldn’t stop running in circles. I would fall asleep at 5AM, woke up at 6.30AM for Fajr prayer, slept and woke up again at 8.30AM and up the whole day. And this cycle repeats. I would wake up either crying or feeling grumpy because all I ever wanted was a good night rest or a deep sleep without feeling tired. And there were days when I just want to sleep and never wake up again.
This isn’t my first time going through this phase. I’m tired of going through it and repeating the same feeling of insecurities, same low self esteem, same dysfunctional thoughts. I’m tired and I just want to move on and get it over with. I tried to distract myself by doing the things that I love but I feel very much demotivated and no energy.. and I'm forcing myself to just get through the day. And I feel - drained. It is a blank state of mind and soul I cannot describe.
Most days, getting up to shower and eat a little bit feels like a major achievement. Some of my free times were spent by reading and reciting the Quran. I always pray that Allah grants me patience and the strength to cope. Because sometimes I am like a hurricane, there's calm in my eye but little does anyone know, there's a storm in my head.
Within that couple months of my darkest time, I finally got myself back together. When this phase hits me in waves, I try my hardest not to dwell on it for too long. I let my emotions do their thing and try to move on. Slowly, but surely, I'm recovering the pieces of my self-worth that I lost over the years. I recently got my motivation back and have decided to sit for the exam again, and will work harder for my last chance.
I’ve got to admit that I am afraid to sit for the fourth and final exam scheduled in March 2019. If I fail this last exam, I will not be allowed to practice as a doctor even though I have passed and graduated from a top medical school in China. I am broken and damaged way too much, I know I am not the smartest or been blessed with photographic memory. So I know someone like me need to work extra, like extra extra hard for this last chance.
I got so close to giving up but you know whats keeping me going forward with it? My faith and my dream. I need to be strong for myself. I believe that I can and thus, I will. It’s something that I have always wanted and I am not letting any negativity get in my way.
I dont want to relapse, and I dont want to fall back into that black hole. I want to get better, and be better.
