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The man on top of the mountain didn’t fall there.

This blog post is written for those who are struggling to pass MRCOG part 2 for a while, but actually can help anyone who is struggling through any sort of a difficult situation. Be prepared to read through a long page because I’m going to talk about how to identify the cause of your failure and how to avoid it happen for the next time.

By now, most of you might be trying to get back to study mode after the acute phase of depression, frustration & devastation on the results. Some of you might still be considering whether or not to continue this struggle to get through MRCOG. Remember, Giving up is NOT/NEVER an option. Although, there can be occasional exceptions when you identify that you have opted for a path that is not a suitable and appropriate choice as a future career. But if you are sure that O&G is your career path and you know that getting MRCOG done is a way to go for your future, then there is nothing that should demoralize you.

Remember the man on top of the mountain didn’t fall there. They have reached there through their own tough journey. They definitely have struggled, tripped, and failed before reaching at the top, may be in ways invisible to you but no one has ever achieved anything without being through hardships. The obstacles and delays are not there to stop you meet your destiny, they are there to help you create the best version of yourself before you finally arrive your destination.

It’s a hard but true fact that everything that happens to us is a consequence of the conscious choices we make. We have a far more control on things than we actually realize. Failure is in fact the worst word in the dictionary, but it’s not always bad. For me, I’ve learnt the best lessons of my life through failures and disappointments. The only problem is that failure doesn’t automatically teaches you a lesson, you have to figure it out and decode the hidden messages by yourself.

Examining our failures is emotionally unpleasant and we often tend to play the blame game on everything else in order to downplay on our own responsibility towards it. To examine your recent failure in the written exam (or any other exam/situation), I want to take you through an exercise. I really want you to write it down on a paper. This is a great exercise, because writing forces you to think from the left side of your brain. The left side is the logical side of the brain, and the right side is the emotional side.

We will go through steps listed below:

  • Identify the cause of failure
  • Anticipate future problems
  • Devise strategy for next attempt
  • The new start

I will now take you through each step one by one.  Make sure you are ready with a paper and a pen in your hand.

Step 1: Identify what went wrong?

You must have thought over it several times. This is not only the most difficult step but is especially challenging if you have found that you did everything right, prepared in the best of your capacity and really don’t know what went wrong. Let’s do it a bit systematically now following the principle of risk management and using fish bone model. My blog currently doesn’t support inserting pictures so you will have to do it by yourself but I will explain what to do.

Draw the fishbone skeleton, label fish head as failure, and label every spike of skeleton with factors listed below. These are the most important factors but you can add as many more as possible according to your own understanding.

  • Personal circumstances
  • Work place circumstances
  • Study material and strategies
  • Time management
  • Previous lessons
  • Exam day performance

Next step is to write down any elements that you think may fall under each contributing factor listed above. Everyone may have a different element and some of the examples can be:

Personal circumstances:

  • House-help not available
  • Childcare issues
  • Moving house
  • Health issues
  • Emotional stresses (were you emotionally stable, too drained, too anxious etc?)
  • Family member related issues (parents, partner, children)

Work-place circumstances:

  • Over-worked?
  • Lack of clinical experience due to a break in career?
  • Study Leave issues?
  • Do you have supportive colleagues at work?

Study material and strategies:

  • Were you clear about the syllabus?
  • Did you have the right study material?
  • Did you need help/support in form of tutoring or an appropriate course?
  • Did you need a study buddy and did you find one?

Time management:

  • Did you give yourself an appropriate time scale for full preparation?
  • Were you able to cover the entire syllabus before the exam?
  • Were you able to revise before the exam?

Previous lessons:

  • Did you try to identify your problems/deficiencies in the previous attempt?
  • Did you try to do anything differently this time?
  • Did you find any use of the changes made in view of previously learnt lessons?
  • Have you been just going through exam after exam without an adequate analysis of possible problems in your study pattern?

Exam day performance:

This is by far the MOST important factor. Keep in mind a very important fact: no matter how hard you have studied and how well you have prepared, your result ultimately depends on your performance in the exam itself. Never underestimate the harms of over-confidence, not reading questions properly, or reading the question with a pre-conception about it in your mind. Eyes cannot see what mind doesn’t know, and sometimes eyes only see what mind dictates them to see. Try speaking to others who sat the exam (passed or failed no matter), recall some of the questions and see if they have understood the question differently.

Only you can help yourself to find out the actual pitfalls /deficiencies so you can fix those issues. Trust me, this is doable because I do it often to identify the actual problem (in any situation) and it always works for me. You can rectify a problem only after you have identified it.

Step 2: Anticipate future problems

Once you have identified the factors that might have affected your results in the previous exam, next step is to anticipate what can go wrong in the next exam that you plan to sit.

Again take each factor individually and list down what hurdles/challenges can be expected in the next 6 months or so. If the factors are beyond your control, then skip the next attempt. Remember, no cramped, squeezed or over-whelming effort is of any use. You cannot compromise on some absolute factors like an adequate time frame, completing the entire syllabus or revision time etc.

Step 3: devise strategy for next attempt

After this, devise your strategy for the next attempt keeping in view the identified factors. Try to rectify any past mistake/miss. Write down those points and place it where you can frequently glance it. Plan anew and restart from scratch. You have to erase all past stereotype information engraved in your mind and look at the whole syllabus with a new and fresh eye. Only then you would be able to pick up the information that your mind missed last time.

Last step: The new start

Lastly, start this time with OSCE prep first. There are a few reasons why I recommend this.

  • Your ultimate goal is to pass the entire exam after all this effort and you obviously don’t wish to pass the written only to be unsuccessful in OSCE, and then to re-sit the written (OSCE is still attached to the written for the next few years)
  • This gives you a change and helps break the stereotypical pattern of thinking.
  • This gives you an opportunity to prepare for OSCE while preparing for the written, as OSCE is more of a learned behavior that is achieved over a period of time and cannot be adopted in just a few weeks prior to the exam.

Honestly, if you really sincerely follow the steps mentioned above, you should be able to identify the possible reason of your failure and the solution to it. I would love to hear your comments below if you tried this exercise.

Wish you all the best!

Asma Naqi.

May 5, 2015

3 Responses on The man on top of the mountain didn’t fall there."

  1. shaista rehman hashmi says:

    Respected Dr Asma, it was great experience after reading your root cause analysis, I have two questions 1st is now the part 3 is separate so need to focus on part 3 as well while preparing part 2 and 2nd what about preparing first time and having so many root causes like you mentioned time management and childcare issues etc.

  2. Jyotsna says:

    Hi I m staying in kuwait Just finished part 2 but dont have any idea for part 3 Want to prepare for may 2018 Need ur help Thank u

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