The dreaded TULE exam

It's time to write the post I was never looking forward to writing.

Because this is about NOT clearing TULE.

My worst nightmare has come true. Something I had never expected and still am unable to accept.

I have to admit it, I am still shocked, and wake up every day hoping and wishing that all this that happened in the past month was just a bad dream. But it's not. It's true. I did give the exam, and I did not clear it. That makes me feel like a really dumb student, because this kind of failure is something I have never experienced, nor awaited.

Let me go into the background a little bit. I am a good enough student of medicine, I have never failed any exam, I chose this profession by my own choice and I am very passionate about it. Since the time I found out I'd be moving to Sweden, I have been trying to find out about this particular test. From whatever I gathered (and I can't quote any sources, unfortunately) the practical test is a breeze, because all they want to know is whether you are good enough at communicating and have a clinical mind-set. The theoretical part is comprised of 70% questions from past papers that are available on the website.

Now, moving on to my own preparation with this background in mind. I took keen interest in learning the Swedish language, not just as a chore, but as an interest. That and my natural gift for languages resulted in a very good command of the language, and much appreciation from every Swedish person I've met.

For the written test (short answer type- telegram format) I had no better option than reading the books. Or at least that's what I could think of, since there is no chance of finding review books or summary books of the epitomes that they have.
Anyhow, I did not start reading until after my Swedish B exam and by that time it had been 18 months since I finished medical school. I tried to read according to a schedule but it was not possible to keep up. I take it as my personal weakness. The problems I faced were: not being able to keep up with a routine, hard time reading the medical books in a new language, since those words could not be linked to any past memories, since all the past memories were in English. Even reading the books was troublesome in the beginning and I had to constantly consult Google translate on my phone, until I came to terms with words like begära (request), åtgärd (measure), sätta ut (stop), syrgas (oxygen), saltsyra (HCl), utsöndra (secrete), and many many more. There was no concise book for guidance and abbreviations or anything. The books are written in a different style, it's very long and tiresome to read a whole page and find out only one fact worth noting. The common illnesses in Sweden is a whole different spectrum than those in Pakistan. I can't recall sclerodermia and coxitis simplex back to front. I can do that for TB and hepatitis though.

I believe I do not have a good memory and I had a hard time remembering almost any thing form my medical degree. Some of it might have been not having read or memorized it properly in the first place, and the second being not having any revising mechanism, or job, or problem solving to keep it afresh. That's why I would put most of the fault on myself and a little on Swedish language.

I spent almost 4 months struggling with the books, and I couldn't read much, so in the last few days I resorted to the past papers. During those few days before exam, I realized that the past papers for a few subjects have changed a lot during the past 3 or 4 tests. Like the pattern is changing. I understood by then that it won't be helpful to do just the past papers, but I had no choice during the last few days.

On the test day, I reached Skånesuniversitetssjukhus (SUS) at 7.30 am for the written test. The first half (7.30 am to 12.30 pm) was 3 subjects, and the second half (1.30 to 5 pm) was 2 subjects. I realized while starting the first test that I was screwed. The questions were not at all repeated and I could not tell all those answers to diseases I haven't memorized before and protocols that are too simple to be true. By the end of the day, I was sure I would not clear Medicine, Pediatrics and Surgery. As the results showed later that I have to re-take the whole written test again.

The next two days were just one-hour passes of clinical exam. The good thing is, you get information about which subjects will be tested on the written day, so you are mentally prepared. I got medicine on day 2 (liver cirrhosis) and surgery on day 3 (hematemesis). I was good at the communication part, history taking, hygiene, consent, examination and so cleared both of them. Though I wouldn't boast about the after-test discussion. In the medical one, I had to put on a lab coat they gave and in the surgery part I had to change into white scrubs. Both the patients were elderly females and I was supposed to speak loudly. (And to know the commonest cause of hematemesis in an 80 year old?!)


Anyway, so now I am heart broken and have to take the theoretical test again. In September I suppose. My hopes are not high.

I wish I had this kind of first hand information available before I attempted, or before I even moved to Sweden.
Now I hope at least someone would benefit from this. I'm sure it can be done on first attempt, I just had the hard luck of not being too sharp at the memory bit and having no guidance at all.

I am ashamed of myself, don't have the guts to tell this to everyone who complemented my Swedish.

Funny thing, my mentor (that I got through mentorprojekt, rotary through arbetsförmedlingen) said: If you were expecting to clear this test within a year and half of moving to Sweden, you were being unrealistic and expecting way too much from yourself.

For now, I like these words and would like to believe her.