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Outrageous Fortune

March 12, 2014

This Monday, the deaneries were announced.

Some background: When applying for the Foundation Programme, the first two years of doctorhood, final year medical students first apply to deaneries, areas of the country where various hospitals and foundation trusts have been gathered together in postgraduate bureaucracy. When you discover which deanery you have been placed in, you rank all the different jobs within that deanery. After another nervous interval, you will learn of the content of your next two years.

Precisely which deanery and set of jobs you will be gifted with depends on your FPAS score. Half of this is derived from your educational achievement at medical school and things like additional BScs and publications. The other half is derived from your score on the SJT – the Situational Judgement Test. This strange test presents you with likely scenarios as a junior doctor and asks you to rank responses to the scenario in terms of appropriateness. It sounds very subjective but there are definitive right answers – it is just very difficult, even after weeks of revising and dissecting the exam, to know what the right order of answers is.

The SJT is not related to educational achievement. It is not even related to medical aptitude. In some private research, one of our lecturers set a practice SJT to first year engineers in our college. Their scores were comparable to final year medical students.

The SJT is, in my opinion, one big wheel of fortune. Roll up, roll up! Take a spin and let Lady Luck decide!


You gotta ask yourself one question. Do I feel lucky? Well, do ya, punk?!

So, back to the present. The deaneries were announced on Monday and Eve and I will be heading to our third choice deanery. We’re happy with that. We linked our FPAS applications to guarantee the same deanery – they only look at the lower score. I was somewhat surprised to learn that I was responsible for that lower score, and now our deanery. We had the same educational score, but I slipped nine points below her in the SJT.

I scored 35.

35? 35 out of 50! I felt I had been torpedoed by the SJT exam. But the deanery we’re going to is a good one, we’re together and we’re looking forward to it.

Then yesterday, our first choice deanery posted the various quartiles and scores they required for entry. We missed out on it by one point! So close and yet impossibly far. But I took it well. A lot of my friends, both in real life and on Twitter, are heading to the same deanery as us.

Then later, our deanery posted their own scores. Eve has ranked in the second decile and I’m proud of her. My half-formed, nerfed score ranks me in the ninth decile. That one…that one hurt. The way jobs are ranked, if any of the 80% of applicants above me want the same jobs as me, they get the preference. I get…whatever’s left.

All through medical school, my fate has been in my hands. My progress has been due to my knowledge, my skills, my talent…and a soupcon of luck here and there. Whereas now, I feel adrift, cut loose on the high seas of uncertain destiny. I haven’t felt like this since applying to medical school, when I was just a pawn on the playing board between fate and the admissions board.

If I were in this position because I didn’t work hard enough, I could understand that, I could bear that. Thanks to that perfidious SJT, I feel punished Kafka-esque for a crime I didn’t commit. With a pair of twos in my hand, while everyone else is holding aces, I worry that won’t get the foundation jobs I want…and without that foundation, there is dwindling hope for specialty training later on.


Kafka – Architect of the SJT

But perhaps I’m being too melodramatic. Perhaps I’m catastrophising. Instead of letting myself be scuttled by the rolling seas of fate, I will raise the sails!

From this point on, I know I will have a job for at least the next two years. That is a security that graduates of any other course would lust after.

Foundation training isn’t the first immaculate step on golden road to consultanthood. It’s two years of finding my feet and gaining basic competencies as a doctor. All the jobs are the same, more or less. I have done well before in diverse situations and dammit! I’ll excel again!

Perhaps most importantly, I am going to be spending the next two years with Eve. That matters. Whatever I do, we’ll be together. What have I done to deserve the love of such a caring, beautiful ginger mess? What’s more. We won’t be alone…we’ll have plenty of old and trusted company.

Lastly, as Eve consoled me last night, I “still have that writing thing.” Yes, that writing thing I like to dally with. Perhaps paradoxically, one of the greatest lessons medical school has taught me is that I am more than just a doctor and there is more to life than medicine.

So, I take arms against this sea of troubles, this outrageous fortune!


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