Looks like I started a trend with the very last exam I took at York. After doing below average in a course (Molecular Biology 2) for the first time ever in my life in my last year at York, I have begun the year by getting below average marks on my first two exams, as you all already know. Looks like I might be continuing this trend.

I took my third exam this past Monday – Histology, Embryology, and Ethics. The embryology answer key came out a few days ago, and unsurprisingly, I scored below average again. The class average was 75 and I got a 67 – yeah I guess the exam questions were pretty “challenging”. I say that in quotes because the type of challenge wasn’t something I particularly appreciated. It was challenging because some of the questions required knowledge of pretty minute details. If you know me well, you’ll know that I love concepts and hate rote memorization of random facts. That being said, maybe I will end up doing above average overall across all three sections, though I highly doubt it.

Does this bother me? A little bit, but not really. It only bothers me in the sense that some people might only correlate my intelligence or capability as a future physician with my grades.

It’s weird that we think this though, and when I say this, I mean the pure correlation between marks and intelligence. I remember growing up, whoever got the highest marks in class was considered the “smartest” or whatever. Forget for a second that we haven’t even defined what intelligence is, or if you believe in multiple intelligences, or what type of intelligence school even tests – even if we neglect these important discussions, it’s pretty clear that it takes more than “intelligence” to do well in school. I know people who I think are much smarter than I who I’m sure I got way better grades than in school.

Yes intelligence affects your marks, but so does work ethic, test-taking skills, and ability to perform under pressure (there are probably more, but these are the four that to my mind the fastest). Among all four, my work ethic is my weakest aspect. Unless I am very interested in something, I can’t find the drive to put in the work ethic to learn it. And if you are weak in one of these areas, it’s going to hurt your marks big time. For me in particular, the problems with having a poor work ethic when studying things I don’t want to becomes amplified in medical school because so much of it is based on effort. Knowledge requires time to learn, and in medical school (at least here at UofT), knowledge is constantly being thrown at you. I can’t reason my way out of knowing the concentration of sperm cells in semen (my very first exam question required this knowledge, and of course, I never expected I would actually need to memorize that number – yes you could argue that anything taught is “fair game”, but you can easily write an unreasonable exam using all knowledge taught).

What saddens me is that it’s almost as if things still haven’t changed yet. One of the things that discouraged me about my undergraduate education was that there was so much emphasis on knowledge and next to nothing on developing thought processes, which as you know, I think is far more important in the grand scheme of things. We assume those thought processes will develop on their own, despite the fact that they are much more difficult to develop than simply accumulating knowledge, which simply requires reading a textbook (yes learning material from a textbook requires the ability to understand, but wait, that comes from thought process!).

I’m not saying knowledge isn’t important, because it is important. But knowledge becomes meaningless when we don’t know how to think about that knowledge, how to manipulate it to come to a solution to solve problems – and not just a solution, but to be able to develop the best solution. I feel like we grow up learning how to identify the best answer on a multiple choice test, but are never told that maybe the best answer isn’t listed on there.

Then again, you could just tell me to forget all this, suck it up, and memorize the damn textbook. I’ve got my last anatomy exam in less than two weeks, and there are loads to know (the head is pretty complicated as you can imagine…). But hey, I think I enjoy whining more.

Best of luck to everyone with their fall exams!

Joshua Liu
MD Candidate
University of Toronto 2013