Revision Week vs Tenta-P

I can’t believe it. I just finished my first medical school exams in Sweden. I’M FREE!!! 😀

So I just underwent my first “Tenta-P” (Tenta = exam, P = period) aka revision week followed by exams. I must say, it is very different from my past revision weeks in the UK (at least in St Andrews). Here are a few reasons why.

Revision week – UK; Tenta-P – Sweden

Also, see my previous blog post on Being a medical student in the UK vs Sweden.

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1. Tentagrupp/exam study groups

Revision week: Your exam grade depends on the normal distribution of how the rest of the class does on the same exam. Owing to this competitive nature, preparing for the exams tend to get competitive as well.  You’re on your own, good luck!

Tenta-P: This is probably the best thing about Tenta-P. It’s more social, and you’re not alone. Most join a tentagrupp or an exam study group (including myself) where you meet everyday to go over topics and past exam questions according to your revision week schedule. It’s basically a way to keep yourself (and each other!) motivated and on track, since you know you have to go through the topic before you meet the rest!

community study group group work gif

2. Previous exam questions

Revision week: As previous exam questions tend to get reused, the medical school don’t provide a database with previous exams. Knowing this however, students of previous years collectively made their own “previous exam database.” After one’s exam, one writes all the questions one could remember that came up, to share to the coming students the following year (thug life). This document is constantly growing and is being secretly passed down year after year like an heirloom.

Tenta-P: On our internal school website, we have a database of previous exams (from several years ago up to the one from last semester) available for us to study on, including answers. The questions also have a tendency to be reused, so there were many moments when I was beaming during the exam – that meant I had seen that question before.

simpsons happy paper writing gif

3. I’m still on Facebook

Revision week: Every revision week every semester, I usually deactivate my Facebook to minimise my procrastination and hopefully increase my concentration. My friends were used to this so as revision week approaches, they would normally ask me when I plan to take my Facebook down – and make sure they have my number so I’m reachable.

Tenta-P: I didn’t close down any of my social media accounts, instead I even added another one – Jodel. It proved to be quite a fun method of procrastination.

4. More space to study

Revision week: Back in St Andrews, we only had one central university library for all 9000 students. One could say that it definitely was not big enough to fit us all. Especially during revision week. Once, I walked around the library for over an hour trying to find a space with no luck – I just ended up going home. To be fair though, it was also a form of procrastination since you see everyone there during revision week, as everyone take their exams at the same time. Because of this, an early version of Jodel and Tinder combined begun called Spotted at St Andrews Library, where students could post about their library crush anonymously. Procrastination at its best.

Tenta-P: There are several study spaces across campus and I studied in my campus which is part of the university hospital area. To my surprise, I never had a hard time to find a spot to study, and I still seemed to see my fellow medic friends at the medical school. Where do they come from? Where do everyone else study? Wherever they may be, I’m definitely happy they left me a spot to study at the medical school anyway.

5. I’m actually sleeping

Revision week: At first, I would set some alarms at about 6/7am to make sure I wake up and study. After a while, my body gets used to waking up so early, that I don’t need an alarm clock anymore, regardless of the time I go to bed the day before. My body gets used to the 5h a day sleep routine. However, when it’s an extra harsh study day, I can’t afford 5h of sleep. That’s when the caffeine pills come in. Believe it or not, all-nighters with the right company are actually quite fun!

Tenta-P: I never had an alarm during the entire time and I think I got about 7h sleep each night. I never pulled an all-nighter nor took my typical caffeine pills to help me study. I feel so much healthier – and definitely more well-rested.

6. Packed lunches

Revision week: Bringing food to university isn’t really a thing in the UK – well at least in St Andrews as there are no microwaves in campus. So during study breaks from the library, you go to a fast food place and get take out, or to a nice restaurant to eat. Considering one could get a three-course meal from Jahangir (my favourite Indian place ever) for ÂŁ5 (at the time about 50kr), it wasn’t really a big deal eating out everyday. Which definitely explains why most of us gain weight during revision week. For example, a friend of mine gained over 3kg from eating take out pizza everyday during revision week. But pizza is bae so it’s okay ❀

Tenta-P: To save time, you prepare your packed lunches for the entire week you will be spending in the library during tenta-P, and keep them in the fridge. Then you bring them one by one, and eat with your fellow medic classmates with their packed lunches at the medical school. You end up eating the same thing everyday but who cares, it’s revision week. And definitely more economical (#studentlife). Thank God for microwaves in campus.

7. One doesn’t study in the evening

Revision week: As previously mentioned, late night studying and all-nighters is a thing back in the UK. I used to do at least one all-nighter every revision week and mastered the 5min nap. Literally, I’d put my head down and my friend would time me, but I would automatically get up after 5min anyway and keep going. Also, it’s so much calmer in the evening hence so much easier to concentrate!

Tenta-P: In general, the medical school clears out around 5/6pm during tenta-P. I tend to study more effectively during the evening, so I usually stay on until nearly midnight. Which is apparently unheard of as most during this time are at home relaxing – or better yet sleeping – after the day’s study schedule. I often wished I was them.

sheldon cooper from big bang theory gif all nighter don't need sleep need answers

8. I’m actually doing other things apart from studying

Revision week: Life is wake up, study, eat while studying, sleep (if you can), study. Breaks every now and then if you deserve it. Repeat.

Tenta-P: So my friend Arianne from St Andrews came to visit over the weekend (yes, the few days before the exam), and I also celebrated a friend’s graduation back home in Stockholm. Arianne was a regular revision week study buddy of mine back in St Andrews, and I must say she was quite surprised by how “normal” I was. Not sleep deprived, not talking medical jargon to myself and lastly, not too stressed to not have a good time out!

9. The fear of failing

Revision week: In the UK, passing is not the difficult part and passing is not enough. You need to get a good grade as well because the better you get, the better it will be for you later. Also, your grade once again depends on the normal distribution of your class’ results. The fear was never about passing, so in a way I never had the anxiety of failing. Rather, the fear was getting a bad grade.

Tenta-P: The day before my exam, I had the biggest pre-exam anxiety ever. So bad I even had to go to church to calm myself down – God was the only one who could help me now. As we don’t receive grades but just a pass or fail on our exams, the fear was on passing as there’s nothing else to aim for unlike before. 65% total minimum was the goal, otherwise you gotta come back in August to do the resits!

spongebob rips in half gif

10. Meh, I’ll just do the resits

Revision week: If you fail an exam, you have one chance of redoing it during the summer. No matter how well you do on the resit, the maximum grade you can get is a pass. Also, it will state on your academic transcript upon graduation that you had to do a resit. If you fail the second time however, you need to repeat the year – touch luck! In other words the mentality is: failure is not an option.

Tenta-P: Once I overcame my pre-exam anxiety of failing, I accepted the fact that I know what I know and I can simply only do my best during the exam. I accepted my highly likely fate of returning for a resit in August. I listened to my friends’ advice who have this embedded within them – doing a resit is not the end of the world. At least the information will be fresh in your mind when the next semester starts! Meh if I fail, whatever there’s always next time 🙂

cat rolling psh whateva whatever i'm out gif

Time for summer vacation. Ehh, Linköping see you during resits in August? 😂

How I developed radial tunnel and lost the ability to play the violin

Five years ago, possibly owing to my Type A personality and absurdly high expectations on myself, I lost one of my biggest passions at the time, which was the violin.

Starting at the age of 16, I decided to pick up the violin again after a hiatus of three years. I auditioned and started taking lessons and playing in an orchestra at the Royal College of Music in Stockholm. I quickly picked it up again, and starting from playing in the furthermost row in Violin 2 in my orchestra, the following year I was playing in the front row beside the Concerto Maestro in Violin 1. The College also allowed me into their violin vault filled with priceless violins to pick one for myself. After going through several priceless violins, I picked a Danish violin from the beginning of the 1800s. That moment I chose my violin is a very special memory for me, which I can most closely describe as like when Harry Potter chose his wand from Ollivander’s Wand Shop.

Harry Potter chose his wand at the Ollivander wand shop

My teachers at school found out I play the violin, and so apart from the pieces I played at the College, one could see me with my violin at assemblies as well. For all these pieces I was expected to play, I practiced at least 4h a day, especially during concert season nearing the summer. People had very high expectations on me, and my expectations on myself even higher. I had my violin with me everywhere, we were inseparable.

Nearing the end of concert season right before the summer of 2011, I suddenly would start getting severe shooting pain and numbness/tingly feelings in my fingers in my right hand/arm. My doctor told me I needed to rest and was referred to a physiotherapist. But no. I was going to finish concert season.

I would hide my wrist splint prescribed to me by the physiotherapists every time I came to the College, so my teachers won’t know I’m actually not allowed to play. Eventually my arm got the best to me near the end of concert season, to the point I couldn’t move it for an entire month. I skipped exams as I couldn’t write anymore (I’m right handed and that was where I got injured), attended my medical school interviews wearing a wrist splint etc. It was very hard on me physically, but even harder on me emotionally. But somehow through it all, I managed all my concerts.

At the end of concert season, I told myself I need to rest my arm. I rested it until I moved to university in St Andrews. I started playing a little for myself there, but I still kept getting pain. Now the pain was persistent every time I used my arm. I lost the ability to play the violin.

The following years, I sought healthcare back and forth in the UK with no result. I started getting physiotherapy including ultrasound (or what my teacher calls whale song therapy) and was prescribed NSAID anti-inflammatories. I started getting tested in various ways such as X-ray, MRI, electrophysiological tests you name it. I was given different diagnoses all the time and met various doctors constantly. Carpal tunnel, tennis elbow, repetitive strain injury, tendonitis
 but none of them were correct until I came back to Sweden after four years in the UK.

I was referred to see a hand surgeon who happens to be a lecturer at Karolinska (my friends remember him and said that when they came out of his lecture everyone wanted to be hand surgeons!) and within 30min of hearing my story and examining me, he decided that I was to be operated. I was finally diagnosed with the correct diagnosis – radial tunnel.

It has gone three weeks since my operation and right now I’m on my way to Stockholm to see my hand surgeon for the first time since. We’re finally removing the steri-strips (the protective layer applied on the surgical site during the operation) and I’ll be seeing my surgical scar for the first time. Or my battle wound as I’d like to call it. My violin battle wound.

Soon I can play the violin again. Soon I can return to one of my passions. Soon. ❀

girl with violin from the Royal College of Music in Stockholm

This is a photo of me and my precious violin from the Royal College of Music in Stockholm five years ago when my problems started. This was the last time I could properly play the violin. My violin was repaired in 1862 by a Danish instrument maker named G. Enger in Copenhagen.

Tonsillectomies are not just routine operations anymore

Sorry for the hiatus, but I am finally feeling better now. I have returned to my normal activities-ish. I now only have a plaster over the surgery site and wear a wrist splint every now and then. Thankfully, my recovery was quick! I promise to write about the surgery and put photos ASAP!

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I am currently on my ENT (Ears, Nose and Throat) placement, now on my final week. Last week due to my newly operated arm I missed more than half the week. But I’m bouncing back now!

Yesterday I attended my first ENT operation (tonsillectomy) ever. This is the first time I’ve attended a surgery for almost a year, and almost two weeks after my own surgery. Suddenly, after being newly operated on myself, my attitude towards operations have changed. It really is different when you’ve been on the other side of healthcare.

Despite tonsillectomies being routine, a range of new thoughts popped up in my head that I’ve never thought about before during operations. Thoughts such as:

  • I wonder what the patient is dreaming about right now. Are they dreaming?
  • Would they remember being woken up and leaving the operation room?
  • How would they react now that their tonsils are gone?
  • How long will their pain last?
  • I wonder if they’d be able to go back to work/school with their throat – sooo painful…

I no longer only think about the long term effects of the surgery, but how the patient will feel right after the operation. I was there too. You enter the hospital with full control of your body and feeling okay. Then you go to sleep, and all of a sudden, you wake up and everything has changed.  

After my operation, I was in pain. I was in such excruciating pain in my arm, that I was dependent on strong opioids such as oxycodone and morphine. I remember how debilitating it was, and how one was so helpless and dependent on others. The pain took over one, and all one can do is wait until it passes – or until the opioids knock you out. But then you wake up several times in the night with the pain needing more. Then you take more painkillers and can finally fall asleep again…

When I see a patient get operated now, I can relate. I can relate to their fear, anxiety, and sympathise for the pain they will undergo post-op. I recall how it was for me and realise, even though this is one of the hundreds of routine tonsillectomies done, the bi-product of the operation itself is the same. All patients will experience a change in their daily lives, with its impact highly underestimated in the beginning. That was definitely the case for me anyway. Of course I think like myself too, all patients are willing to undergo it. Patients have so much hope and trust in the treatment, that its bi-products is long overweighed by its benefits.

After being a patient myself, I understand now why patients feel the way that they do before an operation – even one as common as a tonsillectomy. One is scared for the drastic change that is about to happen – both the good and the bad. One is scared because there is nothing one can do but accept the change, and be patient.

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Arm is that you? I've missed you 😭

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I’m about to get operated.

I know I’m in my fifth year of medical school, I know I’ve grown up hearing about operations, I know I’ve seen countless surgeries… But somehow I’m still somewhat scared. Even though this is a quick and non-invasive surgery. 

It’s definitely a completely different experience being the person on the other side of the bed now. Now I understand what patients feel when they come to the hospital. Now I’m one of them lying here waiting for my turn to get operated on.

In a few hours my five years of pain in my right arm will be over. Soon, I can play the violin again! 

Wish me luck and prayers are warmly appreciated! Time for me to become the patient! 😊

Dermatology: expectation vs reality

I’m going to admit, dermatology wasn’t one of the placements I was looking forward to. I’m sure I wasn’t alone in this either. Luckily, after two weeks at dermatology, one can say I was very much positively surprised!

Here are some of my expectations from before the placement and my insights of the specialty after my two-week placement.

1. You see acne and eczema everyday

arnold schwarzenegger it's not a toomah gif

On the contrary, most of the times it was a toomah.

During our two weeks there, I saw two acne patients and probably around five eczema patients. Skin cancer patients on the other hand? I definitely lost track. They came by the truckloads. Perhaps the reason why I thought dermatology = eczema and acne is because those are the only two skin problems I ever sought medical help for. Also, I’m brown. So what skin cancer?

2. Apart from acne and eczema, it’s all about too much sun

ross from friends back with a failed tan gif

So many patients come in with different skin lesions, many explained by too much sun exposure. However, when I was studying about the different diseases we saw at the hospital, I was surprised that it is so much more than that. This really became apparent for me when I was reading about psoriasis. I mean in this case, it is even the opposite.

Psoriasis is a skin condition which has a complex immunological pathogenesis – a lot more than just simple skin damage. It has been shown that sunlight has a therapeutic effect, improving the patients’ disease. Consequently, psoriasis patients in Sweden actually get offered a free three-week “therapeutic” vacation in the south of Europe. Not bad eh?

This is just one of the many skin conditions that is not because of sun damage.

3. There is a cream for everything

shaq holding a lotion bottle gif

Rash? Take this cream. Acne? Take this cream. Palmoplantar pustulosis? Take this cream.

Although there is some truth in this (yes, the main treatments for those conditions I mentioned are creams), it’s only a very, very small part of what dermatologists do to treat patients. Dermatologists also prescribe other forms of medication like injections and tablets, and also perform surgery of course – via liquid nitrogen “freezing” or excision! They also treat their patients in different baths and therapeutic light therapy, which is basically therapeutic solariums. Also, did you know that dermatologists in Sweden are  venerologists (STD-specialists) too? Yup, if there’s some funny business going on down below, you go to a skin doctor.

4. Most dermatologists are women

beyonce who run the world girls

When we came to the clinic during our first day, I was positively surprised that our supervisor was a very friendly and jolly male överlĂ€kare or consultant. There were actually a lot more male dermatologists than I thought, because he wasn’t the only one I met at the three hospitals I visited. At our main hospital there were at least three!

5. Most patients are vain

cat looking at the mirror saying I am beautiful gif

My thinking before the placement: “Patients who come to dermatology are vain which is why they’re super self-conscious about their skin.” Boy was I wrong.

In cases of acne and eczema, I thought patients come in because they want to make themselves even prettier by treating the disease. I realised that they come in because they want to be pretty. Because they don’t think they are.

There is apparently a link between acne and negative mental well-being, and this I could definitely see from some of the patients I met. Many develop low self-esteem and even a form of dysmorphism, because of their skin problems. Definitely the opposite to what I thought in the beginning.

6. Dermatology is a “clean” specialty

a pig taking a bath being clean gif

What I mean by clean is that there is no need for messy tubes here and there, sputum/faeces/sweat etc. samplings, no need to open patients up etc. The speciality relies mainly on the visual evaluation of a person’s condition. See, clean. Although it might be so most of the time, there are definitely exceptions.

During our first visit to the dermatology ward, we visited a patient with a rare but severe cutaneous vasculitis called pyoderma gangrenosum. If you’re curious, do google it, but be wary of what you will see. I warned you. Keep in mind though, the photos you will find on google are very, very far from what I saw. The patient we saw basically had no flesh all the way down to his tendons, on both feet extending above his ankle. Exactly like how you would see a fixed cadaver model of feet muscles for anatomy. But this time the specimen is alive. That is not what I would”clean” at all, and I don’t even want to start about the smell…

7. Skin lesions will no longer be dots for me after two weeks

Jokes nope, still dots.

elmo shrugging gif

Medical School In Europe: Sam Valles’s Story

This is my interview featured on DailyMedicine.co!

Daily Medicine Blog

Have you ever wondered what it is like to go to medical school in Europe? Well Sam Valles knows all too well. She was raised in Sweden but went to medical school for four years in the UK! Even more amazing, she is not only going to be an MD doctor but also is receiving her PhD. Check out her unique medical school story for more about international medical schools.


  1. Who are you to the world Sam?

Hi! My name is Sam and I’m on my penultimate year of medical school in Sweden. I also do cancer research on the side of medical school, aspiring for a PhD. I started medical school in the UK: three pre-clinical years at the University of St Andrews and one clinical year at the University of Manchester. In the end I decided to return home to Sweden, as I realized I wanted to be


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More than a patient

 

Being my family trade, becoming a doctor had always been expected of me. I had never allowed myself to consider other options. Because of this, I had always focused on how I was going to become a doctor, instead of why I wanted to become a doctor. And it was going well. Or so I thought.

Four years into medical school, everything was going as I had planned and better. But suddenly, I saw my life racing away from me. My life was getting closer and closer to the goal, but I was only at the starting line. I thought I was almost there, when really, I had never started. I had no fuel to start, with nowhere to find it. Because I had never known what it was in the first place.

Why do I want to become a doctor? Is it for me or for my family? Is it actually what I want to do? I had to find the answers to these questions, and I knew I couldn’t find them whilst I was in the hospital. I believe that sometimes you need to lose your way to find it. So I took a break.

On my break, I was fortunate to work as a gymnasium (high school) teacher for students studying to become healthcare assistants. I was able to use my experiences from medical school for my students’ learning and development. All the theory, and more importantly, all the stories I have from encounters with my patients. One day, a student came up to me after class. He said:

“I wish we could have you as our permanent teacher. When you talk, we can relate to the things you say and it makes it easier for us to listen.”

I was touched to say the least. I guess like what people say, if you speak with passion, people will care. People will listen. So it turns out, I was and am passionate about what I do. But it was only then when I finally realised what it was.

As a doctor, yes, I get to utilise my interests in science and yes I get to make a difference in people’s lives – but that’s not my passion. What I love the most about what I do, is that I get to be a part of people’s lives. As a doctor, I am given the gift of being entrusted into people’s lives. A part of their family and everything  else about them, even their thoughts, fears and dreams. For me, I don’t only get to treat the patient, but I also get to meet the person.

See, sometimes you do have to lose your way to find it. And I found it when being a teacher.

Everyone who I see when wearing my white coat, are all more than a patient. Being able to be a part of it all is the beauty of my profession, and is what makes me passionate about what I do. I want to share this with all of you, so on occasional Sundays (because #storysundays), I want to share you stories from my patients. Stories not focused on their disease, but what makes them more than a patient. Stories on what makes my patients people.

If I didn’t choose Oncology I would’ve probably chosen Infectious Diseases

During the first week of my Infectious Diseases placement, I recall attending a teaching session by one of the specialists. With much enthusiasm she said: “All diseases start with an infection!” I pondered about that statement for a while and realised that maybe she has a point.

In cases like rheumatic fever leading to heart problems etc later on in life, or H pylori infections leading to gastric ulcers that could eventually lead to cancer, maybe there is truth to her statement.

Infections occur in all systems, and has a multiple-system effect. They don’t always present themselves in the same pattern either. By giving the right antibiotic/antiviral etc among the masses available, you can save a life. Pretty exciting indeed.

During my placement, I met several patients who were in severe sepsis (basically dying) one day, seemed unaffected the next. Magic. One patient around my age came in and was barely able to open his eyes and breathe (he was breathing about >30 breaths per minute). He was losing his breath whilst talking to me. We administered antibiotics and when I visited him the next day, he was back to normal. Magic.

Perhaps my mom had a point when she was encouraging me to pursue Infectious Diseases as a specialty. She has always spoken highly of the specialty, ever since she worked very closely with them as a clinical epidemiologist. I recall the days when mom would travel to Vietnam with the WHO to help eradicate malaria. Perhaps it is due to my early exposure to the specialty that I took a natural interest to infectious diseases. Or perhaps it’s actually in the blood.

Nevertheless, after these two weeks at the Infectious Diseases department, my commitment to oncology is still as strong as it has always been. But my respect and interest for the specialty has definitely grown.

I maybe won’t become an Infectious Diseases specialist in the future, but if there’s someone I would entrust to save the lives of the masses, I would definitely turn to an Infectious Diseases specialist to save the world.happy dancing cats

“Vad bra svenska du talar!”

“Vad bra svenska du talar, verkligen!”

Translation: “You speak really good Swedish, really!”

Ever since coming here to Linköping to continue my studies, I seem to get this quite a lot. Once I tell them about my background of course.

After I tell people about moving to Sweden as a 7-year-old from the Philippines and being in medical school for four years in the UK, somehow, people seem to only focus on that. I chose to study in the UK, because I have studied in English ever since moving to Sweden – international schools from elementary to university. However, I did grow up in Sweden in the end. Somehow, the fact that I’ve been raised in Sweden is overshadowed by my immigrant background and international education.

Should I take this as a compliment? That I learnt how to speak good Swedish after living in Sweden for over 10 years? And didn’t forget it whilst abroad?

Or should I feel offended that because I look and am from a different country, I was expected to speak Swedish badly?

Nevertheless, I must understand, I’m a minority. Not everyone have met us modern Swedes with international backgrounds. In that case, I can be an ambassador to show that assimilation into Swedish culture from another background is possible. Maybe next time they meet someone like me, they won’t be as surprised.

My patient hugged me goodbye :)

For the past two weeks, I have been placed in Infection, and this final week I have been placed in the wards. But I’ll write more about this Infection placement some other time.
During the entire week, I have been in charge of a patient ever since he came into the ward. I was there when he came in, and watched him improve with the antibiotics as the days went by. I was sent in to take a quick history with him alone, and I even met his wife in the corridor. She was looking for him, and luckily I knew where he was.
Today, his infection had improved so much, that he was ready to go home.
I typed out his discharge notes, and came to him with the doctor in charge. Since he was my patient, I was going to discharge him. I gave him my papers, explained what we had done and asked him if he had any questions. At the end of the consultation, I stretched out my hand to say goodbye and to wish him well.
He took my hand and shook it, but then afterwards, he pulled me in for a big hug, thanking us for taking good care of him during his stay.
“I have felt very well taken care of during my entire stay here! At first I was quite angry about it, but you all have been so nice towards me. Thank you very much!”

It is not always you actually manage to reach out to a patient, and for them to understand that you want what is best for them. But when you do reach out to them, the feeling of knowing that something you have done has helped someone else feel better, and for that person to actually appreciate it, is priceless.

giphy