#044 - What no-one tells you at the start of your career

I don't know when neurosurgeons started taking exams in driving centres.

The snow beat down in the Glaswegian winter as I drove to the first part of my final neurosurgery exam.

Mask in hand, I did the requisite ID checks and sat at my station. With 240 questions - and just over 4 hours to do them - I had to set the pace early.

After one short break, I was done. My brain was so fried that I didn't attempt to review my answers and returned outside to the cold winter day; the sun now dazzling the snow.

Was that it? 7 years of training condensed into 270 minutes? Something didn't feel right. My machinations, however, left me as I drove home. My mind was already focussing on the next hurdle – The Oral Exam.

I'm standing on a set of stairs four months later. As I look around I am the only one of my peers smiling. We are in Edinburgh's Royal College of Surgeons and are about to walk into an exam hall filled with tables. At each table sit a pair of neurosurgery examiners about to ask us questions for nearly three hours. There will be real patients, real scans and real grillings.

I am smiling because I've decided today is the last day I will be a trainee surgeon. When I leave this hall I will have proven that I have the knowledge of a first-day Consultant.

"Alright, it's time to come in."

I look around as we march up the steps and into the hall. Still no smiles. Just me.

Perhaps I am deluded and everyone else is appropriately somber. It's too late now anyway and the smile doesn't go away. If anything, it intensifies as I choose to enjoy the discussions with my future peers. I even tell the examiners, "Thank you, I enjoyed that" at the end of my stations.

The mixture of grins and wide-eyed non-response tells me that I continue to be an outlier in my positivity.

Times up. We collect our things and disperse to our separate corners of the country. Once again the sun is shining on a cold Scottish day. But this time I'm at peace with my assessment.

This is what changed and this is what no one tells you.