Hi! My name is Daniel Lim Jhao Jian. Here is where I share my experience, knowledge and ideas. You are welcome to leave comments and follow my blog. You are free to copy anything from this blog. Please recommend this blog to your friends.

Thursday 23 August 2018

Stage 5: The most difficult year in MBBS

The 5th and final year of my MBBS course at NUMed is known as Stage 5. Many students consider Stage 4 to be the most difficult year, and they describe Stage 5 as being "not as difficult as Stage 4". But in my opinion, Stage 5 is definitely the most difficult year in the MBBS course and there is no doubt about this.

There are many forms of assessments in Stage 5, which include Elective Assignment, combined Written Skills Examination (WriSkE) & Prescribing Safety Assessment (PSA), Single Best Answer (SBA) examination, in-course MOSLER assessment, and End of Stage MOSLER assessment.

In order to pass Stage 5, we have to pass every single form of assessment. Failure in one form of assessment cannot be compensated by good performance in other forms of assessment. Any student who fails Stage 5 will have to repeat the entire Stage 5 as the final attempt.

In the Elective Assignment, we have to write a report about the medical elective that we did in Stage 4. This is the one and only assessment in Stage 5 that can be considered as easy. It's quite rare for students to fail this assessment.

The WriSkE and PSA test our prescribing skills. Our scores for the WriSkE and PSA will be combined and it has to reach or exceed the combined pass thresholds of the two assessments. Actually, the questions in the WriSkE and PSA are not too difficult.

However, the marking of the WriSkE is quite strict. Making certain mistakes will cause us to lose a substantial amount of marks. Meanwhile, the time provided to answer the PSA is quite limited. We have to answer a total of 60 long questions within just 2 hours. The pass thresholds of the WriSkE and PSA are also quite high, often above 60%.

The SBA examination tests our knowledge gained throughout Stage 5. In Stage 5, we learn about Orthopaedics and Trauma, in addition to what we have learnt during Stage 3 and 4. Orthopaedics and Trauma involve a lot of anatomy.

Anatomy mostly has to be studied through memorising rather than understanding. Personally, I am not good at memorising, which makes my revision for the SBA examination challenging. To make matters worse, the Stage 5 SBA has a very high pass threshold as well, usually above 60%.

For each in-course MOSLER and the End of Stage MOSLER, we have to see a patient, take a history, perform a physical examination, determine the differential diagnoses, plan the investigations and plan the management.

There are 6 domains in the MOSLER's and we have to pass all of them. The domains that I particularly find difficult are "Clinical & Diagnostic Reasoning" and "Management", because they require doing a lot of revision and applying knowledge in a real clinical scenario.

There is an in-course MOSLER at the end of each and every clinical rotation in Stage 5. Each rotation in Semester 1 of Stage 5 lasts for just 3 weeks, so there isn't much time to revise for the in-course MOSLER's.

During the End of Stage MOSLER, we have to see 4 patients back-to-back, and the total duration of the assessment is more than 2 hours. This makes the End of Stage MOSLER very stressful and tiring.

As you can see, with the exception of the Elective Assignment, every other assessment in Stage 5 is quite difficult to pass. If I fail just one form of assessment, I can't pass Stage 5 even if I get full marks in all other forms of assessment. Therefore, Stage 5 is definitely a very challenging year. Despite that, I will try my very best to pass Stage 5.


  1. Hi! Come here from your 2014 article about all your university articles. Glad you are still pursuing your dream and blogging.