The specials

No matter what medical school you study at, you cannot escape one thing—the end of year exams. Medical students everywhere share the same dreaded fate, and having completed five years, I know what a nightmare they are.

Everyone piles into the same exam hall, like cattle into a slaughter house. Some students are still revising the anatomy of the pelvis until the last possible moment. Many are staring into space, with dread in their eyes as if walking towards the guillotine for execution. And usually a small group is in tears, and you know that they will fill the top 10 places when the results are published in a few days.

But a handful of students each year seem to escape this chaos—“the specials.” Not only do they get to sit their exam in a more relaxed atmosphere, usually a small room away from the intimidating conditions, but also they get extra time for each paper. The reason? They have dyslexia.

Dyslexia is often looked upon as a bit of a joke, unless you are a member of this group and understand what it means to be dyslexic. During my time at university this group always seemed capable—most were much more capable than me. So why did they get 10% or even 20% extra time to finish the exam? Just because they have difficulty with spelling or reading, why should they get preferential treatment?

The medical school did not help with its handling of the situation, often making announcements during lectures in the lead up to exams to remind the specials that they were to meet somewhere other than the exam hall. This must have been embarrassing, especially after five years of the same announcement.

I have always had a problem with reading and spelling—I am not particularly good at either. But I always thought this was normal. Some people are good at maths or science; others are not. Some people excel at reading and spelling; others are a lot slower. Everyone I knew thought the same, never in a harsh or malicious manner, more because of a lack of understanding.

In my fourth year I really began to struggle. When revising with friends I could not pick up things as quickly as they seemed to, and I had no chance when reading words I had never seen before, which happens all the time in medicine. This came to a head in the objective structured clinical exam of my fourth year. I could not read the question in enough time before the station started. But I thought everyone was finding it as difficult as me, after all it was an exam.

My best friend eventually pushed me to see the university’s educational psychologist and have a dyslexia test. I laughed it off, somewhat ashamed and embarrassed. I didn’t need extra help, and more importantly to me I didn’t want to be a member of the specials. I finally decided to go after just scraping through the objective structured clinical exam even though I had done more than enough work to pass.

In a few minutes the educational psychologist confirmed that I had a form of dyslexia. Great: I was special. Why was it so embarrassing? Why did I feel stupid, inadequate, ashamed, and, more bizarrely, guilty? I did not deserve extra exam time than my friends and colleagues.

Dyslexia comes from the Greek words dys (impaired) and lexis (word). It is a learning disability that manifests primarily as a difficulty with written language, characterised by difficulties with learning how to decode at the word level, to spell, and to read accurately and fluently. Therefore, the extra time built into the final year exam is not there to give students more time to think about the question, it’s there to give students more time to read the question. The British Dyslexia Association says that 4% of the population will be severely dyslexic, needing support at school and beyond, and a further 6% may have mild or moderate dyslexia, me being one of them.

The feelings of embarrassment and inadequacy are still there a year after completing my finals and half way through foundation year one. I do not think they are going to disappear any time soon. But now that medical school has finished no one ever asks about it, and you are not referred to as special any more.

In my first year I failed an anatomy spot test and had to resit it the next year, consequently finishing a year later than I was supposed to and costing my parents a year’s extra support and me £30 000 (€37 000; $60 000) earnings. The main reason I failed was because of a 60 second timer counting down behind me, and I could not read the questions in time. I failed by one mark. Would things have been different if I had known I was dyslexic? I will never know.

I cannot see things changing in the future: there will always be a special group sitting exams aside from the rest of the year. I was able to go through more than 13 years of school education and four years of medical school without anyone picking up my dyslexia. I am sure that many other medical students wonder why they seem to struggle to read a page in 30 seconds before a fourth year exam station. But they are sure everyone else is struggling as well, right?

       

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