Distinction Viva

To obtain a distinction, you had to pass all three components of the viva - Anatomy, Physiology and Biochemistry. The panel must come to a unanimous decision whether you get/don't get a Distinction. My panel comprised Dr Zul Izhar (Anatomy), Dr Ang Boon Suen (Physiology) and myself (Biochemistry). My panel interviewed seven students and we decided to give a Distinction to only the first Chinese girl.


Anatomy 

1. Bone specimen. The bone specimen was the left clavicle in my group (humerus in the other groups). You had to figure out whether it was the right or left bone and support your answer with a description of the bone - why you thought it was the left bone and not the right bone. You had to name the ends and attachments of the bones. Some students weren't sure whether it was the left or right bone. Most gave the wrong answer! Most cannot describe as they couldn't figure out whether it was the right or left bone. Please review your Anatomy.
2. Ootic nerve. Dr Asma' Hassan covered this topic to great length in her Revision Lecture. I was there in the lecture hall when she reviewed the ootic nerve.
3. Cranial nerve
4. Ciliary ganglion
5. Parasympathetic and outflow
6. Postganglionic
7. Sigmoid sinus
8. Muscles of mastication

Physiology

1. Exercise. The scenario posed by Dr Ang was exercise. The questions asked evolved around exercise.
2. Organ system. Dr Ang asked what systems are affected by exercise. Most students answered correctly, ie the respiratory system and cardiovascular system.
3. Respiratory system. Dr Ang asked what changes occur in the respiratory system during exercise. Answers were correct in most cases except for those who didn't know the answer. Other questions were ventilation rate, perfusion-diffusion during exercise and venous return.
4. Cardiovascular system. Dr Ang asked what changes occur in the cardiovascular system during exercise. Answers were a bit slow (shaky, unsure). A lot of students just guessed the answer! Dr Ang even asked what is the maximum pulse and heart rate, and whether there was a formula for maximum heart rate. Other questions were cardiac output.
5. Physical. To give you a better picture, visualise (just imagine) what happens if you do exercise. Will you breathe harder? Why? Can you explain it? What happens to your pulse, heart rate etc? Why? Can you explain the changes?

Biochemistry

1. Diabetes mellitus and hyperglycaemia. Questions were How is blood glucose controlled. Most answered Endocrine via insulin and glucagon. I then asked What are the actions of insulin? Most could answer. For hyperglycaemia I asked re how blood glucose can be elevated to such high levels. I asked What are the causes of hyperglycaemia? I was asking for the causes and most of you could give a list of possible causes, which was good.Some of you could name the sources of hyperglycaemia - high intake & low intake. Insulin receptors on cell surfaces were not responding to insulin. I asked the effects of high blood glucose. I was expecting glycation, eg glycated hemoglobin (HbA1c or A1C) and AGE (Advanced glycation products) but nobody answered those. 
2. Hyerlipidaemia. Then I asked re hyperlipidaemia and what were the possible causes. I asked What are the causes of hyperlipidaemia? Some took ages to answer about causes of hyperlipidaemia. I asked about the role of lipoprotein lipases (LPL) and some of you could answer alright. I asked re LDL, LDL cascade and role of LDL. I asked how high numbers of LDL behaved in prolonged lipaemia. Most could not answer. The correct answer is prolonged hyperlipidaemia leads to oxidation of LDL. Oxidised LDL (oxLDL) are small destructive particles as they can easily penetrate the arterial intima and cause harm. The macrophages consumed the oxLDL till they become foam cells and die, leading to changes of the artierial intima and underlying area.
3. Free radicals and antioxidants. I asked you to define free radicals and antioxidants. I asked What are free radicals/antioxidants? I asked you what would happen if free radicals won over antioxidants. I asked you to give examples of free radicals and most just answered simply. I then asked How do free radicals cause damage? Some answered all right. I then asked What are cellular defense systems? Some were able to answer - the glutathione system, etc.
4. DNA mutation. I asked you where mutations occurred in the cell. Most answered correctly, within the DNA structure. I asked How does DNA damage occur? Some were able to describe what went wrong at some stage in the cell cycle. I asked whether there are repair systems that can repair mutations as they occurred in the cell. And most students could answer.
5. Cancer. I asked what was the general scientific basis for understanding cancers. I asked How does cancer occur? Most of you just memorised and blurted. It would be better to understand and try to explain slowly but clearly.

Congratulations to the two Chinese medical students who obtained Distinction for their first-year studies. Here are the names of the two medical students: Kwa Schee Li (female) and Tan Fo Yew (male).

I remember Kwa Schee Li. She was the first person to be interviewed by the panel which I headed. She was calm, well-composed and fluent with her answers. To me, she was appropriately dressed as a medical student. She knew her subject matter well and the three of us who interviewed her agreed she deserved a Distinction.

The other male student who got Distinction is from Dental School (PPSG).

Prof Faridah