1 step nearer

Time : 9:00am
“Welcome to the Navy Seal CRT selection program the ACLS instructor course pretest…..”
I was sitting in the lecture hall in a medical center, anxiously waiting for the result of written test.. it was 30 minutes to my destiny . I was confidence this time though, unlike my last 2 trial. I finally realized I did not study well in the past – that was the cause of my failure in the past. For the past 1 week I had read thoroughly and downloaded questions from the ACLS joint committee website. I studied till late 2am and get a good 4 hrs sleep. Left house by 6:30am and grabbed myself a Mc Bagel with bacon and egg, latte and hit straight to the express way 88. It was Sunday and the traffic was light, I sprinted (speeding of coz…). I managed to reach the medical center (unlike Malaysia, medical center is the highest grade of hospital here) in 25 minutes. I glanced through my ‘arsenal’ again and headed to the lecture hall 20 minutes before the written test start.

my arsenal - the pocket booklet was borrowed from ED

When I answered the last few question, I was confidence – I did well, I had less than a handful of questions which I was not sure of the answer– rumors in the past said that you will need to answer 40 out of 50 questions correctly to pass the instructor written test.

I waited for the introduction lecture to conclude – this was my 3rd lectures in the past 3 years. I looked around- about 150+ came to sit for the exam – most of them were 4th year resident or fellow doing their subspecialty training. I was one of the ‘senior’ on board.
Well, the result came out 10 mins later than expected and I saw my name being marked by a glowing marker – that means I made it ……half of the participants were slashed. The rest of us were sent to a smaller lecture hall.
This was the 1st time I entered stage II. I was anxious – it won’t be easy …. Stage II comprised of 3 stations – the megacode , the airway and CPR as in the ACLS provider course evaluation. But the examiners (or committee members) were either ED director of medical center or Superintendent of some hospital. The marking would be very strict and the schedule had stated clearly “high quality BLS/CPR is required during the skill station…”

I am not worried with the megacode and airway station , afterall, that was what I did for a living. As for the BLS station, I mumbled, “definitely a Skillguide attaches to the Anne…” It had been at least 4 years since I lay my hand on an Anne with Skillguide.

Anne with Skillguide

Well, I was wrong… I was sent to the CPR station first – 30% of the rescue blow was not effective and in about 25% of the chest compression , my hand was not properly position. The intubation sequence was better but I forgot to say that I would wear glove and mask prior to the intubation. Before I left the station, I saw the examiner wrote down a 4 on my marking sheet – there were 8 items on the marking sheet and I got a 4 (later I found out 5 was the best)? I thought I was gone case, after all the effort and coming so far, I just couldn’t believe that I had blown it…
The next 40 mins was a stressful experience as I waited for my turn for the megacode station. I overheard about the scenario in the megacode station – mostly vfib or bradycardia case, I am familiarized with such cases. But after my poor performance in the previous 2 stations, I was too upset to be cheered up by those conversations. Finally I was called. I was sent to one of the station and managed to work my way out. Before the end, the examiner asked me why did I come for this test – I told him that I was BLS instructor back in Malaysia and wanted to be ACLS instructor here( short chat of coz)…. Before I stepped out – he told me to work hard in the future and we shall meet in few weeks time …. My heart was pumping badly while I walked toward the door. I was confused though, in an actual ACLS provider course, you would need to pass every station – no fail allowed.  But if I am the BLS examiner I would fail myself….
The final result was delayed as the BLS station was badly jammed( a 5 cycle of 30:2 is required).  I was too anxious to sit down for a proper lunch, I bought a red bean bread instead.
2 hrs later I finally saw the list again and my name was circled with red ink. I paid up the fee and took a seat in the lecture hall and was still unable to believe that I had survived the pretest. During the pretest summary, the examiners had commented that they had used the combined evaluation scheme ( total marks from all skill station ) to select the candidate instead of the original ACLS provider evaluation scheme. I was lucky….

60 was left after the pretest … 40% pass rate and in 3 weeks time, I would have to return and present what was assigned to me – still, some would be dropped out during this stage. If I make it again ( oh mighty God, please…), I would need to go for a 2 days demo course in May and later find a course and teach under supervision once before I received my instructor certificate…
I was NT 10000 poorer on my way home…......