The day I failed an examination

Source: The Sunday Times, May 3, 2009

In February 1982, I took my MRCP part 2 in Edinburgh. The MRCP exam is the postgraduate examination for internal medicine and paediatrics organised by the College of Physicians in Britain. Three universities conduct the examination simultaneously – London, Glasgow and Edinburgh.

I chose to take my examination in Edinburgh because I was not sure I could understand London’s Cockney accent or the Glasgow accent. The Edinburgh accent, I figured, would be much easier for me to understand. I was down with flu at the time of the practical examination in which we were supposed to examine patients.

I was told to listen (‘auscultate’) to the heart of my first patient. I guessed what she had but could not hear the corresponding heart murmur. From then on, my examiners became unfriendly and I became nervous. When the examination was over, I went back to the hospital where I had examined the patient and asked her mother what was wrong with the patient. I had guessed correctly: She had a mitral stenosis, which causes a murmur that is notoriously difficult to hear.

Nowadays, doctors no longer need to have acute hearing in order to diagnose heart conditions. A cheap and simple ultrasound produces clear anatomical pictures, including of heart functions. No more guessing is required. I was sure I had failed the examination though I had sailed through the written paper and the subsequent viva voce.

When the results were announced, I was in the Royal College of Physicians of Edinburgh building. After the crowd had thinned, I went forward to read the list of names. Mine was not on the list. The news spread like wildfire among the Singaporean medical community. ‘Lee Wei Ling has finally failed an exam! She is like any one of us.’

I took my failure very badly because I knew I did not deserve to fail. I did not even need the MRCP as I already had my Master of Medicine (in paediatrics), which is on equal footing with the MRCP. I was also hurt by the fact that many Singapore doctors seemed happy I had failed. I swore to myself that I would not take the examination again. But my father told me: ‘You have to take that exam until you pass it. You have to prove to Singapore you can do it.’

My parents have never pressured me or my brothers to aim for academic success. If there was any ‘pressure’, it was no more than an implicit expectation. This was especially so with me, the most highly strung and stubborn of their three children. I was determined to prove I could equal my brothers’ academic achievements.

All my previous examination successes – except for the one doctors need to pass to practise in the United States – had occurred in Singapore. For all written medical examinations, local or foreign, one wrote only one’s index number on answer sheets. So there was no question of examiners favouring me because I am Mr Lee Kuan Yew’s daughter.

But my father nevertheless wanted me to show Singaporeans that I could succeed outside of Singapore, though success in the MRCP examination is to a small but significant extent dependent on luck.

So I returned to Edinburgh to re-take the MRCP in October 1982. This time I took great care not to catch any bug, and I went up to Edinburgh by train wearing a face mask. Everything went smoothly and I knew I had passed. Indeed, I knew more about the patient – a young child with brain damage – than the examiner.

I returned to London after the examination and asked a friend to telephone me the results. After I received confirmation that I had indeed passed, I phoned home. Ming Yang, my late sister- in-law, picked up the phone. I asked her to tell the rest of my family that I had passed. And I asked about her new baby. She told me he was an albino. Hsien Loong was a little disappointed and had told our father the boy would not be able to do national service. I also knew that albinos have poor eyesight. My heart went out to Ming Yang and Loong.

I flew back to Boston, where I was based then. While napping after my arrival, my father phoned me. ‘Ming Yang passed away of a heart attack,’ he reported. ‘Come back now.’ I returned to Singapore for Ming Yang’s funeral and stayed to mark the new baby’s first month.

My father arranged my return flight to Boston. As he believed flying west was less tiring, I flew through London and stopped there for a day. Since then, London has always brought back unhappy memories for me and I avoided going there until 2004, when I needed to meet someone in Edinburgh.

As luck would have it, his house was but a street away from the Royal College of Physicians of Edinburgh building. After our meeting, I walked right up to the front door of the building. The building was locked since it was a Sunday. I stood there for a few minutes, before turning to another friend who had accompanied me and said: ‘Red dust.’ (A Chinese expression signifying the illusions of life.)

Twenty-seven years later, my examination failure seems inconsequential. But I have no regrets having tried and failed the first time. It made me appear normal to the Singapore medical community. Also, considering how outspoken and aggressive I can be, a failure that lent me a vulnerable image did me no harm. My failure forced me to learn how to roll with the punches and to react to life’s capriciousness with equanimity.

As for my albino nephew, he has grown into a kind, considerate and responsible young man who is not ashamed of being different from the average man in the street. He too has learnt to accept what he cannot change and to adapt his life around the constraints. Life is unpredictable for all of us. But if we persevere and adapt, many apparently impossible difficulties can be overcome. That my nephew will graduate soon from the National University of Singapore is proof of that fact.