Looking at the candidates, watching them put everything on the line as they walk into the examination room to show how much they want to become one of us—a psychiatrist—always brings me back to those days.
The days when I spent sleepless nights buried in endless books.
The days when my friends and I patted each other on the shoulder, offering reassurance when confidence was running low.
The day I opened my email and wept at the result staring back at me.
And the day I reminded myself, with gratitude, that there was still a long road ahead.
It feels like only yesterday that I was sitting in that chair, trying to stay focused on the simulated patient in front of me while being painfully aware of the examiner watching from the corner of the room. I sat there twice, and twice I walked away without the outcome I had hoped for.
The failures left me with despair, self-doubt, and questions that seemed impossible to answer.
What did I do wrong?
Why is this so difficult?
Why am I putting myself through this? Is it even worth it?
Those questions followed me for three years before I finally understood the purpose behind the struggle. It was never easy, and my experience over the last two days as an examiner only reinforced that truth.
Over two days, across four circuits, I watched sixty-two candidates demonstrate their knowledge, skills, and determination. I felt a sense of sadness whenever I had to fail even one candidate at my station. Like I once was, many of them were anxious—some terrified—because this was not their first attempt.
They were not simply seeking a passing mark.
They were seeking confirmation.
Confirmation that they were worthy of becoming psychiatrists.
Confirmation that they could carry the responsibilities that come with the title.
Confirmation that they belonged among the future leaders of our profession.
As I reviewed the examination stations, worked through the questions myself, and participated in the preparation sessions, I found myself realizing something unexpected: the exam was not as difficult as I remembered it to be.
Perhaps that was because I was standing on the other side this time. Perhaps experience had changed my perspective.
The structure of the examination seemed logical. Necessary, even. The tasks reflected what I would expect a competent psychiatrist to do when faced with a real patient. There were no hidden traps, no unfair obstacles, and certainly no room for personal bias in the marking process.
The questions that once felt overwhelming had become routine parts of my daily practice.
“Have we really grown that much?” I asked a colleague who had endured the same journey with me.
“I think we have,” he replied with a bittersweet smile, carrying equal parts nostalgia and gratitude.
Five years have passed since the day I stood holding my fiancée—now the mother of our two wonderfully mischievous sons—with tears in my eyes as I stared at an email containing a single word written in capital letters:
PASS
Since then, I have stumbled, climbed, fallen, and climbed again. I continue to pursue a summit I know I may never fully reach.
Yet I keep climbing.
Because failure taught me something success never could.
Failure taught me resilience.
Failure taught me humility.
Failure taught me growth.
The scars it left behind have healed into strength.
In just five years, I became a psychiatrist, a Head of Department, a lecturer, and someone entrusted with helping shape the next generation of psychiatrists.
I often remember something my father told me after my second failure, when I sat defeated in his house, convinced I was not good enough.
“Failing an exam doesn’t mean you are bad. It only means you are not ready yet.”
At the time, I did not fully believe him.
Today, I know he was right.
So, if any MRCPsych CASC candidate happens to read this, allow me to leave you with a few thoughts.
There is a difference between being a psychiatry trainee and being a psychiatrist. The examination is trying to identify that difference, and it is looking for evidence that you are ready to make that transition.
The best preparation is not found in revision courses, model answers, or study groups alone. It is found every day in front of real patients. Every consultation is an opportunity to practise the very skills the examination is assessing.
Listen carefully to yourself. Record your practice sessions and watch them back. You will often see things that your friends are too kind to point out. Sometimes the most valuable feedback comes from observing yourself honestly.
Most importantly, never quit on a bad day.
A bad day is not a bad career.
A failed attempt is not a failed future.
The person you are becoming is often shaped most by the moments when you wanted to give up but chose not to.
That is how I eventually passed.
More importantly, that is how I kept moving forward.
And if you keep moving forward, one day you may find yourself standing where I am now—looking at a new generation of candidates and remembering exactly where you once were.
Dr Vie Cheong Thong M.D. 