Clinicals are 2 exams- medicine and surgery (I’ve already done Ob/Gyn, Paediatrics and Family Medicine/General Practice).
For each exam you get 1 long case where you have 45 minutes to take a history and examine a patient (a real in-patient in the hospital, not an actor or someone brought in for the exam). Then you have 15 minutes to present the case to 2 examiners and show your examination findings, and answer any questions they might decide to put to you (they have complete discretion on what to ask).
After that you get short cases, where 2 different examiners take you around as many patients (again, real ones) as they can in 30 minutes, and say things like “Listen to this man’s chest”, “Look at this lady’s hands” or “What operation do you think this patient has had and why?” and you have to try and say something sensible.
If you do very badly or very well, you get a viva voce exam, where they grill you for 15 minutes in order to see if you’re safe enough to become a doctor (if you’re doing badly) or smart enough to deserve an honours degree (if you’re doing well).
All in all, 1 1/2 hours of face-to-face, one-on-one grilling, plus possible vivas and the 90mins alone with the patients in the long cases. It’s daunting.
10 days before the clinicals, we have the written papers, a 2hour medicine essay paper, then 100 medicine MCQs on Monday, then 2 hours of surgery essays and 100 surgery MCQs on Wednesday, then 250 psychaitry MCQs on Thursday. The MCQs are negatively marked and worth 50% of the written grade for medicine and surgery (the written is worth 1/3, the clinical exam 2/3, but if you fail the clinical, you fail completely).
The papers (MCQs and essays) don’t come from a standardised bank- each consultant (attending) submits an MCQ question of their own devising, and the head Professors of Medicine and Surgery write the essay paper- again, questions completely of their own devising.
I have no idea what American boards or the final exams for American Medical schools are like, so I can’t tell you if it’s at all similar.
I can tell you that it’s very, very nerve-wracking- like doing a driving test, but about 100 times worse!