Thursday, October 14, 2010

More Testing

Last weekend, I flew to Chicago to take my oral boards. To be board-certified in Emergency Medicine, one must first pass a written exam (woohoo!) and then the oral boards. Oral boards are scheduled twice a year, and there is a lottery system to determine whether or not you get the Spring or Fall test date. Luckily, I drew October, since there was that whole wedding business going on in April.

If you ask me, the concept seems kind of outdated. The oral boards take place in a hotel by the airport, and several floors are rented out. Over a four-hour block, applicants are shuffled around from room to room, and given test cases. Basically, you go into a hotel room and sit down at a card table with a plastic divider set up between you and the examiner. They give you a sheet of paper with a few lines on it, and some vital signs. From there, you have to ask 50 bazillion questions to scratch out a review of systems and physical exam, and respond to the answers given by the examiner. It's like a painful GI-distressing version of "20 Questions" in formal business attire. You are also given x-rays, EKGs and lab results to review on the spot. Each case lasts about 15 minutes and there are a few multi-patient cases that last 30 minutes.

The whole situation is just awkward, from having to wear a suit, to being in hotel rooms, to trying to picture a patient that is not in front of you and respond to them. I feel that it is outdated, as a lot of residency programs (mine included) have Simulation labs, where residents are tested with interactive mannequins that you can do procedures on and respond live to your interventions. I am just not exactly sure what the oral boards are testing. My knowledge base was already tested with the written exam. They can't really test my bedside manner or procedural skills by a on-the-spot dialogue in a hotel room. It seems like they should just get rid of the oral boards or modernize them with Sim testing if they really want to ensure that candidates have been trained equally by their residency programs.

That being said, I do think that the Board does go through a lot of effort to make sure that everyone is fairly tested, from their bizarre scoring system, and all of the examiners were very courteous and professional. All of my patients lived, and I think that I passed, although now I have to wait for three months to get the official results. Even more revealing is that once I am board-certified, I will have to take the written test every 10 years, but never the oral boards again, so I don't really see the point in the whole thing.
The nice thing about the weekend, is that I did get to see some of my buddies from residency. We went out to dinner together after the test, and then took the train downtown to a piano bar called "Howl at the Moon". It was a fun place, and there were a lot of people there who had just run the Chicago Marathon, and still had energy enough to dance away the night.

Here, for your viewing enjoyment, is a new bride dancing to "All My Exes Live in Texas"... the groom was off drinking in the corner.