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If you ask me, the concept seems kind of outdated.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 I feel that it is outdated, as a lot of residency programs (mine included) have Simulation labs, where residents are tested with interactive mannequins that you can do procedures on and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.

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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.

Testing

I am taking my EM Boards on Wednesday. I'm not feeling so confident, and yet I am so tired of studying.

Death By Powerpoint

Last week I went through a five-day board prep course. A few of my classmates from residency and I flew out to the Midwest and camped out in a hotel. We endured 50 lecture hours over 5 days! I had forgotten how painful it can be to spend so much time in a lecture hall, and haven't slugged down that much caffeine in a long time. A couple of my classmates from medical school were there as well, although no one that I keep in touch with.

The course itself was pretty thorough. Some of the lectures were interesting, while others weren't really geared to board review. In addition to attending the lectures and following along with the provided notes and daily quizzes, lectures were continually run on one of the TV channels in the hotel rooms. There were also a couple of rooms upstairs that were filled with x-rays and images to quiz yourself on.

The first couple of days were a little overwhelming, but by the end of it, I feel like I had been given enough material. Very little of it was new, but there are a few areas like hemotologic disorders, derm stuff, and random neuro findings I need to focus in on to pick up a few points here and there. The majority of first-time test takers pass the exam, but it is pretty expensive and only offered once a year, so I would like to not repeat the experience if at all possible. Board certification in Emergency Medicine is a two-step process. The second part involves an oral exam that you only get "invited" to take once you pass the written part. After that, there's just some continuing education stuff to keep up with, and recertification isn't for another 10 years.

AG finally gets to come home for his "mid-leave" break in just a few days, and so my plan is to just relax during his leave. Afterwards, I have about a month after he leaves before the exam, so that will be the time to hunker down and really get back into studying.

duh!

So, my conclusion from today's test was that I definitely need to read more. Parts of it were good, and I think I probably misinterpreted stuff, but I still think my score will be up from last year. Maybe this was the inspirational kick in the pants that I needed to get back on track.

I cleared 8" of fresh snow off the driveway before I went in to the test this morning.

Mock Me

Sometime tomorrow, emergency medicine residents all across the country will be sitting down with #2 pencils. It's that time of year again, mock EM boards. Bleh. Luckily, our program doesn't put too much weight on your scores, but I would like to at least improve on my performance from last year (which should be pretty doable, as I set the bar REALLY low).


Most of my time this year has been in the ED, so I think I am probably at least learning things more relevant to my profession. The last two days I have been taking practice tests, which range from "duh" answers to what-the-Hell-is-that syndrome-type questions. I generally find it's not good to hear of a condition for the first time ever during testing. Judging from the way the count of tests taken on the website has been going up rapidly over the past 3-4 days, at least I know I am in the company of fellow test-crammers.


Last year it took several months before we got results back as there was a program that was caught cheating. Some programs like to use their residents' scores as bragging rights for future applicants. At my program, we just take our applicants out to drink. This year, I think I will probably have to face the music a lot sooner.

1, 2, 3

Found out today that I passed the last part of my medical licensing exam! Now I feel like I can finally focus on Emergency Medicine. Woohoo! No moonlighting (working for extra money on the side) until next summer, though.

The Short of It

On Saturday I ran a 5K. This one was for breast cancer and there were about 7000 participants. No medals for me this time! This one was much fancier, with bands playing at a few intervals along the sidelines. And there was a chip for runners to tie to their shoelaces, so that they could get their times. However, the time was when the gun fired at the start to when one crossed the finish line. There were so many people ahead of us and the walkers were mixed in with the runners that it took several minutes to get away from the crowd. I came in 839th if I recall properly, with a time of 33:41 minutes. I think I probably did better and was under a 10:30 mile but the slow start messed me up.

My friends, who are much more seasoned runners, said that usually there is a starting strip and an ending strip when one runs with a chip so that the times are more accurate. The guy that came in first ran a 15:40 time. I thought they were being over ambitious when there was a starting point for people averaging a 5-minute mile, but I guess not!

After that, I took a quick nap and then joined the gang for a barbeque before working the 5pm-2am shift. I pushed it a bit too much, as I just felt feverish and out of it the whole night.

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On Sunday, a group of us met up for a game of Ultimate Frisbee. I thought I would be much better at it than last fall, given all of the running. However, it's more of a sprinting game. There was a med student there that kept smoking me, so I ended up just doggedly running after him the whole game. One of the other residents sprained her knee, but other than that there were no casualties.

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On Monday, a group of movers came and removed the playhouse from my backyard. I have been wanting to get rid of this thing because it sits right in the middle of my grass since I moved in. Fortunately, one of the other interns has a 4 year-old that wanted it desperately, so she was willing to pay a crew to come pick it up. It took 6 men over an hour to maneuver it down my driveway, and they still ended up banging into the roof over the side door!

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Today, I met up with a friend to start studying for boards. I will be taking the last part of my licensing exam in July (hopefully only once), and I am trying to make myself just do a little bit every night. Step 3 is not supposed to be as bad as the first two parts, but I have a friend who failed it, and the stupid thing costs over $600, so I am not at all interested in repeating it!

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Only 8 more days left until my vacation! I haven't had time off since September, so I can't wait! A lot of the impetus behind all of this running is for a big upcoming hike with "The Phoenix". Just the thought of not setting foot in the hospital for 9 days has me excited.