Six hours of multiple choice questions at the rate one per minute


You can’t say we were having a blast

And six hours sure didn’t go fast

It was multiple choice,

Don’t mourn or rejoice,

I certainly hope that I passed.

Synopsis:  I’m a family practitioner from Sioux City, Iowa.  In May 2010, I left my position of 23 years, and honoring my non-compete clause, traveled for a year doing locum tenens work.  In June of 2011 I joined up with the Community Health Center, which provides care for the underserved.  I’m now working part-time, which, for a doctor, means 54 hours a week.

Today I did six hours of multiple choice questions at the approximate rate of one per minute.  I did it so I can say that I am a Board Certified Family Practitioner.

Board Certification carries status, and status means money, employability and flexibility in the medical profession.  Each specialty has a Board that puts together an examination and sets standards. The American Board of Family Medicine led the way for regular recertification; when I first certified the Internal Medicine ticket remained valid lifelong. 

The generation of doctors who stopped their testing when they finished residency have started to retire; most doctors who call themselves Board Certified have to endure a torture every few years.

I logged more than 300 hours of Continuing Medical Education in the last ten months, and, in fact, I’ve been using some of the pearls I picked up.

Consider the dilemma of the doctor who doesn’t know if the patient has real seizures or pseudoseizures.  During residency I met a patient who knew a good deal more neurology than I did, and who could fake a seizure that would fool the best in the business (and, regretfully, the expertise brought about the loss of an arm).  Two weeks ago I learned a simple blood test, prolactin, if drawn within three minutes of the event can make the distinction with 95% certainty.

I took care of a hospital patient this last week where that single datum made all the difference to getting the proper care.

So studying for the test has brought me new, useful knowledge, but I doubt that the test itself measures the quality of a physician.  The immunization schedule, for example, came up three times.  I purposely refuse to memorize the sequence of shots because the recommendations keep changing.  If I need to know the dose of a drug, I consult my smart phone’s app, Epocrates. 

Too many questions came down to “Guess what I’m thinking.”

I had to bring my literal passport AND driver’s license to get into the test; I emptied my pockets and had to pass the metal detector wand (which failed to pick up my 1 ounce Navajo silver belt buckle).  After the first two hours I took an optional five-minute break, then worked on till noon and went out to hot lunch at the supermarket (very good Chinese).

By the time the last 80 minute session started my eyes had lost their focus and I had to fight to continue to care.  When I walked out of Western Iowa Technical Community College’s Testing Center I concluded that the test, more about test taking than about the material, was for the sake of testing.

I won’t get my score till December.  I hope I passed.  I don’t want to take that thing again.

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