The Exam

Just in case you were wondering, I've decided that I'm going to sit for my board exams in September. I've already paid the fees, and I *do* still have 2 months and 21 days left to study.

I decided that I would wait and see how I felt after the practice exams that my department was nice enough to organize for us this week. I didn't have high hopes, as I've done all of two months of emergency medicine in the past year and the last time I was in the emerg here was 11 months ago. That's a long time to be out of the swing of things. 

Well... I wish I could say that I aced the practice exams and that my confidence is back. But no. In fact, I failed two of the four orals. In one of them, I practically killed a patient. 

So why am I still thinking of writing the exam? Well for starters, I did really well on the written. And my strength is usually the oral. I'm good at thinking on my feet, less good at retaining minutiae that I don't use every day. So if I already have a pretty good base of knowledge for the written, that helps a lot. As for the oral... well, I sucked. I won't sugar-coat it. But one that I passed I managed to get through with very little knowledge simply by thinking my way through it, and the two that I didn't pass were for incredibly STUPID mistakes on my part. Things that when I'm actually confronted with the situation, I always think to do.

If you're curious, I forgot to ask about Viagra use before giving a cardiac patient nitro, and had to watch helplessly as his pressure bottomed out in spite of fluid bolus after fluid bolus. Finally I conceded defeat after starting him on two different pressors and crystalloids. Gah. The other case I failed because I didn't examine the scrotum of a young boy with RLQ pain and vomiting. I ruled out appendix and missed a testicular torsion.  Again, stupid mistake that I would never make in real life. Grr.

Basically it all went down in a way that made me realize that once I'm back in the emerg and getting back in the EM frame of mind, it will all be second nature. I *can* do this. 

Hearing that PGY-3 EM candidates have over a 90% pass rate made me feel better as well. Heh.

One more week until I'm back in emerg. It's been forever. I can't wait!