Bored with Boards

Here I am getting ready to take my Pediatric ID boards in less than two weeks and my brain is saturated.  I should have one more hour of study in me, but I just can’t do it.  No more antiviral mechanism of action, no more mechanism of resistance (much more painful to remember)!  So I am taking a break to finally do a post.

My older brother is now a third year medical student, and this past summer as he studied and crammed for Step 1 of the boards and felt so much pressure, I tried to calm him down and talk him through the psychology of the big tests.  He had built it up to be the biggest, almost unconquerable set of questions and was so worried about getting a good score.  I did agree with him, because the test is hard in all the minute details is tests- the enzymes of the krebs cycle, the endless neuropathways, etc.  But I tried to tell him that you have to calm down about it, because boards just become a way of life. There is always a boards or a recertification looming.  He didn’t believe me, he knew that conquering step 1 was the main goal.

Then he said something hilarious, that I will always remember.  Having just finished 2nd year med school, with a determination to get a good score on step 1 of the boards he said, “I just have to do this, and then all of this with be half over.”  I chuckled, and have chuckled many times over, because there I sat- 10 years since starting medical school, step 1, 2, 3, and peds boards behind me, and the peds ID boards looming, then peds boards recert a few years after that, and I was pretty sure that the halfway point wasn’t getting through step 1.

But in my brother’s defense, there is no way to know what is ahead of you until you make your own way and live it yourself.  It has made me reflect on my own medical training.  What was the hardest part for you?  What was most physically demanding?  What was most mentally taxing?

I loved medical school.  Sure it was hard, but I loved the classes, then loved rotations.  Except for psych- finding myself in the ER at 3 am with a schizophrenic who thought she was Abraham Lincoln is only entertaining now in dinner conversation.  Residency was great- hard when it was supposed to be hard, intellectually stimulating, great cases, amazing clinic mentors, such fun people to work with, and nurses with great NYC attitude to keep me laughing on the inside.  It also helps that I fell in love and got married during residency.  That casts a nice pink rosy glow over those years.

Then comes fellowship.  Undeniably, the first year of fellowship was the hardest year of my training. Great cases, learned all I should ever hope to learn about ID in the crazy immunocompromised, crazy traveler, and every once in awhile-ID in a normal kid.  But my program has one fellow a year and you do all clinical service all year long with breaks few and far between.  I remember when I was on my 11th week of straight 24/7 service and I thought I was going to die.  Always getting paged through the night by a pmd or er doc 100’s of miles away wanting me to manage a kid via the phone.  Then 14-16 hour days every day with constant paging, rounding, new consults, outside physicians calling for curbsides.  Yikes. It wore me down week by week until I had nothing left at all.  The other fellows in my program all agree, it takes a couple months after finishing that first year to let all the insanity start to fade.  But it did start to fade.  I finished my fantastic and interesting research projects, have a couple of publications under my belt, have a wonderful real grown up job, and now once I finish these peds ID boards, then all of this will be over?!?

Dr. C