Studying

I’ve been studying for the gastroenterology board exam. It covers everything GI-related and all the stuff I learned as a fellow. So even though I know a lot of GI, the test is expensive enough (>$1k) that I feel obligated to study (alot) until I actually take it.

Medicine is full of standardized tests, which is good, because you want doctors to know stuff about medicine. But bad, because they're irritating, expensive, often the information tested isn't practical, and good test scores don't guarantee a good doctor.

The standardized testing started prior to med school, with the MCAT (medical college admissions test). I studied a lot for this one. Then in med school, there was USMLE (United States Medical Licensing Exam) steps 1 and 2. Step 1 was all about memorizing biochemical pathways and which viruses were double-stranded DNA viruses vs single-stranded RNA viruses – clearly very practical. Step 2 was a bit better, asking questions about diseases. USMLE step 3 came right after my intern year and was all medicine, which was great for me as an internist because there was very little on the test that didn’t apply to the general adult patient. The internal medicine boards came next, which I took during my first year of GI fellowship. They rocked because it was a day off of work and all my work friends were taking the test at the same place. That test was in a country club ballroom complete with chandeliers, which made it an extra-classy testing experience.

So now I’m to the GI boards and have spent the afternoon reviewing the different anorectal manometry patterns that can be seen in fecal incontinence and the plethora of diseases that can cause diarrhea. Now is probably not a good time to invite me to dinner. Or if you do, don't ask me what I've been up to.

With each level of testing, the price goes up, I think mainly because there’s no one to say ‘stop, there’s no reason this test should cost so much’. I’ve also been a party to the advent of computer-based testing. Step 1 and the medicine boards were paper. Step 2, 3 and the GI boards are computerized. Hopefully the computer test will go better this time than with steps 2 and 3. The computer at the testing center crashed for both my steps 2 and 3, ending my test early and requiring a reboot. During step 2 (which is two 8 hour days of testing), most of the people around me were taking an HVAC test, real estate licensing, or the GRE and they would all finish in a few hours. For step 3, the whole test center crashed, so they made all of us go sit in the hall, but weren’t allowed to speak. I’m sure they’ve worked out the kinks by now, right?