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Wednesday, April 25, 2012

Done! Maintenance of Certification for the American Board of Internal Medicine

Today I took my boards, for the first time since 1989. It wasn't bad. I can't write anything substantial about the content because I swore on a stack of Harrison's Text Books of Internal Medicine that I would not, "copy, reproduce, adapt, disclose, solicit, use, review, consult or transmit ABIM examinations, in whole or in part, before or after taking my examination, by any means now known or hearafter invented."  Also, I "further acknowledge that disclosure of any other use of ABIM examination content constitutes professional misconduct and may expose me to criminal as well as civil liability." My lips are sealed.

I scheduled the test through the ABIM site on the computer and had to travel about 2 hours to get to a testing office since I don't live near a big city. The test began at 8 AM, and was limited to 6 hours to answer 3 blocks of questions and about an hour and a half of break time that could be taken between these blocks. The office had about 12 cubicle style desks and was quiet and warm enough that I didn't need a jacket. Jackets were discouraged since they were very serious about making sure that we didn't have any electronic devices or notes with us. We even had to remove watches, turn out pockets and show the proctors that we didn't have contraband in our socks. Really. We were videotaped and observed by the proctor as we worked. The testing was done on a computer and a tutorial was available before the test and online from home. The format was not difficult and didn't require any typing skills. It was possible to finish each block of questions well within the allotted time, even though I was pretty sleep deprived. I took both of my breaks, but not for the full amount of time. I brought food, which was a very good idea since getting up early and being nervous makes me really hungry. It was also kosher to look up answers to questions during break, though we weren't allowed to change any answers after leaving the desk. Each block of questions seemed to be similar, no change in themes as far as I could tell. After completing a block we could review and change answers before electronically sealing them in stone.

After the test there was a little survey about what we thought of the whole thing. I pretty much "strongly agreed" with statements about how the testing site was just fine and the staff was helpful, but was unable to strongly agree that the test questions were relevant to practice. I actually did enjoy taking the test and found that the game of multiple choice was as much fun as it ever was, a logic puzzle crossed with a trivia game with obvious questions thrown in for variety. But most of the questions were about hypothetical patients who were very sick but weren't morbidly obese, didn't have more than 2 or 3 chronic medical problems and took a maximum of 5 medications. These are not the very sick patients we see in practice. The other thing that was unrealistic was the fact that we didn't have access to our computers and cell phones which are the way that we make sure we do our jobs right. Good doctors know where to go for the right information and don't depend on their limited cranial capacity to keep track of medication interactions and treatment regimens and  the difference between proximal and distal renal tubular acidosis. I recognize that an open book format would be difficult to incorporate into a standardized testing situation, but that would be a test that would be really useful to prepare for.

I hope I passed. I think I passed but I won't find out for something like 3 months. The human/digital interface works in mysterious ways.

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