Medicine

So…About Those Boards

First a little background information because, oddly enough, the path to becoming a certified foot surgeon apparently is not common knowledge. To get to where I am today I had to go through undergrad followed by four years of podiatric medical school and a three year surgical residency. Like any other schooling, there were tests, midterms, and finals along the way. Unlike other schooling paths, there were also a whole slew of national board examinations to pass. These are the important ones, since failing any meant no licensing and therefore no work regardless of getting a diploma. My medical school diploma really grants me a whole lot of nothing except the ability to sit for more tests. Yay!

cropped-img_1657.png
No new media because studying, so you get a complication of my favorites from the past year. This one takes the cake as the first time I enjoyed jumping Gemmie and was over the last fence in our first ever 2′ jumper course. 

Here are all the boards I have taken since 2006:

Part 1 NBPME (National Board of Podiatric Medicine Examination)/USMLE Equivalent (no clue what this stands for) Boards – didactic (multiple choice, academia based questions like any other standardized style test) examination. Taken after 2 years in medical school and based on the fundamentals: pharmacology, pathology, biochemistry, anatomy, physiology, and some other classes I no longer remember.

Part 2 NBPME- didactic examination taken at the end of the 4th year of medical school. Covers podiatry specific topics including medicine, surgery, biomechanics, physical therapy, sports medicine and on and on.

Part 3 NBPME- didactic examination which basically covers everything part 2 does only more surgical based. I was never sure why we had to take this, but I assume it is for money reasons. This is either taken right after 2 or after 1 year of residency depending on the state you do your residency in. Passing this part grants you your license to practice medicine and perform simple in office procedures (removing ingrown nails, warts, removing soft tissue masses and the like).

IMG_5488
Gemmie and I tackling our first ever “ditch” at Windridge while out cross country schooling. PC Bette Mann. 

Thankfully, after passing all three of those, you no longer have to give your money to the NBPME. However, you still aren’t done giving away your money to take tests. While in residency, every single year you take the American Board of Foot and Ankle Surgery Training Exam. My residency paid for this each time which was a nice bonus and I took it a total of 3 times by the time I graduated. This is the important test series for my current story.

These exams are two parts. Part 1 is the run of the mill standardized didactic multiple choice test on all things surgery: peri-operative management, surgical principles, complications, post-operative care and a slew of other topics. Easy to study for as long as you don’t mind going through phone book sized texts, online practice exams and articles. Part 2 is a whole other beast. It is a computer simulation of patients. The exam gives a brief, and incredibly not helpful, presentation of the patient. From there you have 15 minutes to perform an exam (there is a drop down menu of items to select from such as “palpate the fifth toe” and “range of motion ankle joint”), order any pertinent labs and imaging studies, diagnose the patient, provide treatment, get a complication, diagnose the complication, and finally treat the complication. I could go on about the specifics of the test and how it sets everyone up for failure, but I won’t bore you all with that.

By the time you graduate from residency you will have taken this three times (in addition to the three boards taken to get to residency) and each time the test format is the same: three hours to do the didactic portion followed by three additional hours to take the computer based portion (CBPS). You kind of get into the groove of this test after the first couple of times.

img_1361
Wyatt holding a better jumping position than I likely ever will

Then right before you graduate residency, typically in May, you take the American Board of Foot and Ankle Surgery Qualifying Foot Exam which is the exact same format as the training tests, only this time residency doesn’t pay for it (it costs over $2,000 for those who were curious) and passing this gives you the right to do foot surgery on your own after graduation. You can also, and I did, take the American Board of Foot and Ankle Surgery Qualifying Reconstructive Rearfoot and Ankle Exam, another two parter only focused solely on reconstruction of the rearfoot and ankle. The qualification lasts 7 years during which you perform surgery and collect cases until you have performed 65 foot cases and an additional 30 ankle cases if you decide to sit for those as well. While I passed both exams, in SC I am not permitted to do ankle work (a highly political discussion about scope of practice could occur here but I won’t), so while I am qualified in ankle surgery I wont ever be certified in it.

Ok..everyone caught up? To date I have taken 8 sets of boards with the last 5 all being two parts didactic and CBPS.

img_0502
At the completion of my first ever CT last June. We ended up in 4th out of 9 with no jumping penalties over some very decorated jumps. 

This morning was my American Board of Foot and Ankle Surgery Certification Foot Exam . I had submitted all my cases way back in March and now was time for the computer part. Registration was last November and the cost was equivalent to prior tests (around $1,600 if I recall correctly). Come January I started studying, slowly ramping up through March when I hit the panic button, ceased all extra curricular activities including riding and spent every night for two hours from 8-10 pm studying before bed. I made note cards on topics that would not stick. I had a journal filled with notes from text books I poured over. I stressed. And stressed some more. I then found an online practice test bank, shelled out $250 for access, and proceeded to take nearly 3,000 questions over the course of 6 weeks.

I was focused. I was determined.

You can just imagine my reaction then when I sat down to take this test this morning and saw on the screen “Welcome to the CBPS exam”. I paused.

Then I panicked! I had signed up for only half the test! Where was the didactic portion?? I had spent close to 200 hours studying for it. What was going on? Can I take only half a test?? What was I doing???

img_2304-2
My last jumper rounds with Gem back in February. I’m not sure I will never take her out and do a course again, but her main job will no longer be jumping. 

Having only 15 minutes per case, I set aside the panic and settled in for the torture that is the CBPS exam and three hours later I exited the exam center, grabbed my cell phone and immediately logged into my ABFAS account to see where on earth I screwed up.

Turns out there is no didactic portion to the certification exam. Unlike the prior 8 tests of the same name and under the same board of examiners which were all two part tests, this one was only the CBPS. You can’t study for the CBPS. It is impossible to. There are no academic questions. No anesthesia, classification systems, pharmacology etc…questions. Let me repeat this…YOU CAN NOT STUDY FOR THIS TEST.

The 200 hours, the lack of sleep, the no riding, the weekends spent reading and taking notes? USELESS. Utterly, devastatingly useless. 

I’m not really sure whether to laugh or cry to be honest. My days are pulled in so many directions at all times… mother, physician, boss, business owner, wife, farm work, hobby equestrian…that it is a wonder I get anything right. I know that if I did fail this time, when I go to retake it next year I won’t be making this mistake again and will instead cruise on up to the test hoping for the best.

I suppose it really doesn’t matter now anyway. It is over with. Friday I go pick up E if he passes the PPE and all next week I am on vacation. I took it off as a reward for all my hard studying. HA!!! Oh man. Don’t be me folks. Seriously, I can’t get over this incredible journey and the fact that it was 100% unnecessary and even worse, not helpful in the slightest. I would have performed the exact same without all that studying. It boggles my mind al the stressing I did for nothing. I guess it is better to over prepare than under, but man my life has been a self imposed suck fest for months!! It would have all been worth it to pass the test and settle in for 10 blissful years boards free, but for it all to amount to nothing? For it all to be for naught? Ugh. I think I may settle in tonight with my bottle of a friend’s homemade toasted marshmallow wine (delicious by the way) and try to forget this day ever happened.

 

 

27 thoughts on “So…About Those Boards”

  1. Oh no!!!!!! But at least you were over prepared? Even though as you said there’s no studying for the test you did take!!!

    Fingers crossed E passes!!!! And ummm Toasted Marshmellow wine?!?!?! Ummmm that sounds AMAZING!!!!!

    Enjoy being done with studying!!!!!!

    Liked by 1 person

  2. Definitely better to be overprepared than underprepared! I hope you pass and new pony too so you can settle in happily to some restful times and learning more about each other!

    Like

  3. I would have felt better studying even if it wouldn’t have helped. That whole process sounds daunting so congrats on it being done. Enjoy your time and don’t forget to update us on the PPE

    Like

  4. Ummm, totally sorry but this really made me laugh out loud (only because I’ve done similar things so I can relate). So glad the boards are over, though, and you can get back to real life. Oh and go to TIEC with us Saturday 🙂

    Like

  5. Oh, boy, that totally sounds like something I would do. Urgggg!!!! Ah well, it is now over and you learned a BIG lesson of not taking things for granted/assuming anything?!?! 😉 Sometimes you just have to laugh at yourself! Here’s hoping everything in the PPE works out on Friday and you can have a super fun vacation of riding your new horse!

    Like

  6. wowza. i’m kinda speechless… on one hand i want to congratulate you for being prepared and ready for whatever may come (even if it, uh, ya know, *didn’t*….). on the other hand tho i kinda just want to give you a hug. sheesh. that was good foresight to book vacation tho – i hope you enjoy it!! (and hopefully with E!!!!)

    also unrelated – i jump crewed at a twilight series schooling event tonight for ~4hrs….

    Like

  7. Oh man. I don’t know what to say! I think the important thing is to focus on the fact that it’s OVER and just fully embrace the present moment and fill it with all the happiness you can! Fingers crossed tomorrow…

    Like

    1. A huge weight was lifted as soon as I walked out that test center door. Even if I failed I have to wait a year to take ti again, so there is nothing to do now but wait and see and get back to living life. The older I get the more I hate the rat race. Back to living!

      Like

  8. i was giggling madly yesterday when I texted you to ask how it went (why that day stuck in my mind and i thought of you taking a test yesterday am I have no clue maybe cause my life is a constant suck fest lately too and birds of a feather…) HA and then you came back with this whole saga. And yes I can see Elizabeth AND Sarah both doing this same thing so dont feel bad :)Still giggling (Sorry not sorry). But i dont think you failed. I am sure you passed. You are fine. Breathe in and out and maybe have some more wine tonight. I am so excited/scared/nauseous/thrilled for tomorrow… KEEP ME POSTED!

    And congrats for wasting all those weeks studying…I bet Dusty just kind of gave you a look 🙂 HA HA How is his hand doing??

    Like

    1. The hubby looked at me and was like “I’m not sure if I should be furious or make fun of you” Then I pointed out that he punched the cabinet and broke his hand thus cancelling half the plans I had made for our vacation week. So he shut up.

      Liked by 1 person

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s