• Rosalind Kaplan, MD

Pandemic Board Recertification

I haven't posted in quite a long time. I'm going to publish the last post I wrote, a few weeks ago- I never put it up because I didn't feel like it was all that edifying. But I realize, looking at it now, that it is a reminder of how fast things are changing in our world right now. So it's going up along with this one, and we can look at how much has happened over these weeks.

I'd also taken myself off social media for a little while when I wrote that, out of self-preservation. It was hard to stay logged out when California started burning and the White House became a Covid hot-spot, but too much screen time was making me feel pretty crazy. The problem being that, for a blogger, being off social media isn't helpful for circulation! So I'm back up on Twitter and Facebook, but not logging in more than a few times a week now.

That being said... well, the reason I haven't been posting much really is that I've been trying to study for Internal Medicine Board Recertification. Yes, reviewing the entire body of medical knowledge for a ten-hour exam to prove that I (still) know enough to practice medicine.


On October 27th, I will enter the Pearson Vue Center in Philly, where all my belongings will be taken from me and put in a locker, and I will be fingerprinted, and placed in a cubicle to take the American Board of Medicine recertification exam. Someone will watch my every move and I will have to check in and out to go to the bathroom, as though I am a criminal. Because, of course, they have to make sure I don't cheat. I might have Harrison's Textbook of Internal Medicine transcribed into my sock, or planted in the ladies' room, printed on a single square of toilet paper.

This will be my third time taking the 10-year board recertification test. Meanwhile, colleagues who were just 1 year ahead of me took the test once, after residency, and have never had to take recertification, because they were 'grandfathered in.'

Now, you might ask, why am I doing this? I work part time, and have lots of other things to do, so do I really need ABIM certification? Well, yes, if I want to work in any health system, I must maintain certification, even if I just want to do Locum Tenens work. And I do still want to work. So I signed up voluntarily to sit in a cubicle and be treated like a criminal for 10 hours. And I PAID for it! The truth is, I'd rather have all my teeth pulled out without anesthesia than take this test. But I'm doing it, because I've been told to. If I were any kind of decent anarchist, I would not be giving into this!!!

As far as studying for the test, that didn't really bother me that much. I am always in favor of reviewing what I may have forgotten and learning new information. I accumulated Continuing Medical Education credits, and I have learned quite a bit. The problem with the learning that a lot of it isn't useful to me. Sure, some of it is-- new antibiotics, an overview of the new biologics (the -mabs and -nibs and -mibs), reviewing new cardiac guidelines--yes. But I don't need to know how to dose chemotherapy (hopefully, my patients can see an oncologist for their cancer care, right?) or how to treat Balkan Endemic Nephropathy (that almost seemed like a joke- how often am I likely to see someone from Serbia with new onset renal failure?), and it makes me wonder what the ABIM thinks Internists do.

Reality? I see all kinds of things all the time. I look things up if I don't know them. Like last week, a patient accidentally injected his Epipen into his hand. I had never seen that before, but a simple search gave me the answer I needed. These days, we are spending an awful lot of our energy on Covid- from how to best handle patient flow to limit the risk of infection in the office, to how to manage getting in and out of PPE all day, to what symptoms we need to know about, and how to predict who will need hospitalization. But Covid will not be on my test at all, because the information is too new.

I have to be honest. The ABIM gives us the choice of this 10-year exam or taking a shorter, at-home exam every 2 years. I chose this 10-year option because I can't stand the thought of preparing for a test every 2 years. And I have until next year to pass this. I decided to take it early. Because why waste a perfectly good pandemic? We can't go anywhere, so rather than watch Netflix, I studied all summer. It's the last time I'm going to take a big test. In another ten years, hopefully I'll be happily retired.

My younger colleagues have many years of testing ahead of them. Just one more burden to add to their mounting burnout. My generation failed at reforms to certification. Maybe the next one will succeed.

© 2017 Rosalind Kaplan