Standardized Tests

 Doctors are some of the most tested professionals in the workforce, especially when it comes to standardized tests. If I remember correctly, I took the MCAT test while in college to get into medical school, followed by three rounds of national boards during medical school, followed by specialty standardized board tests in residency, followed by my specialty board test at the end of residency to become "board certified" when graduating from residency. They really want to make sure we know what we're doing when we graduate from med school and residency, which makes sense given the nature of the work that we do.

After graduating residency and passing my board certification test, I was determined to be board certified in my specialty for the arbitrary duration of 8 years. During that time period, I had to maintain 150 continuing education hours every 3 years but there were no additional standardized tests. During the first 3-4 years in practice following residency, I felt up to date on medical topics in my specialty, relying on my knowledge from residency. However, as time progressed and medical knowledge evolved, I needed to rely on continuing education in its various forms more often. This is a normal phenomenon and the reason why continuing education requirements exists. Medical knowledge evolves rapidly, and as practitioners settle into their style of practicing medicine, it makes it easier to fall behind the education curve. I have no issue with maintaining education to stay up to date on the newest guidelines and recommendations (though surprisingly there are some drawbacks to this which I may explain in a separate post). However, a funny thing occurs at the end of that random 8 year time period where you are board certified: you have to take another certification test.

When I was in medical school and residency, I was at the peak of my educational career. This is no longer the case. Turns out, a lot can change in 8 years. Back then, I was a full time student who did little of anything except study. Now, I have a career, a house, a family with two kids, etc. There's a lot going on. While I have kept up to date through conferences and reading, I haven't taken a standardized test with any meaningful result since the last time I certified my boards 8 years ago. Needless to say, I was a bit nervous about the test.

I started dreading this test a couple of years ago. I didn't think about it a lot, but it would periodically enter my mind as we approached the end of the 8 year period. It doesn't help that despite the number of standardized tests that I've taken, I'm pretty average at it, which adds to the anxiety. I didn't want to cram, so I started studying in January. This gave me five months to prepare. With my busy schedule of things to worry about, I decided to approach studying with a slow but steady cadence. I wasn't going to be able to dedicate hours of study time per week. Instead, I studied for 15-20 minutes daily in the months leading up to the test. This slow pace also prevented me from getting burned out studying. I decided to study by doing test questions. This allowed me to get into the habit of taking tests again, while forcing me to read about subjects I'd likely avoid if I were picking the content myself.

When test day came, I felt prepared. I had been studying and preparing for months, what else could I do? I took the test at home with a proctor watching me on camera. Overall I liked this because it allowed me to be in the comfort of my own home (there were a few oddities to this, however). The test was 4 hours long, consisting of 200 questions, which is half as many as my previous tests. When the test was over, I did not feel good about it. I was not confident at all. I had to wait two months to get my result. The entire two months I was worried about needing to take it again, mostly because I didn't know what I could do differently to prepare. After two months of worrying about my result, I finally found out that I passed, taking a huge monkey off my shoulders. 

I'm bringing all of this up, because I think the idea of this standardized test is ridiculous. Once you've gone through everything that is required to practice medicine, and once you've been practicing medicine for nearly a decade and have a career and family and everything else going on that comes with life, it seems a bit ridiculous to potentially put someone's career in jeopardy over 200 random questions answered on a random Thursday. Thankfully, a lot of specialty boards are moving away from this standardized test and if I understand this correctly, I won't have to worry about taking such a large test with such large ramifications in the future. The education will be more frequent but in smaller chunks, which is honestly a better way to learn. In fact, I believe my class was the last class to have to take the recertification exam. Starting next year, certification requirements are changing and no longer require taking a huge standardized test. Lucky me for missing this by one year.