Surgery Board Exam

New Orleans is the site of this years Super Bowl. After preseason practices, a 16 game regular season and playoff games, there are two teams left to participate in the culmination event of the 2013 NFL season. The hard work put in by the San Francisco 49ers and Baltimore Ravens got them a trip to "The Big Easy" to play in this years championship game.
I too traveled to New Orleans during Super Bowl week. Unfortunately for me, it was not to relax and enjoy the festivities surrounding the big game. 

I had a different big event to attend. After four years of college, the MCAT, four years of medical school, my medical licensing exam (three separate tests), five years of general surgery residency including five ABSITE tests (our yearly in-service exam) and a written qualifying board exam, I made the trip for the "Big Uneasy" Super Bowl of surgery tests...the oral board certifying exam. 

A little background for all of those unfamiliar with this unique test. Surgeons who have completed their training and have passed their written boards are allowed to sit for the orals. If you pass, you have completed your training and are now a board certified general surgeon. The exam is compromised of three thirty minute sessions of case scenarios given by the leaders in the surgical world. (You know, the guys who run the big famous hospitals, write the textbooks, advise the president on healthcare policy. Little everyday stuff. Having already mastered clinical surgery and gotten bored with the things I've been studying the past 5 years, they have moved up the food chain and can't wait to eat us alive.) 

All general surgery residents get a sick feeling in their stomach whenever you mention that they will eventually have to take oral boards. The ones that don't get sick are the ones who know they are changing to an emergency medicine residency at the end of the year. Many horror stories are passed down from generation to generation about the oral board. My favorite story of surgical lore is when one of my colleagues was waiting outside his examination room to be invited in when the door opened and out walked a girl who immediately burst into tears. The examiners politely invited him in by saying "so you're next?" There is even an episode of Grey's Anatomy about it. (Which I haven't seen yet.). To their credit, The American board of surgery has made changes to the exam throughout the years, providing more structure and standardization to eliminate any hazing or snipe hunts. None the less, it is still extremely stressful to be seated in front of two surgical giants who present you with clinical scenarios that encompass the breadth and depth of surgical knowledge. Worse case scenario...you fail and get to look forward to retaking it. Or, you get so nervous that you mess yourself... and then fail.  

With this context set, I landed in New Orleans on Tuesday afternoon, seated next to a guy who would be working behind the scenes of the NFL awards show Saturday night. I knew I wasn't in Grand Rapids any longer when my Rastafarian cab driver with sweet dreads was talking on the phone in Creole and listening to some Caribbean music that made me want to work on my tan at the beach. 
Thankfully, I had made my hotel reservations back in November and was able to get a hotel room at the same place where the test was held. My plan was to do some last minute review for the afternoon, then head out for a nerdy dinner alone and  wander over to the ESPN set to catch a glimpse of some famous people.  

           My hotel room, exactly the same as the rooms the exam was given in.  

The concierge at the hotel gave me some recommendations for local creole and Cajun style food, but as I was walking to the restaurant I had second thoughts. "What if I got food poisoning tonight? What if I have developed a shellfish allergy and shrimp will make me suck down albuterol in the ED all night? What if the spices give me a perforated ulcer and I become one of the oral board scenarios? " I opted for a hamburger and fries. 

After dinner I pretended to be down in N.O. for the Super Bowl. I watched sports center being taped live, saw a few sports celebs (Archie Manning, Teddie Brueski, Chris Carter, Steve Levy, Jerry Rice.), had coffee and a beignet at Cafe du Monde (thanks Bailey for the recommendation), and enjoyed a stroll through the tame parts of the French Corridor. 

By 7 I had made it back safely to the hotel. I didn't want to stay out late for fear that I might start drinking and wake up in a back ally behind Bourbon St with all sorts of beads around my neck. :)
Lights out 10pm. 

                                                              ESPN Sportscenter

                                                     Archie Manning (Payton and Eli's Dad)

                                                                   Jerry Rice

CBS NFL show

6 am Wednesday January 30. Super Bowl Wednesday. I put on my suit, which by the way is the same suit I wore to my med school interviews back in 2002. That statement tells you three things about me...I'm cheap, ten years out of style, and have maintained my girlish figure. 

After a brief orientation alongside 60 other nervous clones in an eighty degree conference room I was given my room assignments. First room: 426. I made my way up, and realized that I still had about 15 minutes to kill. What do you do for 15 minutes while waiting in the hallway of a hotel? Look at the wallpaper and pray...for clarity of thought, peace, and that I don't have a stroke right there outside my first exam room. 

I struck up a conversation with the guy next to me, a pediatric surgery fellow in Miami named John Fitzwater, only to learn that he went to Tenwek hospital for three months during his residency and did research on esophageal cancer. It was totally a God thing that we were able to encourage each other and even pray together right outside our exam rooms. 

Before I knew it, my three rooms were completed. Room one went smooth. A lady with breast cancer, an alcoholic with colon cancer and liver mets, an elderly lady with all her stomach stuck in her chest, and an obese lady with a complication from bariatric surgery. Pretty run of the mill general surgery with a little sauce to make me think.
Room two was more of the same. I was feeling ok. No tears yet. And then, room three. Oh room three. Lets just say that the examiners in this room were experts in gentle manipulation to frustrate the crap out of you. I had a feeling this was coming, as I had recognized one of the names as a past president of the American College of Surgeons. He has had years of examination experience and I could tell he had perfected the ability to tease out what you know and what you don't.  God gave me that third room for a reason...to keep me humble.  

I left the exam with a sense of accomplishment, and a curious wonder of if I would be back next year.  In order to pass, you have to get thumbs up from the examiners in two of the three rooms.  I was fairly confident about room one, fairly distraught about room three, leaving it all up to room two.  I wouldn't find out until I got home...which proved to be a story all by itself.

My flight out of New Orleans was delayed due to weather in Chicago, forcing me to miss my connection to Grand Rapids.  Instead of getting home Wednesday night, I spent the night curled up on a bench in O'Hare airport too cheap to get a hotel room for 5 hours.  My rescheduled flight for 7:30 am was on time until the pilot abruptly aborted the takeoff and we coasted back to gate...mechanical problems...more delays.  I'm just glad the plane broke before we took off.  

As we were sitting on the runway I met two nice strangers and we decided to rent a car and just drive back to G.R.  I felt like the mom on Home Alone..."I have to get back to my son(s)!"  After a 3 hour drive with two new friends I finally arrived home...checked the ABS website...and found that I had PASSED!!!  No more tests!

When I was at Cedarville and was trying to decide whether to go to medical school, I told God that He would have to be with me through it all, because I knew I couldn't do it alone.  He led me through the MCAT, allowed me to get into Med school, and by His grace Erin, I and the boys have made it all the way to the end.  He is always faithful, and Solo Deo Gloria!