A couple weeks ago, I posted about feeling constrained in what I was able to post about.  After my husband read the post, we talked about it, and he encouraged me to go ahead and put some of my thoughts out there.  There are still some things I don’t feel comfortable talking about just yet, but it feels good to write this much in the meantime.

As BWB and I begin a year of residency applications, interviews, and matching, oh my, we are studying for Step II of the board exams.  This exam consists of 8 hour-long blocks of 44 questions designed to trick you into pick the wrong answer.  It’s awful.  The exam is awful, studying for the exam is awful, the fact that the scores matter so much is awful, the whole process it just plain awful.  It’s only slightly better than Step I, which most people with an MD concede that they likely would not be able to pass if they had to sit for it tomorrow.  To sum up, this exam is a big, ugly pain.

However, I am supposed to think this exam is a breeze, according to conventional wisdom.  “Two months, two weeks, two pencils” is the phrase medical students and residents kick around for the three parts of the licensing exam.  By that they mean for Step I one is supposed to study for two months, for Step II, 2 weeks is supposed to be sufficient, and for Step III, an intern should able to walk in without having cracked a book and ace the sucker.  As a result of this little pithy phrase, I feel the need to conceal the fact that I am studying my little rear end off for the second part of the boards.  Standardized tests and I don’t get along all that well (and that’s putting it mildly), so my studying is as much to try and figure out how to beat the system as it is to get the information into my head, and yet because of this urban myth I feel ashamed that I am spending far more than two weeks working on the thing.

The reality is that most of the medical students I know have had to spend a lot more than two weeks studying for Step II.  Most of us are pretty convinced that the guy who came up with the above saying was trying to trip up his classmates in hopes of a better curve.  And yet all of us, the ones who are working so hard before taking the exam, are keeping it quiet.  None of us admit to studying for it, nor would we publicly discuss how much it sucks.  It’s a code of silence, maintaining the illusion that this test is not a big deal.

News flash: It is a big deal.  Do you hear me, interwebs?  I am intimidated by this exam.  The idea of spending 9 hours sitting in a testing center, sweating over the finer points of urinary casts, leukocytosis, and neurologic deficit localization is not my idea of an easy task.  It is actually pretty difficult, as a matter of fact.  I’m driving myself hard to try and beat the test, beat the people who wrote the tricky questions, and hopefully improve my clinical knowledge base along the way.  It is taking longer than two weeks, and I’m okay with that.

Don’t get me wrong here.  When I say I’m okay with it doesn’t mean I’m having a blast.  I’m miserable.  I wish I were in a hospital working with patients.  I would gladly be taking call and working 80+ hour weeks instead of being here, doing this.  I hate sitting at a desk staring at tables of testicular cancer markers.  I’ve had to push my exam back in the wake of dealing with BWB’s grandmother’s death, and as a result I’ve had to study here in Florida when this was supposed to be my reward post-exam.  This is not how things were supposed to go, and I am not happy about it.  In the broad scheme of things, though, I have accepted that preparing for the test is going to take me longer than two weeks if I expect to do well, and I’m doing what I have to do.

In the end, if knowing myself well enough to know that I need this time to study makes me lesser in some way, then so be it.  I’m sure I have classmates who would scoff at me for this entry.  I prefer to think instead that knowing my own limitations and being honest about them will make me better, safer doctor — and probably a better person along the way.