I took it yesterday. Or, more correctly, it took me. From behind. It bent me over and made me its bitch. It wants me to call it “Daddy” from now on.
Taking an eight-hour test is bad enough, especially when you’ve got nine hours to do it. (I’m glad there are lunch-type establishments very near the testing center.) The worst part is near the end, when you’re hallucinating a little bit and the 67-year-old men with a 3-day history of chills and a cough productive of green sputum seems to come to life, hocking one up right in front of you. It was at that point that I remembered that I paid $400 for the fucking privilege. (It’s gonna suck to have to pay it again, too.)
Other Random Things that Piss Me Off:
–Questions of the form, “Which of these is the best initial step in management?” I don’t know how they practice medicine in USMLE Land, but here in the Real World, we don’t order one test at a time. We tend to order several, and most of the time, my mental list would include three or four of the answer choices. In that case, my initial step would be the first one of those I came across in the computer (at the VA, where we order by computer).
–Kids with rashes. Yeah, I know it’s important, but I can never keep the damn things straight. (This is one of the many, many reasons that I’m not going into Dermatology or Pediatrics.) I don’t think it’s important enough to make approximately 61% of the questions about kids with rashes. (At least it seemed that way. Fortunately, the other 39% seemed to be split evenly five ways: 1. Old Man with Chills and Green Sputum, 2. Pregnant Woman with Vaginal Bleeding, 3. Old Patient Who Had Surgery A Few Days Ago And Then This Wacky Thing Happened, 4. Baby with a Cough, and 5. Tuberculosis. Those I have a handle on.)
–Custom-built test question patients. “A 34-year-old Ashkenazi Jewish woman comes to your office because of a fever. She recently made unplanned trips to Mexico and Cambodia. She is adopted and is unsure of her family history (except for the note left with her at the doorstep saying that she was an Ashkenazi Jew, of course). She is an IV drug user, and works in a health-care facility. Before that, she worked at a chemical plant, and before that in an asbestos factory. She is sexually active, and has had unprotected intercourse with several new partners over the last two years, all of whom were IV drug users. What is the most likely cause of this woman’s fever?”
–Ethics questions. Sure, I can mark out A. “Tell the woman to get the hell out of your office” and C. “Remove the patient’s kidney and sell it on the black market”, but the right answer among the other three choices really depends on the point you’re trying to make. Is it the importance of informed consent, the right of the mildly retarded but competent mother to make decisions about her pregnancy, or the obligation to keep her medical information confidential?
I probably passed the damn thing. I’m just bitchin’.
Dr. J
Perhaps you could have a little discussion with these people.