COMMENTARY

ABIM CV Recertification Exams: I Passed! Free at Last!

Melissa Walton-Shirley, MD

Disclosures

July 02, 2013

In This Article

Let Me Be Clear

Studying for the 2013 cardiovascular recertification board exam made me a better cardiologist. Testing me temporarily ruined my life. As a matter of fact, preparing for the exam rendered me ineffective as a wife, friend, daughter, and mother. It was stressful to the point that for a short time, it depressed me, distracted me, and made me feel less well, with mild headaches, fatigue, loss of sleep, and increased appetite. There was no joy in any outing or dinner in the months preceding the May 2013 exam. I felt like Katniss as I stood with this huge task before me, an academic Hunger Games, if you will.

On our spring break in March, I did not study. It was an early celebration of our 29th wedding anniversary. I reserved that time for my husband, whom I love more than any board certification. During quiet times, at dinner, on long walks, and bus rides for tours...I felt guilty.

My husband sensed it and often gently placed his hand on mine, telling me everything would be okay. That time out was for us, yet the threat of the board exam loomed behind every vacation photo. The dread associated with being on academic death row was omnipresent.

What If?

I checked the pass rates for "recertifiers" a few months ago. Although steadily dropping, it was still a reassuring 84%. No matter, I couldn't get a handle on the best approach to study. About a year ago, I started reading the maintenance of certification (MOC) material, chapter after chapter, taking the mock exam questions, disappointed with not only my scores but also the scores of all takers. The chapters were incredibly well written. The images were excellent; graphics fantastic! And I loved the videos. The technology was light-years better than the study material 10 years ago, which was nonexistent when I first certified.

Yet, my plans were foiled week after week. I'd only manage about 2-3 hours of studying at most and some weeks could manage none. I fell asleep at night several times on my books, exhausted from a full-time overbooked office schedule. The 5 weeks prior to the exam, I dared anyone to speak to me in the mornings. Just being asked if I could go to dinner annoyed me. I canceled office the 2 days prior to the test and studied about 6 hours per day, taking long walks in between study sessions.

No More Waiting

In February, I decided I could not wait until November to take the exam.

My parents are now in their 80s, and their health issues serve as a slow but steady affirmation that we should optimize our time together. I cried one morning telling Tony that I feared I was spending the last year of my father's life with my head in a book. I'm ashamed to say that anytime I decided I'd make the 18-mile trip out to my parents' farm, I'd hesitate, thinking, "I need to study" and abort the trip.

Our daughter Aaron needed her wisdom teeth extracted "But if she does that now," I thought, I'd like to be with her and help her a few days -- but selfishly reasoned, "It might cost me study time." Our older daughter Kate has just graduated from college and wanted to go to lunch to talk about career opportunities. "Sure," I said, but secretly I thought, "Well, maybe I can spare a little time, but I really should study." My best friend has MS and I never get to see her between work and family, and I would have loved to run across the street and have breakfast with her on occasion. Excuses and "buts" became my mantra. "It could be worse," I'd often remind myself, but like a hand in front of my face, the games we play to make ourselves feel better just didn't work.

There were ever-present worries: "If I flunk, will I still get reimbursed? Will I still be able to make a living? Can I get hired for any other job if I decide to move? In the current defunct medical environment in our area in Kentucky, the political gap is wide and there are a few haters. "Wouldn't they be gleeful if I flunked?" The constant back-and-forth conversation in my head must have been the closest thing to schizophrenia I've ever experienced. It was completely mindless.

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