I took the AP/CP pathology boards in the middle of May, far earlier, as I mentioned, than I had previously anticipated, and wanted to update everyone, save for a few things.
1. The ABP is absolutely *insane* about giving any slip of detail about the exam, to the point that they asked us *directly before taking it* if we used rememberances, and better yet, if we knew anyone who used rememberances. This strikes me as overkill, piles on the stress at a bad time, and has a "are you or have you ever been associated with communists" feel. It was a continuance of a lecture I received at an event a couple of years ago delivered to us in a tone of voice more fitting for disobedient children than doctors with a minimum age of 24. The simple fact of the matter is if the variety of honors codes and oaths haven't gotten to us by now, nagging us in the minutes before a 2300 dollar, 16 hour exam probably isn't going to ferret out the evildoers and it's disrespectful to those going through it since the vast majority of us are not poring over half-remembered previous questions for guidance.
2. It's hard for me to critique the whole process since 1) I like my job and they're the gatekeepers 2) I know some members on the ABP and they're cool people that I can't imagine are responsible for the babytime fun talk 3) I don't know my results yet, so whether that monster of a test bore fruit or not is beyond me.
3. The end of boards corresponded with having a bunch of administrative nightmarishness drop onto me from the future employment end, which then corresponded with getting a terrific headcold, so I've spent more of the last week curled on my couch crying rather than blogging. I got better.
Things I can say:
The shorthand. Pathology residency usually consists of a dual program comprised of Anatomical and Clinical Pathology. This lasts four years (doing either separately is 3 years), and to be employable in a difficult job market, most people complete a fellowship. Some fellowships are boarded (like cytopathology); some are not (like gynecologic pathology). Nearly all pathology fellowships are a year long, contrasted to some of our clinical colleagues that have three year fellowships. Fellowships are typically compensated like an extra year of residency. Being board certified in AP/CP pathology is pretty much a requirement to "sign out" anything in pathology, which is, have your name on a report and the report goes into a system. Since my residency is two parts, I'm technically taking two board exams, which were administered on consecutive days.
Pathology exams, unlike almost every other field, and allegedly due to the microscope requirement, are held in Tampa, Florida. There are several weeks between May and early July in which whole residency programs are assigned dates to show up and attend. It's expensive, time consuming, and notoriously difficult. You are usually at least there with your equally miserable colleagues, as I was. So knowing that, let's go.
-I was told by everyone that it was an awful experience and virtually everyone feels like they failed. This in no way prepared me for how bad it would actually be. I didn't think I'd feel better off than anyone; I just underestimated exactly how heartbreakingly awful the process is. I mean, few people feel great after the RISE, but this was like being kicked in the gut repeatedly by someone wearing steel toed shoes while another person stood above you describing the details of your dog dying. Just awful. I came out too beaten down to cry, but several others did. The worst part is coming out after your first day feeling like an utter failure and knowing you're going to have to start the whole process over again the next day.
-One of my colleagues and I managed to separately utterly ruin the confidence of other people coming in to take it the day after our last exam by her "that was f-ing awful" (and she never swears) to a man she thought was in business (taking it the next day) and my response to a wide eyed girl in the elevator who said "Did you finish your exams? Congratulations!" to which I responded "it is definitely wayyyyy too early for congratulations". I need to stop talking to people in elevators.
-Mild gripe. This hotel has hosted this exam for a lot of years. Everyone in the hotel knows you are there to take the pathology exam, and if they didn't, the fact that you're checked in under the exam rate should tip them off. As such, call me Ms. Sancho if you like, but please don't say "Good luck on your exam, Ms. Sancho". If you know I'm taking that exam, you know we're all doctors. Or better yet, don't wish me luck. Just kick me in the shin as I'm checking in, so I know what to expect.
-That hotel is nice but absurdly dark. When you already feel bleak, having Fight Club lighting doesn't improve your mood. And I had a gorgeous "lobby view" which looked out into the across offices. The only thing worse than working in a cubicle is watching other people work in cubicles.
-Computers broke. For an exam that costs the same amount as a lower model used car, getting the software on par with the SAT would be cool.
-There are totally other culinary choices than Panera. Are you people blind? Or did you think a giant shopping mall doesn't have a food court? Also, while the hotel is a'ight, their room service ain't not bad and you can get them to deliver a burger to your room during the exam break.
-Everyone I know says Tampa is a really nice place. I honestly feel so dejected from the exam that I have absolutely no desire to go there again in the near future (though if I failed, I have to go back, and if I passed, I have to go back for the cytopathology exam). People asked if I was going to stay over the weekend (since I was off Tuesday-Friday) and check out the beaches. I scarpered back to Charleston as fast as I felt safe to drive (the next morning). The only reason I didn't leave earlier is I didn't feel equipped to handle a long drive when I was that wiped out.
-Exam study destroys your health. I may have already mentioned that. The months leading up to the exam did more damage to my back than if I'd been moonlighting as a crash test dummy, and I had to up my blood pressure meds back up to a full pill. Feh. I'll find out I passed both exams the day before I have a hypertensive stroke.
So there's that. The rest of my non-reporting has been a frustrating flurry of paperwork.
Took ACLS, and not only passed it, but had the instructor out at my honey's wrestling match, in which a man was concussed. I did about 5 seconds of voodoo "doctor" neurological hand waving in front of the concuss-ee's face before going outside and getting the instructor/former medic to come help, so worth the price of admission I guess? Still no excuse for training pathologists to run codes.
Paperwork is a nightmare. It never stops being a nightmare. Even when you think you are on top of *everything*, something will come back to bite you unexpectedly so prepare for it.
An example: In between college and medical school (A LONG time ago), I worked a number of odd jobs for money, as one does. Since there is a noticeable gap between school attendances, I didn't want to just write: "2004-2006: Played Halo. Ate at Taco Bell". So I had the main time fillers listed without much detail (since it's completely irrelevant to my present job), and they've been sitting on my CV for nine years, unmolested by SGU, the ECFMG, the Step exams, ERAS, residency, the state licensing board, or the FCVS, thus I had no reason to expect that one 3 month entity, in the interim, was progressively burying any evidence I ever worked there, up to and including absorbing the entire company into another, shutting down the office I worked out of, and possibly salting the earth behind it to ensure nothing would ever grow.
This is where you go from being mildly annoyed that the government is always spying on you to relying on it. As I scrambled to not fail my employment history, I found that the usual suspect for being up in your business, the IRS, was tied up in hacker attacks. I briefly considered whether offering some cash up to a Ukranian mobster would get them to relinquish my ancient W-2s from the IRS website, but I put that up as Plan B. Nothing yet at the social security office, and apparently there isn't a master number where you can just desperately punch in your social security number, caution to the wind, and get a full print out of your work history, shoe size, and social media posts. Big Brother sucks at being Big Brother.
Fortunately, where the government fails at creating a dystopian nanny state, the internet always has your back, so I was able to sufficiently cyberstalk an old work contact based on a long forgotten forwarded email to get employment verification.
So that was stressful. Pretty much, spend a few days crawling through all your paperwork, including your CV. Now pretend you're on an episode of CSI. If you can't link the soil on your shoe to that barista job in 99, strike it from your CV so it doesn't pop up again to testify against you in court. I spent a terrifying couple of days convinced I was about to be broke and homeless because the software staffing markets in the early 2000s were someone volatile.
The final date until the move is approaching fast. I'm really going to miss Charleston, and I've come to think of it like home, but Texas will be a whole new set of opportunities. Let's hope that somewhere in late July or early August, you'll get the second to last of the "I PASSED" blogs and not a "NO I CAN'T DO IT AGAIN!!!!" blog.