Musings of a Dinosaur

A Family Doctor in solo private practice; I may be going the way of the dinosaur, but I'm not dead yet.

Saturday, July 26, 2008


I took Boards for the fourth time today; my third re-certification of Family Medicine Boards.

Our Board certification is good for seven years, although most people take the exam after six years in order to be safe. This was the first time I let it go for the full seven years, which means I first certified 19 years ago, when my baby was two months old. He is now about to start his second year of college.

What I remember most fondly about the initial certification exam was the pencils. They were lovely, sturdy white #2 pencils with the words "AMERICAN BOARD OF FAMILY MEDICINE" emblazoned in a gorgeous shade of green. We received two of them for the full-day exam, and we got to keep them; my $350 pencils ($175 each, of course.)

Six years later, I again reported to a downtown hotel ballroom with several hundred other FPs to take my first re-certification exam. This time, though, the pencils they gave out were the regular, grungy old yellow ones -- sharpened to a tiny little point, like a golf pencil! No way these were going to make it through an entire day of testing! Except that close on the heels of the lady checking IDs and handing out pencils was another person carrying a large plastic bag. As he stepped in front of me, he reached into it and extracted -- I kid you not! -- a small, white, plastic, birthday-party-favor-style pencil sharpener (that actually worked pretty well.) The best part of the day came when the head proctor was reading us the instructions and came to this line:
No test materials may be taken from the room.
At this point she stopped, looked up and added sheepishly:
You can keep the pencil sharpeners.
And that is the story of my $500 pencil sharpener.

Fast forward another six years, and it was time to do it again. I found myself wondering what the pencil situation was going to be. I wasn't disappointed: this time we were each handed a spiffy pink mechanical pencil, complete with extra leads and erasers tucked away in its little hidden storage compartment. The more memorable thing about that day, though, was the occupants of the ballroom on the other side of the foyer from ours, where there was an official Ballroom Dancing Competition. Watching the dancers warm up and practice in the foyer, the women resembling life-size Barbie dolls and the men in their stylized tuxedos as they glided and spun around the room at full speed, was amazing. Several of us taking the re-certification exam agreed we would far rather be in the other ballroom. But I did get to keep my $850 mechanical pencil.

That was seven years ago. Times have changed. Prices have gone up. More importantly, the ABFM has moved away not only from the paper-and-pencil format, but also from the hundreds-of-docs-gathered-in-a-ballroom venue. Instead, the exam is administered on a computer (of all things!) at multiple contracted testing sites on multiple dates. Amazing! You register online, pay $1,150 by credit card, and show up at a suburban office building on a Saturday morning where you are surrounded by people taking all kinds of other tests.

I'd been warned in advance that no pens, pencils or papers were allowed in the testing room. We were told that we'd be given white boards which we could use for any calculations or notes we wanted to make during the exam, but that all materials would have to be returned at the end of the test.

The exam followed along the lines of my recollections of the others pretty well. Questions ranged in difficulty from, "Are you kidding me?" (ie, I learned that in high school) to "Not a f***ing clue!" I've always been fortunate enough to test well, so although I went through each question as slowly and deliberately as I could, I was still done with the entire exam (scheduled to last eight hours) in five hours. That included scheduled breaks. Of course the other nice feature of the individualized computer experience was that the breaks were optional. Instead of having to sit around for over an hour waiting until the lunch break was over and the afternoon session could start, I just went out and stretched my legs, then plunged back into it.

And here's the best part: I told the above pencil stories to the folks monitoring the exam, and they were so amused that they let me keep the dry-erase pens (2 of them!) they'd given me for the white board (which was actually a yellow sheet of laminated paper with the facility's name on it.)

So I am now the proud owner of a pair of dry-erase markers that only cost $575 apiece. I'll find out in 6-8 weeks whether I will also be the recipient of a nifty engraved certificate that doesn't expire until 2015. I wonder what the exam will be like by then.


At Sat Jul 26, 04:51:00 PM, Anonymous Anonymous said...

I so hear you. I still have one of those pencil sharpeners (still works, too) and miss those days. This last time was a real experience. It's all contract labor now, not like before when an actual doctor from the board attended. We couldn't even bring in tissues, had to use their (crappy) tissues when our noses started to run from the air condiditoning. As an added bonus, they didn't like my ID because it has my married name on it, same ID I've used for the last 25 years and 4 different exams. It never seemed to bother them when they were cashing my ever-increasing large checks all this time. Anyway, I have to wait outside until they call the board and find out this is in fact OK, until the test has already started, thanks very much. And now, for added outrage, you have to do the MOC's since apparently every 7 years wasn't enough money. I've completed two and they are the most collossal waste of time and money. I'm on the 10 year track so I'll only have to do the exam once more before retiring. Did I mention I've passed (easily) every time? It hasn't made me one bit better. Just bitter about the process and our so called professional organization who let this happen.

At Sun Jul 27, 01:02:00 AM, Anonymous Anonymous said...

Maybe not for the next one, but by about 2022, they'll just have links directly into your mind. You won't even need to think about the exam; they'll just make sure you have enough random information in your head. Of course, brain links would make the ridiculous price understandable.

At Sun Jul 27, 07:13:00 AM, Blogger cellar_door said...

In England we have to bring our own pens to any exam, and if it runs out/breaks you are given the most crappy, uncomfortable spare they can dredge up.

Is there a reason you use pencils so much in America? Just curious as we are not allowed to, everything has to be in pen...

At Sun Jul 27, 01:20:00 PM, Anonymous Anonymous said...

Brain links? Hey, don't give the &^%*ers any ideas. They'll try it if they think people would sit still for it.

At Sun Jul 27, 01:38:00 PM, Anonymous Anonymous said...

I took the test for the first time ever yesterday (and start my first real job tomorrow)

All my USMLE tests were in the same computer format, at the same Prometric/Sylvan testing centers. Most of my med school tests were in the same format on computers.

It was kind of quaint seeing the old guys and gals saying "wow! computers! What is this going to be like?"

At Sun Jul 27, 05:15:00 PM, Blogger Lynn Price said...

Damn, girl, you shoulda gotten to take the computer home.

At Mon Jul 28, 07:57:00 AM, Anonymous Anonymous said...

In 2015 the multiple choice format will be gone. You will be presented with a series of interactive patients similar to the clinical simulations now part of the Self Assessment Modules (SAM's) when you do your maintainence of certification.

At Tue Jul 29, 07:08:00 AM, Blogger Dr. A said...

My initial exam was with those ancient things called pencils. Yes, this was my first re-cert and it was an interesting experience. Thanks for stopping by blog to check it out.

At Tue Jul 29, 08:02:00 PM, Blogger Mother Jones RN said...

Maybe they will hook you up to Spock for a Vulcan Mind Meld. Thanks for that trip down memory lane.


At Tue Jul 29, 09:17:00 PM, Anonymous Anonymous said...

Wow -- the price for the certification (er, pencils; er, sharpeners; er, dry-erase markers) has gone up almost twice as fast as inflation!! According to the handy dandy inflation calculator at everyone's favorite website -- that of the Bureau of Labor Statistics -- $350 in 1989 has the same buying power as $617.62 in 2008. Check it out for yourself at

--Kensington MD

At Wed Jul 30, 01:30:00 PM, Anonymous Anonymous said...

Hilarious story - even if the underlying subject matter is nothing to laugh at. I could not imagine spending 575 on a pair of white board markers!

At Wed Jul 30, 05:43:00 PM, Anonymous Anonymous said...

It's only funny if you're not involved. Those of us who have been separated from our money at regular intervals for this nonsense don't find it so.


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