After you take your psychiatry oral boards, you are faced with a period in which you have only your own thoughts about your performance to fall back on. And for most psychiatrists those thoughts are not positive, usually focused on all the performance shortcomings. You may pass or you may fail, but you won’t know for 2-3 weeks. And it is these weeks of waiting I wanted to talk to you about today.
My thoughts on this topic were prompted by an email I received from a psychiatry oral board candidate. She wrote me:
Candidate’s Comments While Awaiting Her Board Exam Results
“I don’t believe I put forth a passing performance…..my anxiety choked me yet again. I am now awakening from a dead sleep shouting “gabapentin…gabapentin…..thiamine…folate!!!”
“I hope the trauma reaction clears soon and I can once again tolerate solid food ….
“I will likely be seeking admission to the next course…does Jack recommend taking the year to prepare, or, alternatively, getting back on the horse and riding as soon as the ABPN can accommodate me? I am kind of afraid of horses now…..not unlike little Hans.”
Jack’s Response About His Own Board Exam
I can totally relate to this candidate’s reaction. On my last oral board exam – the one I actually ended up passing – I had a case of of a woman with OCD and an eating disorder. The patient was not responding to her SSRI. During my presentation, when asked what to do next, I said that she deserves a trial of clomipramine. The examiner asked me what issue specific to this patient would be of concern in starting the clomipramine.
Since the patient had a hx of a suicide attempt, I said that the concern was the risk of lethal overdose since clomipramine is a TCA, lethal in overdose. The examiner nodded and said “our time is up.” As soon as the door shut behind me I thought “seizure risk!” since clomipramine has an elevated seizure risk as compared to other antidepressants. I was so sure I was going to fail, I drove around the rest of the day in my rental car in the Massachusetts’s country-side (my exam took place in Boston) feeling a dark gloom. The weight of that day was oppressive as I burned up the hours until I had to go to the airport.
I was relieved to find out a month later that I passed, but to this day am not sure I deserved to given my failure to mention the seizure risk in the context of an eating disorder.
I’m not sure there are any lessons for you here. Perhaps I would say, if you are feeling gloomy as you await your exam results, know that you are not alone. For some people those weeks of waiting are actually emotionally harder than the weeks after learning that they failed the exam. At least with the results known, the healing can begin.
And the second, possible lesson is that even if you feel your performance was lacking, that doesn’t mean you failed. Sometimes the hardest judges are the candidates themselves.
Last, the good news is that the ABPN now provides results much more quickly than in previous years. For the psychiatry part 2 boards, the wait is 2-3 weeks as compared to the 4-6 weeks common when I took my boards.
That’s it for now. Take care and I’ll have another post next week.
Take care and
Happy Studies
Jack Krasuski, MD
877-225-8384
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