Sandtrap offers perfectpractice for Iraqi desert

March 1, 2009

Your putt, Bob. You know,this is the best CME courseI've been to. I'm sorry it'sthe last day.

Your putt, Bob. You know, this is the best CME course I've been to. I'm sorry it's the last day.”

“I know. My room's fantastic. “

“And dinner every night has been a poem.”

“Not to mention the spa, which has been heavenly.”

“The conference rooms are also very impressive.”

“Really? You've seen them?”

“Sort of. As I was signing in this morning, the doors opened briefly and I got a peek inside.”

“You've been signing me in every day, too, right?”

“Yes. They have a CT Body conference next year at the Ritz.”

“Think it will be worth it?

“Yeah! It's 28 hours of CME.”

“No, is the golf course there worth it?”

I love reading the perp sheets from state medical boards of doctors disciplined for specific crimes. (What is it with podiatrists and the whole foot fetish thing?) The number of physicians having their licenses suspended for CME problems always catches my eye. The most famous was Dr. Sean R. Tunis, chief medical officer for the Centers for Medicare and Medicaid Services. The Maryland Board of Physicians suspended his license for a year and fined him $20,000 for reporting CME he had not earned. Ever sign in for a CME conference, then go golfing or sightseeing? One doctor had his license suspended after being turned in by one of his hospital colleagues. Ouch, that hurts! But maybe not as bad as what the state boards have prepared for you next. More about this later.

In December, I had to take the recertification exam for my Neuroradiology certificate of adequate qualifications. I love learning about radiology, but when I actually have to study for a critical test, things get weird.

When I received my certificate in 1998, recertification was 10 years off, so I had lots of time to study. Then I had eight years. Then five. Pretty soon it's three years. I should probably start studying for real-next month. Suddenly, I have only a year left. Six months later: Yikes! How did time fly so quickly? I seriously need to start- next week. Now only three months. THREE MONTHS!? I had procrastinated too long.

So I sat down at my desk with a stack of textbooks-only to notice that the carpet had not been vacuumed or the desk dusted in who knows how long. Can't study that way. After several hours cleaning, I was now really ready to study.

But first I needed a snack. Which is when I noticed the state of the kitchen. After washing the dishes, cleaning shelves, waxing the floor, defrosting the fridge, and alphabetizing all the food in the cabinets, I was really ready to study. But then I took out the garbage and noticed the garage was a mess. A few weeks later, the garage was spotless and totally organized.

Suddenly, I had less than 30 days to prepare. I took comfort in the thought that I could take the exam twice a year for three years before they refused to recertify me. This was not so bad. Take the test, get a sense of the exam, and then study afterwards. Cool.

I took it at the RSNA. I knew I had failed. I left after only an hour and 15 minutes. I didn't feel that bad, however, since I had turned it into a win-win situation. I had told God that if I passed, I would go to Iraq to help people. So if I failed, that was actually a good thing. Believe me, I walked out thrilled that I didn't have to go shopping for a bulletproof vest and steel codpiece.

Once home, I did hunker down and begin studying very seriously. I was motivated by an article I had read in the August 2006 issue of Scientific American called “The Expert Mind” by Philip Ross, as well as a book by Geoff Colvin, Talent is Overrated. Both share the same argument, that talent is overrated.

People become experts-in sports, science, music, or finance- by applying themselves over a period of 10 years/10,000 hours. This is not the passive approach where you reach a certain comfort level and relax. No, this application is characterized in Ross's article as constant “‘. . . effortful study,' which entails continually tackling challenges that lie just beyond one's competence.”

Most of you reading this have lifetime certificates from the ABR, so you needn't worry about recertification exams, right? Wrong. You see, the Federation of State Medical Boards in May 2008 adopted proposals to require all physicians seeking relicensure to demonstrate competence by passing an exam not more than every 10 years.

An AMA News article from Dec. 24, 2007, quotes licensure committee chair Dr. Stephen I. Schabel, a radiology professor at the Medical University of South Carolina in Charleston, as saying that some boards are eager to do it.

“It's not going to be a burden. It is going to be good for everyone,” he said. If it is easy to do, then they probably aren't doing it right. Requiring patient satisfaction surveys and documentation for performance accountability looks pretty hairy. Still, I have drunk the Kool- Aid; I am totally on board. Nonetheless, the hard studying of the past weeks has convinced me I can do a better job. I have even signed up for the general radiology MOC (maintenance of certification) exam despite the fact that I have a lifetime certificate.

Oh yeah, I forgot. About 30,000 of us with lifetime certificates are going to see those certificates evaporate when we try to get relicensed in our states soon. Now's probably a good time to sign up for some CME courses-and plan to actually sit through them.

I finally checked the ABR results. I passed. Dammit, I was going to friggin' Iraq! I immediately called the ABR. I explained about my deal with God.

“Did you tell God when you were going?,” the ABR woman asked.

“No.”

“Did you tell God how long you would stay?”

“No”

“Well then. No problem,.”