One month ago I sat for my oral boards for final certification by the American Board of Radiology. This exam represents the final hurdle in what is (normally) a decade long road after college. It should be 4 years of medical school, then 5 years of residency and one final year of independent practice. During this time, you take innumerable exams: the USMLE Steps 1, 2CK, 2CS and 3 followed by the ABR radiation physics and biology exam, then written clinical exams, followed at last by the oral boards.
I found it interesting that during the time leading up to residency (during undergrad), we have been selected based on who performed the best. This includes striving for As in college (and high school...), the highest #MCAT score you can manage, and then doing as well as you can on 'the Steps' so as to assure the residency you desire. Once you make it to your speciality training however, this turns on its head. The desire to perform your best is replaced by the abject fear of failure. This fear basically ramps up higher and higher until by the week before the oral exams, everyone in your discipline is just standing at the edge of the abyss of self-doubt (at least I was).
The change is from filter to pump. At the beginning, the desire is to filter folks out, but once the desired level of rarification is reached, they don't want you to fail any more - they want to pump you through. It was a long road, and one which I am extremely happy to be done with.
I will resume this stream next week with an update on my research and what I think is a nice result about stem cells and phylogenetic trees...
A final thought. I was speaking with a friend and mentor of mine recently about the transition from resident to faculty. He said when you finish residency you feel like you've finally climbed to the top of the mountain. But, in academic medicine, you realize that the mountaintop that you just summited is actually the bottom of an even bigger one. Now you are no longer competing against your peers and co-trainees, but instead you are competing against those who trained you. In the ridiculous funding climate, this is a hard truth. So, while I feel good to have gotten to where I am, the climb is just beginning.
