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Reflections from “The Boards”

Every year in February, 250 or so urologists make the pilgrimage to the Dallas airport to take the Urology Certifying Exam (a.k.a. the Oral Boards). This ranks as one of the strangest events in my life. I felt it appropriate to share my experience.

My trip to Dallas begins with a very sincere “good luck on your test daddy” from my 5-year old daughter. This makes me feel great, until I realize I am less than 24 hours from actually taking the exam. My stress level now starts to rise. As I board the plane in Portland, ME, I see one of my patients. I am pretty sure that I operated on her, but since my brain is crammed full of (now in hindsight) useless information, I cannot remember any details about her. I avoid all eye contact and quickly take my seat. By some miracle, I have the exit row all to myself. Is this a good omen? I feel slightly better until my second flight is delayed on the tarmac for an hour. Nervousness ensues.

I check into the hotel, which is conveniently located at the airport. My room isn’t ready yet, so I wander into the lobby, which is filled with other nervous urologists who are waiting for their rooms. They are all quizzing each other on case scenarios. This doesn’t help my anxiety, so I flee the area. Things become very “real” at registration where all of the other panicky urologists are crammed into a small ballroom. This exam is actually going to happen. I cannot back out now. To make myself feel better, I mock those wearing suits and ties. Who are they trying to impress? I am much cooler than them. Unfortunately, no one passes the boards for being cool. Maybe I should have put on a tie.

It is now t-minus 1 hour to exam time. My brain goes totally blank. I am convinced I have forgotten all of urology. I wonder if my hospital will hire me as a scrub tech. My stress level is now off the charts. I take my first exam – only took 45 minutes. Is this good or bad? I am convinced that I failed, but take solace in the fact that everyone else feels the same way. We are sequestered after the exam for 2 hours. There is nothing else to do, so we all end up talking about the exam. This doesn’t help my anxiety. For the rest of the day, I think about things I should have said during the exam. This again convinces me that I have failed.

As I walk down the long corridor (nicknamed the Green Mile by the staff) to my exam on the second day, all of the examiners are standing in the hallway with half smiles on their faces. What does this mean? Unfortunately, day #2 does not go better than day #1. I now realize why they are all smiling. I am now thoroughly convinced that I have failed. I wonder what I will do when I lose my job. I will need to modify my CV to apply for the scrub tech job. Not sure what else I am qualified to do.

Twenty-four hours later I am slowly relaxing. I try to put things in perspective. The numbers (90% pass rate) tell me that I probably haven’t failed. I am thankful for the colleagues that I saw this past weekend and for new connections that were made. Seeing all of them and sharing this experience confirms why I love urology and can’t see myself doing anything else. We are all blessed to be able to take care of patients and improve their lives. I am looking forward to returning to work tomorrow to get back to being a doctor. And I can’t wait to see my daughter and tell her that daddy did his best.


Matthew Hayn is an attending urologist at Maine Medical Center in Portland, ME and an Assistant Clinical Professor of Urology at Tufts University School of Medicine. His views are his own. @matthayn


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2 replies
  1. Matthew Bultitude
    Matthew Bultitude says:

    Isn’t it odd that we have to take significant career-defining exams at such a late stage such that many, like yourself, will have children who understand what it is that you are doing. What do you say if you have failed ? … and what happens to those who fail again. In the UK, we only get 3 attempts – imagine the pressure 3rd time round having spent all that time in training. And what do you do if you fail … maybe you are right, scrub tech it would be !

  2. Ananda Kumar Dhanasekaran
    Ananda Kumar Dhanasekaran says:

    How much the kids miss their exam going dad or mum is phenomenal. Sometimes it’s difficult to think from the kid’s point of view. All they understand is dad or mum is busy in their own job.

    It’s important to start preparations for the exams as early as possible, so that some quality time with the kids is maintained. It will be a good break in monotonous exam preparation. Support from the spouses (if they are not exam going !!!) in taking care of kid’s wellness is important.

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