Sunday, September 30, 2012

Reassessment Day - 9.30.12 Sunday

What I've Learned So Far since 9.30.2012
  • Better Clinical Anesthesiologist -- Experience w/ cardiac cases, anesthesia for non-obstetric surgery on parturient
  • Meditating daily
  • More settled w/ job and w/ current living situation
  • More Financially Responsible - Balancing Quicken (Started paying student loans with own money :-) )
  • Starting LLC
  • Avett Brother Music :-) 
  • Radiolab
  • Louis CK
Everything You'd Like to Learn before ABA 2013
MINIMUM PASSING SCORE: 209
Your Scale Score: 187
Previous Scale Score: 148

  • Learn all Recalls Keywords - 2012 Part I Writtens & ITE Exams
  • ACE Exams (Goal 100%)
  • Hall Exams (Goal 100%)
  • Lock N Load Sheets
  • Equations Sheets
  • Review Sheets!
    • Consolidate Big Blue w/ ACE, Hall, Baby Blue info, & Oral Board Texts
    • LEARN NEW TOPIC EACH DAY! 
Topics I would like to Learn before Next Assessment:
  • Pharmacology Missed Keywords from ABA 2012 Part I Exam 
    • Drugs - to Finish from Big Blue
    • Diuretics MOA - Furosemide, Bumetanide, HCTZ
    • Renin-Angiotensin-Aldosterone system
  • Hematologic KW's missed from ABA 2012
    • Coagulation factors deficient in ESLD
    •  Von Willebrand Dz: Management
  • Regional KW's missed
    • Superficial vs Deep Cervical Plexus Block: Anatomy
    • Supraclavicular brachial plexus block: Cx
  • General Anesthesia KW's missed
    • Pathophysiology of neuromuscular diseases
    • Child-Turcot-Pugh score
    • Differences between causes of blindness - retinal artery occlusion, ischemic optic neuropathy, etc.
    • Lung Transplantation
  • Machines & Stats:
    • L.I.M. - equipment monitor
    •  Null hypothesis: alpha value
    • Unpaired t-test: Use
  • Cardiovascular KW's missed:
    • Cardiac tamponade: Dx
    • HIT Hx: Clinical implications
    • Mitral Regurg: TEE Findings
    • Myocard O2 supply determinants
    • CEA: Cerebral hyperperfusion synd

Reflections - 9.30.12 Sunday

To start of another project of "Study Harder, Not Smarter" -- And CONQUERING THE BOARDS!!!

Day 1 -- Take 1,000

What I've Learned In The Past Year.

Well, a year ago, I hadn't started my first job as an anesthesiologist attending yet.  I remember feeling apprehensive about it... about being the boss... about being the go-to person... the last resort if the CRNA couldn't get an IV or an airway... about hurting a patient... about knowing who to trust... about knowing enough even if I wasn't board certified yet... and have been having trouble getting board certified.

Well, I finally got the paper results of this second attempt at passing Part I of boards.  So it's true.  I have to take it again.  I didn't take it well... of course.  But I took it better than I did in the past when I've failed.  I did want to quit right there and then when I found out though.  I was with my mom hanging out at their house when HB texted me to tell me the results were online.  I was confident that I had passed.  I was getting ready to start studying for oral boards.  But when my mom checked.. and paused.. and looked at me sadly... I thought she was joking with me at first.  But it was true.  I took one glance... blurred vision... and I held my head and said aloud, "I don't think I can do this again."  I didn't cry.  Not just yet.  I only did when I saw my dad.  My mom had apparently told him, so he knew.  When he came down to see me... no words.  I knew by the sad look on his face that he knew the pain I was feeling.  He hugged me... and I cried.

The positive outcome of this... I feel I have a better relationship with my dad, for one.  But also... it gives me another chance to learn this information much better.  And this whole experience has actually made me a stronger person... a better person.. I think.  Things have always come so easily to me during my academic life.  Granted that hasn't been the case during medical school.  But I sought help... and in so doing... I'm becoming a better person overall... not just academically.  Furthermore... I get to take this exam with my true friends from residency.  At least have study partner friends... or at least the moral support.  So all in all... lemonade out of lemons.  I'll get through this.

I at least have a job.  I also finally had the guts to tell Fred, our group's president.  I teased him and said... well... Fred, you probably already know... but just to officially tell you... I've saved your group another couple hundred thousand dollars for another two years.  I have to take the exam again.  He looked a little sad for me.  I said I've always had trouble taking written exams.  His reply... you're not the first... and you won't be the last.  There are plenty of intelligent people who never passed their boards.   I understood what he said.  I already knew of it too... but him saying it did make me feel better regardless.

So now... back to work... on to what I love.  Because I realized that I do love my job.  With reflection and with these current events... I've finally come to realize that.  I am so lucky to have my job.  And I will continue to work hard to become the best anesthesiologist that I can be.  To become the best person that I can be.  10,000 hours baby!

As Cristina Yang from Grey's Anatomy said... when she was reflecting on whether to continue her career as a surgeon... "Would you love me if I became a plumber?"... Her doctor fiancee's response... "I would love you regardless... but would you love you if you were a plumber?"

I'm not sure I'd be happy being anything else but an anesthesiologist.  I love my job.  I see the importance of it.  I see that I am talented enough.. and "smart enough".. to do it.  And so here I go back into the trenches.  Onward I go.

Thursday, August 2, 2012

Reassessment Day - Post-Exam - 8.2.12 Thursday

List 1: Everything You've Learned So Far for ABA 2012 Preparation
  • Topics Learned:
    • Celiac Plexus Block si/sx
    • Stellate Ganglion
    • Ax Nerve Block
    • Cancer drugs
    • Resp equations
    • Flow Volume Loops
    • Pressure Volume Loops
    • TEG
    • AIP
    • Renal
    • Anterior Pituitary Hormones (F.L.A.T. P.I.G.)
    • Maximal allowable blood loss / EBV
    • Stats: SD/SEM, Type I/II Error, Statistical tests: Chi square test, t-test, ANOVA
    • Peds: CDH, Croup, Epiglottitis, Physiology numbers
    • Equip/Physics: Calculating O2 left, Mapleson circuits
    • Post-pneumonectomy pulmonary edema
    • Drugs - comparing NMBD & Sux effects on Burns, MG, Lambert-Eaton, MS, GBS
    • LaPlace's law
    • TNS vs Cauda Equina Syndrome
    • Drug effects on Intraocular Pressure
    • Dexmedetomidine
    • MAO of Drugs - Ketamine, Gabapentin, etc
    • Dibucaine number
    • TCA vs SSRI & CYP2D6 effects
    • Volatile anesthetics - CO poisoning, metabolism, vapor pressure, B/G solubility, effects of right main stem intubation, Ventilation, cardiac output
    • ASRA Guidelines on coagulation and neuraxial anesthesia
  • Hall MCQ's x 3 Rounds
  • ACE MCQ's 8A&B to 6A&B x 3 Rounds + ACE 5B & ITE 1996 Exam Book A x 1 Round
  • Reviewed all Hall MCQ's (except Peds & Neuro)
  • Review Sheets: OB, Anat/Reg/Pain, Resp, Neuro
  • Reviewed Jensen B 2011 Explanations
  • Hyponatremia
  • Airway anatomy
  • Some Lock'n'Loads
  • Better Clinical Anesthesiologist -- Experience w/ cardiac cases, anesthesia for non-obstetric surgery on parturient
  • IV Drugs
  • Improved or Stayed the same on All MCQ's (even without fully reviewing everything)
  • Meditating daily
  • More settled w/ job and w/ current living situation
List 2: Everything You'd Like to Learn before ABA 2013 - ITE & Oral Boards - February 2013
  • Review Recalls Part I 2012 & Recalls ITE 2012
  • ACE Exams (Goal > 80%) = 8A (59%), 6A (61%), 6B (63%), 5B (63%), 8B (72%)
  • Hall Exams (Goal > 65%)
    • Equip/Physics
    • Resp/CCM (41%)
    • Blood/Txf/Fluid (44.4%)
    • Volatile Drugs (47.5%)
    • Cardiovascular (49.4%)
    • OB (55.4%)
    • Peds (56.6%)
    • Anat/Reg/Pain (58.27%)
    • General (58.4%)
    • IV Drugs (60.5%)
    • Neuro (62.9%)
  • Review Sheets!
    • Work on Consolidating all ACE, Hall, Jensen Review, Big Blue, Lock'n'Loads, Baby Blue info
    • Do so in order of topics above (or as is most interesting).. but with goal to continue to LEARN NEW TOPIC EACH DAY!
  • Lung transplantation
  • Cardiac tamponade
  • Drugs - to Finish from Big Blue
  • Coagulation factors deficient in ESLD
  • Superficial vs Deep Cervical Plexus Block
  • Diuretics MOA - Furosemide, Bumetanide, HCTZ
  • Pathophysiology of neuromuscular diseases
  • Renin-Angiotensin-Aldosterone system
  • Child-Turcot-Pugh score
  • Differences between causes of blindness - retinal artery occlusion, ischemic optic neuropathy, etc.
  • L.I.M. - equipment monitor