What an amazingly beautiful day. I woke up with a quiet sprinkling of rain drops on our bedroom window, when I walked out the door I was greeted with a vanilla sky with a shining sun, rays bursting through the clouds. That's how the whole day went, the patients came in on time, things moved silky smooth. My fellow residents joked around in between patients and things just seemed uncharacteristically optimistic. I had a patient come in with text book illness, which shows just how odd the day was...there is no such thing as text book illness. We read about diseases, but they don't read about themselves, it's a very rare day when you get a patient that presents exactly like a test question.
A 6 year old male previously healthy presents with a 6 month history of behavioral changes and pica (eating odd things). He lives in a house built before the 1970's that has lots of pealing paint. He likes to play outside in the dirt, unsupervised.
Uhh...is the answer B. High Risk for Lead Poisoning?
So rare does it happen that I really didn't expect the lead level to come back abnormal...but it did. That's how the whole day was...uncharacteristically perfect...but then I checked my email...I hate email. We had to take an "in-service" exam the day we entered residency. It's a test that checks to see if your knowledge base is adequate enough that you will likely pass your pediatrics boards at the end of a 3 year residency program...there is a 30% chance that I will fail. Damn...
I'm not exactly worried about it. I've never had a problem passing tests, but from time to time I get caught with my pants down...the day I took this test was one of those days. I just wanted to squash the rumors that I'm perfect ;P in case any were floating around...this isn't the first test that I have failed to pass. I often do very well on exams, but this would be my 5th "bad" test in my 9 years of upper level schooling. I remember every one I've done poorly on and there isn't a one that I look back on and say "Gee that was a great life lesson!" Nope every one of them depresses the hell out of me, regardless of all the rationalization I throw into my fire of disappointment, it never seems to quash the flames. I know I'll pass boards. I've never failed a standardized test and my board scores (the tests you take at the end of medical school) predict that I have a >90% chance of passing the pediatric license exam at the end of residency, but I still feel like an idiot. They aught to have a class on failing before you start college, because knowing how to get back on the horse is almost as important as learning how not to get bucked off in the first place. I don't know if this is great advice to those in similar situations but here's what I do.
1. I try not to freak out about my bad performance. I do something that relaxes me for a bit.
2. I then tear apart the events leading up to the failure until I have a good understanding of what caused the it (ideally that's #2 but I've usually been doing it for awhile before I find time for #1).
3. I work on any weaknesses that I spot from #2.
4. I try like hell not to make the same mistake twice.
I've always thought that if you follow those steps...especially #4 that you can close your eyes at night with a clear conscience...that's the only thing that puts me at peace when something like that happens...that and a couple beers when I get home. Alright...it's time to study : )
Newbie Doc
