Fear and intimidation:  these two words should not be found in the same sentence as “testing for competency”.  Most of the time, though, they go together.  Last weekend, I had the opportunity to take my recertification exam in gynecology–something we periodically have to do, just as all medical specialties do to assure continued competence.

The good news is that I didn’t have to fly to Houston, dress up in a suit and present cases to a panel of scary-looking examiners (the ones who literally wrote the books!) for as long as they felt like grilling me.  No, that just happened the first time around.  This time, I got to drive up to a computer testing center in Princeton and take the exam online.

One thing you need to know:  I hate standardized testing.  I came of age in a school that fostered writing, so we rarely had multiple choice tests–mostly, it was lots of papers, lots of essay exams.  I love these—give me a chance to explain myself and I’ll do fine.  Give me three or four little circles to mark, and I’ll often overthink the whole thing.  I even prefer oral exams to written ones (thank goodness that one of the few oral exams we had in med school was in obgyn!).  Also, remember that this test in Obgyn is given by my conventional accrediting body, which expects a conventional answer to their questions.  As all of us who practice holistic medicine find, it’s  really tough to read a case scenario, be presented with 4 options and asked to choose “the best answer” when what we know actually works best isn’t even listed.  But I digress…

So, the morning of my test, as I drove to the testing center, I imagined that I was taking the board certification exam for the ABIHM, my integrative holistic medicine board.  We also use testing centers now, but traditionally, if you take the exam at the end of our review course, here’s what it’s like:  we offer breakfast for examinees.  (Can’t think straight on an empty stomach).  Once the paperwork is all passed out and we’re ready to start, everyone stops, closes their eyes and does a brief centering exercise.  (We know that this gets us out of our amygdala, the part of our brain that handles “fight and flight” and gets us up into our cerebral cortex, where our verbal skills, math skills and cognitive memories lie).  As the exam progresses, we quietly show beautiful slides of nature on the screens at the front of the room, so if you look up to take a break, you see something calming.  (And many of those photographs were taken by a dear friend, at a retreat center in Molokai, HI, which is dear to my heart).  And, if you need a break, there are massage therapists in the back waiting to give you a chair massage.

The ABIHM only has one more opportunity to give our exam, as the certification will be taken over by the new ABoIM.  I’m not sure what their testing environment will be like, but I’m hoping it will be humane.  When I reached my testing center, about 20 of us were waiting to take a test; mostly, different tests all being held at the same time, so I didn’t even have a comrade to commiserate with!  Here’s what it felt like:  two picture id’s, take my photo, scan my palms, send me back to the testing room.  Scan palms again (hey, I walked around a corner and went about 4 feet, you never know what might have happened!).  Sit at a cubbie, my back to the glass wall so we can be observed, a security camera aimed at my face.  Interact with the computer, and when the test was done, scan my palms again!

But as I started the test, I closed my eyes, breathed through my heart and remembered the words of the proctor the very first time I took my holistic medicine boards:  “Remember that you already have everything in you that you need to do well on this exam.  You are enough”.  Thanks Bob!

PS.  Only good thing about a computer exam:  I knew in 48 hours that I had passed.  Whew!