Savage.MD Blog

Today I took my 8-hour initial certification exam for ABIM. This marks 10 years of me taking secure, high stakes exams for medical licensure. June 2011 - USMLE Step 1 October 2012 - USMLE Step 2 CK December 2013 - USMLE Step 2 CS October 2020 - USMLE Step 3 (2 day exam) August 2021 - ABIM Certification Exam In total, the exams above cost > $6,000 in registration fees over the years to take. And if you include the prep materials (USMLE World Question Banks, MKSAP, First Aid Textbooks, and a Doctors in Training Review Course for Step 1), it probably brings the grand total closer to $10,000. It costs a remarkable amount of money to get Certified to practice medicine.

The past two months I've been studying every evening and most weekends for a big test that's coming up next Monday. It's the certification exam in Internal Medicine for the ABIM. It cost nearly $1,500 to register for this test, so I sure do intend to pass it on my first attempt! I told one attending this week that I would be taking my Board exam next Monday. He simply shrugged and said "Well, don't worry too much. It's just a rite of passage." Clinic has been going well. I had two different patients in clinic today compliment me on my explanation of their disease and our plan for their care. They were genuine with the compliments and it meant the world to me. It's nice to get affirmation that I'm having a positive impact on the lives of others. Oncology is really a special field and I'm glad to be a part of it.

Consistent health insurance/coverage is vital for every person.  I think it is a shame that for so many people, myself included, health insurance is intricately linked to employment.  I have seen on far too many occasions the challenges that cancer patients face in getting care when they either do not have consistent health coverage or experience a lapse in that coverage.  This seems inappropriate in a country as developed and wealthy as ours. Can you imagine being midway through cancer treatment and then losing your job because your cancer makes it impossible for you to work?  I recently saw this happen to one of my patients.  I imagined myself in his/her shoes.  It would be incredibly stressful to wonder if your next scan or treatment will be covered.  This is exactly the situation that can lead people to financial ruin.  It's an inappropriate stressor to place on someone who is already incredibly stressed. In my ideal world, I would hope that a...

I don't think the importance of lab and imaging results can be overstated, especially for a patient with cancer.  I was reviewing patient charts last night for today's clinic. Part of this involves checking for new labs and scans. Some people had great responses to treatment, while others did not. I took notes and prepared mentally for the conversations we might have in clinic today. I tried to imagine what it would feel like to be the recipient of this news, both good and bad. I tried to anticipate the answers to questions they might ask, which inevitably and appropriately includes "What's next?"   I like to start each conversation by asking "Have you seen your report of your recent scans?" In the era of open access to the electronic chart, many patients have. In which case then I ask, "What questions do you have about it?" I pull up the scans and walk my patient (and their family members) through the pictures. We discuss the newest labs, too....

I've now officially been a hematology/oncology fellow for two months and it has been a great experience. Each day reaffirms that I made the right choice with this speciality. Internal medicine is expansive, and I've enjoyed the opportunity to focus deeply on one just set of problems - namely blood disorders and cancer - for the past two months. The relationships that I've begun to establish with faculty, peers, and patients are really rewarding. The past two months have also been busy with studying for the ABIM board exam, which I will take two weeks from tomorrow. Passing it will allow me to become a board-certified internist for the next ten years. I've done well over 2000 practice questions and have studied every day since late June. It will be nice to have this milestone behind me so that I can whole-heartedly focus on learning the field of hematology/oncology moving forward. On a personal note, it's now been nearly three months since my father abruptly died of ...