When one becomes a physician, there are a number of very painful, very long, and VERY EXPENSIVE exams that you must take to ultimately become a legit board-certified doc.
It all starts in medical school, when you take the first 2 exams of the USMLE (United States Medical Licensing Exam) "boards". The first exam tests mostly basic science knowledge...i.e. things you really don't need to remember to treat patients. The second exam tests clinical knowledge of ALL of the major medical specialities (Internal Medicine, Surgery, OB/GYN, Psychiatry, Pediatrics). And beginning in the past couple of years, medical students are now required to take another interactive "clinical skills" portion of the 2nd exam, in which you have to interview "patients" (actors who are pretending to be sick), examine them, and come up with diagnoses & treatments. I, very fortunately, did not have to take part in this. (Though I was forced to participate in the pilot, experimental clinical skills exam by my medical school).
The fun really begins once you begin your post-graduate training (aka "Internship/Residency"). Not only do you get to work super-long hours, be sleep deprived, have no social life, and get paid very little for all of this, you then need to take the third (and, thankfully, final) exam of the USMLE "boards". Only after all three steps have been taken (and, I should also say, passed) can you apply for a medical license.
Ok, so now you're wondering, "what the rush? why do you need a medical license anyway". Well, the short answer is: You can't practice medicine in ANY state without a medical license. Internship/Residency is a little different. Since you're still technically "in training" (i.e. you're a student in a hospital), the hospital essentially takes responsibility for everything that you do, so you're technically not practicing medicine by yourself. Technically, the "attending physician" (i.e. your master) is the one practicing medicine and telling you (i.e. the slave) what they want you to do. However, once you inevitably graduate for Residency, you have to start taking responsibility for yourself. And, as a way to monitor your actions/behaviors and make sure you're not doing anything crazy/bad/negligent, each US state has their own "Medical Board" that you must register with if you practice in that state. The process is basically bureaucratic, involving a lot of paperwork and, of course, MORE money.
Ok, so now you're a licensed physician in whatever state of your choosing. You've also graduated from a Residency program of your choosing and can start practicing anywhere you want. So, why am I still talking about "Boards". Because being "licensed" only means that you're generally legit; it does not specify legitimacy in a specific medical field. Hence, the term "board-certified". This is what you read on ads for various docs in the subway ("Dr. Zizmor, board certified in dermatology, he'll give you a beautiful face again without any surgery!!") or when you're looking through the panel of docs who accept your insurance (ex. Dr Kindheart, Board Certified in Internal Medicine & Cardiology).
At this point in my career, I am a licensed physician in the states of New York and New Jersey. Once I finish my fellowship in child psychiatry this coming June, I can even start seeing patients on my own. However, in this day & age, it is not good enough to just be "licensed". You must be board certified. For insurance purposes and for bragging rights.
So, getting back to what I said at the beginning of this long explanation, I will be taking the first part (of two) of my American Board of Psychiatry & Neurology (ABPN, for short) board exam in a little over a month. This exam is BY FAR the most important exam I will take to date. It's no laughing matter. It's given once a year, it's SUPER expensive, and I don't want to take it more than once! So, this requires some serious studying. For those of us lucky enough to be in the NYC area, we are fortunate to be able to easily enroll in the NYC-based Psychiatry Board Review exam course given by David Kaufman & colleagues. Sure, you pay a chunk of change to take this course, but if it improves your chances of passing by even several times, it's worth it.
Here's the kicker...the entire course takes 5 full days (8:45 am to 5:30 pm). It's high yield so you pretty much have to pay attention every second of it. After being out of school for a number of years, thus not being used to sitting in a big lecture hall for several hours per day, it's an exhausting, brain-draining experience. The worst part is that the course runs from Friday to Tuesday meaning that a VERY LONG weekend is occupied taking this course.
Nonetheless, despite being exhausted and nearly brain dead now after the past 5 days, I feel about 100 times more prepared than 5 days ago. I'm giving myself a couple day "brain rest", and back to studying it is!
Wish me good luck!!
