* * Anonymous Doc: Bored of Boards

Monday, August 13, 2012

Bored of Boards

All anyone wants to talk about is the internal medicine boards.  I've been dodging a handful of phone calls and text messages from former and current colleagues who I imagine want to wish me luck but I'm afraid in doing so will happen to ask a question I don't know the answer to and make me freak out about which of the  two dozen heart murmurs we need to know the details of haven't quite stuck.

So many multiple choice questions.

As with everything that has come before, you end up building up such an anticipation about how much life will be when this test is done / when this rotation is done / when this year is done... but then you get to the end and, too quickly, there's a new next badness to replace the one you've completed.

Patient comes in with nausea, vomiting, nystagmus, ipsilateral Horner syndrome, ipsilateral palate and vocal cord weakness, and "crossed" sensory loss.  You correctly identify that he is suffering from lateral medullary syndrome, but before you can tell him, you instantly become unresponsive, apneic, and have no pupillary function.  Is an EEG required for your diagnosis of brain death, what kind of stroke caused the problem with your patient, and whose responsibility will it be to tell him once you have been wheeled to the morgue?

(A) Yes, hemorrhagic, neurology fellow
(B) Yes, vertebral, neurology attending
(C) No, hemorrhagic, resident called in to replace you
(D) No, vertebral, risk management officer


  1. E - Perhaps you should wait 48 hours, then order your own cerebral perfusion study to document lack of blood flow. You should probably send one of your medical students to inform the patient of his diagnosis.

    I unfortunately was already diagnosed with brain death many years ago.
    -Daily Medical Examiner

  2. This is brilliant! I'm going with C. Med students and residents are a dime a dozen-- completely replaceable as far as my attendings are concerned haha I took step 1 a couple of months ago and as soon as that was done, I immediately started obsessing over my rotations and shelf exams. Sounds like this cycle of hell never ends! haha Love your posts.