Reduced to a number

-or- a bitter pill

Now that the match is over, and I have successfully secured my place of training for the next six years, I have a confession to make.

I didn't do terribly well on step 1 of the USMLE (United States Medical Liscensing Exam), aka 'the boards".

Oh, I passed, no question. And quite comfortably too. But I was not in the 99th percentile. There are lots of reasons I could toss out: um, 3 kids, our foster daughter chose that week to run away (for the first time, which was hands down the most stressful of the three), I was working on my thesis and had just finished preparing for and giving a major podium presentation at the AUA (American Urologic Association) meeting. Or, simply it could be that out of some of the 50,000 most intelligent folks in the US (not from the US, just in the US-lots of brilliant foreigners) there are quite a few who are smarter/better test takers than I am.

Whatever the case may be, I passed, with plenty of room to spare. I was pleased, considering how stressful that week was for me (for us!).

But when it came time to apply for residency I suddenly was reduced to that number: my board score. It didn't matter that I had a publication in the major Urologic journal, nor that I had given a podium presentation at the national meeting, that I had done a year of research, or any of my activities outside of school that, to be less than modest, I feel made me a pretty unique applicant. Nope, most people wanted to reduce me to a three digit number. Suddenly that was the key indicator to what kind of doctor I would be. Ignore all the "Honors" grades I received on my clinical rotations. Forget all the comments from attendings about my patient skills, my work ethic, etc. Focus on that number. That became me.

Frankly, it pissed me off. Fortunately there were programs who saw past that number, offered me interviews, and eventually a place at their program based on the strength of my application and interview as a whole. For that I am extremely grateful (thanks Dartmouth!!! You guys rock!). But perhaps the one that hurt the most was the one closest to home.

After spending a month, busting my butt on the Urology service here at Duke (that aside from all the time I spent working with them the year prior to that) I had my Duke interview. The chair of the Urology department, during his interview with me, decided that my board score was all that mattered. It didn't matter that I spent a good portion of my month working with him, in the clinic, in the OR, going out of my way to work with difficult patients so he didn't have to, tracking down numbers, contacting families, etc. to take care of his patients. Apparently that wasn't important. It didn't matter that he knew how hard I work, how well I got along with all the attendings and residents. All that mattered was that number.

In the end, it resulted in my not matching here at Duke. I am quite glad, as I don't think I would want to spend the next 6 years working for someone who "really liked [me], but that board score. . ."

Instead, I will be spending the next 6 years working with people who just really liked me, and refused to reduce me to a number.

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