I paid a lot of money to fail the oral board exam in emergency medicine. Somewhere north of a grand – American dollars. I had no expenses to get there because we still lived in Chicago. I just drove over from the inner drive (Marine Dr.) to the O’Hare Marriott. Taking it again will be much more expensive.
Since then we moved to California and I have flown to Las Vegas for Pennsylvania ACEP’s Oral Board Review (over a $1,000) this spring (flight and hotel $700). I bought the Rivers CD’s (7 of them) and books which cost over $450. I bought the “Emergency Medicine Oral Board Review (Pearls of Wisdom) by William Gossman and Scott H. Plantz for $50. A tutor in Chicago (Dr. Weber) is charging $1,200 for 9 hours which I pay plus expenses coming from the west coast ($600). Flying to New York for the Long Island Jewish review course of two days was $1,500 plus flight and hotel ($600). And ABEM (American Board of Emergency) charge over $1,000 to take it the damn thing again.
So, for the pleasure tonight I saw a 1yo baby girl with a broken arm after a stay with the babysitter. A ventricular fibrillation (Vfib) arrest in a 49yo (year old) man who likely had alcohol withdrawal seizure, aspirated, arrested and sustained anoxic brain injury. A woman with known nasopharyngeal CA (cancer) now coming with pancreatitis and a sodium (Na) of 116, a seizure disorder and nausea with vomiting and low dilantin. A chronic COPD (emphysema) patient with worse SOB (short of breath) with new onset atrial fibrillation with rapid ventricular response (Afib RVR) unresponsive to diltiazem (what would you do next?). A pregnant 16yo girl screaming and wailing in pain who had a UTI (urinary tract infection). A woman who had a tooth pulled today by her dentist and came because her Tylenol 3 was not saving her from the experience of pain had a blood sugar at triage of 375. A 6 year old had her abdomen irradiated (with a CAT scan) because she had fever, vomiting, and had RLQ (right lower quadrant) pain and tenderness. A healthy appendix was revealed (for about how many thousands for the CT?). A prisoner swallowed a razor blade that stuck in his throat (that will show them!) and went to the OR with ENT (ear nose throat – they prefer ‘otolaryngologists’). Another guy had a boner for 3 days (priapism) while in jail. I cannot make this stuff up. He had his bulbous cavernosa injected with phenylephrine.
And many, many, many more – in an 8 (read 10) hour shift. I got shit, puke, blood, and cervical pus on my gloves, and I stepped in human urine, and smelled many foul smells. My coat stayed clean tonight. I am glad because my pregnant wife refuses to wash it. For the pleasure I will bring home after taxes and insurance about $700. I don’t expect you to shed tears for me, but just don’t think that EPs (emergency physicians) are just thrown loads of money for nothing. Hey, I am still $100,000 in debt for just getting educated to this point, and my parents helped me tons financially.
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