Board Eligible

We've spent many blogs elaborating on the practice of medicine in Kenya, quite different than our US training. However, I would venture to speak for all four doctors to say that we are very grateful for our US education none the less. Perhaps we never learned how to manage malaria and typhoid, pull worms out of bowel, or laser parasites growing on the retina, but we learned a lot about critical thinking, surgical skills, etc. And a US medical license will open many doors for us in the future, as it is recognized in almost all countries (not true for the reverse--Kenyan doctors, for example, need to take 3 expensive and difficult tests, then redo an entire residency before practicing in the US). So. Now the issue is...getting or maintaining that US medical license. Harder than it sounds for four doctors living in Kenya.

Every medical field has a different way of "board certifying" their doctors. Eric took a written test when he finished residency, passed it, and voila. Board certified. Jason took a written and oral exam before leaving the US. John has already needed to fly back to the US once for his written exam, and will likely need to fly home one more time next year for the oral exam. Me? I took a written exam prior to our departure for OB-GYN, but then comes part II. I'll take my oral exam in front of a panel of examiners winter of 2011-2012, but in the meantime I have to collect something called a case list. Basically, I need to record every surgical case and every hospital admission I take care of for 12 months. I think most OB-GYN's case lists would look something like this:

Normal delivery

Normal delivery

C/S for failure to progress

Normal delivery

Endometrial ablation

Normal delivery

So far, my case list looks like this (after 10 days):

Failed VBAC, repeat C/S

C/S for fetal distress

Hospital admission for abnormal uterine bleeding w/ Hgb of 4

PPROM at 28 weeks, chorio, induction

Hospital admission for metastatic choriocarcinoma and likely brain metastases

Cervical cerclage for 3 2nd trimester losses

Repeat C/S

I could go on, but basically what this means is that my stuff is weird, rare, and there's a lot more of it than an average OB in her first or second year of practice. I'm a little wary of this oral exam.

So once we're all board certified and such, then we need to be RE-certified. This means that every few years we need to prove to our respective boards that we are not just a bunch of hacks, and we've maintained all our medical knowledge, and we are safe to take care of patients. Alright, admittedly, this is not a bad idea. But for Jason, for example, he needs to log on the internet all the surgical cases he's doing. Because he's in a supervisory role, he does probably in excess of 5 cases per day, far more than the average general surgeon in the US. And because the cases are all weird (removing sacrococcygeal teratomas from babies and ex laps for bowel obstructions due to worms and the like) and our internet is slow, it takes about 20 min per case to log these procedures. Sigh.

All this to just give a glimpse into the other side of medicine, just in case you were curious.