A hematologist prepares for the internal medicine boards
Generally, one would expect 3 years of internal medicine residency training to more than adequately prepare you to pass the American Board of Internal Medicine (ABIM) certification exam. Since everyone has to spend at least three years in post-graduate training before being eligible to sit for the ABIM exam, a funny thing happens if you ’short-track’ through medicine residency (ie, train in medicine for 2 years instead of 3) and end up spending a year in fellowship thinking about almost nothing related to general internal medicine for a full year before you’re allowed to take the exam: You forget a lot of things! Regardless of whether you short-track or go the long way, I suspect most people don’t have a lot of time to dedicate to studying for the boards. I’m no different, so I’m hoping my past year as a hematology fellow will help me in some regards. Here’s my strategy for the ABIM exam:
Infectious disease - Everyone can be treated with a fourth generation cephalosporin or carbapenem, right?
Neurology - Headache? Intrathecal methotrexate ought to take care of that.
Cardiovascular - We don’t deal with much cardiology in hematology, but since I was trained at Stanford, anyone with chest pain has takotsubo until proven otherwise.
Pulmonary and critical care - Is “Initiate goals of care discussion” an option?
Nephrology - Acute renal failure? If any of the answers involve $18K worth of rasburicase and giving you enough IV fluid to drown a Guatemalan polo player, I’m all over it.
GI - The gut is a black box (er, tube) from which blood sometimes emerges in various forms. “Check platelet count and coags (and for good measure, a complete iron panel) and then call a gastroenterologist,” better be an answer.
Rheumatology - I’m not too worried, since I’m pretty sure answers A-E will be “Predisone.”
Endocrinology - Hemochromatosis causes all endocrine abnormalities in my world. Hope phlebotomy is an option on the test.
General internal medicine - I could really be in trouble here if “Refer to primary care for diabetes and hypertension management” isn’t an option.
Heme-Onc - Been there, done that. (Well, half of it, anyways.)
Yeah. Everything is going to be just fine.
