I Failed the Boards…Twice.
And it was one of the best things to ever happen to me.
In the summer of 2013, after successfully completing my medical training, I boarded a one-way flight from San Francisco to my hometown of Jackson, Mississippi, to officially begin my career as a pediatric rheumatologist. By returning to my home state, I would double the number of practitioners in this very specialized field to a grand total of 2 for the entire state.
As the first day of my “all grown up, big girl job” approached, I became more and more excited, like a child who can’t wait for the first day of school. I purchased a new work bag, crisp slacks & chinos, fit & flare dresses equally professional & stylish, and shirts that didn’t have to be ironed (because who has time for that, right?). I was also gifted, by a very special group of friends, a turquoise iridescent stethoscope that remains one of my most prized possessions. I was finally ready to take on all the autoimmune and auto-inflammatory illnesses that dared to rear their ugly heads in the lives of the children of Mississippi. And for the next year and a half, I did exactly that. I dedicated myself to caring for children with lupus, dermatomyositis, arthritis, vasculitis and a myriad of other connective tissue diseases.
The seasons changed, and in the winter of 2014, I began studying for the pediatric rheumatology certification boards. Check out the article below for the background and relevance, or potential lack thereof, of medical certification boards.
Board Certification for Doctors: What Does It Really Mean?
The value of this process is being debated. Are patients benefiting?
Nevertheless, I poured over textbooks, notes and journal articles for 3 months. And when the time came to put pen to paper in April 2015, I felt confident I had it in the bag! I mean, I’d spent the past two years caring for children with chronic diseases. I knew pediatric rheumatology and put it into practice every day. Surely passing the boards would prove an accomplish-able feat. However, there was one small problem. The boards don’t test what you do everyday. They test how well you can take the test! And to my dismay, I didn’t take the test well. One month later, I was heartbroken to receive this correspondence from the American Board of Pediatrics:
Dear Dr. Washington:
The American Board of Pediatrics (ABP) regrets that you were unsuccessful on the 2015 Pediatric Rheumatology Certifying Examination administered on March 23, 2015. A report of your performance is available in your ABP portfolio on the ABP website, www.abp.org.
The tears I cried were unending. Self-doubt occupied the position where my confidence as a physician use to so comfortably sit. I questioned my clinical decisions. I felt like an outsider in my medical community. And worst of all, I experienced the disappointment all over again every time someone asked “Have you received your results?”. I took residence in this state of mind for far longer than I anticipated. But eventually, through prayer, encouragement from friends & family, and daily affirmations from my patients & their families, who, coincidentally, had no idea what I was going through, I was able to rebound and begin the process of healing. You know what they say, “Time heals all wounds”.
And heal I did. So much so that two years later, when the test was offered again, I clocked no less than 20 hours a week of studying. I hired a test taking psychologist. I joined a new practice that supported my preparation efforts. And I consistently turned down invitations to participate in social events. My sole and primary goal was to pass the boards. But in May 2017, as I sat in a roomful of colleagues at the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Annual Meeting, amongst peers who were receiving the congratulatory response from the ABP on passing the boards, I instead, received the devastating news that my attempts to be certified as a pediatric rheumatologist were again foiled — by a mere 9 points.
But this time, depression didn’t follow. Instead, ambivalence took its place and led me to ask myself some hard questions. Was pediatric rheumatology still my calling? What more did I want from life? What consistently brought a smile to my face and joy to my heart? Sure, I could continue practicing as a “board eligible physician,” but is that what I wanted? Who doesn’t want to be certified in their field? Would I sit for the test a third time? Were there dreams that were yet unfulfilled?
I had more questions than answers. Yet, in the span of 48 hours, conversations with my younger sister, my best friend and a trusted colleague (somewhat of a Medical Mogul [copyrighted] if you will) both helped and forced me to be honest with myself in answering those questions.
I was good at pediatric rheumatology. Hands down. No questions asked. My patients and their outcomes were proof. But somewhere between the electronic medical record, the snowball effect of charts and an inbox that regenerated every day, I’d lost the joy of practicing medicine. And consistently for the past 4 years, traveling was the only thing that brought a genuine smile to my face that could literally be felt by anyone who viewed it. And, brace yourself, there was still a high school senior inside me who wanted to be an actress but knew science and medicine were the far safer route.
So there. All was out in the open. I was honest with myself about my feelings and my options. I would take the test again. But this time as a formality — not as a measure of my worth. I also started making tangible steps to create a life that brought me joy and as my younger sister calls it, a permanent “travel smile.”
Fast forward to April 4, 2019. After a restful slumber, I woke up to a rainy spring day and drove to the Prometric Testing Center for the third time in 6 years. But this time was different. I had a clearer outlook on the potential outcome of my boards. If I passed, I’d be elated. If I didn’t pass, I’d still be ok. I’d taken the time to reflect on life and what I wanted from it. I’d taken the time to search within and answer those hard questions. And even more so, I was comfortable with the answers to those question — as unconventional as they might be.
As fate would have it, on May 11, 2019, while surrounded by my family and one day after my younger sister walked across the stage to receive her PhD, I received the following correspondence from the American Board of Pediatrics:
Dear Dr. Washington:
The American Board of Pediatrics (ABP) takes pleasure in informing you that you passed the 2019 Pediatric Rheumatology Certifying Examination administered on April 4, 2019.
I passed! I was now a BOARD CERTIFIED PEDIATRIC RHEUMATOLOGIST! I was elated! But not merely because I passed the boards (although I’ll admit that was definitely a weight lifted), but of the process of self-discovery that led me to that point. If not for failing twice, I wouldn’t have had the courage to begin my current year long journey of traveling around the world. I wouldn’t have had the courage to think outside the box. I wouldn’t have had the opportunity to increase my faith. And I wouldn’t have had the courage to change my mind (at least for the time being) about medicine. Failing, was indeed, one of the best things to ever happen to me.
What about you? Was there a perceived “failure” in your life that actually worked out for your good?