Things are still slow around here, and that’s fine with me. For the first time in a while, I’m actually working only 12 hours a day. I got to enjoy looking at the snow today. I haven’t had this few patients to see in a morning since I was in medical school.

I’m also studying for Step 3. Common wisdom says it’s not necessary to study for this test, but since it takes two days, I would hate to have to repeat it. Besides, I’m a compulsive perfectionist. Although the score doesn’t matter to anyone, for my own private satisfaction I’d rather it not be too much lower than the first two USMLEs I took.

Actually, my main problem in studying is that I know too much about a few things. Colon cancer? I could recite you the staging in detail, and all the kinds of presentations and routes to diagnosis, as well as the surgical therapy indicated in each case. According to First Aid, however, all you really need to know is that it often presents with anemia, should be diagnosed by colonoscopy, and can be treated with chemo and surgery. Similarly the other surgically-treated cancers. I’m astonished by how little the general practitioner seems required to know about these. On the other hand, the book goes into great detail about the treatment of hypertension and hypothyroidism and diarrhea and labor, to all of which my reflexive answer by now is, consult some other service, there’s no surgical issue involved!

I’m doing practice questions too, and at least for the ones I’m using, the most basic memory of medical school, plus a firm handle on how to eliminate clearly impossible answers, solves everything. Makes me think these questions are too easy. (Compared to the ABSITE, and the distant prospect of oral boards, no general test can be scary.)

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