PROVING MYSELF?

I’m going to Paris,” I answered through my operating mask when asked why I wasn’t scheduled to be in the operating room that afternoon.

“Taking a little vacation?” asked Dr Nieuwendijk, the attending surgeon in the cataract centre that day. “Good idea,” he continued. “We can all use some time off once in a while.”

After all the stress I had given him in the OR over the past few months – with him stretching the limits of my surgical abilities while making sure I didn’t overstep my boundaries – Dr Nieuwendijk certainly deserved a holiday.

“A vacation?” I said. “Not exactly. I’m taking the EBO exam tomorrow,” referring to the European Board of Ophthalmology Diploma Examination.

“Excellent, good luck with that,” he replied. “I took the exam a few years ago.”

I continued looking at him as he pulled on his operating gown and gloves.

“Yes, I passed,” he added, before handing me the knife.

That was what I wanted to hear. I wasn’t really looking forward to it all, and was questioning why I made the decision to sign up. Was I looking to prove something to myself or to someone else? Did I just want the extra “FEBO” title after my name? Honestly, I was more interested in doing cataract operations all day than travelling to another country to take an exam, but I convinced myself to consider the whole ordeal as a little adventure, if not a vacation.

I hadn’t told too many people about my plans, just in case they didn’t work out as planned. The exam is not required for residents in the Netherlands, so only a few take it every year. First-hand information is scarce, particularly in relation to our collective training experience. Would it be easy or difficult? My main sources of information were Belgian ophthalmology residents with whom I went to medical school. For them, passing the exam is a prerequisite for receiving their licence. They have to pass, so they make sure they’re very well prepared.

Organised and efficient

My assumption was that I should be able to pass the exam based on what I had learned during the first four years of residency. After so much time in the clinic, in the operating room, and on call in the emergency department – not to mention preparation for the yearly exams that residents are required to take in the Netherlands – I figured I would know enough to pass.

But there was no time left for these sorts of considerations. Two hours later I was on the high-speed TGV. The train from Holland to Paris is a dream. Starting in Amsterdam, it zooms south through the countryside at 300 kilometres per hour, stopping only momentarily in Rotterdam, Antwerp and Brussels before arriving in Paris three hours later.

The following day, the exam centre was full of young doctors from 28 European countries. Although it was all well organised and efficient, it took me a while to figure out where I had to sign in because my mind was concentrating on how to differentiate disc oedema from papilledema rather than on which escalators to take to the correct floor.

Before I knew it, however, I was in the main examination room with a 260-question multiple-choice exam in front of me with two-and-a-half hours to complete it. The topics spanned the whole spectrum of ophthalmology. The questions mostly tested useful knowledge, like relevant prognostic and therapeutic factors in glaucoma, but occasionally asked silly details like drug concentrations and genetic percentages. Each question had three options: true, false and I don’t know. “I don’t know” is an interesting choice, I thought. If I didn’t’ know it, how could one be faulted for telling the truth?

The afternoon session was more interesting. It was an hour-long, viva voce session with photo-based questions and four different two-examiner duos who each presented a clinical case and interrogated us until we reached the outermost limits of our knowledge. I have to admit, this part was actually fun. It was like working in the emergency room, examining very demanding patients with reasonably challenging pathology and a lot of well thought-out questions. I was shown a photo of an iris with radial, spoke-like transillumination defects in the midperiphery. “Pigment dispersion... young myopic males... haloes after exercise....” It all went by in a blur, and before I knew it, I was outside, on my way to the station to catch the TGV back north to Rotterdam.

A few days later I received notice that I had passed. With that, I immediately booked a long weekend trip to Paris to celebrate with my wife.