Respect

I am writing this from my hotel room in Tucson, where I am giving boards (well, in Tucson, not my hotel room. That would be too Weinsteinesque. Ick.). I must admit that this year feels very different than previous years when the boards were given in Louisville. For starters, who wouldn't love to go back to the Executive Inn in Louisville, the site of so much sweat, tears, and vomit? Every year I returned there I was reminded of two things: first that I am not the diagnostic radiologist I once was, and second that I never was all that good. But my mantra that got me through medical school also served me well as a resident (MPL [minimum pass level] = MD). It isn't just the environment that is new, however. There are several new examiners this year, which is always good to see. While there is something to be said for experience in a position such as board examiner, it must also be true that the new generation (which will become the older generation, after all) must have their chance to learn and to prove themselves. It is a fun thing to watch, this gradual passing of the baton. And, I must say, that the new generation of examiners such as Maureen Kohi and Saher Sabri are as impressive as they can be—we are in good stead. The above comments are not, however, the reason for this editorial. Instead I wanted to talk about respect, and use the concept of respect in the context of the board examination. Let me start by saying that this is not yet one more dig against the millennials, although undoubtedly it will come across that way. I don't hold anything against that generation, or at least not more than any other generation. It may SEEM that way simply because I've become more curmudgeonly over the past few years, but I digress…. What I have noticed this year is what comes across as a true lack of respect for the board process. It isn't just that these candidates are the first who have never taken an oral board exam before, this being the first year that the exam is being given to individuals who have not had to sit for the prior diagnostic radiology oral boards. Sadly, this lack of respect is a comment on the entire cohort of individuals who just sat for the exam, 95% of who were just fine and treated the exam with the respect it deserves. But the other 5% were so egregious that it colors the experience of the board examiners to such a degree that many of us are walking away from this exam confused and disappointed, frustrated and angry, about the process. Now some lessons for future board examinees. First—do not show up for boards in unpressed polo shirts (or any polo shirt, for that matter), jeans, or flip flops. Wear something that you would wear to a job interview. Second—do not call your examiner by their first name, even if that is how they introduce themselves. Third—please do not bring a Starbucks into the exam room with you. Drink it or get rid of it—you can always get another at the nearest street corner. Fourth—if the examiner interrupts you, it is for your benefit. They are trying to redirect you, so don't continue to speak over them. Finally—if the examiner says that the exam is over, she/he really means it. Don't make them escort you out of the room; and if they do, for God's sake don't follow them back into the room and continue to discuss the last case (yep—true story). The common theme between those five examples above is simply this: respect the process. You don't even really need to respect the examiner, although I would highly suggest it since a quick perusal of the names of your examiners should be enough to impress you. There is a saying in the Army—you don't salute the woman/man, you salute the rank. The same holds true for a process such as a board examination, even more so than a job interview. By not showing respect for the process, one is obligatorily disrespecting the system. Respect seems to be something that has gone the way of the dodo. Perhaps it is the familiarity under which we all live, and the intentional demise of hierarchical ways that we all once lived under. It isn't all bad; I'm sure we all knew somebody who “demanded” respect but hadn't “earned” it. But there is something to be said for showing someone that you appreciate what they (e.g., board examiner) have brought to the field, and a show of respect in that setting is merely one way of saying “thank you.” It is simple, painless, and the right thing to do. And respect works both ways. I don't like to dress up—well, in a suit that is but again I digress—but I do so not for myself but for the position I hold at work. I would find it disrespectful of the position and those who might be speaking to the temporary holder of that position to not dress nicely. I should even extend that to beyond the normal work hours—I have a friend who is also a chair who refuses to enter the hospital in jeans. I wish I could take it to that level, but sometimes jeans and an AC/DC t-shirt are just called for— but, to agree with her, not at work. So the next time that you decide to call an elder or someone in a position of authority by their first name, think about it. Even better yet, think about calling a person OVER whom you have authority by something other than their first name, such as Mr. or Ms., particularly if they are calling you “Doctor.” Perhaps, like a returned salute, a nod to bidirectional respect may be in order. Oh, and if that candidate who followed me back into the room is reading this, then no—adenomyosis is not actually a contraindication to UFE.