Passing the medical boards at age 63 [PODCAST]

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Inner medication doctor Rajeev Khanna discusses his article, “I handed my medical boards at 63. And no, I used to be not having a midlife disaster.” He shares his journey of finding out for the ABIM exams a long time after medical faculty, balancing household skepticism, humor, and dedication. Rajeev displays on growing older in medication, the evolution of research instruments, and the deeper objective behind lifelong studying. Viewers will find out how ardour, perseverance, and self-belief can redefine success at any age, and why ambition doesn’t expire; it merely adapts. This episode delivers perception and motivation for anybody chasing a purpose later in life.

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Transcipt

Kevin Pho: Hello, and welcome to the present. Subscribe at KevinMD.com/podcast. At the moment we welcome Rajeev Khanna. He’s an inner medication doctor. At the moment’s KevinMD article is, “I handed my medical boards at 63 and no, I used to be not having a midlife disaster.” Rajeev, welcome to the present.

Rajeev Khanna: Thanks. Thanks for having me.

Kevin Pho: All proper, so inform us slightly bit about your story after which we’ll leap proper into your KevinMD article.

Rajeev Khanna: All proper, I’m an inner medication doctor based mostly in Virginia. I’m 63 years previous. I got here to the U.S. on the age of 29, having carried out my med faculty and residency in inner medication again in India. Then I got here right here, I used to be 29, needed to do my residency over again on a J-2 Visa. Then I went to North Dakota to work in an underserved space to get my inexperienced card, and that I’m certain could be two or three extra podcasts. I’m placing them collectively, working in North Dakota. I’ve been in inner medication follow for the final 28 or 29 years in Virginia, related to sure hospitals, however primarily ambulatory outpatient inner medication follow as of now.

How this text took place was, I’m a part of a really large group right here, regulation Medical Group. And one of many inner medication components of that. Lately UnitedHealth, Optum confirmed curiosity in buying the entire loud medical group. That introduced into perspective the place I used to be.

See, I handed my board. Once I completed my residency, I obtained into follow. These a yr or two older than me obtained grandfathered into not repeating boards once more. Nevertheless, I used to be in that place the place you needed to retake the boards. The medication obtained busy, the follow obtained busy, life blew up with the children, and all obtained busy. I by no means wanted to move the boards once more to follow. That doesn’t preclude you from training, so I by no means felt the necessity for it. Life was occurring effectively. At 63, I used to be already considering of enjoying extra golf, making extra time for myself, and possibly some form of retirement. Then this UnitedHealth factor occurred. That introduced me into focus: that if one thing doesn’t undergo, possibly I must look into the place my schooling was or what my standing was.

That introduced into query, ought to I take my boards? Do I must be board licensed if I’m going out on the earth? I didn’t must do something if I continued to do the best way I used to be, nevertheless it piqued my curiosity. So again in late 2024, I signed up. I mentioned, “Let’s see what’s occurring.” At the moment, I didn’t inform anybody, not even my spouse or youngsters, that I signed up for the board. In case I failed, what was I going to inform them?

Nevertheless, over the following 4 or 5 months, I did what I wanted to do, and I did find yourself passing my boards with a superb rating and felt glad about it. Then I sat down and mirrored upon what occurred. And that’s how the article took place.

Kevin Pho: All proper, so that you had a call level. You had been 63 and also you had a fork within the street, whether or not to take your boards or possibly retire and do one thing else that didn’t require board certification. Inform us the questions that you just requested your self to give you that call.

Rajeev Khanna: I nonetheless felt that I had it in me to do extra. I didn’t have a lot left to show to the world. I’ve a reasonably busy follow, am very well-known in the neighborhood out right here, and am very effectively vested in the neighborhood. I actually didn’t must do a lot. However then I assumed, “Let me no less than look into what’s concerned in passing the boards,” and checked out all of the stuff that was on the market. I decided to do extra. “Let’s see how worthwhile I will be to myself.” That’s what made my resolution to deliver it on.

Kevin Pho: What was it like finding out for the boards? As you mentioned, you’ve been training inner medication for 29-plus years. You have already got a longtime follow and an important fame in the neighborhood. What was it like coming dwelling from a busy day in clinic after which having to review for the boards?

Rajeev Khanna: That’s the place the entire story lies. That’s what made me do it. I might see sufferers all day lengthy, and as I mentioned, it’s a reasonably busy follow: actually 40 to 45-plus inner medication sufferers. Then you definitely needed to do the EMR and the notes. I might deliver work dwelling, and watching Netflix is the place I caught up with my Netflix exhibits and did my notes. The day would get locked. On high of that, if I needed to do one thing extra, the place to search out the time?

I begin my day at eight o’clock. I began attending to the workplace at seven o’clock within the morning, and one hour earlier than the workplace began, I started trying into varied useful resource supplies. That was the principle factor.

I’ve college students rotate with me for observerships, and I used to be what they had been finding out. All this UWorld and the whole lot else wasn’t there after I handed my preliminary boards. I went to Boston for the Harvard Med Faculty Harvard board overview in inner medication, did seven days, and took the exams.

However now, the quantity of stuff that’s on the market, the TikTok movies, so many movies, and a lot useful resource materials, it’s superb. That piqued my curiosity. It made it simpler to get the knowledge.

Once I began studying about it, the opposite factor I spotted, as I put it in my article, was that it took me loads longer to retain stuff. I might nonetheless perceive all of the ideas and I nonetheless would have a imprecise remembrance, nevertheless it took me time to retain it. Finally, I obtained into the rhythm of it. I might come dwelling, and as a substitute of watching exhibits or doing one thing, I began placing down time to make use of all these useful resource supplies, MKSAP.

Then I seemed on the MKSAP, the entire MKSAP. I discussed in one in all my articles, my daughter completed inner medication. She simply took the board. She’s ready on her examination outcomes, and she or he had MKSAP. I didn’t purchase MKSAP, so I used to be her books. I attempted to open one and undergo it. It wants a lot time, a lot info on the market. I whittled it all the way down to MKSAP Pearls. Then any person mentioned, “No, you simply go forward and do the UWorld.” So I purchased and obtained UWorld questions and I began doing these.

The essential ideas had been there, however they wanted recalling. Medication has developed a lot and so rapidly. In the true world, I don’t must know all these pointers, particularly with ChatGPT, open proof, and UpToDate. If I want to inform any person about pointers, I simply open up my laptop, get the knowledge, and provides it to them. I actually didn’t must have all that in my mind on a regular basis.

Issues have modified tremendously. Within the previous occasions, you by no means had these sorts of issues. Once I did my medical faculty, there have been no computer systems or something. You needed to bear in mind the whole lot. Step by step, I obtained issues put collectively. And that’s the way it began.

You talked about a query: if I had recognized it was going to be this tedious and tough, would I’ve began finding out once more? Nicely, I’m glad I didn’t understand it was tough. It did put a dent in me. I felt, “Why am I doing it? I actually don’t must. I didn’t want this.”

However then each time I learn one thing new, it piqued my curiosity and my curiosity. “That is one thing new that I’ve discovered at present. Can I put it into follow?” It’s a undeniable fact that after I went again and noticed my sufferers, now each joint ache, myalgia, or fever introduced ten extra ideas to my thoughts, and I might return and examine it. It made me really feel higher. That feeling of constructing me really feel higher made me learn increasingly.

Kevin Pho: For individuals who aren’t conversant in the MKSAP, these are the overview questions offered by the American School of Physicians. You mentioned that you just went by means of the MKSAP and also you had been doing studying. What number of hours a day did you research to assist put together for the board? You mentioned it was over a interval of some months.

Rajeev Khanna: I might say no less than 5 to 6. One hour within the morning, three to 4 hours within the night. Within the night, between 5:30 and 10:30, wherever I might discover time. In between sufferers, I might discover an issue, go to UWorld, and do one or two questions.

I introduced it on myself, however that’s how. Right here and there, it was not cumulative, like seven hours. I by no means had that form of time, however I might spend 10 minutes there, quarter-hour there, 20 minutes there. As a substitute of watching too many exhibits, I used to be spending extra time finding out.

Kevin Pho: After which whenever you took the examination with that quantity of preparation, did you are feeling comfy with all of the questions that got here your approach on the examination?

Rajeev Khanna: To start with, my spouse stood by me. “This man’s gone loopy, however let’s do no matter he needs to do.” However the important thing factor was my youngsters. My daughter is an inner medication resident, and it was good speaking to her. I see the place the ABIM goes, the place inner medication goes. She’s a brand new resident. She simply completed. I see the distinction between the place I used to be and what these guys had been doing.

It was good speaking to them. My youngest one is in med faculty proper now. My oldest one, he’s a nerd. He went into GW Med faculty however then left after one and a half years to enter IT.

I had completely different views on my scenario, and all these items added up, however I felt higher and higher as I went into it. Once I went to take the examination, the most important factor was I didn’t have that stress of, “What would occur if I didn’t move?” I actually didn’t care. I might play extra golf and go do extra stuff. That stress was not there. That’s what I really feel is the distinction between myself and my daughter taking the examination. She has a unique form of stress state of affairs. I didn’t have that stress.

I made them do a care package deal for me. Once I did the examination at 63, I used to be in all probability the oldest one sitting in that room. I’m certain there have been different physicians taking the examination at this age. However in that room that day, there have been 4 or 5 different ABIM takers, and I used to be the oldest. I didn’t really feel dangerous. I’m normally fairly good with computer systems, so I might tempo myself. I actually didn’t have a lot downside.

Although, sure, I’ve a beef with ABIM on sure questions and the best way they had been introduced or what sort of info they need us to hold out, however I’m certain they’ve their causes. One factor that taking the ABIM did was to extend my curiosity, which I’m going to come back to later, nevertheless it did make me really feel higher. It did make me really feel rejuvenated, and I felt extra related to myself.

Kevin Pho: Now, to be clear, what you probably did was completely different from the upkeep of certification. You truly let your preliminary certification lapse, so that you needed to take it from scratch, virtually like for the primary time. Now remind me, was it closed-book? Did you will have any entry to any assets throughout the examination?

Rajeev Khanna: Good query. You could have entry to UpToDate now. It is kind of closed-book, with this selection that you would be able to entry UpToDate on-line for a sure model. However you need to do a block, three blocks, and also you barely get time to learn the query, give it some thought, after which attain out to UpToDate.

Keep in mind, whenever you go to UpToDate, you might be opening up one other Pandora’s field. You all of the sudden want the important thing buzzword that you would be able to plug into UpToDate to get some questions. As soon as I used to be carried out, I did entry UpToDate. It does assist. It provides you extra confidence, however I’m unsure it helped me move. You needed to do your preliminary exhausting work to get to that time the place you understand what to place in UpToDate to get correct solutions.

Sure, it does assist. They’ve UpToDate for MOC these days.

Kevin Pho: You spent 5 hours an evening finding out over a interval of months after seeing a busy day at clinic. Do you are feeling any resentment that you just needed to take it? I feel the rationale that you just mentioned you needed to take it’s as a result of UnitedHealth was contemplating shopping for your follow, and so they required their medical doctors to be board licensed. Do you harbor any resentment that you just needed to go down this path and spend nonetheless many hours getting ready for a board examination?

Rajeev Khanna: I’ve thought of it. To start with, no resentment. No resentment in any respect. In reality, I’m glad I did it. Did I want it? Or do ABIM, or do we’ve got to have ABIM certification? That’s a subject for dialogue on a unique day. We do our persevering with medical schooling and, as I mentioned, with all this AI, UpToDate, and open proof, you’ll be able to proceed working your approach by means of day-to-day affected person care. That does enable you to. You actually don’t want the licensed phrase behind you.

However as soon as you might be carried out, and the best way our medical group is constructed up now with insurance coverage corporations, pharmacies, and the whole lot else, after you have “board licensed” behind you, it provides you a unique presence or completely different connotations for that matter. Sure, it’s useful. Did it make me a greater individual? Sure, by feeling good about the entire scenario and feeling that I can do that. Total, no resentment in any respect. In reality, I’m glad I did it.

Kevin Pho: Inform me what sort of recommendation you will have for older physicians in the event that they’re on the sting of taking board certification or not. Do you will have any recommendation or phrases of knowledge for different physicians who could also be in your place?

Rajeev Khanna: I’ve one. I really feel a technique it has modified a number of issues for me. What I might recommend, or what my recommendation could be, is: Go for it. Attempt it. What’s the worst that would occur? You might be nonetheless on the similar place the place you might be. No person is stopping you from doing what you’re doing.

Nevertheless, what it modified in me was it put me on a path of mental rejuvenation. I used to be in a rut. I didn’t must know a lot. I used to be doing very effectively, making the identical sum of money. But it surely places your thoughts in a rut, in a relentless. There’s no change; there’s no evolution.

For instance, to place it into perspective, since I handed my board, I began studying about being previous and longevity. That’s the brand new buzzword lately, together with AI. I’m massively fascinated about AI and its impact on well being care. The best way therapeutics are modified, the place the diagnostic challenges are altering. I’m trying into entering into some AI-related program that I can move or learn extra about, and I’m getting increasingly into longevity at this age, at 63. However once more, evidence-based longevity. How did all of it come by means of? If I had not gone by means of my board and recognized what extra is on the market, I in all probability wouldn’t have launched into this path.

Now I’m establishing a long life clinic as an offshoot of my follow, attempting to chop down on seeing too many sufferers and develop it right into a concierge follow. With that, it’s nonetheless evidence-based as a result of at coronary heart, I’m nonetheless an evidence-based allopathic doctor. In order that did change. It rejuvenated my thoughts. It makes you are feeling youthful within the mind. My recommendation could be to go for it. You would possibly discover some curiosity, some new component. It’s going to in all probability rejuvenate your mind, if nothing else.

Kevin Pho: We’re speaking to Rajeev Khanna. He’s an inner medication doctor. At the moment’s KevinMD article is, “I handed my medical boards at 63.” Rajeev, let’s finish with some take-home messages you wish to go away with the KevinMD viewers.

Rajeev Khanna: Nicely, as I’ve written in my article, desires don’t die. They sag slightly bit. Go for it. You would possibly discover a shock on the finish. Go for it. It’s going to in all probability rejuvenate your mind, if nothing else. That might be my message. And thanks for having me, Kevin. It was a pleasure speaking to you. I’m glad I did this.

Kevin Pho: Rajeev. Congratulations on passing the boards. Thanks once more for sharing your story.