Lifelong learner with AI

From Childhood Tinker to Certified Thinker

I love learning. I know my perspective dates back to my childhood and many years and long before I became a physician. My parents would remember the challenge of dealing with my learning when I was younger which included taking things apart and not always knowing how to put them back together. It was definitely fraught with some dangers as I took a keen interest in rapid kinetic disassembly and how to effect this on a variety of things.

The key for me at least was I needed to be fascinated and interested in the specifics. Not everything was interesting and learning things that were not interesting was not a top priority. This proved to be a hurdle that I had to overcome especially when I went through school where Latin was not my most favorite subject, nor was history or geography (which btw is a little sad to me now as I find all of those subjects intriguing and realize how much I skipped learning as a young boy.

As I moved up the academic and learning ladder those challenges remain. Anatomy was a little like Latin, in more ways than you might imagine and I certainly struggled with the huge volume of data I was required to learn as part of my medical degree. But other areas proved easier simply because they were fascinating, at least to me. Passing examinations when I took them was all based on long-form essays and Oral exams or Viva’s as they were called (here’s that Latin again the shortened form of “Viva Voce” which literally translates “with the living voice”).

Fast forward to this year and I found myself at the ACPA annual conference NPAC in San Diego. As I have shared with a number of folks I truly felt I had found my tribe. Here was a group of clinicians focused on case management, hospital utilization, clinical documentation integrity, health system revenue cycle, and healthcare regulation. I met so many smart passionate people across a wide range of domains, specialties, and experiences all trying to learn from each other on ways of tackling some of the most wicked problems in healthcare.

The obvious thing in my mind was to learn more and the organization offered a certification for Physician Advisors. With an online option available year round there was no better time than now to jump in and start learning and work towards the exam and certification. 13 modules of differing lengths covering the core topics proved to be fascinating, and with virtual training, it was possible to start, stop, rewind and redo sections and content to my heart’s content. It was so good I created 164 pages of notes from my studies. My first module was hosted by someone I knew, Ron Hirsch, who is something of a luminary in this space and I settled into a rhythm of doing a module or two in the morning or evening before or after work to get through the full collection.
Each of the modules was hosted by a different proctor/lecturer and I got to know these individuals through their content enjoying the insights into the space. But more than that, in the case of this immigrant who may have passed his citizenship exam but realizes each and every day how little that taught me, learning more and more of its history.

Preparing for Certification

The examination is a time-pressured affair. 100 questions to be answered in 100 mins. 1 minute per question. For those used to multiple choice exams or MCQs this might seem normal, ok, or ordinary. For someone whose last MCQ test was in the driving center in one of several states where I have had to take my driving test yet again (I have taken and passed first time 7 different driving tests around the world) this was a tad stressful.
Each of the modules came with a mini multiple choice test which I was guessing was some indicator of what to expect. The trouble was that some of the questions were long, quite detailed, and took some time to process and think about before answering. There was of course a mix with other questions being short quick and easy but given the material, I was expecting more of the former. But the mini-test was static and despite going over the content again as part of my program of preparation I took the same 4 or 5 questions at the end. I was caught out on the first round several times. But in each instance, I could hear my old physics master reading me the riot act when I did my mock A-Levels and did not read the instructions carefully missing the fact I was supposed to answer 3 out of the 4 questions, not the 2 that I submitted. He was not pleased and apparently, I was still rushing through exams and not reading the question carefully, missing keywords that reverse the meaning of the question. Oops!

Tapping into newly qualified doctors who spend 9 hours in a single testing session answering MCQs I sought advice. Prepare and watch your time carefully. Not especially revealing and the only thing I could do was focus on the first of these. So prepare I did. Using all the tools available creating tests to test myself, taking notes, using those notes to create tests, and finding any and all ways I could to test my understanding of the material and most importantly the speed with which I could process it.

The clock or countdown timer was my biggest fear and I knew I would need to manage my time carefully. All the preparation took me back to preparation for finals and the 6 months of time that I spent with a daily revision routine covering all the topics on a rotating basis based on a schedule I had written out and pretty much followed to the letter.

Exam Day Jitters

Certification and Heart Palpitations – The Exam Day Experience

After a few more cycles of preparation and testing, I decided it was time to bite the bullet and take the exam. I will say it gave me a while new appreciation for the Medical Students and Doctors who endure what I can only describe as inhuman testing experiences that are hours long and filled to the brim with stress levels that must be hard to adjust and terrible for individual wellbeing. At least in my case, it was a shortened session – 100 minutes vs 9 hours.

Out of the gate, I felt my heart pounding in my chest and I can only imagine what my blood pressure would have been recorded as for the first 10 to 15 minutes as I stepped through the initial questions. But slowly my stress started to decrease as I felt confident in answers, capturing a list of questions that I wanted to spend more time reading and checking but keeping things moving. As my progress continued unabated my sense of Zen increased and much like finals I was feeling quietly confident thanks to all the preparation time and effort that I had invested before walking into the exams.
I don’t recall exactly what the timer said when I reached question 100 in the list but I know I had a lot of time still left to go back and review questions.

Reflections and What’s Next

The good news with online MCQ testing is the results are or certainly can be instantaneous. With my pass notification I knew I was just starting on this particular journey, much like driving a car, passing your test is a good start, but you really only start learning to drive once you have passed your test. That’s where I am at now, exploring more areas and seeing how I can give back to the community and the folks that helped me get through this next chapter in my book of life.

To the folks at Iodine both corporate level and individual level who supported me I am so glad to be here and part of this amazing team. Thank you.
To the folks at ACPA and in particular all the proctors and lecturer’s for taking the time to design, create and deliver the course modules and examination. The content was truly fascinating and I really enjoyed each of the modules and benefitted form the insights and shared experiences. Thank you.
And to all the other folks in the case management, hospital utilization, clinical documentation integrity, health system revenue cycle, and healthcare regulation space, all of whom are working to find ways of delivering better healthcare who inspire me each and every day to continue on this journey working towards better solutions – thank you.

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