28 January 2009 Whew

Yes, another long stretch without updates from me. The nickel version of it is moved to Torrington, Wyoming, and took my first board exam for licensure--USMLE Step 1.

Why Torrington, Wyoming? It's hard to explain, but a card from one of my friends told me that she agrees that moving to Wyoming from Miami is a good step, and one she would take, too. So, here is the reason Becky and I first give when we are asked why we came here from Miami and the Caribbean: when you are cold, you can always put on more clothes. But, when you are hot, there is a limit to how many clothes you can take off. When we were in Dominica, usually that limit wasn't enough to ensure comfort. But, there are other reasons.

The people we were generally around in Dominica and Miami weren't our kind of people. There was a pace to them that Becky and I just didn't fit into, and frankly didn't like very well. Here it's different. Becky and I haven't gone to a place to sit down in that people haven't come up an introduced themselves to us. Bar, Library, Post Office, Court House, Grocery store..., you name it, and we have been met with open arms here. Not only that, Becky and I haven't met a single person here that we don't relate well to and with. It's amazing how different people are. I think it might have something to do with the strength of winter here and it's effect on how you look at people. I shamelessly stole it from Garrison Keillor.

Another thing we like is the weather. Just this past week, we had over a foot of snow, and following the snow storm, the temperature dipped to -20F. While it was cold, we enjoyed it. It's an opportunity to put things on hold because the whole outside world slows down when it's that cold. It also didn't hurt that the snow closed all of the major roads to the west of us, I-80, I-25, and WY-34 were all closed, meaning that there's painfully little traffic to Torrington. But beyond the snow, the weather is dryer here. So, when we shower, we feel fresher longer. No persistent stickiness for hours and days on end.

Don't get me wrong, there are other things to contend with here. The wind almost always blows--we are on the plains less than 80 miles from mountains. And, since it's so dry here, the wind blows dust and sand. Also, it is VERY dry here. I think Torrington gets fewer than 10 inches of rain a year. But, these things can be contended with as long as one is prepared. It also helps that we are of a mind to be willing to contend with these things.

So, now that's done, here's what I've been doing. On January 15th, I took the USMLE Step 1 licensing exam. It is the first in a set of 3 exams, the others being Step 2 CK (clinical knowledge) and Step 2 CS (clinical skills). Those I am eligible to take after I complete my core rotations--the ones I plan on doing in Scottsbluff, NE at Regional West Medical Center.

Step 1 is a long exam. It is a computer-based 8-hour exam. The exam is broken into 8 blocks of 48 questions. You are given 1 hour for each section, but you can complete them earlier if you wish. The exams themselves are given at Prometric testing centers. Since the only one in Wyoming is in Casper, I drove to Casper the day before, spent the night, and took the exam. After the exam I drove back. Three things happened on the way to the exam that I took as good omens. First, it snowed. I know--it was not the best driving conditions. But, Becky and I moved here for snow. So, if the weather decided to greet me with snow as I drove, I took it as a charming good luck. Also, I saw a lone doe elk on the interstate. She made eye contact as I drove past, just standing there in the ditch. Finally, on the morning of the exam, I saw a herd of antelope in Casper on my way to the center, about 2 blocks from it. I'm not going to deny that these good omens likely have no legitimate bearing on my exam score, but they made me feel better anyway.

The terrible part about this process, though is that the scoring process takes 2 months after the date you take the exam. So, I have roughly 6 more weeks to wait before I find out how I did. And, the exams aren't strictly pass/fail. The score on the exam roughly correlates with the prestige of specialty and residency program you can get into. Becky has told me if I get over 240 (a stellar, but not unattainable score) I can do something special. I haven't decided what I want to do yet. The thing to keep in mind is that being a Caribbean student, I have to look better on paper to get a similar position. So legitimately, I think I need to score about 210. 185 is passing for whatever that means.

Since that process is done, I've started to bring in a painfully small amount of money by getting a paper route with the Scottsbluff Star Herald. I started that this past Tuesday. The day after it snowed. The morning it was -20F. Those together almost make it not worth it. But, there probably won't be too many days with a foot of snow and below zero temperatures, so I'll tough it out til late March when I get ready to go to Belize for a wilderness medicine clinical rotation.

Aside from those things, Becky and I did have one very unique experience here recently. Our older dachshund, Gabby, got an infection in her womb called pyometria. In the process of getting her healthy--which she is again--we met a very interesting veterinarian here. The guy comes up from Cheyenne 3 times a week to work at this practice, but the part that took us back was that he knew Dominica and knew Ross. Since he was wearing a University of Wyoming shirt, I'm pretty sure he isn't a Ross Vet School grad. But, even the vet school is on St. Kitts, which is a much better place than Dominica. And, he knew more about Dominica than I would expect a person who spent a couple of years on St. Kitts would. Becky and I haven't quite got a handle on him yet. I'm not certain if we will try to manufacture a social situation to probe his knowledge a bit more, but we might. It was very odd because we are typically a little cryptic about what we were doing in the Caribbean, and he was also a little cryptic about how he knew of things there. It all made for a very unique experience. We shall see what happens in the future.