Not long ago, I, like many of my fellow residents, was sweating it out over the in-training exam. This year, however, instead of taking the traditional written exam, many residents took the much-anticipated, computer-based in-training exam. To say the least, the first attempt to take this 3- to 4-hour test on a computer was not an overwhelming success. Some centers gave up the computerized test administration in the middle of the session and requested the traditional paper-based test. It was taking a few minutes for each page to download and with one question per page it was taking too long to get through the 300 questions. Then, the traditional test materials arrived days later, and this raised some concerns about the accuracy of assessing the residents’ knowledge. Never-Ending Eponyms Just as many residents and practicing dermatologists do, I believe that the test not only fails to assess the real knowledge of a candidate, but it also pushes us to memorize minutiae. In particular, I couldn’t help noticing the large number of eponyms included in this test. There were frequently used ones such as Darier, Degos, Ehlers-Danlos, and Cow-den. But we also had to know a number of unusual eponyms as well — Heertford-Waldenström and Wolff-Chaikoff. Compound names such as Fox-Fordyce, Melkerson-Rosenthal, Birt-Hogg-Dubé, and Ruvalcaba-Smith-Bannayan completed the list. And for those who have time for extracurricular activities, there was a question asking, “Who was the artist who had scleroderma?” It turns out that Paul Klee was the victim. Overall, the test included a mixture of new and old questions, which may or may not be the best way of testing our knowledge. An alternative would have been to assess residents’ performance when examining patients to see how well we narrow a diagnosis and use evidence-based medicine to recommend a treatment. My Quest for Fame Of course, even with all of that said, I must admit that I have a secret desire to have a sign named after me. In my endeavors, I tried and was successful in touching the tip of my nose with my tongue. Alas, someone named Dr. Robert Gorlin had already given this sign his name. Then, I attempted to reproduce a sign on patients who had basal cell carcinomas (BCC). The blanching of a clinically suspicious lesion upon stretching the surrounding skin or pressing both sides of the perilesional skin suggests that the lesion is a BCC. However, this “sign” was shown to me by my friend Dr. Daniel Loo at Boston University, which he learned himself from a teacher during his residency at the University of Michigan. Last, but not least, I reported a case of nodular vasculitis as a possible paraneoplastic manifestation in a patient with colon adenocarcinoma (in press), and was hoping that, if confirmed in subsequent reports, it would be “my” disease. But credit should be given to Dr. Grant Anhalt for his landmark description of what he called paraneoplastic pemphigus — not Anhalt’s disease. You get the idea. I’m still trying to find my namesake. But Khachemoune is a difficult name to remember — although I think it’s less difficult than Klippel-Trénaunay-Weber or Vogt-Koyanagi-Harada. Who knows, maybe years from now some anxious residents will be sweating it out taking the test and trying to come up with the correct spelling of my name. I can visualize it now . . . Khache who?
An Elusive Search for Fame
Not long ago, I, like many of my fellow residents, was sweating it out over the in-training exam. This year, however, instead of taking the traditional written exam, many residents took the much-anticipated, computer-based in-training exam. To say the least, the first attempt to take this 3- to 4-hour test on a computer was not an overwhelming success. Some centers gave up the computerized test administration in the middle of the session and requested the traditional paper-based test. It was taking a few minutes for each page to download and with one question per page it was taking too long to get through the 300 questions. Then, the traditional test materials arrived days later, and this raised some concerns about the accuracy of assessing the residents’ knowledge. Never-Ending Eponyms Just as many residents and practicing dermatologists do, I believe that the test not only fails to assess the real knowledge of a candidate, but it also pushes us to memorize minutiae. In particular, I couldn’t help noticing the large number of eponyms included in this test. There were frequently used ones such as Darier, Degos, Ehlers-Danlos, and Cow-den. But we also had to know a number of unusual eponyms as well — Heertford-Waldenström and Wolff-Chaikoff. Compound names such as Fox-Fordyce, Melkerson-Rosenthal, Birt-Hogg-Dubé, and Ruvalcaba-Smith-Bannayan completed the list. And for those who have time for extracurricular activities, there was a question asking, “Who was the artist who had scleroderma?” It turns out that Paul Klee was the victim. Overall, the test included a mixture of new and old questions, which may or may not be the best way of testing our knowledge. An alternative would have been to assess residents’ performance when examining patients to see how well we narrow a diagnosis and use evidence-based medicine to recommend a treatment. My Quest for Fame Of course, even with all of that said, I must admit that I have a secret desire to have a sign named after me. In my endeavors, I tried and was successful in touching the tip of my nose with my tongue. Alas, someone named Dr. Robert Gorlin had already given this sign his name. Then, I attempted to reproduce a sign on patients who had basal cell carcinomas (BCC). The blanching of a clinically suspicious lesion upon stretching the surrounding skin or pressing both sides of the perilesional skin suggests that the lesion is a BCC. However, this “sign” was shown to me by my friend Dr. Daniel Loo at Boston University, which he learned himself from a teacher during his residency at the University of Michigan. Last, but not least, I reported a case of nodular vasculitis as a possible paraneoplastic manifestation in a patient with colon adenocarcinoma (in press), and was hoping that, if confirmed in subsequent reports, it would be “my” disease. But credit should be given to Dr. Grant Anhalt for his landmark description of what he called paraneoplastic pemphigus — not Anhalt’s disease. You get the idea. I’m still trying to find my namesake. But Khachemoune is a difficult name to remember — although I think it’s less difficult than Klippel-Trénaunay-Weber or Vogt-Koyanagi-Harada. Who knows, maybe years from now some anxious residents will be sweating it out taking the test and trying to come up with the correct spelling of my name. I can visualize it now . . . Khache who?
Not long ago, I, like many of my fellow residents, was sweating it out over the in-training exam. This year, however, instead of taking the traditional written exam, many residents took the much-anticipated, computer-based in-training exam. To say the least, the first attempt to take this 3- to 4-hour test on a computer was not an overwhelming success. Some centers gave up the computerized test administration in the middle of the session and requested the traditional paper-based test. It was taking a few minutes for each page to download and with one question per page it was taking too long to get through the 300 questions. Then, the traditional test materials arrived days later, and this raised some concerns about the accuracy of assessing the residents’ knowledge. Never-Ending Eponyms Just as many residents and practicing dermatologists do, I believe that the test not only fails to assess the real knowledge of a candidate, but it also pushes us to memorize minutiae. In particular, I couldn’t help noticing the large number of eponyms included in this test. There were frequently used ones such as Darier, Degos, Ehlers-Danlos, and Cow-den. But we also had to know a number of unusual eponyms as well — Heertford-Waldenström and Wolff-Chaikoff. Compound names such as Fox-Fordyce, Melkerson-Rosenthal, Birt-Hogg-Dubé, and Ruvalcaba-Smith-Bannayan completed the list. And for those who have time for extracurricular activities, there was a question asking, “Who was the artist who had scleroderma?” It turns out that Paul Klee was the victim. Overall, the test included a mixture of new and old questions, which may or may not be the best way of testing our knowledge. An alternative would have been to assess residents’ performance when examining patients to see how well we narrow a diagnosis and use evidence-based medicine to recommend a treatment. My Quest for Fame Of course, even with all of that said, I must admit that I have a secret desire to have a sign named after me. In my endeavors, I tried and was successful in touching the tip of my nose with my tongue. Alas, someone named Dr. Robert Gorlin had already given this sign his name. Then, I attempted to reproduce a sign on patients who had basal cell carcinomas (BCC). The blanching of a clinically suspicious lesion upon stretching the surrounding skin or pressing both sides of the perilesional skin suggests that the lesion is a BCC. However, this “sign” was shown to me by my friend Dr. Daniel Loo at Boston University, which he learned himself from a teacher during his residency at the University of Michigan. Last, but not least, I reported a case of nodular vasculitis as a possible paraneoplastic manifestation in a patient with colon adenocarcinoma (in press), and was hoping that, if confirmed in subsequent reports, it would be “my” disease. But credit should be given to Dr. Grant Anhalt for his landmark description of what he called paraneoplastic pemphigus — not Anhalt’s disease. You get the idea. I’m still trying to find my namesake. But Khachemoune is a difficult name to remember — although I think it’s less difficult than Klippel-Trénaunay-Weber or Vogt-Koyanagi-Harada. Who knows, maybe years from now some anxious residents will be sweating it out taking the test and trying to come up with the correct spelling of my name. I can visualize it now . . . Khache who?
