She lays out her highlighters, gathers her papers. She attended a review course with peers months ago, took notes from the lectures, sitting three quarters of the way back where she always can be found. She’s sorted the lecture slides, distilled the notes into neat documents organized by medical topic. She prepares to study.

The test only comes every ten years. She last took it at the end of her twenties, freshly graduated, freshly married. Studying was familiar then, she had no distractions. Now a decade later, three children and mid-career obligations provide frequent interruptions.

She sits in front of the computer screen in the early evening after tucking her eldest into bed, bleary-eyed from a full day’s work. She answers multiple choice question after multiple choice question, has to quit quizzing by 9 p.m. and crawl into bed.

She over-highlights her notes, as she always has. Neon yellow streaks her notebook so much that it doesn’t draw the eye to the critical as it should. She’s always been wary of leaving something out, letting a tidbit go, afraid she’ll miss it later on. She records even the most basic fact in black and white in case it escapes her overburdened mind. The result is too much retained, significance lost in overabundance. So much kept, she can’t tell what’s important anymore.

Prone to anxiety but gifted with compulsion, she never liked taking tests but survived the most examined profession. She sits for it again in two weeks, the boards. She’ll present her photo ID and settle into a straight backed chair, be issued her tiny whiteboard and dry erase marker. She’ll stare at a computer for six hours, interpret electrocardiograms and select the most appropriate treatment plan from the multiple choices.

Just after lunch her mind will become boggy. She’ll have to push through the examination fatigue, conjure the will to concentrate on each each vital sign, each lab result. She’ll muster renewed energy close to the end, sensing it near. She’ll collapse at completion, simultaneously buoyed by elation, as if she’s run a marathon, as if she’s climbed a mountain. And she has, in a way. She’s deposited all that information, stuffed into the recesses of her thoroughly educated synapses into the Prometric receptacle. She’ll be done. At least for another ten years.