Oooomph. Despite being in the office four days a week, immersed in clinical duties, and constantly logged on to UpToDate, I realized there was a lot of unfamiliar material. We would be tested on clinical issues that I did not regularly encounter in outpatient primary care practice, such as practical oncology, acute cardiac care, rheumatology treatments, and so on and so on. For the first time, I felt nervous. Could I fail this test?