Best Prep for EM In-service Exam

[inspirationmd]

So there are about 2 months left until I take this thing and I want to put in some efficient study time and have a solid showing on it, Any recommendations for how to best prep for this?

CORD exams? Tintinalli, Rosen's, Harwood Nuss? General Prep for Step 3 (1st aid, UWorld Questions)? 1000 questions for the EM Boards?

Please share any and all recs.

---

Members don't see this ad.

 

[BJJVP]

For me, it was the Ohio ACEP board review CDs. Listen to them over and over. I could listen to a CD on any topic 4-5x while it would take me the same amount of time to just read the same subject matter in any textbook once. Therefore, retention is better for me with the CDs. THIS IS ALL YOU NEED TO DO WELL ON THE IN SERVICE. Don't get caught up with using a ton of different sources and then not having enough repetition...I have to fight that urge for every standardized test I have ever studied for.

If you like to do questions, guys like to use the PEER set but I never like questions because it is too random, and it never feels comprehensive enough.

 

[Zanegray]

PEER VIII. It's brand new. You can still get VII too.

 

[Colbert]

I've been looking at the Ohio ACEP review CDs, but they're pretty steep. Do you have any experience with the "Fast Facts" one that are still like 3 days long? Those ones are more ine the $200 range

For me, it was the Ohio ACEP board review CDs. Listen to them over and over. I could listen to a CD on any topic 4-5x while it would take me the same amount of time to just read the same subject matter in any textbook once. Therefore, retention is better for me with the CDs. THIS IS ALL YOU NEED TO DO WELL ON THE IN SERVICE. Don't get caught up with using a ton of different sources and then not having enough repetition...I have to fight that urge for every standardized test I have ever studied for.

If you like to do questions, guys like to use the PEER set but I never like questions because it is too random, and it never feels comprehensive enough.

 

[tkim]

http://www.intrainingprep.com/index.php

Watched the video. $50. Worth it.

 

[pinipig523]

For me, so far...

Tintinalli for 7 months (I read about half).

Then 1000 questions. Then I did all of Peer VII.

Currently reading through the second half of River's 2 books and will start Peer VIII tomorrow (too tired today).

Then finish up end of January.

And then repeat through the questions before the 2/29/12 inservice.

After that, I'll go back to reading another 500-700 pages of Tintinalli before my year is over. Then I'll start with the Ohio Acep CDs for the real deal and re-read my stuff.

 

[xaelia]

....

Then 1000 questions. Then I did all of Peer VII.

Currently reading through the second half of River's 2 books and will start Peer VIII tomorrow (too tired today).

....

After that, I'll go back to reading another 500-700 pages of Tintinalli before my year is over. Then I'll start with the Ohio Acep CDs for the real deal and re-read my stuff.

Yikes. Is there a prize for the highest score? All you gotta do is pass, man...focus on non-textbook knowledge to prepare for entering practice.

 

[Groove]

For me, so far...

Tintinalli for 7 months (I read about half).

Then 1000 questions. Then I did all of Peer VII.

Currently reading through the second half of River's 2 books and will start Peer VIII tomorrow (too tired today).

Then finish up end of January.

And then repeat through the questions before the 2/29/12 inservice.

After that, I'll go back to reading another 500-700 pages of Tintinalli before my year is over. Then I'll start with the Ohio Acep CDs for the real deal and re-read my stuff.

Good grief dude...

 

[pinipig523]

Good grief dude...

I noticed that once I started reading and I made it a part of my routine, it's something I can't stop doing.

Weird.

 

[BKN]

I noticed that once I started reading and I made it a part of my routine, it's something I can't stop doing.

Weird.

Don't take any grief. The point is to be the smartest doctor you can - a much higher hurdle than passing a fairly easy test. Good work!

 

[blackavar]

Can anyone shed some light on a specs of the exam?
Passing score?
How many questions?
Computer or paper?
What's a good goal as an intern?

I've started studying w/ PEER Questions and my general goal is to do both VII and VIII before the exam, but otherwise, just try to keep pace with my normal scattered reading topics...thoughts or advice for interns?

I don't really want to go crazy studying...but I'd like to make an attempt so that if it bombs, I have somewhere to go off of for next year.

 

[EM_Rebuilder]

Can anyone shed some light on a specs of the exam?
Passing score?
How many questions?
Computer or paper?
What's a good goal as an intern?

I've started studying w/ PEER Questions and my general goal is to do both VII and VIII before the exam, but otherwise, just try to keep pace with my normal scattered reading topics...thoughts or advice for interns?

I don't really want to go crazy studying...but I'd like to make an attempt so that if it bombs, I have somewhere to go off of for next year.

I do not think there is a 'passing score'..its just a score. You particular residency program probably has a goal set for each year you take it. On the 'real deal' (EM boards qualfying exam), a 75 is the passing score.

I *think* its about 225 give or take. I am sure this information is on abem.org.

It is a paper test sent to your program and adminstrered on the same day at all programs.... there will be the typical secure type situations you encountered when you took most any other standardized test.

I think the intern year is the hardest to do well on it as you tend to be off service and on very busy rotations. I think if you can do a 75 or better, you are doing pretty darn good. I think the important thing is to not fret that much if you do 'bomb' it with a bad score.

One way or another, take the test seriously. 10 people in my graduating EM class all did the same or a few points better than our last year inservice... it supposedly correlates rather well.

 

[pinipig523]

Can anyone shed some light on a specs of the exam?
Passing score?
How many questions?
Computer or paper?
What's a good goal as an intern?

I've started studying w/ PEER Questions and my general goal is to do both VII and VIII before the exam, but otherwise, just try to keep pace with my normal scattered reading topics...thoughts or advice for interns?

I don't really want to go crazy studying...but I'd like to make an attempt so that if it bombs, I have somewhere to go off of for next year.

Ah... we meet again blackavar.

Main thing is this year, just start a healthy reading schedule. Something that is a little less scattered so that you can actually track your progress through whatever particular book you are going through.

If I could do it over again, I'd read Tintinalli alongside Rivers Review Books and annotate on Rivers. That way, when it comes time to review again - I can just look at Rivers and it would trigger synaptic memories of what I read on Tintinalli.

I guarantee you, if you start a healthy reading habit your 2nd year (just do whatever you're doing for your intern year)... you'll annihilate the exam and your entire class.

Just read 10 pages a day. Doesn't sound like a lot. It'll take you a good 1 hour. Every day for the year. You'll get through an entire Tintinalli in approx 9 to 10 months.

 

[Groove]

So, to catch up with PinPig since I'm on the hind leg of 3rd year, I got up early this morning and read through Rosens once and am about halfway through Tintanalli. I ran out of paper in the house to write notes on (including toilet paper), so I'm using a magic marker and all the blank space on the walls in my study since there's no wallpaper. It's currently 3/4 covered, balancing on my chair to write on the crown molding is a bitch though, I won't lie about it. I'm going to break for lunch and then do the 1000 questions book, 100 times. In 10 days I'll have done 1000 questions...1000 times. In service, here I come.

lol... in all seriousness, looks like you've got a good system in place PP. I would say you are probably a rarity among most EM residents in your discipline staying up with all the reading.

 

[EM_Rebuilder]

So, to catch up with PinPig since I'm on the hind leg of 3rd year, I got up early this morning and read through Rosens once and am about halfway through Tintanalli. I ran out of paper in the house to write notes on (including toilet paper), so I'm using a magic marker and all the blank space on the walls in my study since there's no wallpaper. It's currently 3/4 covered, balancing on my chair to write on the crown molding is a bitch though, I won't lie about it. I'm going to break for lunch and then do the 1000 questions book, 100 times. In 10 days I'll have done 1000 questions...1000 times. In service, here I come.

lol... in all seriousness, looks like you've got a good system in place PP. I would say you are probably a rarity among most EM residents in your discipline staying up with all the reading.

Don't dis the Pig; thats why he has been recruited to the great state of TEXAS!

Carry on my friend.

 

[Groove]

Hey, no DIS. God knows it's not safe to risk retaliation from a crew of crazy Texans.

I was def poking fun, but hey... if someone can read Rosens and Tintanalli every single day, they are badass.

Did you do that Rebuilder? Tell the truth now my friend... I know you're on a high from passing the boards (congrats btw), but I know not all of you guys were doing anywhere near that type of reading and all of you still had 100% pass rate this year! Don't lie dude, I know you!

 

[pinipig523]

So, to catch up with PinPig since I'm on the hind leg of 3rd year, I got up early this morning and read through Rosens once and am about halfway through Tintanalli. I ran out of paper in the house to write notes on (including toilet paper), so I'm using a magic marker and all the blank space on the walls in my study since there's no wallpaper. It's currently 3/4 covered, balancing on my chair to write on the crown molding is a bitch though, I won't lie about it. I'm going to break for lunch and then do the 1000 questions book, 100 times. In 10 days I'll have done 1000 questions...1000 times. In service, here I come.

lol... in all seriousness, looks like you've got a good system in place PP. I would say you are probably a rarity among most EM residents in your discipline staying up with all the reading.

ROFL!

But the thing is, I should've started earlier... I went through my first 2 years just doing crappy review books and questions books. I just got my butt in gear starting PGY3 year - and the only thing that saves me is that I'm in a 4yr program and I haven't stopped reading since.

Yesterday, I read 40 pages of Rivers Review and did 25Q of Peer 8. The other day, I read another 40 pages of Rivers Review and did 25Q of Peer 8.

Today, another 40 pages of Rivers Review and another 25Q of Peer 8.

I stopped Tintinalli temporarily because I can't do 10p of Tintinalli while reading Rivers and doing questions.... it's too much.

Ah well... it is kinda fun just reading for my own knowledge. I feel smarter over time.

My goal is to finish Tintinalli before I graduate. Finishing Rivers and doing 1000 questions, Peer 7, and Peer 8 - these are my goals prior to the inservice.

Don't dis the Pig; thats why he has been recruited to the great state of TEXAS!

Carry on my friend.

Bwahaha... thanks broman.

Hey, no DIS. God knows it's not safe to risk retaliation from a crew of crazy Texans.

I was def poking fun, but hey... if someone can read Rosens and Tintanalli every single day, they are badass.

1. Yes, don't mess with Texans.
2. No, I am not a badass.

 

[pinipig523]

Truth be told, I feel behind.

Ideally, the ideal EM resident should have read:

- Rosens
- Tintinalli
- Rivers
- Ohio ACEP Audio review
- Podcasts EMcrit and EMrap
- 1000 Questions
- Peer 6
- Peer 7
- Peer 8
- 1400 Tintinalli Questions

I think that would be ridiculously badass.

 

[Colbert]

What is the 1400 Tintinalli Questions? I don't think I know that book

 

[pinipig523]

What is the 1400 Tintinalli Questions? I don't think I know that book

One of the seniors when I was a 2nd year gave them to me. I don't know where they came from but it is a freaking boatload of questions.

 

[Arcan57]

Truth be told, I feel behind.

Ideally, the ideal EM resident should have read:

- Rosens
- Tintinalli
- Rivers
- Ohio ACEP Audio review
- Podcasts EMcrit and EMrap
- 1000 Questions
- Peer 6
- Peer 7
- Peer 8
- 1400 Tintinalli Questions

I think that would be ridiculously badass.

Reading Rosen's is a complete waste of time. Better to read through the UpToDate or Emedicine ( I guess it's Medscape now) websites on ED pertinent topics. Agree completely with doing every PEER you can and following EM:RAP (+/- EMCrit) religously. Also, read through the list of LLSA articles each year.

 

[inspirationmd]

Wow. Thanks for all the strong advice on how to prep for this thing. I have a lot of work to do. Pretty much been doing CORD tests, reading Harwood-Nuss, and 1000 Questions for the EM boards. The Ohio ACEP CDs are expensive and I doubt I will get through much in the time I have left but I will see about buying them for review as residency goes on. Probably will try that $50 website and see if one of the seniors has PEER VII or VIII and try and jump on that. I'm in the MICU right now anyway so doing anything beyond that is gonna be tough.

Thanks again everyone.

 

[deleted206819]

Reading Rosen's is a complete waste of time. Better to read through the UpToDate or Emedicine ( I guess it's Medscape now) websites on ED pertinent topics. Agree completely with doing every PEER you can and following EM:RAP (+/- EMCrit) religously. Also, read through the list of LLSA articles each year.

I have to agree with this. As an intern and someone who just doesn't retain much after reading Tintinalli, EM:RAP and EMCrit have become my go to sources along with the PEER questions when I'm off but eMedicine is a great source when the patient is in front of me and I'm trying to brush up on the epidemiology, pathophys, workup, and treatment.

 

[pinipig523]

I have to agree with this. As an intern and someone who just doesn't retain much after reading Tintinalli, EM:RAP and EMCrit have become my go to sources along with the PEER questions when I'm off but eMedicine is a great source when the patient is in front of me and I'm trying to brush up on the epidemiology, pathophys, workup, and treatment.

I also use emedicine when the patient is in front of me, otherwise I think it's just a quick and dirty source.

I can understand your frustrations with Tintinalli, but as you said - you're an intern. I noted that these books are tough to digest unless you have the clinical experience to back up the reading (not so much the reverse). Keep reading, it'll get easier to retain as you accumulate clinical experience.

 

[Hamhock]

Truth be told, I feel behind.

Ideally, the ideal EM resident should have read:

- Rosens
- Tintinalli
- Rivers
- Ohio ACEP Audio review
- Podcasts EMcrit and EMrap
- 1000 Questions
- Peer 6
- Peer 7
- Peer 8
- 1400 Tintinalli Questions

I think that would be ridiculously badass.

I so hope you are joking.

So not necessary...

I would say the EM doc's job is to pass the ABEM exams but be moving beyond basic texts (based on the surgical and medical literature) and further develop the knowledge of true EM or at least understand there is a true EM knowledge that will help you and patients.

Pass and move on.

Would anyone argue that the highest scoring doc on the boards is likely to be far from the best EM doc?

HH

 

[pinipig523]

I so hope you are joking.

So not necessary...

I would say the EM doc's job is to pass the ABEM exams but be moving beyond basic texts (based on the surgical and medical literature) and further develop the knowledge of true EM or at least understand there is a true EM knowledge that will help you and patients.

Pass and move on.

Would anyone argue that the highest scoring doc on the boards is likely to be far from the best EM doc?

HH

I think that you can do both - why is it that if you are heavily involved in reading that you would not be a good clinician? How does reading hamper your ability to participate in clinical duties? If you read texts and invest time into it, you begin to develop a healthy habit of reading. This habit should get you to regularly read journals and relevant hot-off-the-press studies.

I don't get it.

This is the only forum that discourages further reading in place for basic, run-through-the-motions clinical work that every residency requires of you.

Just because you read does not make you a lesser clinician. The whole pass=MD is a tired mantra.

 

[physi]

http://emhigh.tumblr.com/

http://gmergency.tumblr.com/

 

[Hamhock]

I don't get it.

This is the only forum that discourages further reading in place for basic, run-through-the-motions clinical work that every residency requires of you.

Just because you read does not make you a lesser clinician. The whole pass=MD is a tired mantra.

I think you missed the point of my response.

In no way would I ever argue for less reading or that the pursuit of minimal knowledge is advisable.

However, I do still argue that reading Rosen's and Tintinalli's or directing your pursuit of knowledge to the testable cases/facts for the ABEM exam is a poor idea.

The goal is to be board-certified - so pass the test - but also to be the best EM doc...reading Rosen's, Tint's, Peer 6/7/8, Ohio ACEP, 1000 questions, etc is probably not the best way to do that. Yes, this may be the best way to prepare for the EM boards (which was the OP's question), but it is not the best way to become an excellent or well-read or knowledgeable EM doc.

So I stick by my previous point: read enough board prep stuff to pass and then move on to stuff that will help you as an EM doc.

While I certainly don't believe pass=MD is good early in medical education, I think it is good when it comes to the EM boards...focusing on this test at the expense of other reading is a poor choice...just pass it and move on to other reading.

HH

 

[leorl]

Agree with above.

The unfortunate reality is that the exam lags behind "current" literature by at least 5 years or so. When it comes to the EM Boards, you learn it to pass it. The EM Boards doesn't really have anything to do with how you practice clinically, except maybe to test you on some basic knowledge that everyone needs to know (unfortunately the way they test it I found pretty confusing). You have to learn for the exam.

But in order to become the "best" evidence-based practitioner, you have to do some higher level non-textbook reading (ie. journal articles).

Since this is completely off-topic, I found the best practice for the in-service was doing all of 1000 emergency medicine questions. I didn't really find that much correlation between the Peers and the exam.

 

[pinipig523]

Agree with above.

The unfortunate reality is that the exam lags behind "current" literature by at least 5 years or so. When it comes to the EM Boards, you learn it to pass it. The EM Boards doesn't really have anything to do with how you practice clinically, except maybe to test you on some basic knowledge that everyone needs to know (unfortunately the way they test it I found pretty confusing). You have to learn for the exam.

But in order to become the "best" evidence-based practitioner, you have to do some higher level non-textbook reading (ie. journal articles).

Since this is completely off-topic, I found the best practice for the in-service was doing all of 1000 emergency medicine questions. I didn't really find that much correlation between the Peers and the exam.

I can't disagree. But how would you go about reading literature if you don't even know the basics?

I think you should lay a solid foundation of knowledge, then start adding to it via new findings, protocols, ideas, literature.

 

[Rendar5]

By the second half of my second year, Tinitinalli just seemed so...vague? Just not enough depth for most EM topics. It's a great basics book, but as soon as I had to start preparing lectures, I realized how little there is to it in a large number of areas.

 

[leorl]

Pinipig, the thing I found and still find is that reading "higher" literature like journal articles does give you a good review of basics because in good articles often in the abstract, introduction and discussion sections they go through the basics in a succinct way, as well as discuss how they added to the wealth of knowledge on that topic but doing their specific research.

I'm not saying don't read any textbook because I still use and refer to textbooks (Tintinalli the most current edition has very good algorithm charts). But like Rendar, I found Tintinalli too basic and too vague to be really useful for boards studying. I also never read through Tintinalli all the way through during residency even though we designed our curriculum to cover the chapters . Harwood-Nuss is even worse than Tintinalli for being too basic. And Rosen's is just impossible to get through completely.

My personal feeling is that you should be getting basics + discussion on EBM and literature in your residency lectures and with your case interactions with your attendings. Then you "learn for the boards" by doing mainly questions in addition to board prep designed by your residency curriculum.

 

[la gringa]

+1 that reading more than 1 textbook is a waste... unless you just love reading textbooks. i found Rosen's to be more readable.

haven't touched Rosen's since sometime in residency... bought the new edition for my bookshelf and it has never been opened.

i found questions to be the most helpful.... did 1000 q's, PEER. did CORD my first year and didn't feel the need to repeat.

if anyone actually read all of Volume III of the old Rosen's, please raise your hand so you can be escorted to another specialty

(nb - i scored nearly well enough to pass after my IM prelim yr... then highest in my class my 2nd and 3rd yrs. no one ever said anything 4th yr. passed written and oral w/o taking any fancy courses. known in residency and after as being the one you ask if you don't know something... guess i'm a lucky gal b/c i was never the big studier)

 

[OccupyTheED]

Bump, I saw a chart a while back that shows your inservice score by PGY level and your projected chance of passing your oral and written boards, anyone have a copy or know where I can find it?

 

[HunterGatherer]

Peer VIII is $4.99 for iphone if you are an ACEP member. Offer only good for 24 hours as per ACEP email this morning.

 

[deuist]

Bump, I saw a chart a while back that shows your inservice score by PGY level and your projected chance of passing your oral and written boards, anyone have a copy or know where I can find it?

Here it is

 

[OccupyTheED]

Thanks!!

 

[Thoracotomy]

How can one really have that much time to read in residency? 26 shifts a month at 10 hours a shift (11Hrs w/ dictations), + grand rounds, +flight time, +interview socials, not to mention ICU months, +a wife. I feel I can only learn by doing.

Trying only to get through Peer VIII, hopefully that's enough for 1st year. Work less as a 2nd year.

 

[Arcan57]

How can one really have that much time to read in residency? 26 shifts a month at 10 hours a shift (11Hrs w/ dictations), + grand rounds, +flight time, +interview socials, not to mention ICU months, +a wife. I feel I can only learn by doing.

Trying only to get through Peer VIII, hopefully that's enough for 1st year. Work less as a 2nd year.

26 ten hour shifts is going to be a violation of duty hours. RRC requirements limit you to 60hrs/week while in the ED.

 

[BADMD]

How can one really have that much time to read in residency? 26 shifts a month at 10 hours a shift (11Hrs w/ dictations), + grand rounds, +flight time, +interview socials, not to mention ICU months, +a wife. I feel I can only learn by doing.

Trying only to get through Peer VIII, hopefully that's enough for 1st year. Work less as a 2nd year.

Which program is that? Beat Your Ass University? That would take some creative scheduling to pull off.

Most places are doing 18-21 shifts a month with a few doing fewer.

 

[patch28]

I'm still having trouble keeping my rash diagnosis straight. Everything looks just about like everything else. Does anyone have suggestions for a good, consolidated ED rash diagnosing guide?

 

[Colbert]

I'm still having trouble keeping my rash diagnosis straight. Everything looks just about like everything else. Does anyone have suggestions for a good, consolidated ED rash diagnosing guide?

This one isn't bad

http://lifeinthefastlane.com/wp-content/uploads/2013/01/Emergency-Medicine-Magazine-EM-Rashes.pdf

 

[Doctor Bob]

A not so subtle plug for a new inservice review book coming out.

It's the Pocket Guide to the ABEM Inservice Exam. It's good for quick review, it's something easy to use when you've got downtime on off-service rotations. It's also structured after the ABEM clinical practice guidelines (the document they use to make the exam).

Pre-orders now available either directly through the publisher
http://www.cambridge.org/us/knowledge/isbn/item7176712/?site_locale=en_US

or at Amazon.
http://www.amazon.com/Pocket-Americ...TF8&qid=1371413894&sr=8-1&keywords=1107696267

 

[physi]

Just recently took and passed the written boards with flying colors. Several of my colleagues and I (either taking the in-service, cert, and 1 person for re-cert) had the opportunity to review and learn from the following new app (Lightning Review for EM Boards): https://itunes.apple.com/us/app/lightning-review-for-em-boards/id628431616?mt=8

Would highly recommend checking it out to synthesize all of your information in the final 2-3 weeks of studying. Both solid content and pictures. Gave me at least 10-15 questions on the exam and helped me answer several more.

Also, social media has really arrived in how we learn. Would suggest the following few people for EM Boards review and feel free to search others:

- @UTHSCSAPearls
- @EMHighAK
- @EMEducation
- @EMBoardReview

Enjoy!

 

[@JackShephard]

Bump.

 

[deleted547339]

Bump.

Used HIPPO:EM - killed the in-service. Would highly recommend.

 

[@JackShephard]

Used HIPPO:EM - killed the in-service. Would highly recommend.

Could you tell me how Hippo is broken up?

Is it mostly video? Mostly audio? Or is the audio exactly the same as video?

 

[deleted547339]

Could you tell me how Hippo is broken up?

Is it mostly video? Mostly audio? Or is the audio exactly the same as video?

All video. Most are 10-20 mins. I usually just listen while I'm commuting, working out or working in the lawn. I don't think you miss a ton by not watching.

Also have like 800 practice questions.

There's a free trial online.

*no financial ties with hippo, just love the product.