Failed Oral Board second time around

[Eyeforyou]

Hi,

Miserable here - failed Oral Board second time around. I attended the Osler Mock sessions both times. I thought I did a good enough job this time around.

Did residency at a top tiered program too.


Any thoughts or anyone with similar experiences to help me get through this? I really need to pass the next one. I am not sure what I am missing - I finish almost all of the cases in each room. Only remember one or two cases that were difficult.

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[MR1]

Is English your first language? Anyway you might be coming off arrogant? Are you giving a decent differential on each case. Have you ever argued with the examiner? Do you ever go off on a tangent about a topic?

These are things that I have heard cause failures. So just asking.

 

[Eyeforyou]

Appreciate your input.

First language - English

Maybe coming off as arrogant? I don't think so, as I was actually nervous and usually pretty humble.

Are you giving a decent differential on each case? Tried to - but maybe I missed a few? But I know that I am supposed to. Otherwise, wouldn't they ask me to name more? That happened maybe once, if I recall correctly.

Have you ever argued with the examiner? Never

Do you ever go off on a tangent about a topic? I am usually to the point, but maybe I did stray on topic if I totally missed the boat on the picture that they are presenting.

Thinking back at the questions - there were a few that I was not comfortable with, but overall with a little prodding / help by the tester, I was able to reach the diagnosis or felt that I satisfied their questions.

I welcome any other advice. I really must be missing something, and I would like to know what it is.

 

[MullerCell]

Did you finish all the questions in each room? I felt that moving at a good pace with each examiner was really important in order to complete all 10 cases in each room and give you the best chance of getting enough cases with a satisfactory response. My understanding is that if you don't get through enough cases in a room, even if your answers are perfect, you still fail that room.

 

[Visionary]

Sounds like you're getting through enough questions. The main stumbling point for candidates is "skipping to the end." In other words, even if you know the answer right away, you must demonstrate your thought process by providing a broad differential, workup, and treatment strategy. The examiner will not necessarily prompt you to do so. You are awarded points for different steps in that process. Getting the correct answer is actually only a small part. Here's the outline I recommend following:

1. Look at the picture (if there is one), then read the vignette.
2. Identify to the examiner, in general terms, what you're looking at (e.g., "In this photograph, the cornea has a whitish infiltrate centrally, and the conjunctiva is diffusely injected").
3. Share your differential with the examiner (e.g., "I would be most concerned for a form of infectious keratitis, which may include....").
4. Describe any additional history you would want and any work-up you would pursue to narrow that differential (e.g., "I would want to know if the patient is a contact lens wearer, and if so how they care for their lenses....").
5. You may or may not get a response to your queries from the examiner. If so, great. If not, proceed to describe your management of what you feel to be the most likely diagnosis.

I always focused on the examination booklet and rarely looked at the examiners. There is a natural tendency to try and read their faces to tell how you're doing. That's a mistake. It will only trip you up. Imagine you are just going over the cases to yourself back at home.