Oral Boards

Maybe an unpopular view, but I think the best review book to read for orals is Faust's keyword book - it has succinct 1 page write ups for the most important topics.

Read that, then just practice doing exams (read board stiff of course). I think the key is always doing practice exams. Faust contains all the knowledge you need to pass, but it is the delivery that will make or break you. If you don't know that cerebral oximetry works by measuring brain tissue blood - both arterial and venous and the percentages of each - big deal - this won't fail you, or you can't remember how oral hypoglycemics work - whatever....

But if you can't rattle off in 15 seconds why you think your patient may be hypertensive in the pacu, then you will not pass. No textbook is going to give you this skill, just practice practice practice.

As far as those big red/blue/yellow books - I can't stand them. Good job for Jensen though...he has made a ton of money on that crap.

epidural man said:

Maybe an unpopular view, but I think the best review book to read for orals is Faust's keyword book - it has succinct 1 page write ups for the most important topics.

Read that, then just practice doing exams (read board stiff of course). I think the key is always doing practice exams. Faust contains all the knowledge you need to pass, but it is the delivery that will make or break you. If you don't know that cerebral oximetry works by measuring brain tissue blood - both arterial and venous and the percentages of each - big deal - this won't fail you, or you can't remember how oral hypoglycemics work - whatever....

But if you can't rattle off in 15 seconds why you think your patient may be hypertensive in the pacu, then you will not pass. No textbook is going to give you this skill, just practice practice practice.
As far as those big red/blue/yellow books - I can't stand them. Good job for Jensen though...he has made a ton of money on that crap.

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Good post. Practice is the key to passing the orals. The first time that I attempted the oral exam I took Ho's course. Practicing and having reasonable answers to the most likely scenerios that pop up in anesthesia made all the difference for me the second time around.

I like the hand book to Anesthesia and Co-existing disease and Board Stiff -III. This is a good book also.


http://www.amazon.com/Key-Notes-Ane...=sr_1_1?s=books&ie=UTF8&qid=1284319433&sr=1-1

I think of every case as being a soap opera. the patient's medical condition and possible treatments will determine how the soap opera unfolds. The worse possible thing will happen during the case. For example 500# ob patient with a bad air way and the epidural just got pulled out. Oh, and now there are increasing late decels. What do we do and why are the important questions.

Cambie

If you really think about how you do each case and then ask yourself how to handle the opposite situation (ie like the easy airway is now blocked with a tumor, or you plan to use sux but now patient has MH, epidural but patient on lovenox) you can nail the boards.
But then get some one to ask you these, not so you can repeat what you know but can practice how to not sound like an idiot when you don't know the answer and can't BS your way out of this.

One of the most useful things I did when preparing for the oral exam was to write down 'probable' questions. There's a long list of classic questions that come up over and over and over again if you talk to people who've taken the exam.

Peak airway pressure is suddenly up, what do you think?
The patient is unarousable at the end of surgery.
What are your extubation criteria?
Should this patient be beta blocked?


Then actually compose complete but concise answers. Write them down, rehearse them OUT LOUD, and revise them so you don't stutter or trip over the words. It helps if you're talking to another person, but even solo practice is useful.

“Likely causes in this patient include a kinked or obstructed endotracheal tube, mainstem intubation, or bronchospasm. Other causes are inadequate depth of anesthesia or increased muscle tone, mucus plug, pneumothorax, pulmonary edema, VAE, aspiration, or foreign body. I would examine the circuit, tube, and patient, listening for bilateral breath sounds, assessing color and O2 saturation, hand ventilating to assess compliance, and suctioning the endotracheal tube. I might also obtain a CXR or perform bronchoscopy.”

“Delayed emergence may be due to pharmacologic, metabolic, or neurologic issues. Residual volatile agents, opioids, benzodiazepines, cholinergics, anticholinergics, and other medications can cause prolonged sedation. Hypoglycemia, electrolyte abnormalities, hypothermia, and other metabolic derangements. Neurologic problems such as elevated ICP, intracranial bleeding, or seizures may also be responsible.”

“The patient should be awake, breathing spontaneously, free of residual muscle relaxant or anesthetic agents, and have a low probability of needing to return to the OR in the immediate future. Specific respiratory criteria include a NIF of -20 or better, vc >15cc/kg, RR <35, adequate oxygenation and ventilation.”

"It's not absolutely clear who benefits from perioperative beta blockade, when the drugs should be given, how long they should be continued, or who is at highest risk for adverse events such as stroke. In this patient I would proceed with surgery and control her HR intraoperatively with a short acting beta-1 selective agent like esmolol."


These are just a few of what I put together before my exam. I rehearsed these words over and over like I was going to be an actor in a play. The above four questions came up on my exam, and although what I actually said varied a bit to fit the scenario, and I was cut off (repeatedly), it was just second nature to speak the words in a fluid, confident way.

These predictable questions are gimme's that you can rehearse in advance.


There's no substitute for time spent speaking though.

pgg said:

One of the most useful things I did when preparing for the oral exam was to write down 'probable' questions. There's a long list of classic questions that come up over and over and over again if you talk to people who've taken the exam.

Peak airway pressure is suddenly up, what do you think?
The patient is unarousable at the end of surgery.
What are your extubation criteria?
Should this patient be beta blocked?


Then actually compose complete but concise answers. Write them down, rehearse them OUT LOUD, and revise them so you don't stutter or trip over the words. It helps if you're talking to another person, but even solo practice is useful.

“Likely causes in this patient include a kinked or obstructed endotracheal tube, mainstem intubation, or bronchospasm. Other causes are inadequate depth of anesthesia or increased muscle tone, mucus plug, pneumothorax, pulmonary edema, VAE, aspiration, or foreign body. I would examine the circuit, tube, and patient, listening for bilateral breath sounds, assessing color and O2 saturation, hand ventilating to assess compliance, and suctioning the endotracheal tube. I might also obtain a CXR or perform bronchoscopy.”

“Delayed emergence may be due to pharmacologic, metabolic, or neurologic issues. Residual volatile agents, opioids, benzodiazepines, cholinergics, anticholinergics, and other medications can cause prolonged sedation. Hypoglycemia, electrolyte abnormalities, hypothermia, and other metabolic derangements. Neurologic problems such as elevated ICP, intracranial bleeding, or seizures may also be responsible.”

“The patient should be awake, breathing spontaneously, free of residual muscle relaxant or anesthetic agents, and have a low probability of needing to return to the OR in the immediate future. Specific respiratory criteria include a NIF of -20 or better, vc >15cc/kg, RR <35, adequate oxygenation and ventilation.”

"It's not absolutely clear who benefits from perioperative beta blockade, when the drugs should be given, how long they should be continued, or who is at highest risk for adverse events such as stroke. In this patient I would proceed with surgery and control her HR intraoperatively with a short acting beta-1 selective agent like esmolol."


These are just a few of what I put together before my exam. I rehearsed these words over and over like I was going to be an actor in a play. The above four questions came up on my exam, and although what I actually said varied a bit to fit the scenario, and I was cut off (repeatedly), it was just second nature to speak the words in a fluid, confident way.

These predictable questions are gimme's that you can rehearse in advance.


There's no substitute for time spent speaking though.

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High yield post!!!

Cambie

I also used Big Blue. I really liked it and did very well with writtens, so I went ahead and used Big Red. It was very similar to Big Blue, but different and geared more towards speaking. It worked for me.
I agree with the above posters that Board Stiff is also very good.
With regard to co-existing dz, many people think it is great for oral boards. For them maybe, for me, I can't imagine it being helpful. Way too many extraneous topics. You don't need to sift through that for high yield items. Get a review book, refresh the material, then begin saying it.
I was surprised at how fair the exam was. Very basic questions, like ST elevation in PACU after a whipple, what do you do? Pt has a double lumen tube and is desaturating what do you do? What are the advantages of an epidural for a pt undergoing an open AAA? Would you dose it during the case? why? why not? I swear to god that is the type of questions you'll get. You know what to do and why, but can you say it in an organized and concise fashion? That is really what you need to practice. There will be some odd ball stuff that you won't know, but if you do fairly well on the basic stuff you'll do fine. Big Red gives you all the common scenarios and a "script" for each situation. Not to memorize per se, but to be able to fall back on in forming your answers. A combination of this prep and practicing with many of the questions in Board Stiff was what I used. In hindsight I should have done more of the practice answering -- and definitely out loud with a partner.
Good luck

I used boards stiff. The stems were decent for the practice material. Anything I wanted to read up on I referred to anesthesia texts I already had or to CCM material I was using at the time

I second the posts recommending practice. Go back to your program and practice, find partners in your group and practice, get used to giving the responses out loud. The biggest obstical isn't knowing the material, it presenting it in a concise effective manner, and thinking on your feet.

Practice, practice, practice.

FYI, if you happen to take oral boards in Atlanta you can't order booze until after 11 or so. Eggs Benedict and bourbon, good post-boards breakfast.

tucker27705 said:

I agree with the above posters that Board Stiff is also very good.
With regard to co-existing dz, many people think it is great for oral boards. For them maybe, for me, I can't imagine it being helpful. Way too many extraneous topics.

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I am endorsing the hand book for Anesthesia and Co-Existing Diseases. This hand book contains a large volume of high yield topics. I skipped the section on genetic diseases. Anesthesia and Co-Existing Diseases is too much. The hand book is another story.

Cambie

I passed on the first attempt. I took the Ho course and found it helpful. As luck would have it, one of my knowledge gaps was identified during a private session at the Ho course that actually was on my real exam. If you go, I would recommend buying a lot of individual sessions, although I found the lecture wortwhile also. I honestly was not in any way paid or coerced to make this endorsement.

As far as reading, I found Yao and Artusio most worthwhile. I didn't attempt to read it cover to cover, or the entirety of each chapter, but I read the sections that addressed my knowledge gaps, or that seemed high yield. Best yet, Y&A can be purchased relatively inexpensively on Amazon martketplace, and it is something that I will continue to use as a reference.

My advice (unless you are super cocky/confident you don't need any advice) is to take the Ho course early. I didn't like the Ho book but found his 2 day weekend course as a wake up call to get ready for the orals.

After taking the orals, practice, practice, practice.

The orals is less about fundamental knowledge (hey if you passed the writtens, your knowledge is there). The orals is all about reasoning and reacting to adverse situation that you will face in real life as an expert in the field of anesthesiology.

If you have access to your old instructors who are Oral Board Examiners, schedule a meeting to have them do mock orals with you.

Than practice with your friends. Do it over the phone if they aren't close. Have one of your colleagues quiz you.

Really think the reason people mainly fail is not because of lack of knowledge but it's lack of practice. Of course there are a few who just "freeze/panic" like my sister did a few times. But usually you can overcome that through practice.

aneftp said:

If you have access to your old instructors who are Oral Board Examiners, schedule a meeting to have them do mock orals with you.

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This is excellent advice. Get a practice exam from an ACTUALLY board examiner. Their feedback is invaluable.

The rest of us are really FOS. I had the opportunity to get exams from at least 7 examiners - some of them senior. And their advice/feedback was very useful and consistent between them.

It was funny how it was in stark contrast to many of the other anesthesiologists that always said ridiculousness like "this is what they are looking for!" but really had no idea.

oh, and one more thing.

A lot of those examiners would tell me about their experiences doing the exam, and many of them said they HATED hearing the same answers that the courses drill into people. They said, it was always very obvious who took the courses because they have wrote answers and use similar language. One senior examiner said "I cringe when I hear that." He may have been referring to the term - "a graded induction" or perhaps "beat to beat monitoring" for an a-line. I can't remember.

Anyway, avoid both those.

And speaking of courses, they all were against them. They felt like they were run by people getting rich on the fears of residents - and they all said (cuz i asked them all that question - should i take a course) that practicing and reading with other residents and anesthesiologists is plenty.

As it has been said many times over and over - practice is the key - not spending money on someone's opinion who isn't a board examiner.

epidural man said:

A lot of those examiners would tell me about their experiences doing the exam, and many of them said they HATED hearing the same answers that the courses drill into people. They said, it was always very obvious who took the courses because they have wrote answers and use similar language. One senior examiner said "I cringe when I hear that." He may have been referring to the term - "a graded induction" or perhaps "beat to beat monitoring" for an a-line. I can't remember.

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I'm not an examiner but I think there's a place for memorized and rehearsed answers to predictable questions. I'd heard others say the same thing you did, that examiners can pick out the course-goers and hate the word-for-word course-taught answers. I easily believe that. I think Jensen sells a set of canned answers, "spiels" or something like that. I just wrote and rehearsed my own canned answers.

I went to Ho's course and thought it was OK, though mostly because there was a lot of talk time. He may have been preying on my fears, but I thought it was useful.

It was also reassuring in a morbid way to see some of the other students do public exams.

If you go to a good residency program, you don't need to take a course and you don't need to buy books to brush up for oral exams.

All you need is to have confidence in your training.

The oral exams aren't magic. There is no hocus-pocus involved in passing. It is very straight forward and the examiners just want you to be able to elaborate the how and why behind what you want to do to take care of a patient. If you've done plenty of cases with sick patients, you already know the questions they are going to ask. You've probably already seen many of the scenarios that will be described.

All you need is a few mock exams to get the feel for the questioning process.

Mman said:

If you go to a good residency program, you don't need to take a course and you don't need to buy books to brush up for oral exams.

All you need is to have confidence in your training.

The oral exams aren't magic. There is no hocus-pocus involved in passing. It is very straight forward and the examiners just want you to be able to elaborate the how and why behind what you want to do to take care of a patient. If you've done plenty of cases with sick patients, you already know the questions they are going to ask. You've probably already seen many of the scenarios that will be described.

All you need is a few mock exams to get the feel for the questioning process.

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I'm with MMan. The best advice I received from my program director was the simplest. When they ask you a question, just picture yourself in the holding area/OR/RR, etc. As you said above, you've taken care of these patients. You know what you do. So relax. The verbalizing of your answers will come with repeated practice.

I took Ho's 4 day course because a bunch of my attendings recommended it and because I was nervous having watched attendings I respected fail the exam. However, I really did not gain anything new from the course. My knowledge base was already adequate and I had practiced extensively prior to the course. So other than some more practice exams, I didn't get anything out of it. It was a waste of the departments money and my money (I got reimbursed for most of it). 9/10 of the Ho book went unread.

Also:

When they ask what do you think, they want a differential.

When they ask what will you do, they want a plan.

Straightforward -- answer the question. However, under stress the two questions can sound the same.

For me the most stressful part was waiting to go in the room. Once in the room I fell into a routine, and the time flew by.

Good luck.

pgg said:

Peak airway pressure is suddenly up, what do you think?
The patient is unarousable at the end of surgery.
What are your extubation criteria?
Should this patient be beta blocked?

“Likely causes in this patient include a kinked or obstructed endotracheal tube, mainstem intubation, or bronchospasm. Other causes are inadequate depth of anesthesia or increased muscle tone, mucus plug, pneumothorax, pulmonary edema, VAE, aspiration, or foreign body. I would examine the circuit, tube, and patient, listening for bilateral breath sounds, assessing color and O2 saturation, hand ventilating to assess compliance, and suctioning the endotracheal tube. I might also obtain a CXR or perform bronchoscopy.”

“Delayed emergence may be due to pharmacologic, metabolic, or neurologic issues. Residual volatile agents, opioids, benzodiazepines, cholinergics, anticholinergics, and other medications can cause prolonged sedation. Hypoglycemia, electrolyte abnormalities, hypothermia, and other metabolic derangements. Neurologic problems such as elevated ICP, intracranial bleeding, or seizures may also be responsible.”

“The patient should be awake, breathing spontaneously, free of residual muscle relaxant or anesthetic agents, and have a low probability of needing to return to the OR in the immediate future. Specific respiratory criteria include a NIF of -20 or better, vc >15cc/kg, RR <35, adequate oxygenation and ventilation.”

"It's not absolutely clear who benefits from perioperative beta blockade, when the drugs should be given, how long they should be continued, or who is at highest risk for adverse events such as stroke. In this patient I would proceed with surgery and control her HR intraoperatively with a short acting beta-1 selective agent like esmolol."

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Who needs Niels Spiels when you've got PGG's Bees Knees? (...hey you try to find something better that rhymes with pgg). I don't think anyone would be too upset if you dazzled us with a few more of those homemade "canned" answers.

Oh, another thing.

The examiners WANT to pass you. They don't want to fail you. I've had multiple senior examiners tell me that there are 3 kinds of exams.

1) Examinee cruises through

2) Examinee struggles a little

3) Examinee has no business passing


Situations 1 and 3 are easy for them to deal with. Situation 2 is the one we all worry about. Guess what? When somebody is struggling, they lob softballs to try to get you back on track. They want you to pass. They try anything to get you to give them the right answer (or perhaps better...a right answer).

They'll work with you to get you back on track and give you a chance to show what you know.

The majority of people that fail do so for one of 2 reasons. They are either so nervous they can't perform or they just don't know what they are talking about.

Another tip from a guy who examined for 25+ years...

When they ask you what you would do, tell them what you would do. Don't tell them what you think they want to hear. Tell them what you do every day in that situation and if they ask, explain why.

Arch Guillotti said:

It was sort of like the twilight zone of anesthesiologists.

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Surreal and dodgy, to be sure.

Narcotized said:

I don't think anyone would be too upset if you dazzled us with a few more of those homemade "canned" answers.

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Shrug, dazzling is pretty generous, I was going for short simple and speakable. I think most of the test prep value comes from rolling your own. Plenty of textbooks out there to memorize. I suppose if there was interest I could post the rest of them. They're not organized in any way.

pgg said:

Shrug, dazzling is pretty generous, I was going for short simple and speakable. I think most of the test prep value comes from rolling your own. Plenty of textbooks out there to memorize. I suppose if there was interest I could post the rest of them. They're not organized in any way.

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There is a lot of interest, honestly.

or, eh, wait, did you mean interest rate?

The ones who are now in intense prep ( 10 days left) are just scrolling diagonally the forum, but certainly will appreciate highly some more bee knees

Don't want to try to reformat for SDN so here's a the Word .doc

There are about 30 in that file. No particular organization. Random questions from whatever stem I was practicing at the time. A few extra notes mixed in. The rest of what I've got are handwritten scribbles in board stiff 3 or Ho's workbook.

No warranty or guarantees for accuracy or suitability for any particular purpose.


Looking back over them, the absolute last topic on there is 'transplant' ... with nothing written after it because I didn't get around to reviewing that topic. My first stem and two grab-bag questions were transplants. Kidney and pancreas, liver. But I flubbed my way through those anyway ...

pgg said:

Don't want to try to reformat for SDN so here's a the Word .doc

There are about 30 in that file. No particular organization. Random questions from whatever stem I was practicing at the time. A few extra notes mixed in. The rest of what I've got are handwritten scribbles in board stiff 3 or Ho's workbook.

No warranty or guarantees for accuracy or suitability for any particular purpose.


Looking back over them, the absolute last topic on there is 'transplant' ... with nothing written after it because I didn't get around to reviewing that topic. My first stem and two grab-bag questions were transplants. Kidney and pancreas, liver. But I flubbed my way through those anyway ...

Click to expand...

Thank you, thank you, thank you

Mman said:

Oh, another thing.

The examiners WANT to pass you. They don't want to fail you. I've had multiple senior examiners tell me that there are 3 kinds of exams.

1) Examinee cruises through

2) Examinee struggles a little

3) Examinee has no business passing


Situations 1 and 3 are easy for them to deal with. Situation 2 is the one we all worry about. Guess what? When somebody is struggling, they lob softballs to try to get you back on track. They want you to pass. They try anything to get you to give them the right answer (or perhaps better...a right answer).

They'll work with you to get you back on track and give you a chance to show what you know.

The majority of people that fail do so for one of 2 reasons. They are either so nervous they can't perform or they just don't know what they are talking about.

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This is true. I knew that I bombed the exam during my first attempt when I left the hotel. My examiners slowed their pace a little and were very gentle with me. I was simply unprepared. I was one of those deer in the head lights. I was given more time to answer the questions. I would not have respected the ABA if they passed me on my first attempt at the exam. I really sucked.

My second attempt was very different. I kept up with the examiners and was a lot more self confident. Practice made all the difference for me.

Cambie

CambieMD said:

This is true. I knew that I bombed the exam during my first attempt when I left the hotel. My examiners slowed their pace a little and were very gentle with me. I was simply unprepared. I was one of those deer in the head lights. I was given more time to answer the questions. I would not have respected the ABA if they passed me on my first attempt at the exam. I really sucked.

My second attempt was very different. I kept up with the examiners and was a lot more self confident. Practice made all the difference for me.

Cambie

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Takes some cojones to come out and be honest like that

It can happen to anybody. Even the smartest ones out there....

FWIW, I think Ho's book is excellent.

Just spent a couple hours on the phone with a senior examiner that has been testing for many many years. I hope this list helps some of you guys taking it next week.

1. Speak to them like they are a colleague.
   
2. Do what you would do in everyday life.
   
3. Don't try to guess what the examiner is thinking.
   
4. Answer the question and move on (don't be thinking about how you answered your first question when you are listening to the third).
   
5. There is a rhythm to the test. Once you find it, it goes much smoother.
   
6. Organize your thoughts. Always start with the forest and then home in to the tree: A patient has hepatitis C and has cirrhosis what are your concerns? Start your answer like this: Cirrhosis is a multi systemic disease. It affects the CNS, respiratory, cardiovascular, renal, hematological systems... etc.. etc... Don't jump into why they have low oncotic pressures.
   
7. They will ask you for detail if they want it. Don't be overly verbose.
   
8. It is OK to ask the examiner to repeat the question in a different way.
   
9. They are not there to trick you. You will have scenarios where you need to take the lesser of 2 evils and then don't forget to defend your answer.
   
10. Be CONFIDANT. Don't be overconfident. The examiners are smarter than you and if you feel like you have something to teach them, you will loose.

Good luck SDN takers.

Arch Guillotti said:

I agree that there are basically three types of examinees because when I was in residency one of the senior board examiners told me as much.

I am not sure about them wanting you to pass. I felt like I struggled at times with the scenarios and I don't think I got lobbed any softballs - of course I may have been overanalyzing in hindsight.

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You may have felt like you struggled, but that is probably overanalyzing if you did indeed pass.

I mean if they had already seen enough to pass you, they certainly weren't going to take it easy the rest of the way. But as far as I know, they aren't going to fail you without trying to coax you through the exam.

The only opinions worth anything are from folks who have been examiners for several years (or those who are quoting them). No-one else has experienced more than one exam, and if they have do you really want to be taking advice from them (that is why I am not a fan of the courses)?

The exception to this rule is friends who have failed, retaken, and passed. They can tell you what they did differently, but even they won't really know why they failed the first time and passed later. Could just be they think and express themselves more like the second set of examiners.

I looked over Faust and Board Stiff to jog my memory on topics. If I felt weak in a particular area, I went to the textbooks. I did the three practice oral exams that were mandatory in residency and just rehearsed the key anesthesia emergency scenarios in my head. I felt pretty comfortable with this preparation and I passed. I have no idea which of the 3 categories I fell into.

Ultimately, we all practice differently but within about a standard deviation of each other so I assume the examiners are just looking for people who are consistently 3 standard deviations off with their answers.

Provide a cogent, safe anesthetic assessment and plan, don't be afraid to say I don't know once or twice, and don't perseverate on the answer you screw up cause everyone I have talked to that has taken the test has royally screwed up one or two answers.

- pod

periopdoc said:

Provide a cogent, safe anesthetic assessment and plan, don't be afraid to say I don't know once or twice, and don't perseverate on the answer you screw up cause everyone I have talked to that has taken the test has royally screwed up one or two answers.

- pod

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FWIW, I was specifically told NOT to say "I don't know". First, if you know something about the subject at hand, then say it- it shows some sort of understanding. Second, a better answer is "I don't recall at this time". I know it means the same thing, but it sounds much better to an oral board examiner who is going give you a pass or fail.

Example:

What does alpha stat vs ph stat mean? Well, I don't fully recall at this time, but it has to do with CO2 solubility and respiratory alkalosis during hypothermia. = Much better answer than "I don't know". You'll get some points with that answer.

Of course if you know something about the subject then share what you know to the limits of what you know and stop.

If you truly don't know then "it is better keep your mouth shut and be thought a fool then to open it and remove all doubt." No sense wasting time stumbling about when you can move onto the next question, which happens to be a topic you published on prior to med school. This is exactly what happened to me when I said I don't know and I am so glad I didn't waste precious time on the first question. It gave me more time to shine on the next one.

This is a judgement test. One of the most important judgements we make in life is knowing the limits of our knowledge and when we need to consult an expert, or look it up. Sure you are going to flunk if you "don't know" a good alternate plan B for your airway management plan A, or if your strategy for the test is to answer I don't know to any question for which you don't have a rehearsed and memorized answer, but if they ask you some ICU esoterica on, say, the mineral content of a particular tube feed and how it might affect your anesthetic management, I believe that "I don't know" is a perfectly acceptable answer. Perhaps you should be more explicit and state I don't know, but I would contact a pharmacist for the information, but the former worked for me. It communicated my desire to move on which we did.

- pod

periopdoc said:

Of course if you know something about the subject then share what you know to the limits of what you know and stop.

If you truly don't know then "it is better keep your mouth shut and be thought a fool then to open it and remove all doubt." No sense wasting time stumbling about when you can move onto the next question, which happens to be a topic you published on prior to med school. This is exactly what happened to me when I said I don't know and I am so glad I didn't waste precious time on the first question. It gave me more time to shine on the next one.

This is a judgement test. One of the most important judgements we make in life is knowing the limits of our knowledge and when we need to consult an expert, or look it up. Sure you are going to flunk if you "don't know" a good alternate plan B for your airway management plan A, or if your strategy for the test is to answer I don't know to any question for which you don't have a rehearsed and memorized answer, but if they ask you some ICU esoterica on, say, the mineral content of a particular tube feed and how it might affect your anesthetic management, I believe that "I don't know" is a perfectly acceptable answer. Perhaps you should be more explicit and state I don't know, but I would contact a pharmacist for the information, but the former worked for me. It communicated my desire to move on which we did.

- pod

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They will never ask you that. If they are, you passed the test like 10 questions ago.

periopdoc said:

Perhaps you should be more explicit and state I don't know, but I would contact a pharmacist for the information.

- pod

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Asking for a consult when you don't know something is a great weapon on the test and in real life.

sevoflurane said:

Asking for a consult when you don't know something is a great weapon on the test and in real life.

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just my opinion, but be wary of asking for a consult on the oral boards. If you did, I'd suggest you have a very specific question in mind that you are asking the consultant. And if your consult is going to delay the case, they can just make the same patient fall down and have an open tibia fx and become emergent and then you have to proceed without the consult.

So asking for a consult might be appropriate, but do so with caution. In general, they aren't trying to assess your ability to call a consult.

Mman said:

just my opinion, but be wary of asking for a consult on the oral boards. If you did, I'd suggest you have a very specific question in mind that you are asking the consultant. And if your consult is going to delay the case, they can just make the same patient fall down and have an open tibia fx and become emergent and then you have to proceed without the consult.

So asking for a consult might be appropriate, but do so with caution. In general, they aren't trying to assess your ability to call a consult.

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There is a script that the examiners follow. They don't make the patient do anything unless it says so in the script (but every script is gonna throw something at you at some point). They are fine with consults; if you would normally call a consult in the situation, then call a consult. If not, then don't.

I have been told that your best bet is to practice mock orals. However you want to accomplish that is up to you, whether it's with your colleagues, courses, or Skype mock orals.

uhh, i mean, "no, books are the way to go, buy every oral board review book there is and of course you will pass" LOL! j/k sorry, you know i gotta throw that in there!

loved the course and the books very current and evidence based U master the course and go punk the examiners. I have the brand new in shrink rap books for sale, just pm me

Contrary to the mood of this forum I think the big Ho book is the best source for the prep, providing you've already have the basic knowledge (which you do ))))

I've read it before I went to his 4 day crash course and actually the most helpful part of the course was the mock orals and some boost to my confidence by watching others - not bragging at all, but that helped a lo )))

Can someone make this thread a sticky? There is a lot of good information on this thread.

hoyden said:

Contrary to the mood of this forum I think the big Ho book is the best source for the prep, providing you've already have the basic knowledge (which you do ))))

I've read it before I went to his 4 day crash course and actually the most helpful part of the course was the mock orals and some boost to my confidence by watching others - not bragging at all, but that helped a lo )))

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I am one of those who doesn't care for Ho. His book is as large as a telephone book and contains way too much detail for the oral exam. I handed over large sums of $$$ over to Ho, twice.

Most people will pass the orals with no sweat on their first attempt. There is a small subset of individuals, present company included who require more effort to clear the orals.

I cannot overemphasize the role of practice in doing well on the orals. I struggled with getting my answers out in a fluent convincing manner. A couple days of sitting in a large lecture hall will not fix that.

It may be entertaining watching a poor soul struggle in front of two hundred people but does it really help. Entertaining yes, high yield no.

After you have been through this process you can tell whether or not someone is ready for the exam. I can tell just based on how they tell a story or speak in general.

The ABA is looking for reasonable answers delivered in a convincing fashion.

I keep saying the same thing over and over. The Ho text and Yao are too much. Board Stiff -3, the Hand Book for Anesthesia and Co-Existing Diseases got me through the exam. This is also a good book,

http://www.amazon.com/Key-Notes-Ane...1_fkmr3_1?ie=UTF8&qid=1293465487&sr=1-1-fkmr3

I think that the oral board process serves a very useful purpose. We will spend the rest of our careers defending and explaining our anesthetic plans to surgeons, patients and other physicians. I tknow that I am a better physician because of the process that I went through and the growth that took place in me.

If you have struggled with the oral boards I would suggest finding attendings who can give you high quality mock oral exams and decent feed back.

Cambie

CambieMD said:

I am one of those who doesn't care for Ho. His book is as large as a telephone book and contains way too much detail for the oral exam. I handed over large sums of $$$ over to Ho, twice.

I cannot overemphasize the role of practice in doing well on the orals. I struggled with getting my answers out in a fluent convincing manner. A couple days of sitting in a large lecture hall will not fix that.

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Couldn't agree more. I dont think it was the kind of test where one should emphasizing studying a large text for hours a day. The Ho book to me seems like it misses the mark entirely. To be fair, I can't say I read it through, just skimmed parts of it. Overkill IMHO.

If any text proved useful to me, it was Reed's Clinical Cases in Anesthesiology. Also going through the ABA practice orals and looking up topics that seemed to come up often.

Best bet, practice with examiners.

Precedex said:

Couldn't agree more. I dont think it was the kind of test where one should emphasizing studying a large text for hours a day. The Ho book to me seems like it misses the mark entirely. To be fair, I can't say I read it through, just skimmed parts of it. Overkill IMHO.

If any text proved useful to me, it was Reed's Clinical Cases in Anesthesiology. Also going through the ABA practice orals and looking up topics that seemed to come up often.

Best bet, practice with examiners.

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Agreed!

To pass the oral exam, you just have to give rational answers in a clear and concise fashion. There is no magic to it. Hopefully by completing residency you have the knowledge base down. Practicing gets you used to being put on the spot to produce answers in difficult situations. There are a lot of possible right answers to almost any question you get asked, you just have to produce one and be able to defend it.

CambieMD said:

I am one of those who doesn't care for Ho. His book is as large as a telephone book and contains way too much detail for the oral exam. I handed over large sums of $$$ over to Ho, twice.

Most people will pass the orals with no sweat on their first attempt. There is a small subset of individuals, present company included who require more effort to clear the orals.

I cannot overemphasize the role of practice in doing well on the orals. I struggled with getting my answers out in a fluent convincing manner. A couple days of sitting in a large lecture hall will not fix that.

It may be entertaining watching a poor soul struggle in front of two hundred people but does it really help. Entertaining yes, high yield no.

After you have been through this process you can tell whether or not someone is ready for the exam. I can tell just based on how they tell a story or speak in general.

The ABA is looking for reasonable answers delivered in a convincing fashion.

I keep saying the same thing over and over. The Ho text and Yao are too much. Board Stiff -3, the Hand Book for Anesthesia and Co-Existing Diseases got me through the exam. This is also a good book,

http://www.amazon.com/Key-Notes-Ane...1_fkmr3_1?ie=UTF8&qid=1293465487&sr=1-1-fkmr3

I think that the oral board process serves a very useful purpose. We will spend the rest of our careers defending and explaining our anesthetic plans to surgeons, patients and other physicians. I tknow that I am a better physician because of the process that I went through and the growth that took place in me.

If you have struggled with the oral boards I would suggest finding attendings who can give you high quality mock oral exams and decent feed back.

Cambie

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I certainly agree with you that strategy changes with arising problems and sometimes it might be pure luck in the results one gets.

The reason it is helpful to watch others struggle is not entertainment ( you do not go there for entertainment) but mentally placing yourself immediately on the spot - most of the questions they were asked I knew how to answer. Obviously, it is way too much harder to perform on a stage, but you are not going to be on a stage while answering to your examiners - that is why watching the whole process is very helpful by itself. Has nothing to do with fun - everybody usually is very respectful to the ones willing to volunteer the embarassment ( at least that is how I see it).

hoyden said:

everybody usually is very respectful to the ones willing to volunteer the embarassment ( at least that is how I see it).

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Yeah, he tore up everybody on the stage, and nobody poked fun. I have no doubt that had I volunteered for the hot seat, he would have found holes in my knowledge and made me flounder and fumble around somewhat.

But I still wouldn't have said some of the eye-poppingly crazy stuff some of those people did. However charitable and kind you are, there's no 'stress of public exam' kind of explanation for the many kill errors displayed, and a large percentage of the bad answers were just straight up basic knowledge gaps.

So as long as one keeps in mind that the people on display are not a cross section of average candidates (ie, it's largely a group of prior failures and worried people), the experience can be a confidence builder. I think it pays to remember the size of the pond before getting any big fish kind of opinions of yourself. I didn't leave the course cocky by any means, but I felt better about my preparation. I still sweated the result though, much to the consternation of my family & non-anesthesia friends who couldn't understand why I was worried about failing it.

pgg said:

Yeah, he tore up everybody on the stage, and nobody poked fun. I have no doubt that had I volunteered for the hot seat, he would have found holes in my knowledge and made me flounder and fumble around somewhat.

But I still wouldn't have said some of the eye-poppingly crazy stuff some of those people did. However charitable and kind you are, there's no 'stress of public exam' kind of explanation for the many kill errors displayed, and a large percentage of the bad answers were just straight up basic knowledge gaps.

So as long as one keeps in mind that the people on display are not a cross section of average candidates (ie, it's largely a group of prior failures and worried people), the experience can be a confidence builder. I think it pays to remember the size of the pond before getting any big fish kind of opinions of yourself. I didn't leave the course cocky by any means, but I felt better about my preparation. I still sweated the result though, much to the consternation of my family & non-anesthesia friends who couldn't understand why I was worried about failing it.

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Agree with everything 100%. Even the family/friends reaction

pgg said:

Yeah, he tore up everybody on the stage ...

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As an addition - when HE placed himself on a spot - some of his examiners did the same thing to him( well, almost))))