4-5 cases on oral boards = pass?

[RadOnc2013]

Some have suggested to me that if you made it to the fourth case on an oral boards section, you've already passed that section. Is that really true? Doesn't totally make sense to me, cause couldn't you have made a failing mistake along the way? Or do they hold you back on the third case if they are gonna fail you?

Does making it through a fifth section (correctly) help much if you did poorly on other sections?

Thanks!

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[Chartreuse Wombat]

Some have suggested to me that if you made it to the fourth case on an oral boards section, you've already passed that section. Is that really true? Doesn't totally make sense to me, cause couldn't you have made a failing mistake along the way? Or do they hold you back on the third case if they are gonna fail you?

Does making it through a fifth section (correctly) help much if you did poorly on other sections?

Thanks!

This is not correct. Don't doubt me. Examiners are encouraged to get through at least 3-5 cases. If you make it to the fifth case it means nothing.

 

[medgator]

I would think that the 5th case could be interpreted either way.... you're either in the bonus round, or maybe your examiner trying to throw you a bone before a decision is made to condition you

 

[radiadouken]

I took the exam this year and I don’t think this is necessarily true. While in general I think getting through many cases is a good sign, I had examiners that clearly wanted to move VERY slowly and were super thorough at every step, while others said at the outset, “don’t care about H&P, want to get through many cases” and were more rapid fire. Clearly there is some examiner preference built in here.


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[ramsesthenice]

I took the exam this year and I don’t think this is necessarily true. While in general I think getting through many cases is a good sign, I had examiners that clearly wanted to move VERY slowly and were super thorough at every step, while others said at the outset, “don’t care about H&P, want to get through many cases” and were more rapid fire. Clearly there is some examiner preference built in here.


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Agree. I had a couple who really got into nitty gritty details (in a good way) and we only did 3-4 cases. Had couple that were closer to 5-7. Don’t think the number of cases necessarily means anything.

Anecdotally, I have heard a lot of people think they might of failed but did ok. I have not heard of Anyone who was honestly surprised to find out they failed.

 

[deleted18755]

I would think that the 5th case could be interpreted either way.... you're either in the bonus round, or maybe your examiner trying to throw you a bone before a decision is made to condition you

It's been awhile now but when I took the exam my first case on the first section was a borderline failing answer and I ultimately got through what seemed like a million but was probably 5 cases . . . I don't know for sure but I definitely thought the examiner was giving me extra cases to try to negate/average out the first poor or marginal response with 3-4+ excellent ones so I agree that going through a lot of cases could be interpreted either way.

PS: I passed but I honestly almost failed the second section because I couldn't stop thinking about the first one.

 

[scarbrtj]

This is not correct. Don't doubt me. Examiners are encouraged to get through at least 3-5 cases. If you make it to the fifth case it means nothing.

But what if I REALLY want to doubt you; am I allowed? Bob Kuske used to diagram a pyramid on a chalk board. At the base of the pyramid were like super-easy oral questions; if you missed those, you failed for sure (and would score a 68 in that category). Anyways, the pyramid had five levels. Once you got up to the apex, you were kind of in an esoteric category and the examiner was just letting you show off. You had definitely passed at that point. Getting something wrong in level 3 put you borderline for 69 (fail) or 70 (pass), but didn't always necessarily mean you would fail. Additional questions would be asked to show if you had that level 3 (midway up the pyramid) knowledge. If you got to the top level, you got a 72. If you got a couple 72's in some categories and a 69 in one category, but 70 or higher everywhere else, they'd usually pass you outright. So, this was years ago, and I doubt Bob still is an oral examiner. But there's some definite truth here. Don't doubt me! Bob used to really harp on this "levels of questions" thing.
EDIT: I do believe if you get a question about how to treat an IMN recurrence that abuts a previous XRT field two years after whole breast RT for a T2N0 ER+/Her2- patient you're going to pass the breast section.

 

[ramsesthenice]

But what if I REALLY want to doubt you; am I allowed? Bob Kuske used to diagram a pyramid on a chalk board. At the base of the pyramid were like super-easy oral questions; if you missed those, you failed for sure (and would score a 68 in that category). Anyways, the pyramid had five levels. Once you got up to the apex, you were kind of in an esoteric category and the examiner was just letting you show off. You had definitely passed at that point. Getting something wrong in level 3 put you borderline for 69 (fail) or 70 (pass), but didn't always necessarily mean you would fail. Additional questions would be asked to show if you had that level 3 (midway up the pyramid) knowledge. If you got to the top level, you got a 72. If you got a couple 72's in some categories and a 69 in one category, but 70 or higher everywhere else, they'd usually pass you outright. So, this was years ago, and I doubt Bob still is an oral examiner. But there's some definite truth here. Don't doubt me! Bob used to really harp on this "levels of questions" thing.
EDIT: I do believe if you get a question about how to treat an IMN recurrence that abuts a previous XRT field two years after whole breast RT for a T2N0 ER+/Her2- patient you're going to pass the breast section.

Different examiners have different approaches but there are a few facts:

Overall pass rate is very high. They are assessing for competance, not excellence.

Examiners have to justify failing an examinee to the rest of the group. I have first hand experience of a couple complaining about getting over-ruled and begrudgingly passing what they felt were boarderline examinees.

They absolutely can move on to other cases to try to help you shine if a previous case didn’t go so well. They know you are nervous and you have to do something really egregious to outright fail because of one bad case. Alternatively, if you are soaring they can keep digging deeper and pushing you as far as you can go with the case(s) you are acing. Number of cases means nothing.

It’s normal for high achievers to feel aweful walking out of board exams. Doesn’t change the first point. And we only have to wait a week or two to know for sure!

 

[Chartreuse Wombat]

But what if I REALLY want to doubt you; am I allowed? Bob Kuske used to diagram a pyramid on a chalk board. At the base of the pyramid were like super-easy oral questions; if you missed those, you failed for sure (and would score a 68 in that category). Anyways, the pyramid had five levels. Once you got up to the apex, you were kind of in an esoteric category and the examiner was just letting you show off. You had definitely passed at that point. Getting something wrong in level 3 put you borderline for 69 (fail) or 70 (pass), but didn't always necessarily mean you would fail. Additional questions would be asked to show if you had that level 3 (midway up the pyramid) knowledge. If you got to the top level, you got a 72. If you got a couple 72's in some categories and a 69 in one category, but 70 or higher everywhere else, they'd usually pass you outright. So, this was years ago, and I doubt Bob still is an oral examiner. But there's some definite truth here. Don't doubt me! Bob used to really harp on this "levels of questions" thing.
EDIT: I do believe if you get a question about how to treat an IMN recurrence that abuts a previous XRT field two years after whole breast RT for a T2N0 ER+/Her2- patient you're going to pass the breast section.

Bob Kuske has not examined in more than a decade. Stories from several years ago have little relevance to what is happening in 2018. The number of cases has nothing to do with whether you pass or fail.

 

[scarbrtj]

Bob Kuske has not examined in more than a decade. Stories from several years ago have little relevance to what is happening in 2018. The number of cases has nothing to do with whether you pass or fail.

So you're saying a kid who gets one case in the course of one section versus a kid who gets 6 cases with 3 being very complex have equal pass chances? OK. If that's true I'll believe it 'cause I sure have nobody on the inside to tell me otherwise and I suppose you're embedded. In other words, if you're doing well in a section you don't get more questions of increasing complexity; and the examiner doesn't do any additional probing for wrong answers vs correct answers (which would also lower the case/minute rate)...

 

[Radiated_GuineaPig]

Onco-lore has it that a decade or so back, an examinee was taking the oral boards right when the data came out that 2.25 Gy/fraction for larynx cancer was "superior" to standard 2 fraction. Apparently on his first case in the head and neck section the examiner (who happened to be a particularly gruff examiner) opened up his file. Started with the first case of a T1 larynx cancer. The examinee said 70 Gy in 35 fraction and the examiner closed his book and said we are done. Keep in mind this was <5 minutes into the section. Man it must have sucked to be that examinee.

I don't think this happens anymore at the boards, but this is an example of one instance where getting through more cases may have been better

 

[medgator]

Onco-lore has it that a decade or so back, an examinee was taking the oral boards right when the data came out that 2.25 Gy/fraction for larynx cancer was "superior" to standard 2 fraction. Apparently on his first case in the head and neck section the examiner (who happened to be a particularly gruff examiner) opened up his file. Started with the first case of a T1 larynx cancer. The examinee said 70 Gy in 35 fraction and the examiner closed his book and said we are done. Keep in mind this was <5 minutes into the section. Man it must have sucked to be that examinee.

I don't think this happens anymore at the boards, but this is an example of one instance where getting through more cases may have been better

Ridiculous. Technically that's a standard of care even now

 

[2014XRT]

Ridiculous. Technically that's a standard of care even now

Right - which is why that story must be lore and not fact. That wouldn't be a failable offense in 2018, let alone 2008 or 2003.