ABA's new ACA exam

[CardiacIntensivist]

Hey all. My department is requiring us to take the ACA boards so it is inevitable. Moving forward, it seems like an unescapable thing seeing as how there is a CCM, NeuroCCM, Pediatrics, Pain etc etc etc that all went into effect and stayed. I am looking at the outline and am seeing if anyone has any suggestions on how I can read up on this particular part of their outline

What has really been annoying are all theses subjects that I have NEVER touched upon that I now need to study. I have NEVER needed to know how to read a cardiac cath or a cardiac MRI but suddenly I do? Anyway, any suggestions on the part of the outline I posted would be super helpful.

Thanks!

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[psychbender]

With the number of quarks on the exam and the content outline, that entire section will pendant only have 10-15 questions. They will likely be easier questions, because they're not really important. Also, you can probably just guess on those, and be fine. I didn't bother studying for derm topics when I studied for my CCM boards, as I knew they'd be at max seven questions, and that can be easily written off.

 

[Bertelman]

I feel that some of those topics are semi-requirements or issues that the ABMS feels should be covered. Kind of like riders in a contract.

Oh, you want to certify a new subspecialty? Then you better include informatics, and billing, and compliance in the topic outline.

I haven't tried them yet, but SCA is building a pretty robust outline series for the exam. I also intend on buying the new Kaplan when it is released. Hopefully either of those resources should cover a superficial understanding of your list above.

 

[Beeftenderloin]

Hey all. My department is requiring us to take the ACA boards so it is inevitable. Moving forward, it seems like an unescapable thing seeing as how there is a CCM, NeuroCCM, Pediatrics, Pain etc etc etc that all went into effect and stayed. I am looking at the outline and am seeing if anyone has any suggestions on how I can read up on this particular part of their outline

View attachment 376275

What has really been annoying are all theses subjects that I have NEVER touched upon that I now need to study. I have NEVER needed to know how to read a cardiac cath or a cardiac MRI but suddenly I do? Anyway, any suggestions on the part of the outline I posted would be super helpful.

Thanks!

For cardiac MRI, just pick late gadolinium enhancement and that’s should cover you for half the questions on the topic.

 

[Iso4ane]

Or CBT or SSRI (and by extension Serotonin Syndrome) for anyone with a psych history.

 

[T-burglar]

Understanding the economics of cardiothoracic anesthesia and cardiothoracic surgery and everything that goes on with the revenue cycle is actually relevant to any attending physician.

It’s boring until you’re in private practice and start to develop an interest because of how much more important charge capture and sound business practice is to the health of your group.

Our collective disinterest in this is how academic hospitals have historically been able to bend us over with such low salaries. It’s only due to this national shortage of providers that academic hospitals are forced to pay us what we’re worth now (and then some). Quite a stroke of luck

 

[CardiacIntensivist]

Understanding the economics of cardiothoracic anesthesia and cardiothoracic surgery and everything that goes on with the revenue cycle is actually relevant to any attending physician.

It’s boring until you’re in private practice and start to develop an interest because of how much more important charge capture and sound business practice is to the health of your group.

Our collective disinterest in this is how academic hospitals have historically been able to bend us over with such low salaries. It’s only due to this national shortage of providers that academic hospitals are forced to pay us what we’re worth now (and then some). Quite a stroke of luck

So….how did you learn about it all?

 

[CardiacIntensivist]

I already looked through all the topics from the SCA review. Granted they still have 7 more topics to go hut none thus far cover what is noted as “other topics” on the ABA outline. Hopefully one of pending topics to be released will!

I dont remember this weird topics on the CCM or Anes boards. Perhaps I blanked it out from the stress….

 

[nimbus]

Hey all. My department is requiring us to take the ACA boards so it is inevitable. Moving forward, it seems like an unescapable thing seeing as how there is a CCM, NeuroCCM, Pediatrics, Pain etc etc etc that all went into effect and stayed. I am looking at the outline and am seeing if anyone has any suggestions on how I can read up on this particular part of their outline

View attachment 376275

What has really been annoying are all theses subjects that I have NEVER touched upon that I now need to study. I have NEVER needed to know how to read a cardiac cath or a cardiac MRI but suddenly I do? Anyway, any suggestions on the part of the outline I posted would be super helpful.

Thanks!

How many boards do you already have? How many hearts have you done? If you don’t take the exam, will they fire you?

 

[CardiacIntensivist]

How many boards do you already have? How many hearts have you done? If you don’t take the exam, will they fire you?

technically 4 boards, this would make 5. I do plan on taking the pacer/ICD device boards at some point in the near future just for funsies. I've lost count of how many hearts, it's been quite a few years already. I don't know if they will 'fire' me but honestly, I would take it anyway. This board is likely here to stay and if I change jobs I don't want the added stress later of having to take it then.

Anyway, I assume the first pass has the best curve, I could be wrong but I took the first CCeEXAM and it wasn't that hard. From what I hear, it seems to have evolved in the past 4 years.

 

[T-burglar]

So….how did you learn about it all?

Putting myself in an environment where it’s more front and center , surrounded by people with a real vested interest in balancing the books themselves who I could learn from. And my own reading and investigation.

I’m talking about how the world of healthcare business really works though, not whatever this test will have in the form of 2 questions

 

[GassYous]

Putting myself in an environment where it’s more front and center , surrounded by people with a real vested interest in balancing the books themselves who I could learn from. And my own reading and investigation.

I’m talking about how the world of healthcare business really works though, not whatever this test will have in the form of 2 questions

Talk to surgeons that are in the know. It's amazing how much the facility fees are for cases like spine and cardiothoracic.

You do a hip scope on a healthy girl and make like 800 bucks, the surgeon gets 2k and the center makes 20k. The numbers get insane on some of the cases.

 

[Leinie]

I haven't tried them yet, but SCA is building a pretty robust outline series for the exam. I also intend on buying the new Kaplan when it is released. Hopefully either of those resources should cover a superficial understanding of your list above.

I went to the SCA website but didn't see the outline series anywhere. Do you have a link?

 

[T-burglar]

It’s interesting also to become aware of the things that chip away at the gross profit of the facility fee. An ICU stay, blood transfusion, delirium, an entire team of highly paid professional technicians and equipment (cardiopulmonary bypass) etc

Once you see this you understand why it’s so difficult to get cardiac surgery right in 2023. In a way that the clinical operations pay for themselves AND generate money. the surgeons and perioperative care and systems have to be excellent. There’s no room for suboptimal surgeries, surgical candidates, crappy ICU care.

I’ve been looking at some of the spreadsheets comparing transcatheter valves and lung cancer surgery vs cardiac surgery. I wish we could get rid of our LVAD program

 

[vector2]

It’s interesting also to become aware of the things that chip away at the gross profit of the facility fee. An ICU stay, blood transfusion, delirium, an entire team of highly paid professional technicians and equipment (cardiopulmonary bypass) etc

Once you see this you understand why it’s so difficult to get cardiac surgery right in 2023. In a way that the clinical operations pay for themselves AND generate money. the surgeons and perioperative care and systems have to be excellent. There’s no room for suboptimal surgeries, surgical candidates, crappy ICU care.

I’ve been looking at some of the spreadsheets comparing transcatheter valves and lung cancer surgery vs cardiac surgery. I wish we could get rid of our LVAD program

It was interesting to learn that ECMO has grocery store-like margins. Bill CMS for $105k but if you're a high volume center of excellence with quick wean times / ICU step down times you can spend ~$98k on the care.

Bad / inefficient low volume care or one bad clinical course and the hospital immediately sets like $10+k on fire for that ECMO run.

 

[abolt18]

I went to the SCA website but didn't see the outline series anywhere. Do you have a link?

SCA University | An Online Learning Management System

scau.vamedu.efrontlearning.com

 

[T-burglar]

It was interesting to learn that ECMO has grocery store-like margins. Bill CMS for $105k but if you're a high volume center of excellence with quick wean times / ICU step down times you can spend ~$98k on the care.

Bad / inefficient low volume care or one bad clinical course and the hospital immediately sets like $10+k on fire for that ECMO run.

Yeah almost the entirety of the advanced heart failure apparatus has very tenuous margins. I’m developing the opinion that maybe these ventures don’t make any sense outside of very sophisticated academic centers , from both a financial and human resource standpoint

 

[Bertelman]

Yeah almost the entirety of the advanced heart failure apparatus has very tenuous margins. I’m developing the opinion that maybe these ventures don’t make any sense outside of very sophisticated academic centers , from both a financial and human resource standpoint

No opinion left to develop. Pretty much accepted knowledge.

 

[triggermaster]

With the number of quarks on the exam and the content outline, that entire section will pendant only have 10-15 questions. They will likely be easier questions, because they're not really important. Also, you can probably just guess on those, and be fine. I didn't bother studying for derm topics when I studied for my CCM boards, as I knew they'd be at max seven questions, and that can be easily written off.

Quarks sounds like an IR exam.

 

[psychbender]

No opinion left to develop. Pretty much accepted knowledge.

And yet, community shops continue to try to chase those dollars, not realizing that their one case per month is costing them a ton, and the patients likely do worse than if they just cannulated, stabilized, and shipped out.

 

[Beeftenderloin]

And yet, community shops continue to try to chase those dollars, not realizing that their one case per month is costing them a ton, and the patients likely do worse than if they just cannulated, stabilized, and shipped out.

We’re a moderate volume cardiac center 400-500 pump runs per year, but this is what we do, driven almost entirely by our heart surgeons not wanting to get calls in the middle of the night.

 

[Bertelman]

We’re a moderate volume cardiac center 400-500 pump runs per year, but this is what we do, driven almost entirely by our heart surgeons not wanting to get calls in the middle of the night.

That's what PAs are for. Not VADs

 

[Leinie]

SCA University | An Online Learning Management System

scau.vamedu.efrontlearning.com

I'm not a member. Is it worth $225 for the outlines?

 

[anbuitachi]

when i googled aCA, i got american cornhole association. what is ACA board?

 

[Bertelman]

Adult Cardiac Anesthesia

 

[Bertelman]

I'm not a member. Is it worth $225 for the outlines?

Individually for just this? Hard to say. But surely you have CME money. I’d say I get more out of my 225 SCA than 1200 ASA.

They have free CME modules for members, too. If you’re a cardiac anesthesiologist, it’s one of the memberships I renew every year