ABFAS in training exam

[deleted1149159]

I luckily passed all four exams this ITE. However, I have no idea how, as it felt like a complete crap shoot. I did study A LOT and come from a higher power program (maybe that helped?).

I agree, if we now have a 3 year residency across the board, why do we need the 2 board exams ?

IMO, granted in my last year of residency, I think ABFAS will become the dominant board.

It already is. And given we went to a three year surgical residency model, it should be.

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[drscott42]

ABFAS 2022 exam pass results sent to program directors:

Foot Didactic- 49%
RRA Didactic- 30%
Foot Cases- 70%
RRA Cases- 32%

ABFAS is a joke and scam of an organization. Extremely embarrassing on their end. It's clearly a huge money grab. Stop sending them your money and go support other board organizations such as ABPM. They need to be shut down and we need a complete overhaul of the board certification process

Those are TERRIBLE

Luckily I passed 3/4 (not didactic rearfoot). I used boardsblast and it was legit the reason I passed. My co-residents used boards wizards and they didn't pass anything. I just don't understand why the pass rate is so low when clearly at least half go to reputable programs.

 

[drscott42]

Also wrong.

Less than 5% of hospitals specify only one CPME-recognized board. And in most of those cases, it’s a podiatry vs. podiatry anticompetitive issue.

When any ABPM Diplomate submits a request for privileging assistance via www.podiatryprivileges.com we commonly find the hospital is violating a law, rule, or standard in privileging and it’s quickly resolved. Out of all that have asked for assistance, only 1 we weren’t able to help and that was due to timing-out of the appeal process.

not true...every hospital near me in a 30 mile radius requires ABFAS

 

[Weirdy]

But DPMTOOTH is right... we should probably just have a one question, true/false board exam: "Big toe is called hallux... T/F?" That would be great for everyone. Lower the bar until it's just a line on the ground.

Feli, how are you!

Only someone smart like yourself would put forth such a deep answer trying to help move the profession forward!

But Fel, only if they charge 4k to "review" true/false questions if you get it wrong! Your right Feli, keep lowering the bar on robbing residents till you bankrupt them all! Im sure theres some more fees you can squeeze out of them sir

Cool it. Both of you.

 

[CutsWithFury]

Those are TERRIBLE

Luckily I passed 3/4 (not didactic rearfoot). I used boardsblast and it was legit the reason I passed. My co-residents used boards wizards and they didn't pass anything. I just don't understand why the pass rate is so low when clearly at least half go to reputable programs.

board wizards is perfect for ABFAS and has been around a lot longer.

 

[drscott42]

board wizards is perfect for ABFAS and has been around a lot longer.

not what my co-residents said...but whatever to each their own

 

[CutsWithFury]

not what my co-residents said...but whatever to each their own

Boardsblast just came out like a year ago.

Board wizards is proven product. Several of us on here have used it

 

[LadyPod]

board wizards is perfect for ABFAS and has been around a lot longer.

Boardswizard for CBPS is a chef kiss. I thought their multiple choice questions were nothing like the actual exam. BUT. It made me remember weak topics and I would spend time reviewing them in McGlams, pocket pod, etc. So idk , after passing and putting in the work, can I complain??

Edit: they had many RRA practice questions on TARs and supramalleolar osteotomies. I was told last years exam has these questions. My exam did not! So I guess their questions were focused on last year topics. Not sure.

Another edit: I did around 1500 of their didactic questions. And around 3/4 of their CBPS

 

[CutsWithFury]

Boardswizard for CBPS is a chef kiss. I thought their multiple choice questions were nothing like the actual exam. BUT. It made me remember weak topics and I would spend time reviewing them in McGlams, pocket pod, etc. So idk , after passing and putting in the work, can I complain??

Edit: they had many RRA practice questions on TARs and supramalleolar osteotomies. I was told last years exam has these questions. My exam did not! So I guess their questions were focused on last year topics. Not sure.

Another edit: I did around 1500 of their didactic questions. And around 3/4 of their CBPS

I did every since question they had and passed everything first try. The CBPS exams teach you how to take the test. It is perfect. The multiple choice questions are diverse enough that you can figure out what your weak spots are and you can better prepare for those topics. It was a solid investment for ABFAS board certification success.

 

[dtrack22]

I did every since question they had and passed everything first try. The CBPS exams teach you how to take the test. It is perfect. The multiple choice questions are diverse enough that you can figure out what your weak spots are and you can better prepare for those topics. It was a solid investment for ABFAS board certification success.

Or you could just take the test like @Adam Smasher told everyone to and pass it without paying anyone for test prep.

 

[lomaric]

 

[podwho]

The fact that people have to discuss what source material you need to study from says everything you need to know about that exam. So much of that test is poorly written, outdated, and makes no sense.

The whole “you don’t even need the imaging to answer the question” is a lazy excuse. The exam costs THOUSANDS of dollars. They brag about the effort they put into writing that exam. Yet you can’t read the fking xray which is a picture of a picture upside-down or sideways. That shows how much effort they put in. NONE. What a joke of an exam and organization.

Other medicine board exams have very clear source material. A few different textbooks that include all knowledge that is standard of care. You could memorize mcglamarry and still fail that **** because sources are made up and the points don’t matter.

Yes I’ve passed, didn’t even end up needing it.

 

[deleted1149159]

The fact that people have to discuss what source material you need to study from says everything you need to know about that exam. So much of that test is poorly written, outdated, and makes no sense.

The whole “you don’t even need the imaging to answer the question” is a lazy excuse. The exam costs THOUSANDS of dollars. They brag about the effort they put into writing that exam. Yet you can’t read the fking xray which is a picture of a picture upside-down or sideways. That shows how much effort they put in. NONE. What a joke of an exam and organization.

Other medicine board exams have very clear source material. A few different textbooks that include all knowledge that is standard of care. You could memorize mcglamarry and still fail that **** because sources are made up and the points don’t matter.

Yes I’ve passed, didn’t even end up needing it.

I have this very issue with the new system of how they are handling the recert issue. The questions aren't difficult, per se, but they pull out these weird answers on occasion and refer to ONE article written about that topic. Are we supposed to read every article there is about the foot and ankle, and then memorize these things to answer these questions?

This round there was a question about a guy who had an open fracture from a lawnmower accident. It looked gnarly, and he was insensate to his toes, but otherwise young and healthy. Anyone in their right mind would try to salvage his foot if at all possible. Or at least try. The "right" answer on what do to for this fellow was "BKA". Even though there was a potential response of Ex-Fix, muscle flap. Which is what I selected. And was incorrect. Makes no sense. So truly, in practice, you're going to meet this guy in the ED and immediately call Vascular to consult for a BKA, and tell this guy he's going to lose his leg when there are other option available? Isn't this why we have Limb Salvage Fellowships?

 

[dtrack22]

This round there was a question about a guy who had an open fracture from a lawnmower accident. It looked gnarly, and he was insensate to his toes, but otherwise young and healthy. Anyone in their right mind would try to salvage his foot if at all possible. Or at least try. The "right" answer on what do to for this fellow was "BKA". Even though there was a potential response of Ex-Fix, muscle flap. Which is what I selected. And was incorrect. Makes no sense.

What was his MESS?

 

[deleted1149159]

What was his MESS?

Toes were cynotic and severe soft tissue injury. Insensate. From MTJ distally. So why BKA when otherwise healthy? This is what doesn't make sense to me. Of all the potential answers, BKA should not be on the list for this type of injury with this demographic. More distal amp maybe. But why not try to salvage at least some part of the foot? No rearfoot or ankle involvement at all. Amp the forefoot and do a muscular flap on someone young and healthy like that. Right to BKA? That's just terrible.

Lavage the crap out of it, IV Abx, muscle flap, see what happens. Certainly not right to BKA. Please educate me if you feel differently. I really don't see these types of injuries, so maybe I'm completely wrong with this.

 

[dtrack22]

Toes were cynotic and severe soft tissue injury. Insensate. From MTJ distally. So why BKA when otherwise healthy?

I really don't see these types of injuries, so maybe I'm completely wrong with this.

So MESS likely >7? You aren’t completely wrong, you can waste everyone’s time attempting to salvage, but this patient had a very low chance of having a functional limb with any salvage procedures. If/when salvage fails patient is getting a BKA. If salvage succeeds the patient has lost months of activity/income and is less functional with a lisfranc amp (at best) than he would be with a BKA and a prosthetic.

Anyone who read a question like this and didn’t immediately think about the mangled extremity severity score really shouldn’t be treating these injuries. And the reality is that something north of 90% of podiatrists arent (and shouldn’t be).

 

[CutsWithFury]

So MESS likely >7? You aren’t completely wrong, you can waste everyone’s time attempting to salvage, but this patient had a very low chance of having a functional limb with any salvage procedures. If/when salvage fails patient is getting a BKA. If salvage succeeds the patient has lost months of activity/income and is less functional with a lisfranc amp (at best) that he would be with a BKA and a prosthetic.

Anyone who read a question like this and didn’t immediately think about the mangled extremity severity score really shouldn’t be treating these injuries. And the reality is that something north of 90% of podiatrists arent (and shouldn’t be).

Most podiatrists are not prepared for these cases because they didn't train in high volume crappy metropolitan county hospital where podiatry actually can do stuff. There are only a handful of residency programs out there that offer these experiences on a regular basis.

 

[deleted1149159]

So MESS likely >7? You aren’t completely wrong, you can waste everyone’s time attempting to salvage, but this patient had a very low chance of having a functional limb with any salvage procedures. If/when salvage fails patient is getting a BKA. If salvage succeeds the patient has lost months of activity/income and is less functional with a lisfranc amp (at best) than he would be with a BKA and a prosthetic.

Anyone who read a question like this and didn’t immediately think about the mangled extremity severity score really shouldn’t be treating these injuries. And the reality is that something north of 90% of podiatrists arent (and shouldn’t be).

I agree with you. I have never seen this type of injury in private practice and would send it to someone I know who does this kind of thing in a heartbeat.

So how again is a question like this on a "Foot" certified recert examination/questionnaire ? Does a question like this represent what 90% of foot certified Podiatrists do? I would say it doesn't.

 

[dtrack22]

Does a question like this represent what 90% of foot certified Podiatrists do?

No. But we’ve already established that ABFAS is dumb.

You could make an argument that one should at least know what MESS is. You don’t even need to memorize the scores, there are plenty of calculators online

 

[Feli]

Most podiatrists are not prepared for these cases because they didn't train in high volume crappy metropolitan county hospital where podiatry actually can do stuff. There are only a handful of residency programs out there that offer these experiences on a regular basis.

Yeah, the open traumas are rough... we had a few teens or young adults in ER in residency who swam into spinning boat props... one got TMA, one was BKA. Even if you can "fix" the XR, you won't fix the vascular damages and contamination, so it's just the smart thing.

I had one last month in PP (I am almost as PP as it gets now but still use almost my whole skill set occasionally). The teen pt in my Xray below had an industrial multi-hundred pound mixer machine crush the distal hallux phalanx through boot and sock. That was a Symes amp hallux asap for sure... I didn't even consider salvage with open fx and heavily necrotic edges with nail matrix pulverized... told her the amp had a crushed flap also and healing amp fast was no slam dunk (it did heal, she was back to work less than a month post-op). With osteomyelitis or bad trauma, I always use the phrase "we need to get done with this and get on with your life."

I did a CME session earlier this month on the ACFAS on demand lectures "Monday Morning Trauma," and the attendings (well trained, PDs at good programs or similar) said they often "leave it up to the patient" for cases of salvage vs amp. To me, that's crazy... one example case they went through was a DM open hallux fx they pinned, it got osteomyelitis, PICC, and then it was "saved" (for how long???). Even smart people over-think these things... patients will always say salvage even if it's virtually 0%.

...As mentioned, they are testing the knowledge of MESS for board exam purpose... basically, if there's insensate digits and delay CFT along with any kind of energy or contamination... that's game over >7 on boards. Clinically, it should be, but surgeons and pts will do what they want. I think some tools honestly choose and sell the wound/salvage route since that is $uperior in their preference.

 

[deleted1149159]

No. But we’ve already established that ABFAS is dumb.

You could make an argument that one should at least know what MESS is. You don’t even need to memorize the scores, there are plenty of calculators online

Not sure why, tbh. Never, ever saw that kind of trauma. Not in residency, not in practice. The answer on the examination should have been, "refer to someone who knows what they're doing with this".

That was another question come to think of it. They asked about a peds ankle fracture (again, for Foot Certification, asking about ankle?) and what the Salter Harris classification was. Honestly, WHO CARES? As long as you're proficient at treatment, classifications have ZERO effect on the practicing Podiatrist. These questions are purely academic and have no real world value. The examination is supposed to test how good you are in the real world, isn't it? Have you ever tried to talk to a radiologist about these classification names? Didn't think so.