Advanced exam 2018-2019

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That was tough. A lot of questions seemed totally irrelevant to the basics of anesthesiology. And many of the rest had two answers that were vague.

Anyone know what the curve has been like in past years?
 
The ABA is a corrupt and criminal organization running this racket of bull**** tests. Totally irrelevant questions unrelated to the field of Anesthesiology.
 
That exam was not what I expected.

Now, I'm just waiting on the report and hoping for the best.
 
To people who are convinced they got irrelevant questions (happens every year), did you study for the exam based on the Content Outline? Because what you may think is not pertinent will be in there.

Not defending the ABA, just explaining how this happens. Every year.
 
FWIW, I just called the ABA on sept 10, 2019 at 1:45 pm to figure out what’s going on with the website. The website has been down all day (and wasn’t down yesterday).

Receptionist: “The website likely won’t be up until tomorrow, and besides the results can take 4-8 weeks.”

Me : “Ma’am, we were told 4-6 weeks. It has been 6 weeks and a few days.”

Receptionist: “Well, we updated that to 8 weeks.”

Me: “Where did you update this. It certainly hasn’t been up on the website previously and you couldn’t have updated it today because the site is down.”

Receptionist: <silence>

All of this unacceptable. Why does it take so long for results for standardized tests? Where is the money that we pay for tests going? Why, in the year 2019, is this still happening with the ABA website/results? Ridiculous.
 
Results also came out basically this day 2 years ago as well.. but alas... update from ABA

"We're posting ADVANCED Exam results tomorrow at 9 a.m. ET."
 
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There was a circle right under my results to click for apply for applied examination. I might be mistaken tho hard to tell with the site taking forever and crashing sporadically.
 
Failed 🙁. I did average or above average on my ITEs. I felt the exam was kind of terrible and out of nowhere but never thought I wouldn't pass. Anyone have any advice on what and how to study?
 
JoelJoel84 said:
Similar situation here, I didn't feel great walking out, but thought I had at least passed. Had performed well on the ITEs, etc. Some very random questions, but I can't fault that really if >90% of everyone else passed...

I did hear from two attendings, associated with the ABA, that they had obviously caught onto TrueLearn becoming the main focus of everyone's studying, and now were trying to write questions that were not covered on the QBank, or at least hit the keyword from a different angle. Perhaps I relied on questions too much, which had worked well for Basic.
Click to expand...

Add Hall question book to your arsenal...I thought it helped with some questions on the exam. Good luck next time.
 
Passed. I did all of TrueLearn on tutor mode, taking notes (and redid all the questions I got wrong) and read through Faust.

Now that they have another $2400 of my money for the Applied exam, do you think that the ABA can afford to rent a server that doesn't crash when a few people try to log in?
 
physicsnerd42 said:
Passed. I did all of TrueLearn on tutor mode, taking notes (and redid all the questions I got wrong) and read through Faust.

Now that they have another $2400 of my money for the Applied exam, do you think that the ABA can afford to rent a server that doesn't crash when a few people try to log in?
Click to expand...

The earth is round, the sky is blue, rain falls, and the servers for any medical education organization or medical board will never be improved.
 
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JoelJoel84 said:
Similar situation here, I didn't feel great walking out, but thought I had at least passed. Had performed well on the ITEs, etc. Some very random questions, but I can't fault that really if >90% of everyone else passed...

I did hear from two attendings, associated with the ABA, that they had obviously caught onto TrueLearn becoming the main focus of everyone's studying, and now were trying to write questions that were not covered on the QBank, or at least hit the keyword from a different angle. Perhaps I relied on questions too much, which had worked well for Basic.
Click to expand...

The keyword from a different angle was what I noticed on this test. They wouldn't ask about the top 5 things you'd think about for any diagnosis/complication/etc, but something way down the list.
 
anesdoc07 said:
Failed 🙁. I did average or above average on my ITEs. I felt the exam was kind of terrible and out of nowhere but never thought I wouldn't pass. Anyone have any advice on what and how to study?
Click to expand...

I’m so sorry you failed. This exam is extraordinarily stupid and not representative of what you know. Please don’t be discouraged. You can rally and crush it in January. Take a little time for yourself. Then, reassess and really analyze the score report when you get it in a couple of weeks. I know that everyone says that if you do true learn, then you will pass. But the truth is TrueLearn didn’t cover all the topics on the content outline.

Passmachine is much more helpful, because it has lectures and a Qbank. Take your time. You can do this.
 
Ketafol enthusiast said:
I’m so sorry you failed. This exam is extraordinarily stupid and not representative of what you know. Please don’t be discouraged. You can rally and crush it in January. Take a little time for yourself. Then, reassess and really analyze the score report when you get it in a couple of weeks. I know that everyone says that if you do true learn, then you will pass. But the truth is TrueLearn didn’t cover all the topics on the content outline.

Passmachine is much more helpful, because it has lectures and a Qbank. Take your time. You can do this.
Click to expand...

Thank you, I appreciate it. I just honestly don't know how to study for some of the questions they had. Things from Step 1, super minute details, things out side the scope of anesthesia I, specific surgical questions.
 
anesdoc07 said:
Thank you, I appreciate it. I just honestly don't know how to study for some of the questions they had. Things from Step 1, super minute details, things out side the scope of anesthesia I, specific surgical questions.
Click to expand...
Don’t worry about studying for those step 1 type esoteric b**** topics..focus on maximizing your ability to answer relevant anesthesia questions. In other words if you answer majority of the common anesthesia topics correctly, the few weird step 1 stuff won’t matter.
Use Hall and TrueLearn..go over this twice and you will be fine.
 
aimedicine said:
Don’t worry about studying for those step 1 type esoteric b**** topics..focus on maximizing your ability to answer relevant anesthesia questions. In other words if you answer majority of the common anesthesia topics correctly, the few weird step 1 stuff won’t matter.
Use Hall and TrueLearn..go over this twice and you will be fine.
Click to expand...

I did do truelearn and a second time with my incorrects. My scores were nothing special but definitely around average. I had also always done well on previous exams so I just don't know where it all went wrong.
 
Ketafol enthusiast said:
I’m so sorry you failed. This exam is extraordinarily stupid and not representative of what you know. Please don’t be discouraged. You can rally and crush it in January. Take a little time for yourself. Then, reassess and really analyze the score report when you get it in a couple of weeks. I know that everyone says that if you do true learn, then you will pass. But the truth is TrueLearn didn’t cover all the topics on the content outline.

Passmachine is much more helpful, because it has lectures and a Qbank. Take your time. You can do this.
Click to expand...
I want to smoke what you're smoking.

Not passing such an easy to pass exam (90% pass on first try) is the equivalent of being branded "too dumb for anesthesia". The holes in the knowledge must be like the Grand Canyon. They don't ask as many dumb questions as you'd think; you just remember the weird ones much more.

You don't have to agree. Just watch the next guy who fails his written boards.
 
FFP said:
I want to smoke what you're smoking.

Not passing such an easy to pass exam (90% pass on first try) is the equivalent of being branded "too dumb for anesthesia". The holes in the knowledge must be like the Grand Canyon. They don't ask as many dumb questions as you'd think; you just remember the weird ones much more.

You don't have to agree. Just watch the next guy who fails his written boards.
Click to expand...

All I did was Hall (like two years ago, but I still had my notes) and TrueLearn (of which I had my notes over the past three ITEs and the Basic) and I felt that you could nail most of the Advanced questions. But, I think the key was I had built my foundation during my CA1 year and built on top of that each successive year. I don’t think the Advance exam is something one could cram for.
 
FFP said:
I want to smoke what you're smoking.

Not passing such an easy to pass exam (90% pass on first try) is the equivalent of being branded "too dumb for anesthesia". The holes in the knowledge must be like the Grand Canyon. They don't ask as many dumb questions as you'd think; you just remember the weird ones much more.

You don't have to agree. Just watch the next guy who fails his written boards.
Click to expand...

As I said before, I did pretty well on my ITEs all 3 years, passed my basic, and was getting decent scores on truelearn. is it more likely that I forgot my entire knowledge of anesthesia in a few months or that maybe it was a crapshoot test not really representative of what an anesthesiologist should know?
 
anesdoc07 said:
As I said before, I did pretty well on my ITEs all 3 years, passed my basic, and was getting decent scores on truelearn. is it more likely that I forgot my entire knowledge of anesthesia in a few months or that maybe it was a crapshoot test not really representative of what an anesthesiologist should know?
Click to expand...

I’m starting to think you are trolling. Because 1) your status say you are an attending 2) it’s hard to fathom doing well on basic and ITE and then inexplicably fail advance exam with pass rate well over 90%.
 
aimedicine said:
I’m starting to think you are trolling. Because 1) your status say you are an attending 2) it’s hard to fathom doing well on basic and ITE and then inexplicably fail advance exam with pass rate well over 90%.
Click to expand...

I am not trolling. It’s hard for me to fathom as well. I am an attending and I just started.
 
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I don’t think the poster is trolling. Instead of accusing him of trolling we could try giving him advice. I thought both the basic and advanced questions were random. Ite was a more fair exam imo and I didn’t think the questions were similar to ite. I would recommend supplementing questions with a book. I liked baby barash it’s a short read and helps consolidate the information. True learn helps supplement random information. I liked m5 a few years ago but now think it’s outdated. Hall I wouldn’t recommend they had a lot of errors and had outdated questions. I heard good things about ace. But didn’t do myself.
 
User21218 said:
The problem with ITE is that it composes of both basic and advanced type questions. When you received your ITE results, did you check out your score/percentile amongst the advanced questions? Your basic knowledge may have driven your ITE score up
Click to expand...

Yes it was split up pretty evenly. Within 10% of each other or so. No big discrepancy.
 
anesdoc07 said:
I am not trolling. It’s hard for me to fathom as well. I am an attending and I just started.
Click to expand...

I’m sorry if you are truly not trolling. I have offered my advice. I think the other thing you could consider doing is using the ABA topic outline as a study guide, it would be more time consuming but it would certainly guarantee success.
 
aimedicine said:
I’m sorry if you are truly not trolling. I have offered my advice. I think the other thing you could consider doing is using the ABA topic outline as a study guide, it would be more time consuming but it would certainly guarantee success.
Click to expand...

Anyone have any experience with pass machine? I really think I can pass it easily the next time but I don’t want to take any chances. I also wasn’t feeling well but don’t want to chalk it up just to that.
 
FFP said:
I want to smoke what you're smoking.

Not passing such an easy to pass exam (90% pass on first try) is the equivalent of being branded "too dumb for anesthesia". The holes in the knowledge must be like the Grand Canyon. They don't ask as many dumb questions as you'd think; you just remember the weird ones much more.

You don't have to agree. Just watch the next guy who fails his written boards.
Click to expand...

I don't know when you took your boards, but they asked A LOT of bad questions. Like, couldn't even look up the correct answer bad. I passed but I think that virtually anybody could fail if they had a bad day and were unlucky.

I hope that berating a colleague who is going through a hard time makes you feel like a big man though.
 
The exam is tough and always has been. There is no shame in failing, but it would be very unusual to drop from being a good performer on the ITE's to failing the advanced exam. It is rare, but I have seen it.

With regards to the content of the exam, every year, it varies. Some years there is heavy OB and the next year almost none. Some years there are 5 questions on ankle blocks and the next year none. My experience and things I have heard suggest that this is an intentional testing method. It allows separating out those candidates that guessed a question correctly. Chances are, if you guess on a question about an ankle block and get it right, you will likely not guess correctly 5 times when they add in different nuances to the question. Therefore, this allows further separation of the candidates based on how much mastery of the topic exists. Each year, people say, where were all of the OB questions they typically ask (or cardiac, or pain or whatever the topic)? They have 200 questions and they take a sampling of topics. Some (most?) are straightforward general knowledge topics. You either know it or you don't. They are tricky questions though. Often, someone will miss a question multiple times, thinking they have always gotten it correct, because they did not understand the nuance of the question that made their answer incorrect and the other one correct.

Other questions are part of a knowledge set that gets tested 5 different ways to separate out the candidates based on their mastery of certain subject matters. Obviously, they can only do this on a handful of topics, so that is where the "why were there so many questions on topic x, y, or z?" comments come from. I heard this explanation about 15 years ago and it has seemed to hold up over time.

Additionally, a certain subset of the questions are being trialed to check their validity. These are typically thrown out of the final scoring. The questions are also scrutinized closely if they are frequently missed, just to make sure they were not mis-keyed or that there might be two valid answers so that they should be double-keyed. Sometimes, a really bad question gets past all of the vetting and editing and makes its way onto the actual exam. If it is problematic, it may just be thrown out, thereby changing the denominator. If a couple of questions are thrown out, and they happen to be the ones you got correct, it can make a difference if you are right on the line between passing and failing.

They also do standard setting exercises to further vet the questions and the exams as a whole. They will invite diplomates (typically Program Directors) to come to a site and take the exam to determine if they are testing the appropriate topics in a fair manner. Each question gets examined and the group decides if it is fair to ask the question and (for example, the Basic Exam) if it is fair to expect a person of that level of training to possess the knowledge to answer the question correctly. At the end of the exercise, they examine the test as a whole and look for break points where candidates are separated with as little gray area as possible to create a standard for passing the exam. They perform this standard setting exercise every few years, as do all standardized exams, I believe. My experience is that they try to avoid situations where a single question separates someone who failed from someone who passed.

They also seem to maintain a standard performance on the exam as the bar, not just a percentage pass rate such as 90%. Back in the late 90's, the written exam pass rate dipped into the low 70's percent and the oral board pass rate dipped into the high 50's, based on data released. That was the time when the NY Times article suggested that graduating residents could not find work and only 43 US grads matched into anesthesiology (1996, I believe) in the NRMP primary match. The rest of the spots were filled with warm bodies who would not have made the cut in other years. The exam pass rates reflected a lower quality candidate for a few years after, as the bar that had been set was not adjusted.

A given is that there will always be some obscure hyperbaric medicine question and at least a couple of toxicology questions.
 
Last edited:
Gern Blansten said:
The exam is tough and always has been. There is no shame in failing, but it would be very unusual to drop from being a good performer on the ITE's to failing the advanced exam. It is rare, but I have seen it.

With regards to the content of the exam, every year, it varies. Some years there is heavy OB and the next year almost none. Some years there are 5 questions on ankle blocks and the next year none. My experience and things I have heard suggest that this is an intentional testing method. It allows separating out those candidates that guessed a question correctly. Chances are, if you guess on a question about an ankle block and get it right, you will likely not guess correctly 5 times when they add in different nuances to the question. Therefore, this allows further separation of the candidates based on how much mastery of the topic exists. Each year, people say, where were all of the OB questions they typically ask (or cardiac, or pain or whatever the topic)? They have 200 questions and they take a sampling of topics. Some (most?) are straightforward general knowledge topics. You either know it or you don't. They are tricky questions though. Often, someone will miss a question multiple times, thinking they have always gotten it correct, because they did not understand the nuance of the question that made their answer incorrect and the other one correct.

Other questions are part of a knowledge set that gets tested 5 different ways to separate out the candidates based on their mastery of certain subject matters. Obviously, they can only do this on a handful of topics, so that is where the "why were there so many questions on topic x, y, or z?" comments come from. I heard this explanation about 15 years ago and it has seemed to hold up over time.

Additionally, a certain subset of the questions are being trialed to check their validity. These are typically thrown out of the final scoring. The questions are also scrutinized closely if they are frequently missed, just to make sure they were not mis-keyed or that their might be two valid answers so that they should be double-keyed. Sometimes, a really bad question gets past all of the vetting and editing and makes its way onto the actual exam. If it is problematic, it may just be thrown out, thereby changing the denominator. If a couple of questions are thrown out, and they happen to be the ones you got correct, it can make a difference if you are right on the line between passing and failing.

They also do standard setting exercises to further vet the questions and the exams as a whole. They will invite diplomates (typically Program Directors) to come to a site and take the exam to determine if they are testing the appropriate topics in a fair manner. Each question gets examined and the group decides if it is fair to ask the question and (for example, the Basic Exam) if it is fair to expect a person of that level of training to possess the knowledge to answer the question correctly. At the end of the exercise, they examine the test as a whole and look for break points where candidates are separated with as little gray area as possible to create a standard for passing the exam. They perform this standard setting exercise every few years, as do all standardized exams, I believe. My experience is that they try to avoid situations where a single question separates someone who failed from someone who passed.

They also seem to maintain a standard performance on the exam as the bar, not just a percentage pass rate such as 90%. Back in the late 90's, the written exam pass rate dipped into the low 70's percent and the oral board pass rate dipped into the high 50's, based on data released. That was the time when the NY Times article suggested that graduating residents could not find work and only 43 US grads matched into anesthesiology (1996, I believe) in the NRMP primary match. The rest of the spots were filled with warm bodies who would not have made the cut in other years. The exam pass rates reflected a lower quality candidate for a few years after, as the bar that had been set was not adjusted.

A given is that there will always be some obscure hyperbaric medicine question and at least a couple of toxicology questions.
Click to expand...

I appreciate all of the insight. I am not sure what happened. Perhaps my state of health screwed me over that day or maybe I just did truelearn and took for granted that I was going to pass. Everyone I talked to mostly just did truelearn and also felt the exam sucked and was not a good representation of what we would expect. It was just a lot of weird questions or topics that were out of left field. I had never expected to fail thought and just want to do what I have to do these next few months to make it right.
 
anesdoc07 said:
I appreciate all of the insight. I am not sure what happened. Perhaps my state of health screwed me over that day or maybe I just did truelearn and took for granted that I was going to pass. Everyone I talked to mostly just did truelearn and also felt the exam sucked and was not a good representation of what we would expect. It was just a lot of weird questions or topics that were out of left field. I had never expected to fail thought and just want to do what I have to do these next few months to make it right.
Click to expand...
I have to believe that the ABA has seen the truelearn QB and other question banks and are actively seeking new and more difficult questions. Back in the day, the question books were limited to a couple that were good. Now there are question banks all over the place and that is the primary tool for studying. Many educators are horrified by this and feel that it provides a very superficial knowledge base. Therefore, the questions tend to require a more in depth knowledge to be able to answer them correctly. But they always have that tempting distractor that looks like it should be the correct answer, but isn't.
 
Passed with Truelearn x 2. First on tutor mode by category and 2nd time around on random and timed. Took notes and reviewed them along with previous ITE/Basic notes from the past. Skimmed ABA outline and Advance book but didn't have time to go over all of it (less than 25% of it). A lot of the questions you could answer in a few seconds while others tested obscure facts/subjects that not many would ever bother to spend much time studying.

If you didn't pass, I would recommend going over ABA outline and reading up on topics you arn't completely sure on. You'll get a better idea of what you thought you knew but didn't really when you review your missed keywords.
 
Agree there were a lot of times during the exam where I saw questions that seem easy and I rushed to answer incorrectly and when I read it carefully I saw that it was the wrong answer. So definitely be careful of buzzwords on this exam, it was often a trap.

And then there were also a lot of questions that should be easy based on the topic, however it ended up being difficult because the answer choices that you would normally look for were not there...so when studying for the test I would recommend going in depth on topics you think should be easy.
 
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aimedicine said:
Agree there were a lot of times during the exam where I saw questions that seem easy and I rushed to answer incorrectly and when I read it carefully I saw that it was the wrong answer. So definitely be careful of buzzwords on this exam, it was often a trap.

And then there were also a lot of questions that should be easy based on the topic, however it ended up being difficult because the answer choices that you would normally look for were not there...so when studying for the test I would recommend going in depth on topics you think should be easy.
Click to expand...
Well, there is a reason this is the ‘Advanced’ exam. If the answer was so simple it would be on the ‘Basic’ exam.
 
0kazak1 said:
Well, there is a reason this is the ‘Advanced’ exam. If the answer was so simple it would be on the ‘Basic’ exam.
Click to expand...

I don’t think that’s how that works buddy lol nice try
 
If doing questions or reading textbooks is effortful, I recommend the ACCRAC podcasts and/or University of Kentucky Youtube videos to supplement. One can easily download the media and simply listen to it while, for example, driving or exercising. Several of my former co-residents found them helpful and did quite well on tests.
 
Do we get “Top 10%” letters for the Advanced? I haven’t heard of it but was wondering.
 
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