Advanced PTeExam 2018 discussion thread.

[dchz]

---

Members don't see this ad.

Mods, delete this if it goes against the agreement I signed (but didn't read) before the test.

But I felt like that was WAY out of left field. Felt like a test of my deduction skills/luck rather than my echo skills.

Anyone took it today and want to comment??

Also PTeMasters go on sell soon!

 

[pgg]

Discussion is fine as long as specific test questions aren't revealed.


I took it last year. We're actually still waiting, a year later, for those useless lazy wankers at NBE to certify us - disgraceful. I've been a testamur for something like 10 months now.

I thought that a lot of the difficulty came from the less-than-textbook images they chose. In one sense maybe that's desirable, to test people on real world images. But there were some where I struggled to figure out what view was being shown.

Anyway, the pass rate is 80-something percent, and people who don't do the fellowship are taking it too. I figure the pass rate for people who spent a year doing echos in an ACTA fellowship has got to be higher.

 

[AdmiralChz]

I’m cautiously optimistic. Doing this test without a true cardiac fellowship would be pretty hard, in my measure. I’d wager the majority of people who fail are those just taking the test to be a testamur.

Hard to emphasize how important PTEMasters is as a resource, there were numerous questions straight from some of the content there.

Hopefully, that’ll be the last formal computing exam I ever have to take. I don’t imagine getting too thrilled to study for the redo Advanced PTE exam a decade from now.

Some of the fun things I’ve seen at those Prometric sites - girl hysterical bawling during the LSAT screaming she wasn’t getting into law school, EMS carting a test-taker out with chest pains and probable ST elevations on EKG, getting accused of cheating when I accidentally put my turned off phone in my lunch bag, power going out just as i started Step 2.

 

[nimbus]

Felt like a test of my deduction skills/luck rather than my echo skills.

That was exactly my experience a few years ago.

 

[dchz]

Also WAY LESS diastology than I expected.

 

[Twiggidy]

Mods, delete this if it goes against the agreement I signed (but didn't read) before the test.

But I felt like that was WAY out of left field. Felt like a test of my deduction skills/luck rather than my echo skills.

Anyone took it today and want to comment??

Also PTeMasters go on sell soon!

Took it a few years back. I echo this (see what i did there)

 

[Robotic Wis-Hipple]

The NBE is also less than helpful when trying to ask even simple things such as if they approve of all your documents or when they will actually be having their certification committee meeting. How many people work there and what do they do all year?

But yes, that test is about reasoning through the context clues associated with terrible images.

 

[pgg]

The NBE is also less than helpful when trying to ask even simple things such as if they approve of all your documents or when they will actually be having their certification committee meeting. How many people work there and what do they do all year?

But yes, that test is about reasoning through the context clues associated with terrible images.

They're not merely less than helpful, they're downright obnoxious and bitchy when it comes to inquiries. They're accountable to no one and have no competition. They just don't care.

Hopefully they'll finish the board certification review before I need to schedule my recertification exam.

 

[AdmiralChz]

I was very surprised at the number of 1 image questions. I would have expected more “what is this structure/pathology” with multiple views.

Many questions were of the “what am I thinking” variety with nearly 4-5 Step seductive reasoning. That’s obnoxious.

 

[dchz]

Many questions were of the “what am I thinking” variety with nearly 4-5 Step seductive reasoning.

 

[Hawaiian Bruin]

Just wondering- to what extent (if any) are they testing things like strain and speckle tracking nowadays?

This was only starting to become a thing when I was in training.

In practice I use it exactly never, so just curious how things have evolved.

 

[sevoflurane]

Or flow propagation velocity....

 

[sevoflurane]

Was on my test... use it... exactly never as well.

 

[dchz]

3-4 out of 200 questions on strain, 0 on prop velocity if I recall correctly.

 

[AdmiralChz]

Problem with strain and speckle is that different manufacturers display, measure and interpret it differently which makes it difficult to apply broadly. The most recent iteration of diastology guidelines de-emphasized their use, actually. That being said there were a couple of Qs on it.

@dchz I wonder if we took the same test? There was several questions with color Vp in it, at least 5 if not 10 regarding diastology. Also de-emphasized in the most recent guidelines since there’s so much variability even in the same patient... but easy to test.

The other diastology BS thankfully wasn’t really on there like ARDUR or TE-e’ which are crazy cumbersome to measure.

Of course all of this means so little intraoperatively, I doubt I’ll even use it much.

 

[T-burglar]

The concept of speckle tracking and tissue tracking in general is great. In the end most of our diastology at present represents indirect methods of measuring what speckle tracking theoretically measures DIRECTLY (relaxation abnormalities).

The problem is cross platform agreement and probably a few other things I. Forgetting because I never do strain maps

 

[pgg]

Some of this stuff will get faster to obtain as the software improves. At some point we'll be able to stick the probe in, obtain a me4c view, hit the "gimme speckle" button (which will be next to the "gimme preload recruitable stroke work" button), and get something in a few seconds. At that point my practical interest in these things will be renewed.

 

[wanttoreadforum]

Some of this stuff will get faster to obtain as the software improves. At some point we'll be able to stick the probe in, obtain a me4c view, hit the "gimme speckle" button (which will be next to the "gimme preload recruitable stroke work" button), and get something in a few seconds. At that point my practical interest in these things will be renewed.

New GE machines basically already do this. Just press the button, acquire the ME4Ch, MELAX, ME2Ch as you would normally and boom, you're done. I still am unsure how I'd use this data intraoperatively to guide therapy, but hey, if you can make interesting-looking pictures everyone thinks you know what you're doing!

I think most software packages are moving toward the "length of line" measurement of strain, including GE. Fortunately some folks way smarter than us are already looking at this issue as it pertains to reaching some semblance of standardization - I apparently cannot post links, but if you search for last month's JASE, you'll find good data pertaining to this topic. Article titled
Right Ventricular Longitudinal Strain Reproducibility Using Vendor-Dependent and Vendor-Independent Software

 

[AdmiralChz]

For the machines we had in fellowship (they were buying new ones), if you didn’t have fairly clear endocardial borders then the strain analysis was sorta... funky. Just like 3D LV recon where you take some liberties, but I found I rarely could get great numbers. I could just suck as an echocardiographer, tho.

 

[dchz]

@AdmiralChz , i misread on my mobile version, i had tons of questions with Vp. sorry.

Also I think I got one of the strain questions right by what I just read above.

 

[T-burglar]

For the machines we had in fellowship (they were buying new ones), if you didn’t have fairly clear endocardial borders then the strain analysis was sorta... funky. Just like 3D LV recon where you take some liberties, but I found I rarely could get great numbers. I could just suck as an echocardiographer, tho.

You don’t suck, what you were discovering is that a lot of ultrasound quantification is suspect (unfortunately). I came to this realization while Trying to quantify MR painstakingly as a fellow, the truth is volumetric ultrasound measurements are often crap. Echo is great for anatomy and pathology in motion but outside of Doppler speeds and gradients the rest of quantification is a real let-down

 

[DM27]

I agree the test was somehow more random than I expected. Physics was a lot less complicated than I expected which was probably the only plus. There was also an odd lack of 3D, and yet there was strain...

Definitely a lot of weird left field type questions and an odd preference for bad stills.

 

[That's a Bingo]

Does anyone know if it actually takes 10 weeks to get our results? We are going on 6 weeks now. And will the NBE office fire delay things?

 

[pgg]

Does anyone know if it actually takes 10 weeks to get our results? We are going on 6 weeks now. And will the NBE office fire delay things?

Well, they're still processing certification paperwork for some people who took the 2017 exam. I've never seen anything like it.

 

[DM27]

From looking at the few old threads I can find relating to this it seems to at least take 2 months from the test date.

 

[Robotic Wis-Hipple]

Well, they're still processing certification paperwork for some people who took the 2017 exam. I've never seen anything like it.

Ha, I thought about asking if any of the 2017 takers had heard anything about their cert yet. I guess this is a no....

 

[pgg]

Ha, I thought about asking if any of the 2017 takers had heard anything about their cert yet. I guess this is a no....

Some of us have. They certified me a few weeks ago. From stalking on the echoboards.org site I know several of my classmates are still listed as Testamurs though.

Seems like a year to look at a two page case log and a form letter would be plenty of time. There are only a couple hundred fellows in the country so it's not like there's an avalanche of applicants. It's crazy.

 

[DM27]

I have a friend who took it in 2017 who is certified. I have another that had the logs rejected due to an issue with row alignment...has to submit it all again.

 

[Robotic Wis-Hipple]

I have a friend who took it in 2017 who is certified. I have another that had the logs rejected due to an issue with row alignment...has to submit it all again.

Yeah I got the sense that the “sample log” was actually the “only format and color scheme accepted”

 

[DM27]

Its overall an absurd process. If you completed an accredited fellowship where your program director attests you hit echo numbers and passed the exam that should be all you need. The idea of having the logs would make sense if it was an alternate path to certification, especially since the data in the logs makes them at best barely verifiable.

 

[That's a Bingo]

Anyone else wondering where our results are?

 

[AdmiralChz]

Anyone else wondering where our results are?

I’ve totally forgotten I took the test at this point!

 

[pgg]

I’ve totally forgotten I took the test at this point!

NBE has probably forgotten too.

 

[sevoflurane]

NBE has probably forgotten too.

Haha... yeah... not very well run institution.
I forget how long it took me to get my actual NBE certificate... but it wasn't quick.. at all.

 

[DM27]

My guess is the end of the month. Looking at old threads it sounds like the email about results goes out before the website registry updates? Probably the first time I've seen it go in that order.

 

[SCgal]

Called NBE today, due to Florence and other “issues” going on at NBE, we should expect an email with our advance PTE results in 2-3 weeks

 

[DM27]

I would love to know what goes on behind the scenes that results in these results not being released nearly immediately after the tests are taken. Especially because I assume that all of the theoretical statistics and score adjustments they may or may not be doing do not alter the pass/fail results for probably >90% of test takers.

 

[cf817]

Definitely was not expecting results today! Thank you Tommy Burch!

 

[AdmiralChz]

I had all but forgotten about the exam. Thrilled it’s over, no more exams for 10 years (and even then, who knows if I’ll recert TEE)!

I reiterate - a thorough watch of PTE Masters is all you really need, plus a good clinical fellowship to help with vignette questions.

 

[DM27]

I agree, PTE masters was definitely sufficient as a source. Physics was much less involved than expected and PTE masters covered it well. Passing seems to have been around 10-20th percentile.

 

[deleted697535]

Where is the exam held and how much does it cost approx? Multiple sites? Any place outside the states?

 

[pgg]

Where is the exam held and how much does it cost approx? Multiple sites? Any place outside the states?

Once per year, middle of July, at a Prometric test center near you. They have test centers all over the world, but I don't know if all locations offer all tests. It was $995 when I took it.

 

[That's a Bingo]

Anyone havea textbook recommendation?
PTE Masters is great but now I need a little more.
Matthews 3rd edition?

 

[Robotic Wis-Hipple]

Anyone havea textbook recommendation?
PTE Masters is great but now I need a little more.
Matthews 3rd edition?

I’m assuming you aren’t going through your presumed cardiac fellowship without a real echo textbook, but if you are.... I’d strongly recommend picking one up in general not just for the PTEexam. If you have the Mathews 2nd edition I’d say that’s enough and I don’t think you need the 3rd edition either way.

 

[That's a Bingo]

No fellowship. Passed APTEexam with Ptemasters. Medium-busy cardiac program with complex valve and aortic work. Hemorrhaging TEE knowledge since exam and need a textbook to keep learning and reinforce advanced topics.
Any other recommended resources, journals etc?
My only textbook is a basic TEE.

 

[vector2]

No fellowship. Passed APTEexam with Ptemasters. Medium-busy cardiac program with complex valve and aortic work. Hemorrhaging TEE knowledge since exam and need a textbook to keep learning and reinforce advanced topics.
Any other recommended resources, journals etc?
My only textbook is a basic TEE.

I also feel like there is a big knowledge drain after taking the test. I occasionally will reread parts of Mathew, look at ACC/AHA valve guideline papers, do the e-echocardiography echo of the day and case of the week archive, rewatch u of utah tee lecture series, and I paid for the deal at PTEmasters so I could rewatch lectures or do q's my first year out. Will probably not pay for ptem again this year.

 

[DM27]

I think a good way to stay fresh is casual reading like e-echocardiography and then doing echo week and PTE masters every 5 years. Also coincides well with the 10 year exam cycle.

 

[Robotic Wis-Hipple]

No fellowship. Passed APTEexam with Ptemasters. Medium-busy cardiac program with complex valve and aortic work. Hemorrhaging TEE knowledge since exam and need a textbook to keep learning and reinforce advanced topics.
Any other recommended resources, journals etc?
My only textbook is a basic TEE.

Buy Mathews. That book is gold.