Best PM&R Board Review Course? The winner is ..

[DrRiddleMeThis]

First I would like to say I have no connections with any of these programs other than attending the board review courses. I decided to write this after finding no resources regarding which program offered the best course.

I have been to the three major board review courses
1) University of Washington in Seattle
2) Kessler Institute in NJ
3) Baylor University in Houston.

We will start with Baylor University. They provided an overall impressive lineup including Braddom (super nice guy) and Buschbacher (odd but informative). The course offered a good overall review of PM&R. They provided access to the PowerPoint slides prior to your arrival. You may decide to print out the handouts yourself to save money. The site of the course was nice which you may not think is important until you are sitting there for days on end. My only complaint were the noisy Baylor residents. It was hard to pay attention when they were always talking during lectures. They were constantly coming in and out of the room which was annoying. I would give this course a 70/100.

Kessler offered a very long, overpriced and poorly organized review. They have most attendees due to location. The cost of the course compared to the value was absurd. They make a killing for what they provide attendees. Just look at how much they charge for handouts. They do provide a USB thumbdrive on day 1 but refused to give access to the powerpoints in advance of the course. The presentations on the USB were not up to date compared to what was presented in the lectures. The site of the course was poor especially the screen which you will be staring at for countless hours. By the end of the course I had headaches, blurry vision and a severe back ache. Do not be fooled thinking a longer course will be beneficial. You will be shocked at the amount of handouts used. If you do not purchase the binders they will not even give you the updated slides despite stacks printed. So they would rather throw them in the trash than give them to you. Don’t bother asking questions to lecturers by email. Of the three emails I sent I did not get a single response. I did use the correct emails provided by the course. Also the Kessler review was the only site without Wifi access in the conference room. According to the hotel AV guy they were too cheap to pay for WiFi access for attendees. Too much time was spent on Orthotics and Prosthetics. They also spent too much time with Anatomy and Physiology. Goldstein makes you more confused than anything. The highlight of the course was the SCI lectures by Kirshblum as well as the NCS/EMG lectures by Malhotra, Ma and Im. I would give this course a 50/100. Save your money and time.


Finally University of Washington in Seattle…. They provided an in depth review of all the relevant information you need to pass the written boards. Having to travel to Seattle was a bit tiring but well worth the time and money. The money you spend on travel still offsets the overpriced Kessler course. The hotel and surrounding area was perfect. The course takes place on the Univ. of Washington campus which provides a great place to study. The highlight of the course was Dr. Hakimi and Dr. Roa. The SCI lectures were excellent. They teach and not just lecture. They kept your attention instead of rushing through countless slides. This course is the best value with an exceptional lecture lineup. They still offer the same Orthotics and Prosthetics Dr. Uustal (he lectures at all the courses) but they provide a more focused review. I would give them a 85/100.

Therefore the winner is University of Washington!

Of note I did not and will not attend the NYU course. Several of my friends thought it was complete waste of time. They used some choice words which I will not repeat on this post.


For people taking the ORAL boards….none of these courses will help. Study on your own and practice talking to another person. It’s a shotgun exam where they bombard you will questions. Even the Mock Orals at review courses did not provide insight on what the real exam is like. The sample video on the website does represent what you will experience. I can NOT provide additional details about the oral exam. The AAPMR basically threatens your career before the start of the exam making sure nobody talks about the exam. You are forced to sign a nondisclosure form prior to the exam. The oral boards is a subjective money making scam created to do nothing but line the pockets of the AAPMR. It was an extremely disappointing process and experience. Shameful! They will fail a percentage regardless to collect additional fees. There were numerous people taking it over and over. I no longer believe the AAPMR has the best interests of our community. If you are an osteopathic physician I would suggest taking your own osteopathic PM&R board. The cost is much less and support the organization that believed in you. The exam is shorter and orals are more realistic. If you compare the AAPMR to any other specialty organizations it an utter disappointment. They will charge you for everything and anything. The resources available on the website are terrible and will by no means prepare you to pass the oral boards. I hope in the future the specialty is better represented.

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[Taus]

Wow- how/why did you attend all 3??

 

[PMR2008]

Can't believe you spent all the time and money for the 3 review courses. I have meet people who have taken 2 out of the 4 but never 3. But I am glad you attended the courses so the rest of the readers can have a better idea when planning for next year. I attended Kessler and I completely agree with your assessment. Too long, over priced and in a very inconvenient location. The best thing about the course was the free ice cream we got on one of the evenings. The food was average as well. The EMG, SCI and P&O lectures were very informative and high yield. A few of the lectures were completely useless and a waste of precious time. I appreciate physicians who work with peds nuromuscular disorder with respiratory issues but there was no need to spend an hour on that topic.
As for the orals which I just took this past weekend I again agree with your assessment. What a scam. There is no need for an oral exam when more than 90% or higher percentage of the current grads are native English speakers. They should atleast have the exam in a convenient location like Chicago. Some people had to fly in from Hawaii, lose a day of work, pay for hotel etc and leave 4 grand poorer for a 2 hour exam. I am taking the Osteopathic PM&R exam this fall and I will be better able to judge the AOBPMR process after that.

 

[kstarm]

For people taking the ORAL boards….none of these courses will help. Study on your own and practice talking to another person. It’s a shotgun exam where they bombard you will questions. Even the Mock Orals at review courses did not provide insight on what the real exam is like. The sample video on the website does represent what you will experience. I can NOT provide additional details about the oral exam. The AAPMR basically threatens your career before the start of the exam making sure nobody talks about the exam. You are forced to sign a nondisclosure form prior to the exam. The oral boards is a subjective money making scam created to do nothing but line the pockets of the AAPMR. It was an extremely disappointing process and experience. Shameful! They will fail a percentage regardless to collect additional fees. There were numerous people taking it over and over. I no longer believe the AAPMR has the best interests of our community. If you are an osteopathic physician I would suggest taking your own osteopathic PM&R board. The cost is much less and support the organization that believed in you. The exam is shorter and orals are more realistic. If you compare the AAPMR to any other specialty organizations it an utter disappointment. They will charge you for everything and anything. The resources available on the website are terrible and will by no means prepare you to pass the oral boards. I hope in the future the specialty is better represented.

I believe you mean the ABPMR, the AAPMR is a completely separate organization that does not do this testing.

 

[DOctorJay]

I'll be interested in your experience with AOBPMR.

 

[DrRiddleMeThis]

I hold them both accountable. The goal is to make money not educate physiatrists. They pander useless CMEs to people thinking it will help them prepare for the boards. SAEs should be free to anyone taking the written boards. Go to a conference from a different organization like the AAOS. Its truly an educational experience compared to what the AAPMR offers. There are residents that have created better websites (ie ThePainSource) for fun than the AAPMRs website.

 

[Paddington]

Which fields (not including fellowships) require a 2 (or more) part board certification?

 

[DOctorJay]

Neurology has done away with oral boards and this will be the last year for Radiology oral boards. Which specialty is next?

 

[Whiteman]

The MOC is another money making scheme. Just a glimpse of what might happen to other Boards if this lawsuit wins.


AAPS Sues to End Recertification Program

By David Pittman, Washington Correspondent, MedPage Today
Published: April 25, 2013


A conservative physician group has filed an antitrust suit against the American Board of Medical Specialties in federal court, claiming its board recertification program is "a money-making, self-enrichment scheme" that reduces patient access to physicians.

The Association of American Physicians and Surgeons (AAPS) filed its lawsuit Tuesday in U.S. District Court for the District of New Jersey, seeking to end the ABMS' sometimes criticized Maintenance of Certification (MOC) program, according to its 20-page complaint.

The Tucson, Ariz.-based AAPS, representing a New Jersey physician in its suit, said the ABMS program offers "no benefit to patient care" and violates antitrust laws by having worked with the Joint Commission since 2009 to require physicians to obtain MOC in order to renew hospital medical staff privileges. Health insurers also use ABMS' board certification as a recognition of credentials, the lawsuit states.

"There is no justification for requiring the purchase of [ABMS]' product as a condition of practicing medicine or being on hospital medical staffs, yet ABMS has agreed with others to cause exclusion of physicians who do not purchase or comply with [its] program," the complaint stated. "Defendant's program is a money-making, self-enrichment scheme that reduces the supply of hospital-based physicians and decreases the time physicians have available for patients."

ABMS works with 24 specialty boards, which cover nearly every medical specialty, to develop recertification programs and promote continuous professional development. Those 24 boards aren't named in the lawsuit.

MOC requires most certified specialists seek recertification -- typically every 10 years -- by successfully completing a four-part assessment. The program started in 2000 but recertification has accelerated since 2009.

AAPS said in the lawsuit it seeks to stop the MOC program from continuing, end "misrepresentations" about doctors who decline the program, and receive a refund of fees paid by its members for MOC-related activities.

MOC Evidence Slow, but Coming, ABMS Says

ABMS hadn't yet seen the AAPS lawsuit as of late Wednesday. "Until we see a lawsuit, there's no comment we could make," ABMS spokeswoman Karen Metropulos told MedPage Today.

However, the group defended its MOC program, saying in an eight-page "myths and facts" document posted March 20 on its website that the program is "anchored in evidence-based guidelines, national clinical and quality standards, and specialty best practices."

"Because the MOC program is relatively new (as it has been introduced gradually during the past decade), we don't yet have evidence that results from decades of gathering data, but the data are emerging," the ABMS said. "Early studies show a link between MOC and improved clinical performance and outcomes by participating physicians."

As further support of its MOC, Metropulos pointed to ABMS' "evidence library" which has compiled nearly 50 peer-reviewed articles related to the MOC process.

More than 450,000 physicians participate in the MOC program, which ABMS says is to help assure a doctor has successfully completed a rigorous evaluation process and assures competency. The pool grows by roughly 50,000 physicians a year.

AAPS said every state licenses physicians to practice medicine, and patients have a right to seek care from any of them. The group said ABMS' work with the Federation of State Medical Boards for maintenance of licensure as a requirement of state licensure was a further antitrust violation.

ABMS' "actions have no legitimate purpose and reduce the supply of physicians available to treat patients in various settings," the lawsuit said.

The MOC "program imposes far greater burdens than any analogous program in any other profession, and surveys demonstrate that an overwhelming majority of physicians – perhaps more than 90% – feel that this program is unjustified," the complaint stated, referencing a 2012 survey of its members.

The lawsuit cites the "unjustified exclusion" of an AAPS member with 29 years' experience -- identified only as "J.E." in the complaint -- from the medical staff at Somerset Medical Center in Somerville, N.J. The physician wasn't allowed on the medical staff in 2011 until he had been certified by the American Board of Family Medicine.

Recertification would have exceeded 100 hours for a typical physician, "thousands of dollars in fees and travel expenses," and time away from patients. Furthermore, the American Board of Internal Medicine earlier this month told physicians it "is requiring more frequent participation in MOC of all board-certified physicians," the lawsuit noted.

MOC Draws Fire from Docs

Physician concerns about MOC expense and the time-consuming process involved were noted in a December 2012 New England Journal of Medicine health policy report.

Robert Baron, MD, medical professor at the University of California, San Francisco, and journalist John Iglehart noted the low number of "grandfathered" specialists -- those certified before 1990 and granted time-unlimited credentials -- as evidence.

Only 1% of nearly 67,000 such physicians holding only time-unlimited certificates from the American Board of Internal Medicine have been re-certified through MOC, they said in the December piece.

MOC fees charged by boards over a 10-year period range from $4,820 from the American Board of Plastic Surgery to $1,250 from the American Board of Surgery, the authors noted.

ABMS said its fees average roughly $300 per year.

The MOC recertification process is complicated, and Baron and Iglehart note that if it went away it could be replaced by a more burdensome system to assure physicians competency.

"If that is indeed the case, the ABMS and its boards must actively (and transparently) respond to the MOC concerns of all physicians, young and old alike, and accelerate its collaborative efforts with external organizations as they strive to navigate a complex system that melds professionalism, government regulation, and market forces," Baron and Iglehart wrote.

This week's action against ABMS isn't the first dramatic step taken by AAPS, which was formed in 1943 to preserve the private practice of medicine, according to its website. The organization was one of the first to file a lawsuit against the Affordable Care Act in March 2010, claiming it was unconstitutional, and also sued then-First Lady Hillary Clinton in 1993 over her handling of the Clinton administration's health reform task force. It also broke stance with other medical organizations to support the patent protection of isolated genes in recent Supreme Court oral arguments.

 

[MedBronc23]

Neurology has done away with oral boards and this will be the last year for Radiology oral boards. Which specialty is next?

Please be us. However, I feel the surgeons will get rid of their oral board requirements before us. Honestly, if the aim of oral boards is to test how safe and competent you are (also non crazy) than what is the point of your 4 years of residency training? I guess I can always look forward to a homecoming if I am not still in med city mn when 2015 oral boards arrive. Honestly if internists radiologists and neurologists ect. have done away with the oral component of their board exam why can't we....ESP since we are much more responsible for adding quality to life than saving it.

I will still plan on taking mine as the ABPMR and Washington Kessler and Baylor/UT won't be removing any revenue generators any time soon (ie oral boards and oral board prep)

 

[DOctorJay]

Anesthesia still takes orals and I don't see them or the surgeons dropping it any time soon.

 

[MedBronc23]

Anesthesia still takes orals and I don't see them or the surgeons dropping it any time soon.

Or us (physiatrists). Didn't realize the GAS folks still took oral boards. Does anyone know if EMG boards still require an oral component?

 

[glacier azul]

Can't believe you spent all the time and money for the 3 review courses. I have meet people who have taken 2 out of the 4 but never 3. But I am glad you attended the courses so the rest of the readers can have a better idea when planning for next year. I attended Kessler and I completely agree with your assessment. Too long, over priced and in a very inconvenient location. The best thing about the course was the free ice cream we got on one of the evenings. The food was average as well. The EMG, SCI and P&O lectures were very informative and high yield. A few of the lectures were completely useless and a waste of precious time. I appreciate physicians who work with peds nuromuscular disorder with respiratory issues but there was no need to spend an hour on that topic.
As for the orals which I just took this past weekend I again agree with your assessment. What a scam. There is no need for an oral exam when more than 90% or higher percentage of the current grads are native English speakers. They should atleast have the exam in a convenient location like Chicago. Some people had to fly in from Hawaii, lose a day of work, pay for hotel etc and leave 4 grand poorer for a 2 hour exam. I am taking the Osteopathic PM&R exam this fall and I will be better able to judge the AOBPMR process after that.

can you comment on your experience w AOBPMR??

 

[PMR2008]

can you comment on your experience w AOBPMR??

I took the exam 2 years back. Had the written on Saturday and Oral on Sunday. Similar to the ABPMR format but I had some OMT related cases. I am glad I took the exam and I am not planning on keeping my ABPMR certification.

 

[axm397]

I hold them both accountable. The goal is to make money not educate physiatrists. They pander useless CMEs to people thinking it will help them prepare for the boards. SAEs should be free to anyone taking the written boards. Go to a conference from a different organization like the AAOS. Its truly an educational experience compared to what the AAPMR offers. There are residents that have created better websites (ie ThePainSource) for fun than the AAPMRs website.

The ABPMR is the American BOARD of PM&R - gets its directive from the ABMS (American BOARD of medical specialties) on Maintenance of Certification and the Core Competencies. The AAPMR is the American Academy of PM&R, the professional society for Physiatrists - it serves its member physiatrists through advocacy and education - most of their revenue comes from membership dues and products but those revenues then go straight back into paying for advocacy, development of educational courses and materials, and representing Physiatrists in national and international arenas. The Academy leaders are unpaid volunteers and no one is profiting off its members.(I know there was an article on MOC about a different specialty society talking about some luxury condo and high salary of a physician director).

The Academy is in the process of developing board review resources for those taking their board certification exam for the first time. They do have some useful free and paid products including old SAE questions and modules on specific topics you may be weak in. They also have subspecialty exam study materials as well. The Academy does NOT get any proceeds from your board exam fee (that goes to the ABPMR). Also, are you talking about the SAE-Rs (for residents) or SAE-Ps? Because you can get truncated versions of past SAE-R exams for FREE if you are a resident member of the Academy. http://www.aapmr.org/members/reside...xamination-Structure-and-Study-Resources.aspx

The resident who created The Pain Source is actually now a practicing physician and he was very involved with the AAPMR and served on the Resident Physicians Council and his intent in creating that website was NOT to discredit the Academy or to provide an alternative to the Academy. I think as you go into practice you will find more value in all that the Academy has to offer. No professional society is going to be able to fulfill ALL your wants and needs -but you should realize that despite your claim that you found very little educational value in the Academy, most of the Board Review lecturers that you raved about are Academy members, leaders, and Annual Assembly course faculty.

It is a very precarious time to be a physician. Private practice is dying and big hospitals and institutions are growing. Reimbursement continues to decrease as the government and payers try to find ways to squeeze savings out of us and since we physicians have the least amount of $$ and lobbying in DC, we continue to be the ones that get hurt. Words like "value based payment" get thrown around and it will mean different things to different players. It is a hard world to navigate in and the Academy has been trying to anticipate the needs of our members to shift away from just a CME providing "country club" type entity to a true professional society advocating for its members, the field of PM&R, and its patients. As a relatively small specialty, we have to be more innovative and strategic - the battles have to be carefully chosen and alliances will have to be made. Change is tough and being the messenger of change can be even tougher.

Having had exposure to both organizations, I can definitely tell you that there is a HUGE difference between the ABPMR and the AAPMR and we should all educate ourselves on the entities that impact your practice and professional career. Hope this helps to clarify.