Board Certification in Psychiatry

[scentofpapaya]

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this is frustrating for me too. There are so many studies. For example, bipolar prevalence has been estimated at anywhere between 2 - 4% depending on the study you're looking at and whether you're going by dsm4 or dsm5 criteria. borderline prevalence has been estimated anywhere between 2-4%, and some have estimated up to 8% among teen girls. That's why I try to stick with sources like KS and board vitals. Ultimately you're competing against your peers to pass, not the exam. They say the exam isn't curved, but certainly they must do some adjustment of scores every year. I'm hoping that as long as I'm not in the bottom 10% of my peers, I'll be ok even if I don't know everything.

I like that BV provides percentile because you can see how you are performing in comparison to everyone else preparing for the boards (at least the ones who are using BV). I think getting 70% overall is good because that is roughly around 50th percentile, which is a pretty good predictor for passing, at least statistically.... I want to know how people did after using BV because none of the other qbanks offer percentile measurement.

 

[shahseh22]

Hey did any of you guys use TrueLearn? They have a percentage as well. I already did BTB questions and Spiegel. Just wondering if you guys also recommend doing TrueLearn? Thanks

 

[skybliss]

Hey did any of you guys use TrueLearn? They have a percentage as well. I already did BTB questions and Spiegel. Just wondering if you guys also recommend doing TrueLearn? Thanks

I didn't use truelearn. Some of the prior comments in this thread from years ago implied it is not as good as kenny/spiegel or psych genius. But this is my first time taking, so I can't speak to the veracity of any of those opinions. 1.5 more weeks to go!!! ahhhhhhh

 

[medshine]

We will all do great!

 

[shahseh22]

hey,
I have an ethics question. Say you are faced with a subpoena, you are required to furnish medical records and confidentiality is not maintained in that instance. However, you also have to adhere to Privelege which means that conversations you had with the patient are confidential (i.e. if its not in the chart) and you cannot be questioned about them?

I was a bit confused as I was going through Spiegel.

Thanks

 

[chillax9]

Does the board score get reported to your residency and fellowship programs or do they just receive a notification that you passed or failed.

 

[shahseh22]

Does the board score get reported to your residency and fellowship programs or do they just receive a notification that you passed or failed.

I don't know about that but you can easily find out who passed and failed via verifycert.

 

[Mass Effect]

I don't know about that but you can easily find out who passed and failed via verifycert.

Nah, that only tells you who passed. You won't know who failed or who no-showed. I no-showed last year and nothing comes up for me.

 

[shahseh22]

For opioid maintenance treatment, I've seen conflicting things, according to MOTHER study it is suppose to be that Buprenorphine is preferred to Methadone, but on BTB, I could of sworn I saw Methadone as the right answer.

 

[OldPsychDoc]

For opioid maintenance treatment, I've seen conflicting things, according to MOTHER study it is suppose to be that Buprenorphine is preferred to Methadone, but on BTB, I could of sworn I saw Methadone as the right answer.

Depends on your desired outcome. Methadone had higher retention rate in treatment--what you want if you're an addiction clinician. Buprenorphine had less severe neonatal abstinence syndrome, shorter NICU stays--what you want as a hospital administrator.

 

[shahseh22]

Depends on your desired outcome. Methadone had higher retention rate in treatment--what you want if you're an addiction clinician. Buprenorphine had less severe neonatal abstinence syndrome, shorter NICU stays--what you want as a hospital administrator.

I wish the ABPN would make the exam question better.

 

[shahseh22]

Quick question, do you guys know the highlights for what we should be familiar with regarding the specific rating scales (i.e. PHQ9, Beck's, HAM-D etc?) I feel like BTB doesn't address this and Spiegel is quite vague (though there are a few questions about it in the text).

 

[Madden007]

Can you highlight question stems and cross out choices on the exam?

 

[skybliss]

hey,
I have an ethics question. Say you are faced with a subpoena, you are required to furnish medical records and confidentiality is not maintained in that instance. However, you also have to adhere to Privelege which means that conversations you had with the patient are confidential (i.e. if its not in the chart) and you cannot be questioned about them?

I was a bit confused as I was going through Spiegel.

Thanks

From what I understand, you first ask the patient if you can give records to the court and pray that the patient agrees. If the patient agrees, give the records. If the patient doesn't agree, then there is disagreement about what to do. The APA says you don't give the records to the court even if the court can then get you in trouble. Old school standard of practice is to take the medical records to the court house, open it in front of the clerk, then close it before they can read it, and leave. Thus, you have "presented the medical records" to the court. I don't know if anyone has ever actually done this. I think current standard of practice is to send to medical records and they take care of it, and if someone gets sued, it's the clinic, not you. For test taking purposes, I think you are supposed to release the medical records even if patient refuses (except substance abuse and therapy notes). Also, I think courts know this is a dilemma, so they don't subpoena records. They instead call you to court to testify based on your knowledge of the records.

 

[skybliss]

Does anyone know if the boards gives you both brand and generic names for drugs?

 

[michaelrack]

I think you're supposed to go down to the court with the records and then object to releasing them, but ultimately obey the judge

 

[medshine]

From what I understand, you first ask the patient if you can give records to the court and pray that the patient agrees. If the patient agrees, give the records. If the patient doesn't agree, then there is disagreement about what to do. The APA says you don't give the records to the court even if the court can then get you in trouble. Old school standard of practice is to take the medical records to the court house, open it in front of the clerk, then close it before they can read it, and leave. Thus, you have "presented the medical records" to the court. I don't know if anyone has ever actually done this. I think current standard of practice is to send to medical records and they take care of it, and if someone gets sued, it's the clinic, not you. For test taking purposes, I think you are supposed to release the medical records even if patient refuses (except substance abuse and therapy notes). Also, I think courts know this is a dilemma, so they don't subpoena records. They instead call you to court to testify based on your knowledge of the records.

If the court subpoenas medical records you have to disclose it to them. As a physician, you do not have to release therapy notes or side notes that you took on the pt while treating him/her even with the courts subpoena.

 

[shahseh22]

Thanks guys for the exam, I think it will just be to obey the court but therapy notes are priveleged.

 

[chillax9]

So left with 4 days including today to take my board exam on Monday.

Have taken only 1 test of Kenny and Spiegel, done 8 blocks of BTB, listened to 15 videos, done 60% of vignettes on Psych genius and 5% psych genius qs.

Given the time frame available and my current status, please advise on the best strategy. I have time off for 4 days including today.

Is it worthwhile to listen to any BTB videos, do BTB questions, BTB book, BTB book questions. Is Psych genius worth it to do more.

What would be the best use of my time if I was to do a 4 day crash course to pass the test. Look forward to your advice.

 

[chillax9]

Does the board exam have questions like
which of following is false?
all of the following are true except
Which of the below are risk factors for alcohol use disorder( choose 3)
Which of the following medications is not FDA approved

 

[skybliss]

Does the board exam have questions like
which of following is false?
all of the following are true except
Which of the below are risk factors for alcohol use disorder( choose 3)
Which of the following medications is not FDA approved

my 2 cents is you should finish rest of psych genius vignettes, and then get through as many of the rest of the psych genius questions as possible. But I haven't taken the exam before so I'm just guessing. What have you been averaging on KennySpiegel, and psych genius? I heard that 70-75% on kennyspiegel is almost certain to pass, and at least 50% on psych genius is almost certain to pass, and 68% on boardvitals is almost certain to pass.

 

[scentofpapaya]

Is MGH board prep review book an overkill?? It seems like only 20% of it is relevant to general psych and the rest of the book covers some esoteric subjects that psych residents don't really encounter during training...

 

[skybliss]

Is MGH board prep review book an overkill?? It seems like only 20% of it is relevant to general psych and the rest of the book covers some esoteric subjects that psych residents don't really encounter during training...

I used MGH board prep. I think it's less overkill than the kaplan sadock book. One step down on the BPBO-r index (board prep book revised) would be beat the boards lecture notes, but I think that is a little subthreshold on the BPBO-r. Meanwhile, knowing memorizing DSMV is probably also supratherapeutic on the BPBO-r. I think MGH is probably the closest you can get into the BPBO-r therapeutic window of 75-100 without overshooting. Significant individual variance in mental bookadynamics exists.

 

[scentofpapaya]

I used MGH board prep. I think it's less overkill than the kaplan sadock book. One step down on the BPBO-r index (board prep book revised) would be beat the boards lecture notes, but I think that is a little subthreshold on the BPBO-r. Meanwhile, knowing memorizing DSMV is probably also supratherapeutic on the BPBO-r. I think MGH is probably the closest you can get into the BPBO-r therapeutic window of 75-100 without overshooting. Significant individual variance in mental bookadynamics exists.

Did you do the questions at the end of MGH book? It seems like so many of the questions are focused on esoteric topics and not enough questions on the topics that are usually covered in other qbanks, I'm not sure if it's better to review BV and psych genius material or try to read MGH book and focus on these random topics.... (ie: only 2 questions on "depressive disorders and 4 questions on "genetics and psychiatry." Ratio of topics in qbank is totally off compared to other qbanks, not sure if this is how the real boards are) I didn't use any book to study and just focused on qbanks until now, and took a look at MGH book last minute and now i'm totally demoralized...

 

[chillax9]

my 2 cents is you should finish rest of psych genius vignettes, and then get through as many of the rest of the psych genius questions as possible. But I haven't taken the exam before so I'm just guessing. What have you been averaging on KennySpiegel, and psych genius? I heard that 70-75% on kennyspiegel is almost certain to pass, and at least 50% on psych genius is almost certain to pass, and 68% on boardvitals is almost certain to pass.

I have not done boardvitals. Kenny and Spiegel 1 test was 75%, Psych Genius averaging around 53, Beat the boards-66

 

[chillax9]

So left with 4 days including today to take my board exam on Monday.

Have taken only 1 test of Kenny and Spiegel, done 8 blocks of BTB, listened to 15 videos, done 60% of vignettes on Psych genius and 5% psych genius qs.

Given the time frame available and my current status, please advise on the best strategy. I have time off for 4 days including today.

Is it worthwhile to listen to any BTB videos, do BTB questions, BTB book, BTB book questions. Is Psych genius worth it to do more.

What would be the best use of my time if I was to do a 4 day crash course to pass the test. Look forward to your advice.

I wish folks who have taken the test can comment !

 

[shahseh22]

I kind of mess up on differentiating reaction formation from sublimation at times. Anyone have any tips for these defense mechanisms?

 

[dassie]

I kind of mess up on differentiating reaction formation from sublimation at times. Anyone have any tips for these defense mechanisms?

Reaction formation is an immature defense mechanism where you do the exact opposite of the undesirable thought/urge, but it does not resolve the conflict (Ex. closeted gay man who becomes an anti-gay preacher).

Sublimation is a mature defense mechanism where the undesirable urge is transformed into something socially acceptable, and this does resolve the conflict (ex. channeling aggression into being really good at martial arts).

 

[shahseh22]

Reaction formation is an immature defense mechanism where you do the exact opposite of the undesirable thought/urge, but it does not resolve the conflict (Ex. closeted gay man who becomes an anti-gay preacher).

Sublimation is a mature defense mechanism where the undesirable urge is transformed into something socially acceptable, and this does resolve the conflict (ex. channeling aggression into being really good at martial arts).

Thank you!

 

[shahseh22]

I'm a bit confused about Beat the Boards and Neurology. I looked at the ABPN breakdown and I know I have been told Neurology is only 5%. But I looked at Part 2 of the ABPN website and I see that Neurosciences is like 17%.

Beat the Boards has like 14 videos so I don't know if they would have done that if Neurology was only going to be 5%.

 

[scentofpapaya]

I'm a bit confused about Beat the Boards and Neurology. I looked at the ABPN breakdown and I know I have been told Neurology is only 5%. But I looked at Part 2 of the ABPN website and I see that Neurosciences is like 17%.

Beat the Boards has like 14 videos so I don't know if they would have done that if Neurology was only going to be 5%.

https://www.abpn.com/wp-content/uploads/2018/11/2019_Psychiatry_CERT_Content_Specifications.pdf

Neuroscience and mechanisms of disease: I. Neuroanatomy II. Cellular and molecular neurobiology III. Neuropathology IV. Genetics V. Neurochemistry VI. Neurophysiology VII. Chronobiology (e.g., biological rhythms, sleep) VIII. Neuroendocrinology and neuroimmunology

Neurologic disorders: a. Infections of the nervous system b. Vascular diseases c. Disorders of cerebrospinal and brain fluids d. Neuro-oncology e. Trauma f. Birth injuries and developmental abnormalities g. Genetic diseases of recognized biochemical abnormality h. Cerebral degenerations of childhood i. Cranial nerve disorders j. Peripheral neuropathies k. Ataxias l. Headache m. Movement disorders n. Spinal cord diseases o. Neuromuscular junction disorders p. Myopathies q. Demyelinating diseases r. Epilepsy and episodic disorders s. Neurologic complications of systemic diseases t. Neurotoxicology u. Pain syndromes

 

[shahseh22]

https://www.abpn.com/wp-content/uploads/2018/11/2019_Psychiatry_CERT_Content_Specifications.pdf

Neuroscience and mechanisms of disease: I. Neuroanatomy II. Cellular and molecular neurobiology III. Neuropathology IV. Genetics V. Neurochemistry VI. Neurophysiology VII. Chronobiology (e.g., biological rhythms, sleep) VIII. Neuroendocrinology and neuroimmunology

Neurologic disorders: a. Infections of the nervous system b. Vascular diseases c. Disorders of cerebrospinal and brain fluids d. Neuro-oncology e. Trauma f. Birth injuries and developmental abnormalities g. Genetic diseases of recognized biochemical abnormality h. Cerebral degenerations of childhood i. Cranial nerve disorders j. Peripheral neuropathies k. Ataxias l. Headache m. Movement disorders n. Spinal cord diseases o. Neuromuscular junction disorders p. Myopathies q. Demyelinating diseases r. Epilepsy and episodic disorders s. Neurologic complications of systemic diseases t. Neurotoxicology u. Pain syndromes

Thank you! I'm not going to go too crazy on some of this stuff especially if its only 5%.

Gosh, I really hope I pass!

 

[scentofpapaya]

Thank you! I'm not going to go too crazy on some of this stuff especially if its only 5%.

Gosh, I really hope I pass!

you're welcome!! Some qbank questions are really hard and they go really in depth about rare neurological disease i've never even learned in med school, but I've come to realize that the topics are just endless and you can't study everything and know answers to every single questions.. I just hope boards tests the fundamentals, and less on some bizarre esoteric stuff.

 

[skybliss]

just a question for everyone out of curiosity. If a patient in a hospital agrees to treatment offered, but the patient likely doesn't understand the risk/benefits or some other component necessary for capacity, has anyone seen physicians incapacitate a patient who was cooperative with treatment? haha

 

[skybliss]

you're welcome!! Some qbank questions are really hard and they go really in depth about rare neurological disease i've never even learned in med school, but I've come to realize that the topics are just endless and you can't study everything and know answers to every single questions.. I just hope boards tests the fundamentals, and less on some bizarre esoteric stuff.

a poster a page ago or so said that the neuro on the exam is pretty basic, and they said they didn't study neuro at all and still passed.

 

[scentofpapaya]

a poster a page ago or so said that the neuro on the exam is pretty basic, and they said they didn't study neuro at all and still passed.

Good to know!! was freaking out because I didn't do so well on PRITE exams, mostly because I did really poorly in neuro section..... Feels like I can never study enough neuro, each qbank has its own esoteric stuff (the list can go on.... from pathology, chromosome #, enzyme involved including what is deficient and what accumulates, pattern of inheritance, what you will find in imaging, type of imaging, how that imaging works etc) I feel like I am covering stuff that would be tested in radiology + pathology + pediatric boards altogether. No matter how much I study, I feel like I'm never gonna know at least 20% from each other their qbank set. I hope boards is easier than these qbanks, if getting 70% means you will pass, it must be easier... Otherwise, getting 70% on these practice questions means you may fail because it's a close call... 🙁

 

[brainmedicine]

Any feedback on the vignette section of Psych Genius?

 

[shahseh22]

Any feedback on the vignette section of Psych Genius?

I just bought the vignettes (not the Q Bank). I did quite poorly to be honest like 55% correct and I don't agree with the answer choices on some of them. BTB was way easier. I felt Psych Genius was kinda hard and demoralizing.

 

[Shufflin]

I just bought the vignettes (not the Q Bank). I did quite poorly to be honest like 55% correct and I don't agree with the answer choices on some of them. BTB was way easier. I felt Psych Genius was kinda hard and demoralizing.

I found the Psychiatry Genius vignettes a little more interesting and challenging that BTB, but not demoralizing. I actually appreciated they were not too easy that would not be helpful.

 

[brainmedicine]

I found the Psychiatry Genius vignettes a little more interesting and challenging that BTB, but not demoralizing. I actually appreciated they were not too easy that would not be helpful.

Do you think the Vignettes are high yield or relevant? I did their MCQ and found it pretty weird. Scoring around 55 percent there

 

[skybliss]

Any feedback on the vignette section of Psych Genius?

I heard that the BTB and board vitals vignettes were too easy and psych genius is supposed to be harder. Some of the psych genius vignettes were a 7 minute video, and then one of the questions would ask you what thought process the pt had right after they said this and this. I thought wow that is very specific questioning, I'll have to be very careful when watching the board vignettes if they are asking questions like that later. Some people on the boards before who took the exam said that psych genius was most similar to board questions.

psych genius said their average pass rate is 96%, and users average 55% on their questions.

If you don't mind me asking, what percentage were you getting on board vitals, or spiegel/kenny?

We're in the final stretch!

 

[scentofpapaya]

I heard that the BTB and board vitals vignettes were too easy and psych genius is supposed to be harder. Some of the psych genius vignettes were a 7 minute video, and then one of the questions would ask you what thought process the pt had right after they said this and this. I thought wow that is very specific questioning, I'll have to be very careful when watching the board vignettes if they are asking questions like that later. Some people on the boards before who took the exam said that psych genius was most similar to board questions.

psych genius said their average pass rate is 96%, and users average 55% on their questions.

If you don't mind me asking, what percentage were you getting on board vitals, or spiegel/kenny?

We're in the final stretch!

I though BTB vignette videos were really poor quality, like their videos were just unclear and one of the questions asked about what kind of skin condition the patient had... I was thinking, is this some poorl quality neuro or derm video?? Overall, I thought K&S vignettes were the best. Psych genius vignettes were kind of all over the place.... some vignettes seemed pretty fair and educational, others were arbitrary. I hated some epidemiology questions, I think psych genius says people between 45-65 have the highest suicide rate, when some other qbank says age >65 has highest suicide rate, not to mention different research papers they quoted in explanation section. One qbanks says "acidify the urine" for PCP, another says don't acidify the urine and give benzo. I hate that there is no "gold standard" study material for psychiatry.

 

[scentofpapaya]

Do you think the Vignettes are high yield or relevant? I did their MCQ and found it pretty weird. Scoring around 55 percent there

I found how they phrased their questions was very confusing and weird..... I found K&S book very straight and to the point, and BV questions were also straightforward and not convoluted and vague like psych genius. I just hope boards is a well written exam....

 

[MLT2MT2DO]

For any future test takers, I have found BTB to be sub par to say the least. If I had to do it over again I would have put my studies elsewhere, it has always just been the "go to" where I went to residency so I chose the path of least resistance. Oh well at least I didn't have to pay for it

 

[scentofpapaya]

For any future test takers, I have found BTB to be sub par to say the least. If I had to do it over again I would have put my studies elsewhere, it has always just been the "go to" where I went to residency so I chose the path of least resistance. Oh well at least I didn't have to pay for it

What part about BTB did you find subpar, if you don't mind sharing your opinion??

 

[MLT2MT2DO]

What part about BTB did you find subpar, if you don't mind sharing your opinion??

This is only in reference to their Qbank as I don't learn well from lectures and did all of 3 lectures on 1.5 speed because 'Ol Jack has some serious speech latency:

Video Vignette's were poor quality, questions with vignettes were super easy (I can't imagine this'll be like the boards) and sometimes incorrect. You're going to tell me the girl that looked at you twice over a 4 minute interview didn't have "decrease in eye contact"?

Question bank difficulty seemed to average out but it seemed as though the questions were too easy (likely would have got them correct in my 3rd year MS rotation) or completely random factoids, not a lot of the middle of the road. Add in poor grammar (like omitted or incorrect word usage), and even at times a complete Font style and size change in the middle of a question and I'm not sure how they have been so reputable. I'm tired of studying like everyone else in here, the final straw for me was yesterday when I was doing a block of questions and had basically two separate questions, worded differently, asking the exact same treatment with 2/4 options being on both yet they both had a different "correct answer".

At times I had also emailed support about certain questions either asking for references, clarifications, or even clarification and I never heard back from them.

Btw: Did you all get that creepy retreat invitation from 'Ol Jack to go to that conference in California that basically sounds like a cult for physicians?

 

[scentofpapaya]

This is only in reference to their Qbank as I don't learn well from lectures and did all of 3 lectures on 1.5 speed because 'Ol Jack has some serious speech latency:

Video Vignette's were poor quality, questions with vignettes were super easy (I can't imagine this'll be like the boards) and sometimes incorrect. You're going to tell me the girl that looked at you twice over a 4 minute interview didn't have "decrease in eye contact"?

Question bank difficulty seemed to average out but it seemed as though the questions were too easy (likely would have got them correct in my 3rd year MS rotation) or completely random factoids, not a lot of the middle of the road. Add in poor grammar (like omitted or incorrect word usage), and even at times a complete Font style and size change in the middle of a question and I'm not sure how they have been so reputable. I'm tired of studying like everyone else in here, the final straw for me was yesterday when I was doing a block of questions and had basically two separate questions, worded differently, asking the exact same treatment with 2/4 options being on both yet they both had a different "correct answer".

At times I had also emailed support about certain questions either asking for references, clarifications, or even clarification and I never heard back from them.

Btw: Did you all get that creepy retreat invitation from 'Ol Jack to go to that conference in California that basically sounds like a cult for physicians?

I agree with you opinion, their qbank seemed very polarized, either very easy or completely random stuff that was pulled out from some random research paper. And all those emails, I'm glad I'm not the only one who found them strange and cult-like... Did you use any other qbank??

 

[MLT2MT2DO]

I agree with you opinion, their qbank seemed very polarized, either very easy or completely random stuff that was pulled out from some random research paper. And all those emails, I'm glad I'm not the only one who found them strange and cult-like... Did you use any other qbank??

I didn't, unfortunately I started my new job hitting the ground running and time has been a commodity I haven't had enough of.

 

[shahseh22]

This is only in reference to their Qbank as I don't learn well from lectures and did all of 3 lectures on 1.5 speed because 'Ol Jack has some serious speech latency:

Video Vignette's were poor quality, questions with vignettes were super easy (I can't imagine this'll be like the boards) and sometimes incorrect. You're going to tell me the girl that looked at you twice over a 4 minute interview didn't have "decrease in eye contact"?

Question bank difficulty seemed to average out but it seemed as though the questions were too easy (likely would have got them correct in my 3rd year MS rotation) or completely random factoids, not a lot of the middle of the road. Add in poor grammar (like omitted or incorrect word usage), and even at times a complete Font style and size change in the middle of a question and I'm not sure how they have been so reputable. I'm tired of studying like everyone else in here, the final straw for me was yesterday when I was doing a block of questions and had basically two separate questions, worded differently, asking the exact same treatment with 2/4 options being on both yet they both had a different "correct answer".

At times I had also emailed support about certain questions either asking for references, clarifications, or even clarification and I never heard back from them.

Btw: Did you all get that creepy retreat invitation from 'Ol Jack to go to that conference in California that basically sounds like a cult for physicians?

I agree. I started studying months ago and was told by my program (attendings and residents), that "Beat the Boards is all you will ever need." I did the Q bank multiple times thinking I would be golden for the test. Big error.

In retrospect I would have utilized K&S first and done a better Qbank.

To give you some perspective, I'm pretty spotty on the different scales, PHQ, HAM-D, BPRS etc. BTB did not cover this at all.

 

[medshine]

Anyone has any good test taking tool/strategy that they don't mind sharing for multiple choice exams? Here are mine when I get stuck on a question:

1) look for patterns, and pick the least or most answer in the pattern
2) pick the longest answer (because exam writers typically use lots of words to get the point across)
3) C is not always the best answer choice, mostly B or D