**CA1 to CA-3 Residency Timeline (ABA, ITE, research, fellowships etc.)

[hrmm]

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In med school, everyone had a relatively similar timeline:
- 2 science base years
- Take step 1 at the end of M2
- Research somewhere in the mix
- 2 clinical years
- Apply for residency early M4
- Take step 2
- Match Spring of M4
- Cruise-control until intern year starts😎

I'm wondering if there is a general timeline for how CA1-CA3 works. I know CA1 is mainly general OR while CA2/3 is sub-specialties. But that's pretty much the extent of generalities that I know.

I'm wondering specifically:
1. What/when are the major exams and when to start heavily studying for them? (ITE, ABA, are these every year? are there other exams?)
2. When is a good time to get involved with research (and is it a must for fellowships?)
3. When do you start applying for fellowships?
4. Any other things you wish you would have known, esp during your CA-1 year that may have set you up for a better job/fellowship down the road?

I guess I just don't want anything sneaking up on me as I go through my CA-1 year and wish someone would've told me these things earlier. Any advice would be helpful.

 

[excalibur]

In med school, everyone had a relatively similar timeline:
- 2 science base years
- Take step 1 at the end of M2
- Research somewhere in the mix
- 2 clinical years
- Apply for residency early M4
- Take step 2
- Match Spring of M4
- Cruise-control until intern year starts😎

I'm wondering if there is a general timeline for how CA1-CA3 works. I know CA1 is mainly general OR while CA2/3 is sub-specialties. But that's pretty much the extent of generalities that I know.

I'm wondering specifically:
1. What/when are the major exams and when to start heavily studying for them? (ITE, ABA, are these every year? are there other exams?)
2. When is a good time to get involved with research (and is it a must for fellowships?)
3. When do you start applying for fellowships?
4. Any other things you wish you would have known, esp during your CA-1 year that may have set you up for a better job/fellowship down the road?

I guess I just don't want anything sneaking up on me as I go through my CA-1 year and wish someone would've told me these things earlier. Any advice would be helpful.

1. ITE's every March. All anesthesia residents across the nation take it on the same day. Some programs use your score on this for possible disciplinary action, moonlighting incentive, etc. Several programs just use this as a guide to determine how a resident is doing. There will now be 3 exams for ABA certification. The BASIC exam (written) taken at end of CA1 year. The ADVANCED exam (written) taken at end of CA3 year. The APPLIED exam (oral) is taken in April or October the year after you graduate residency. More details on these exams can be found on the ABA exam regarding the board certification process.

2. Can do research at any time. It is not necessary for fellowship

3. End of CA2 year, beginning of CA3 year

4. Not really. Just work hard, do the best you can on your exams, and don't piss off your staff, program directors, or chair.

 

[CaliforniaBound]

Having just finished residency, I can tell you that there are no two programs alike. That being said, there are some consistent milestones and core competencies.

Every March you'll have an ITE (this may change with the new "basic" exam)
AKT 0,1,6,24
Some programs have subspeciality exams at the end of these rotations.

You'll do Peds/Hearts/Neuro/OB/SICU/Pain/PACU/Outlying, and probably a hodgepodge of other things. Probably some research time senior year. Research of some kind is mandatory for all residents I believe, something about an academic project.


Within all this I'm sure there is lots of variation between programs. Your program should have a residency handbook that outlines their structure and expectations.


Just keep your head down, work hard, don't piss people off, and don't get involved in petty gossip

 

[hrmm]

Good stuff. Thanks guys. A few more questions I had after the initial responses:

1. Are AKT's different than ITE's?

2. I heard ITE/ABA scores are available to the residency program (just attendings or can everyone see the scores?). Are these ITE/ABA scores as important as USMLE Step scores in terms of jobs, fellowships, how you're viewed by the program?

3. Does one study differently for an ITE exam in March vs. an ABA exam at the end of CA-1/CA-3?

4. When we studied for the USMLE in med school, it seemed like a given that everyone (pretty much) used the same study materials - eg. USMLEWorld, First Aid, Crush, Step Up, Master the Boards, etc. And many times, people felt that if you didn't use something as common as USMLEWorld, you may be at a relative disadvantage vs. the rest of the test-taking pool. Are there certain resources that are "standard" that you are highly encouraged to use for the ITE vs. ABA?

Thanks.

 

[CaliforniaBound]

1. Yes, ITEs are basically "mock" written exams put out by ABA. AKTs or anesthesiology knowledge tests are given at certain periods of training, like zero training, one month training, six month training, and twenty four months of training. I think the content is somewhat different, AKTs in my opinion are more pharm and basic physio, machine questions, etc.

2. ITE scores are released to chair and program director, and while not every attending gets your score, they all talk and at least at my program all the attendings knew what a resident had scored. As far as importance it depends. One, its a marker of progression through training and can serve as an indicator of you passing or struggling with writtens. Some residency programs require certain percentiles to pass to the next year, some don't care, and others I've heard will kick you out for poor performance. As far as future jobs I think it's relative. No where I interviewed asked about ITE scores, but some of my friends encountered this. I've heard some fellowships care a lot and others don't. I guess the bottom line is, do reasonably well so no one hassles you and you don't have problems on down the road.

3. Studying through residency is key, but using a certain set of review material for both is vital. Faust, Big blue, Hall, old ABA exams, Q banks etc.

4. As far as I know no "gold standard" but most everyone uses some combo of the above plus or minus a review course

 

[excalibur]

Good stuff. Thanks guys. A few more questions I had after the initial responses:

1. Are AKT's different than ITE's?

2. I heard ITE/ABA scores are available to the residency program (just attendings or can everyone see the scores?). Are these ITE/ABA scores as important as USMLE Step scores in terms of jobs, fellowships, how you're viewed by the program?

3. Does one study differently for an ITE exam in March vs. an ABA exam at the end of CA-1/CA-3?

4. When we studied for the USMLE in med school, it seemed like a given that everyone (pretty much) used the same study materials - eg. USMLEWorld, First Aid, Crush, Step Up, Master the Boards, etc. And many times, people felt that if you didn't use something as common as USMLEWorld, you may be at a relative disadvantage vs. the rest of the test-taking pool. Are there certain resources that are "standard" that you are highly encouraged to use for the ITE vs. ABA?

Thanks.

California Bound summed it up nicely.

1. AKT's given at different times and in my opinion are not as big of a deal as the ITE The 0 month and one month are a lot of basic pharm, physio, physics, gen anesthesia.

2. See California Bound's answer. The PD and chair will see them, but the gossip will spread.

3. Studying differently depends. Some may kick the studying into high gear as the real deal ABA written exams are looming. This would be particularly true if the program did not do any major disciplining for poor performances on the March ITE's. It might be a different story though if your program kicks you out for not getting a certain score.
--Truthfully, that is way too harsh a punishment in my opinion. The ABA now gives you multiple chances (years) to pass the exam. In the interim you can continue work and make a decent salary. There would be way more pressure in residency if the penalty was getting kicked out for a botched test. I mean if you get kicked out of residency, it might be very difficult to get back into residency. Scary. Thankfully, the vast majority of programs are not like this as far as I know.

4. Lots of same resources available.
There is Big Blue which most utilized like First Aid USMLE Step 1.
Hall questions, ACE questions, and I am now reading about M5 which are like Kaplan Qbank
Baby Miller, Morgan and Mikhail, Barasch are three standard anesthesia texts which would be like, I don't know, Robbins Pathology text.