Cardiology Boards 2024

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sonia1177

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Has anyone started studying for general cardiology boards for 2024? I am really struggling with ECG's and Cath. I find that ECG source has so many errors (eg we don't code Q wave MI anymore, when to code bundle branch block/fasicular block/axis, how to determine rate for sinus rhythm. There are also many discrepancies with O Keefe (eg when to code posterior MI). Anyone noticing the same? Also, what are the best resources to study for Cath?

Thanks!
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yeah I started studying for this thing. I took it once (2 years ago) and did not pass the 2nd day. one of my biggest regrets is using O'Keefe instead of ECG Source. ECG Source teaches you to code for 1 or 2 things, instead of risking losing points. Cath you can use Mayo Clinic online board review course, they have lessons on that.
 
Nobody really knows which is what makes it so ridiculous. I took it last year and passed with just okeefe. The book has the proper coding sheet and clear criteria for coding which ecg source doesn't have. My approach was to make it as simple as possible. I don't really understand how people can overcode things. I read it like i would read any ekg and coded what i saw when it was appropriate.
 
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Anyone available to do rapid EKGs over the weekend. pick the most obvious and move on? Thanks and Good Luck.
 
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doing a subfellowship of cardiology and taking cardiology boards now, have been extremely busy with this demanding procedural subspecialty (EP) and have just started seriously studying when I have time. Done about 20% of ACCSAP questions only. Was planning on finishing ACCSAP in the next 10 days, then focus on ECG Source and echo/cath review. What are you all using for the echo and Cath review/coding? Any advice on how to use my time? Im usually free on weekends and weekdays sometimes run late, sometimes end 4 pm. Thanks in advance.

edit: last question, there's a guy selling an ANKI deck for ACCSAP and MAYO material for 90$ from 2023 material. Worth it?
 
theamazengdoc said:
doing a subfellowship of cardiology and taking cardiology boards now, have been extremely busy with this demanding procedural subspecialty (EP) and have just started seriously studying when I have time. Done about 20% of ACCSAP questions only. Was planning on finishing ACCSAP in the next 10 days, then focus on ECG Source and echo/cath review. What are you all using for the echo and Cath review/coding? Any advice on how to use my time? Im usually free on weekends and weekdays sometimes run late, sometimes end 4 pm. Thanks in advance.

edit: last question, there's a guy selling an ANKI deck for ACCSAP and MAYO material for 90$ from 2023 material. Worth it?
Click to expand...

I am just using ECG source for the coding stuff. I am unclear about cath coding regarding when individual vessels are normal (not all vessels where you check the 'normal' box at the top of the coding sheet). On ECG source you leave the vessel boxes blank if it is normal but on the ABIM website there was an example where the LAD was diseased but Cx and RCA normal and they coded insignificant stenosis (<50% disease) for the Cx and RCA, instead of leaving it blank. This is a big discrepancy.

Does anyone here have any insight on how to code cath? Thanks in advance.
 
Nobody has any insight into the ambiguity of this test. I took it last year (passed). Unless the entire thing was normal I always clicked insignificant stenosis.
 
shouldigomd said:
Nobody has any insight into the ambiguity of this test. I took it last year (passed). Unless the entire thing was normal I always clicked insignificant stenosis.
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so if they showed an otherwise unremarkable artery you clicked on insignificant stenosis for each artery? Or do you leave it blank? Based on ABIM website it seems like you have to code something for each artery shown (doesn't help they just posted static blurry images instead of actual clips as an example). Can someone who did well on cath section last year please confirm this?
 
There are A LOT of discrepancies between OKeefe and ECGSource in terms of coding for MI. ECGSource does not code for anterior MI and anterolateral MI on several ECGs despite there being ST elevation in V2-V5 they will only code for anterior MI. OKeefe codes for multiple MIs. ECGSource only codes inferior MI despite ST depressions in V1-V3 while OKeefe codes both acute inferior and posterior MI.

ECGSource also codes both dual chamber PPM and CRT device while OKeefe only codes CRT.

Which one do we follow?
 
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They don't have a normal option for each coronary thus my opinion is that the "normal" option is only for an entirely normal angiogram. For everything else there is some pathology somewhere thus I would click an option on each coronary. For example if there was a severe RCA lesion I would indicate insignificant LAD (if normal appearing). I also think that it doesn't matter if you leave it blank or click insignificant for normal appearing vessels.

One can only guess how they grade this but I felt like okeefe was more logical and clearer. I did not like many of the ecgsource interpretations.
 
i feel ecgsource sometimes overcodes and sometimes doesn't. never sure if its only LAD or RAD or LAFB or LPFB. Also i agree with if there is inf STEMI it doesn't code for Post stemi if the STD are significant. even the QRS measurements are not always similar to mine. i wish they gave the basic QRS measurements with it.

im thinking of only coding for the major diagnosis and not for the axis etc or non specific ST changes etc.
Regarding cath images- if CABG patient do you code for the native arteries as well?
 
Anyone else feels that the ACC's ECG Drill & Practice program is a little ****ty? It doesn't feel like anything else in the board review world
 
does anyone know if okeefe is doing an ECG session for boards this year, like last time there was one posted on youtube
 
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Not sure what that was. How is that a general cardiology board exam? It's like they took all the difficult advanced subspecialty questions and just put them together and called it general cardiology. The pass rates for this exam are one of the lowest. Are they punishing us for creating a seperate board? Absolutely ridiculous day 1.
 
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A lot of EP questions…

And did you guys think there were questions that had no right answer?
 
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cardiologytexas said:
A lot of peacemaker questions…

And did you guys think there were questions that had no right answer? Like strategy in ACS and anticoagulantion
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yes they were more like asking for opinions not guidelines. And the congenital stuff was also very random, could be multiple options
 
That felt like an impossible test. It was so hard to decipher anything on Day 2. So many borderline stuff, vague stems, and blurry EKGs. Also, like, in the real world you would not be asked to make diagnosis based on one blurry echo image. It felt like "What I am thinking?" sort of questions.
The first day was its own beast. Agree, it felt like the toughest questions from subspecialty boards all placed into one. So much EP questions! Also, testing on random factoids that if you needed in real life, you would look up. I feel really terrible after taking it.
 
Day 2 was a joke. Worst exam day of my life. I find it hard to believe 80% of people pass day 2 if it is that difficult every year. It has nothing to do with your cardiology knowledge or abilities. I did very very well on my ITEs and might fail day 2, unbelievable.
 
Cardiac Amyloidosis said:
Day 2 was a joke. Worst exam day of my life. I find it hard to believe 80% of people pass day 2 if it is that difficult every year. It has nothing to do with your cardiology knowledge or abilities. I did very very well on my ITEs and might fail day 2, unbelievable.
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You know what’s interesting? Not one single question on either day about amyloidosis…
Definitely felt worse after day 1 than day 2 (at least after speaking with my colleagues after the test to see that the things I was guessing on were good guesses). So much EP yesterday. And borderline valve stuff. And I sent every patient in shock to ECMO.
ECGs also had soooo much not-straightforward pacemaker stuff. But at least there were a few gimmes in that section. Cath was stupid (mainly because in real life you’re never going to get one single view of something and expect to diagnose it, and there were so many things that don’t align with the coding sheet). And I say that as an IC fellow…
 
cardiologytexas said:
A lot of EP questions…

And did you guys think there were questions that had no right answer?
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Yes, the VERY first question with recurrent pericarditis and the options were ibuprofen 600 q8, ibuprofen 400 q8 plus colchicine, steroids, or aspirin 325 q8. None of those are correct and it threw me off badly.
 
It’s ridiculous, there was one echo case I still can’t figure out what view I was looking at since there was nothing clear on the image.

Same with EKG… I felt like the same pathology was repeating over and over or I was just coding it wrong.

I still feel the worse was day one, some questions I wouldn’t be able to answer even if I had Internet access. Then missed a few freebies out of exhaustion.. the first block felt easy, 3rd and 4th massacre. So much PPM interpretation.
 
dje91090 said:
Yes, the VERY first question with recurrent pericarditis and the options were ibuprofen 600 q8, ibuprofen 400 q8 plus colchicine, steroids, or aspirin 325 q8. None of those are correct and it threw me off badly.
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There was a lot of choose the least wrong. Like you’re asking me not to send on DAPT?
 
cardiologytexas said:
It’s ridiculous, there was one echo case I still can’t figure out what view I was looking at since there was nothing clear on the image.

Same with EKG… I felt like the same pathology was repeating over and over or I was just coding it wrong.

I still feel the worse was day one, some questions I wouldn’t be able to answer even if I had Internet access. Then missed a few freebies out of exhaustion.. the first block felt easy, 3rd and 4th massacre. So much PPM interpretation.
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Which one? There was an echo that showed a TEE upside down and I had to literally turn my head, the prompt was a young guy with something wrong with his aortic valve? No clue.
To me, block 2 was manageable, but blocks 1 and 4 KILLED me.
 
i think somebody drank a lot of wine while making these questions for day one must have been an EP attending. And that congenital stuff was ****. D2 was bad too, but I think for me day one was still worse.
 
dje91090 said:
You know what’s interesting? Not one single question on either day about amyloidosis…
Definitely felt worse after day 1 than day 2 (at least after speaking with my colleagues after the test to see that the things I was guessing on were good guesses). So much EP yesterday. And borderline valve stuff. And I sent every patient in shock to ECMO.
ECGs also had soooo much not-straightforward pacemaker stuff. But at least there were a few gimmes in that section. Cath was stupid (mainly because in real life you’re never going to get one single view of something and expect to diagnose it, and there were so many things that don’t align with the coding sheet). And I say that as an IC fellow…
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Are you me?! I was wondering if I had missed amyloidosis because it just didn't seem possible not to have it. And I definitely sent everyone to ECMO.
Overall I found yesterday hard but not awful - definitely weirdly subspecialty-heavy. But ECGs today were rough. The pacemaker cases were stupid with their tiny spikes not lining up between leads. The clinical scenarios were completely unhelpful.
Both yesterday and the echo part of today had so much congenital - felt like way more than the 5% stated in the blueprint. But I'm an ACHD fellow so hopefully I don't get embarrassed
 
Does anyone else think they got repeat ekg ? With almost same scenario? EKG portion was the rough.
 
Day 1 was a complete shxt show. This is round 2 for me after failing by about 2 questions on day 1 last year. At this point, I’m really lost on how to succeed at this game. Mayo, ACCSAP and Board Vitals were DRILLED for Day 1 (scoring in the 80s on question sets in the weeks leading to the exam). None of it seems to be enough. Feeling super discouraged😞
 
I'm really hoping that the EKG portion makes up for my lousy performance on the cath portion and echocardiogram. I didn't feel EKG was as hard but maybe I undercoded. It is too bad that we cannot discuss questions among ourselves. I guess what would be the point anyways.
 
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cardioblue said:
I code same. Either both will wrong or i will have a chance to pass 🤣
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Am I the only one who didn't realize it was the same ECG? I was so rushed that I clicked and kept moving. rough test both days. speechless
 
Albein said:
Am I the only one who didn't realize it was the same ECG? I was so rushed that I clicked and kept moving. rough test both days. speechless
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Not the exact same. But I felt the diagnosis was. But I’m not sure really. Idk if age in the stem means anything… could be a 26 yo with arterial switch having STEMI for all that matters…
 
cardiologytexas said:
Not the exact same. But I felt the diagnosis was. But I’m not sure really. Idk if age in the stem means anything… could be a 26 yo with arterial switch having STEMI for all that matters…
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oh i know what youre talking about then. i used age too for some of them, but wiht how useless those stems were... who even knows. i was definitely surprised at not getting more of the pertinent real life ECGs...
 
Albein said:
oh i know what youre talking about then. i used age too for some of them, but wiht how useless those stems were... who even knows. i was definitely surprised at not getting more of the pertinent real life ECGs...
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Well cr@p I coded a few “normal” 🤦🏻‍♂️
 
cardioblue said:
Do w have ti pass ekg portion separately ? Or all imaging is combined?
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The second day is considered a full test. They will report it out as a score. 48% f the test is EKG so its the portion I focused on most. The cumulative score for day 2 is then calculated with all your answers for EKG, Echo and Cath. Of course, fi you don't pass either day, the whole test is considered fail.
 
Kryptodoc1938 said:
The second day is considered a full test. They will report it out as a score. 48% f the test is EKG so its the portion I focused on most. The cumulative score for day 2 is then calculated with all your answers for EKG, Echo and Cath. Of course, fi you don't pass either day, the whole test is considered fail.
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So there are 3 portions you have pass day 1, EKG, and imagin(echo/ cath).
 
Kryptodoc1938 said:
The second day is considered a full test. They will report it out as a score. 48% f the test is EKG so its the portion I focused on most. The cumulative score for day 2 is then calculated with all your answers for EKG, Echo and Cath. Of course, fi you don't pass either day, the whole test is considered fail.
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I think you have to pass both days separately. Day 2 is considered one cumulative test. From what I know. If you fail either day you have to re take both days again
 
I am lost for options too this is my third attempt at this test. Did ACCSAP, Mayo Videos, Okeefe and ECG source. Not sure how what are other resources are left. Also wondering what would be the worst case scenario if we are not ABIM certified??
 
munnadoc said:
I am lost for options too this is my third attempt at this test. Did ACCSAP, Mayo Videos, Okeefe and ECG source. Not sure how what are other resources are left. Also wondering what would be the worst case scenario if we are not ABIM certified??
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It is a very hard test. I feel desolated after today. How was the passing scores of previous years? Do you have any idea of percentage we need to get right?
 
cardioblue said:
Does anyone else think they got repeat ekg ? With almost same scenario? EKG portion was the rough.
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We had two identical ECGs of pericardial effusion. One was a 60 yr old something and another was a 40 yr old something. Exact same ECG with low voltage everywhere except V2 and alternans in III

Speaking of ECGs, since I’m thinking about it… the ECG of the 18 year old who drowned; I put hypothermia because it was brady and looked like big osborn waves across the precordial leads (and not just V2) but one of my EP colleagues said he coded Brugada (speaking of unhelpful scenario; either could be correct). Anyone care to chime in?
 
munnadoc said:
I am lost for options too this is my third attempt at this test. Did ACCSAP, Mayo Videos, Okeefe and ECG source. Not sure how what are other resources are left. Also wondering what would be the worst case scenario if we are not ABIM certified??
Click to expand...
I’m sure we all feel same way after this horrible test. I think they wanted to check our eyesight more than knowledge. EKG were horrible blurry.
Let’s just hope for the best. I heard acc has applied to form new board for cardiology boards , hope this will get approval and we say bye to ABIM.
 
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