dermatology residents and the ITE

[golf4mbs]

As I continue studying for the upcoming ITE this Thursday I am wondering...

WHY do dermatology residents all go crazy about the ITE???? I have a few theories

1. Dermatology attracts intense type A people who have to do well on everything
2. Clinical dermatology has very little to do with what is tested on for the boards/ITE
3. We have higher expectations set by our program directors for doing well on the test

It seems in talking to many of my other friends in other specialties that NO ONE really cares about the ITE. They basically may study for a week and then take it. There are no real expectations and doing good or bad doesn't really mean much.

Most derm residents I talk to all study for months and stress out about it much more. Maybe this is why the board pass rates are very high in recent years for dermatology, but who knows. I just think it is interesting how much this test is emphasized compared to other specialties. Also I can't wait to be done with it for the year and put my Jain book away!

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[dermie1985]

As I continue studying for the upcoming ITE this Thursday I am wondering...

WHY do dermatology residents all go crazy about the ITE???? I have a few theories

1. Dermatology attracts intense type A people who have to do well on everything
2. Clinical dermatology has very little to do with what is tested on for the boards/ITE
3. We have higher expectations set by our program directors for doing well on the test

It seems in talking to many of my other friends in other specialties that NO ONE really cares about the ITE. They basically may study for a week and then take it. There are no real expectations and doing good or bad doesn't really mean much.

Most derm residents I talk to all study for months and stress out about it much more. Maybe this is why the board pass rates are very high in recent years for dermatology, but who knows. I just think it is interesting how much this test is emphasized compared to other specialties. Also I can't wait to be done with it for the year and put my Jain book away!

Does seem highly variable from program-to-program. I interviewed at one that just wanted everyone to get above the 20% percentile. Also interviewed at a different program where one resident was scolded by the PD because she/he got a 90% on ITE rather than the 97-99% of their co-residents.

 

[asmallchild]

As I continue studying for the upcoming ITE this Thursday I am wondering...

WHY do dermatology residents all go crazy about the ITE???? I have a few theories

1. Dermatology attracts intense type A people who have to do well on everything
2. Clinical dermatology has very little to do with what is tested on for the boards/ITE
3. We have higher expectations set by our program directors for doing well on the test

It seems in talking to many of my other friends in other specialties that NO ONE really cares about the ITE. They basically may study for a week and then take it. There are no real expectations and doing good or bad doesn't really mean much.

Most derm residents I talk to all study for months and stress out about it much more. Maybe this is why the board pass rates are very high in recent years for dermatology, but who knows. I just think it is interesting how much this test is emphasized compared to other specialties. Also I can't wait to be done with it for the year and put my Jain book away!

I agree with all the above. The one thing I will say is that program directors tend to put too much stock into this exam (as they do Step 1). Fair or not, it will color (or cloud) their judgment of you even though, as you correctly mention, it has very little overlap with actual clinical dermatology.

I've known some PDs to be loose with this information and fair or not, it also changes how other attendings may look at you. As stupid as it is, I definitely recommend knocking it out of the park as a 1st year (and this comes from someone who was under the gun all of PGY3 thanks to a poor PGY2 score)

 

[charmiedermie]

As I continue studying for the upcoming ITE this Thursday I am wondering...

WHY do dermatology residents all go crazy about the ITE???? I have a few theories

1. Dermatology attracts intense type A people who have to do well on everything
2. Clinical dermatology has very little to do with what is tested on for the boards/ITE
3. We have higher expectations set by our program directors for doing well on the test

It seems in talking to many of my other friends in other specialties that NO ONE really cares about the ITE. They basically may study for a week and then take it. There are no real expectations and doing good or bad doesn't really mean much.

Most derm residents I talk to all study for months and stress out about it much more. Maybe this is why the board pass rates are very high in recent years for dermatology, but who knows. I just think it is interesting how much this test is emphasized compared to other specialties. Also I can't wait to be done with it for the year and put my Jain book away!

I think the emphasis on the ITE seems to be much more program director driven vs. resident driven, in terms of stress, which varies by program. The derm residents just wanted to pass their eventual boards. If it was one thing that was great on the interview trail, is that derm residents were very upfront about their program directors, expectations on the ITE, and whether faculty "judge" you behind the scenes, based on that score.

Does seem highly variable from program-to-program. I interviewed at one that just wanted everyone to get above the 20% percentile. Also interviewed at a different program where one resident was scolded by the PD because she/he got a 90% on ITE rather than the 97-99% of their co-residents.

I bet I can guess this program in up to 5 guesses. Lol.

 

[charmiedermie]

As stupid as it is, I definitely recommend knocking it out of the park as a 1st year (and this comes from someone who was under the gun all of PGY3 thanks to a poor PGY2 score)

What do u mean by under the gun? Were faculty actively quizzing you in clinics, or calling on u more often in conference, etc.?

 

[asmallchild]

What do u mean by under the gun? Were faculty actively quizzing you in clinics, or calling on u more often in conference, etc.?

All the above. You can be subjected to more active quizzing in clinics. You can be targeted in conference. It is worth the effort (IMO) to take the inservice exam very seriously as a first year as it can set the tone for how you are perceived by the program in your remaining time there

 

[Dral]

Study for months? Do people count reading Bogonia as studying?

Months for boards, yes. Inservice is more like weeks...at least for most people I know.

Rocking it first year is definitely a good thing. First impressions and all.

Unfortunately, everyone cares about percentile, so there will always be people who don't do as well...even if they actually do fairly well on raw score.

 

[golf4mbs]

Study for months? Do people count reading Bogonia as studying?

Months for boards, yes. Inservice is more like weeks...at least for most people I know.

Rocking it first year is definitely a good thing. First impressions and all.

Unfortunately, everyone cares about percentile, so there will always be people who don't do as well...even if they actually do fairly well on raw score.

OK maybe not months, most people in my program started at the beginning of January.

As far as I know, only the PD is supposed to know your actual score, the rest of the faculty are only supposed to get an average for each PGY year and not know each persons actual score, although who knows if this is actually the case.

 

[asmallchild]

OK maybe not months, most people in my program started at the beginning of January.

As far as I know, only the PD is supposed to know your actual score, the rest of the faculty are only supposed to get an average for each PGY year and not know each persons actual score, although who knows if this is actually the case.

Definitely not the case at my program, everyone knew (and the actual scores were listed on a PPT slide at a faculty meeting)

I will concede to starting to study for the ITE in November or December in my 2nd year. Admittedly a bit sick, but the plus side is that I knocked the socks off the ITE that way 🙂

 

[Decicco]

I think that this is mostly the fault of the American Board of Dermatology.

We have a great field (the best, I think), but it hasn't always been super competitive. As it has become more competitive, the Board feels that they have to keep failing a certain number of residents each year in order to justify their existence, despite the fact that we have some of the smartest and most committed residents around. In order to keep normal distribution of exam scores, there has been evermore emphasis on clinically useless trivia, like the genes/proteins responsible for conditions like Gaucher's and Hunter's disease, matching pictures of insects/plants to their latin names, etc. Its to the point that attending dermatologists basically are unable to teach residents board-relevant material because it is so esoteric. For this reason, teaching in many programs has become the responsibility of co-residents and drug company-sponsored study guides and practice questions.

In 2011, more than 10% of the residents failed their certification exam. So, after three years of residency, paying thousands of dollars to take the exam and flying across the country, they had to spend the next year re-memorizing gene and protein names just for the chance of passing the boards the next year.

I still think that we have the best field and it really is a privilege to be a part of it, but the Board has needlessly created a hyper competitive and anxiety provoking culture among residents who are already prone to these problems.

 

[estingray]

Very much agree with asmallchild above. I did as expected in my first year and things were good. Did not do so hot second year percentile-wise (the only thing our program cares about) and I was hounded about it from then on.

Also agree with Decico. The certifying exam has now essentially become a (bad) joke. Our faculty all admit they could not pass it now. That says something about what the board has become. I'll come back and update this post with an apology the day I have to differentiate one species of flea from another on microscopy in my clinic.

 

[Dral]

At least we don't have to differentiate fungal cultures by morphology anymore afaik. Heh

 

[doc MD]

At least we don't have to differentiate fungal cultures by morphology anymore afaik. Heh

i really hope this remains true!!!!

 

[dermieorbust]

I really think there is no excuse to not do well as a first year. Doing poorly means you just didn't study, period. The curve is ridiculously generous. Wait till 3rd year when one question wrong drops you 5-7 percentile points 🙁

I agree with others the scores do not really correlate whether you are a good clinical dermatologist - but you can't be a good clinical derm without the knowledge either. If you study (and ahem, have access to questions), there is no reason you will not do well.

 

[doctalaughs]

If you study (and ahem, have access to questions), there is no reason you will not do well.

This is exactly why those exams are comical. At my program no one really cared too much about your score. I actually went through 3 years without realizing that many residents in other programs actually had prior years answers which apparently are frequently repeated. I studied maybe 1-2 days for the actual ITE because we were too busy with clinical duties which i think made a much bigger difference making me a good dermatologist.

Its sad these program directors are congratulating these "97th percentile" residents when they are actually curved against others who don't actually already have 50% of the answers. Its kind of laughable really since the ITE should generally promote useful clinical knowledge, whereas it seems to have an almost opposite effect.

 

[username456789]

This is exactly why those exams are comical. At my program no one really cared too much about your score. I actually went through 3 years without realizing that many residents in other programs actually had prior years answers which apparently are frequently repeated. I studied maybe 1-2 days for the actual ITE because we were too busy with clinical duties which i think made a much bigger difference making me a good dermatologist.

Its sad these program directors are congratulating these "97th percentile" residents when they are actually curved against others who don't actually already have 50% of the answers. Its kind of laughable really since the ITE should generally promote useful clinical knowledge, whereas it seems to have an almost opposite effect.

Conversely, I have scored in the 98th and 99th percentile my first two years, and we have no such access to previous year questions. Which means I will probably be a terrible dermatologist.

 

[doctalaughs]

Conversely, I have scored in the 98th and 99th percentile my first two years, and we have no such access to previous year questions. Which means I will probably be a terrible dermatologist.

Good for you. I actually know a person with a true photographic memory (you could open a random page in bolognia, give him the title and he could read the entire page to you from memory). He used to score in the 70-85% range- after that I decided the derm ITE was a joke. So either you really are a phenomenal test taker several standard-deviations beyond most derm residents, or the "review" material you used incorporated prior questions.

I just don't understand why they can't rewrite new questions each year and make them remotely clinically relevant. It's not that hard to do.

 

[username456789]

Good for you. I actually know a person with a true photographic memory (you could open a random page in bolognia, give him the title and he could read the entire page to you from memory). He used to score in the 70-85% range- after that I decided the derm ITE was a joke. So either you really are a phenomenal test taker several standard-deviations beyond most derm residents, or the "review" material you used incorporated prior questions.

I just don't understand why they can't rewrite new questions each year and make them remotely clinically relevant. It's not that hard to do.

I "review" Bolognia daily and take notes. I use the Galderma binder/Jain book to study some high yield stuff as February approaches. And I did the Galderma questions. I honestly have no clue where other programs get these secret review questions of which you speak.

Having a photographic memory can help, but it alone is not gonna get you to the top of the pile in Dermatology.

Anyway, the ITE is a necessary evil/annoyance. Our field seems to be one of the few that, on average, tends to take it seriously.

 

[golf4mbs]

I'm glad this thread is getting more replies!

Funny story, previously our program director had stated that only herself and the assistant PD would have access to the scores,,, well what do you know, today one of the faculty (NOT PD or APD) approached me and congratulated my score (luckily I did well). After reading this thread I guess I'm not surprised. After talking to my co-residents, I guess that in the past those who have not done so well often get picked on in clinic and expectations among residents and attitudes of the attending's towards residents start to change SIGNIFICANTLY. I think it is kind of ridiculous as the ITE has almost nothing to do with clinical dermatology, but what can you do.

I may have shot myself in the foot by doing well 1st year, I will probably be expected to match or outperform my numbers in subsequent years, which will be very difficult considering the huge curve upward in scores after 1st year. I wish no one cared about the ITE like in every other specialty ha!

 

[golf4mbs]

I'm glad this thread is getting more replies!

Funny story, previously our program director had stated that only herself and the assistant PD would have access to the scores,,, well what do you know, today one of the faculty (NOT PD or APD) approached me and congratulated my score (luckily I did well). After reading this thread I guess I'm not surprised. After talking to my co-residents, I guess that in the past those who have not done so well often get picked on in clinic and expectations among residents and attitudes of the attending's towards residents start to change SIGNIFICANTLY. I think it is kind of ridiculous as the ITE has almost nothing to do with clinical dermatology, but what can you do.

I may have shot myself in the foot by doing well 1st year, I will probably be expected to match or outperform my numbers in subsequent years, which will be very difficult considering the huge curve upward in scores after 1st year. I wish no one cared about the ITE like in every other specialty ha!

 

[sawtella]

I'm glad this thread is getting more replies!

Funny story, previously our program director had stated that only herself and the assistant PD would have access to the scores,,, well what do you know, today one of the faculty (NOT PD or APD) approached me and congratulated my score (luckily I did well). After reading this thread I guess I'm not surprised. After talking to my co-residents, I guess that in the past those who have not done so well often get picked on in clinic and expectations among residents and attitudes of the attending's towards residents start to change SIGNIFICANTLY. I think it is kind of ridiculous as the ITE has almost nothing to do with clinical dermatology, but what can you do.

I may have shot myself in the foot by doing well 1st year, I will probably be expected to match or outperform my numbers in subsequent years, which will be very difficult considering the huge curve upward in scores after 1st year. I wish no one cared about the ITE like in every other specialty ha!

As I've mentioned in the other ITE thread, this is the VERY REASON I encourage residents to take the ITE seriously. We all know it has no bearing on what type of dermatologist you will be but it will/may affect the way your attendings treat you. This may not be a huge deal, but it does make the rest of your residency a whole lot easier when you are given the benefit of the doubt.

 

[sore eye asses]

This thread is all well and good, but what if I'm just too stupid to do well on the ITE? Can I have somebody at my program call the ITE office to refute the score? This is a really flawed test. I mean, it asks all these really hard dermatology questions that I didn't know the answer to, which really isn't fair and doesn't capture my inner chi that I utilize to diagnose dermatologic diseases. I'm not my 4th percentile ITE score! I'm a special snowflake! My daddy told my PD this and it's true and now I'm a resident and you're not and I'm going to be the best!

 

[nsk2828]

Hi! Not sure if this is the right thread to post in but can't find any other on the Derm ITE. Taking it for the first time this year, I was wondering if anyone could kindly advise on the
1. format of the exam: how many qns across each subspec, time limit (4h?/ breaks?) etc
2. if studying the gladerma binder alone and doing all the qns would get one at least at 65?

Thanks in advance!

 

[asmallchild]

Hi! Not sure if this is the right thread to post in but can't find any other on the Derm ITE. Taking it for the first time this year, I was wondering if anyone could kindly advise on the
1. format of the exam: how many qns across each subspec, time limit (4h?/ breaks?) etc
2. if studying the gladerma binder alone and doing all the qns would get one at least at 65?

Thanks in advance!

Sorry I don't remember much about the exam format anymore. If you have been paying attention during your reading for the year (I'm assuming your program has you utilizing some sort of textbook) and do a thorough job of studying the galderma binder and going through the questions (and explanatory answers), then yes, you should be fine for the ITE. I'm not sure about scoring in the 65th percentile but it should be enough to put you (at least) in the middle of the bell curve IMO.

 

[Dral]

There was an experimental section on last year's exam. I'm not sure if it will be integrated into this year's or not.

 

[nsk2828]

Thanks for the replies asmallchild and Dral!