f me...74 on abem. now what?!

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coffeecup531

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i am just devastated. i graduated from a great med school, finished residency at a reputable institution...Im not the greatest test taker but ive always done average at the least.

i hate making excuses but i went into it less than prepared and i knew it. i've been a bit overwhelmed at my new job (do i tell them?) and i just got news earlier that week that my sibling's cancer is back which has been very rough on me.

uuuggghhh...abem's website is terrible to navigate but from what i can gather, i can only retake it next november? no other dates it's administered? i was even thinking of requesting the hand scoring...i mean its one freaking point!! it's probably a waste of $ but im desperate. this is my worst nightmare.

do i contact my old program director?

im just trying to pick myself up at this point and figure out how to fix this giant one i put myself into..
 
i don't have any fantastic advice per se... but it happens. not to me, but to people i know. usually on the oral boards but it sounds like you had some awful extenuating circumstances and it IS just 1 point.

my guess is that if you 1. take some time to prep and 2. do a good course, you will be just fine. no one but your director really will know, just b/c you won't be "board certified" on time. it's not a big deal... i think you have 3 years??
 
In the grand scheme of things - not a big deal. You're just board eligible rather than board certified until next year. I passed the test on the first go, but not by much. I tell the residents I work with to study more than you think you need to. That test has very little to do with the clinical practice of EM. It's just not worth going into that test unprepared.
 
I wouldn't tell your job unless asked. You'll study your booty off next time and pass. It'll only delay your board certification a year, and you'll get that year back on the other end. 🙂 Many of us were awfully close to failing one or the other of the two tests.
 
I agree mostly with what others said. You have some bad things get your down this year, it happens. You can only take it 'next year', do a review course and focus. You should be able to pass it if you just buckle down a bit...

As far as telling anyone... I think it depends on your 'job'. If you work for a big CMG, I would not mention it. If its a small, democratic group, making partner or not, etc... I would sit down with your 'boss' (medical director or group owner, etc) and be very frank with them. I think its much better to be proactive in that situation then not mentioning it or essentially hiding it.

I HIGHLY doubt your job would be in jeopardy, review your contract in detail. I have not heard/seen a contract that requires BC.. most list BE/BC, which you ARE still BE.

Don't stress it, Merry Christmas.
 
Dude,

I passed, but not by a great margin. This is coming from the guy who (sorry for bragging), has crushed every standardized test that he's come across.

That test was bogus. Without discussing content... I had more "IM" questions than "EM" questions. I did PEER-8 and the "1000 questions book".

ABEM has some changes to make. Don't take it so hard.
 
thanks guys. its just cruel going through this before the holidays too, but you're all right- in the grand scheme of things this is just another hurdle...

the fee for hand scoring that's published on their site is $190. will call tomorrow and request it. as said above, i have nothing to lose.

as RustedFox said as well, this test was definitely a different beast. im glad to at least hear i was not the only one that found it so far from what my daily EM practice requires me to know for patient care.
 
thanks guys. its just cruel going through this before the holidays too, but you're all right- in the grand scheme of things this is just another hurdle...

the fee for hand scoring that's published on their site is $190. will call tomorrow and request it. as said above, i have nothing to lose.

as RustedFox said as well, this test was definitely a different beast. im glad to at least hear i was not the only one that found it so far from what my daily EM practice requires me to know for patient care.

Dude. No joke: I hope that the ABEM folks find this post.

I studied for the test as per my above posts.

The content was more "Thursday night IM-pub trivia !" than EM-relevant management principles.

I pulled out every trick that gets me to win pub trivia nights.

I won.

Yay. My board exam content is now 'pub trivia'. LOLZ. May as well have had some Blue Moon beers while I was taking it. Would have probably scored higher.
 
Man... I'm pretty sure the hospitalists I work with broke into the ABEM office, threw a keg and pizza party, cackled with glee and re-wrote the exam the night before it was to be electronically sent to the testing centers. I literally wondered at one point if I had the right test. Same experience as everyone else.

Just study harder next year. You'll do fine. 1 point. If it had happened to me, I would not feel the slightest need to tell anyone unless asked and I would have no problem saying "Look, I didn't pass by 1 point. I had a lot going on and will aim for next year." Nobody should give you grief about that in the slightest and I can't imagine anyone would care unless board certification is a requisite for some sort of bonus or partnership track, etc.. CMGs won't care. In the grand scheme of things, you have plenty of time to pass and you naturally aren't the only person out there who didn't pass.

Do lots of questions. Agree with the post about overstudying. I prob did 2000 questions and although I passed, it was not by more points than I can count with one hand! It sounds like you were under a lot of stress and I understand. I had to do Feb's ITE as a PGY4 while going through a nasty divorce and it was really difficult to compartmentalize and focus on residency obligations. Hopefully, you'll be in a different state of mind next year.

Don't let it ruin your holidays. You're done with residency, earning attending salary, saving lives, practicing good medicine and this is simply a hiccup on your long road of success and happiness.
 
My wife had the same score, 74.
She was devastated when she found out, felt like a failure.
She paid for a hand-rescore, did not change things.
Spent a while moping, forgot about it for seven months, then started studying again.
She took Hippo EM, and did every question she could get her hands on, including their questions, Peer VIII (several times) and others. Literally every practice question that exists.
Just took it again, and passed.
Keep your chin up, work hard and you'll get it next time.
Those questions are ridiculous anyway, it's just a hoop to jump through.
 
The content was more "Thursday night IM-pub trivia !" than EM-relevant management principles.
Man... I'm pretty sure the hospitalists I work with broke into the ABEM office, threw a keg and pizza party, cackled with glee and re-wrote the exam the night before it was to be electronically sent to the testing centers. I literally wondered at one point if I had the right test. Same experience as everyone else.
If it makes you feel any better, more than half the ABIM questions start "A patient presents to the ED with X, what is the first test you would order while in the ED?". The rest ask about the best 3rd line treatments for rare rheumatologic and oncologic conditions.
 
I rocked the SAT, ACT, MCAT, USMLE 1-3 etc. I also did well on the written. However I very nearly failed the oral exam despite doing tons of practice and actually taking a short course on it. You should be a little paranoid about those tests. They're not as well done as other tests and they're hard. At least the annual practice test you do as a resident prepares you for the written. Nothing prepares you for the oral.
 
Nothing prepares you for the oral.

Actually, previous experience playing Dungeons and Dragons might help:

ABEM Dungeon Master: You enter the room and encounter a Zombie Narc Seeker complaining of +2 Back Pain

You: I use the Tome of Prescription Monitoring and throw two Motrin charms

ABEM Dungeon Master: Sorry, the Motrin charms were blocked by an NSAID Allergy shield, and the Zombie casts a Press Gainey spell.

You: Dammit. Okay, I give one small pouch of Percocet and apply a Lidoderm poultice.

ABEM Dungeon Master: I have to roll a ten-sided to see if the Zombie conjures the Nursing Supervisor Balrog.
 
I only passed by a few points and I never got less than a 99 on any of the USMLE exams and did well on my inservice exams. This exam was more STEP I and IM than anything EM. Several of my friends who also scored well on everything up to this point, only passed marginally. It was not at all reflective of emergency medicine practice or even EM "test" practice. My guess is that ABEM needs to prove it isn't a total money making gimmick (which it is) by failing a certain percentage of people. The best way to do that when you are dealing with people who have graduated from an EM residency is by cheating and making a bull**** test.
 
Actually, previous experience playing Dungeons and Dragons might help:

ABEM Dungeon Master: You enter the room and encounter a Zombie Narc Seeker complaining of +2 Back Pain

You: I use the Tome of Prescription Monitoring and throw two Motrin charms

ABEM Dungeon Master: Sorry, the Motrin charms were blocked by an NSAID Allergy shield, and the Zombie casts a Press Gainey spell.

You: Dammit. Okay, I give one small pouch of Percocet and apply a Lidoderm poultice.

ABEM Dungeon Master: I have to roll a ten-sided to see if the Zombie conjures the Nursing Supervisor Balrog.
This is going up at work. Strong work!
 
I rocked the SAT, ACT, MCAT, USMLE 1-3 etc. I also did well on the written. However I very nearly failed the oral exam despite doing tons of practice and actually taking a short course on it. You should be a little paranoid about those tests. They're not as well done as other tests and they're hard. At least the annual practice test you do as a resident prepares you for the written. Nothing prepares you for the oral.

Agree with White Coat--you should be paranoid enough to study to the extent so that you don't have any regrets.

Additionally, I think that the inservice tests actually do a disservice because they give you the percent chance of passing the real thing based on your inservice score, which creates a false sense of confidence most of the time.

I went down on my 3rd year inservice score compared to 2nd year, so I really put a lot of effort into studying for the real test and did fairly well, but I don't think I would have put in that much effort if I'd gotten the "99% chance of passing" that I got my first two years of residency.

As for resources, I've been more the first 6 months out than I did as a resident just for issues relating to clinical care and new things I've seen or been uncomfortable with. Also, I read a lot of the High Yield book from Intraining Prep and did almost all of the 1200 questions book, which was probably best because it has long question stems that test IM-like esoteric knowledge. Aside from that, I listen to a lot of podcasts in the car on when I'm out on long bike rides.
 
Look at the bright side...by delaying completion of your board certification by a year...you delay getting on the LLSA/MOC treadmill for a year.

Sent from my BlackBerry 9330
 
I have a 20 mile bikepath that I ride without any cars or road crossings, otherwise, no audio when I ride elsewhere

He meant to highlight that you listen to podcasts in your CAR when you're on BIKE rides; seemingly impossble to do.
 
My director told me of his Board failure. Passed the next year.

I just re-certed. I think half was EM related. The other half was Step 1. I was sure I'd be doing locums work at the CVS walk in.

Don't sweat it. Study harder next year.
 
i am just devastated. i graduated from a great med school, finished residency at a reputable institution...Im not the greatest test taker but ive always done average at the least.

i hate making excuses but i went into it less than prepared and i knew it. i've been a bit overwhelmed at my new job (do i tell them?) and i just got news earlier that week that my sibling's cancer is back which has been very rough on me.

uuuggghhh...abem's website is terrible to navigate but from what i can gather, i can only retake it next november? no other dates it's administered? i was even thinking of requesting the hand scoring...i mean its one freaking point!! it's probably a waste of $ but im desperate. this is my worst nightmare.

do i contact my old program director?

im just trying to pick myself up at this point and figure out how to fix this giant one i put myself into..

Sorry dude... but pick yourself up and get back to studying.

It happens to the best of us. It's only 1 point.

Just know that the oral boards also need much attention when you get to that point. I absolutely crushed the written but it got pretty close on the orals - others are vice versa. Just study and you'll be ok.
 
Hi all. I know it’s been awhile since these but I just found out that I failed by one point. My biggest issue is that I feel like I’ll just never pass and have to work an urgent care in the middle of nowhere... also my fear is I’ll let this affect my year and all the true joys that I have going on.

Would love to hear some inspiration stories about passing the next year 🙂

thanks!
 
Hi all. I know it’s been awhile since these but I just found out that I failed by one point. My biggest issue is that I feel like I’ll just never pass and have to work an urgent care in the middle of nowhere... also my fear is I’ll let this affect my year and all the true joys that I have going on.

Would love to hear some inspiration stories about passing the next year 🙂

thanks!

Most people will eventually pass. My best advice is set that test aside for the next 5 weeks and spend some time with friends and family. After the Holidays, approach it with a fresh mind and try to do the following:

1) Determine if this was a testing fluke for you, or did you struggle with in-service. For example, do you struggle with time mgmt during exams, were there unanswered questions, etc.

2) Look at your score report. Are there content areas that stand out needing attention.

3) Formulate a plan based on 1&2. If test taking is a problem, do lots and lots of questions under time pressure to simulate the exam. Consider a review course if you struggle assimilating all the information.
 
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will second HippoEM. I totally slacked off my senior year and bombed my inservice. But I took HippoEM, did questions from peer 8 to prep for the written boards, and passed by a few percentage points.
 
Hi all. I know it’s been awhile since these but I just found out that I failed by one point. My biggest issue is that I feel like I’ll just never pass and have to work an urgent care in the middle of nowhere... also my fear is I’ll let this affect my year and all the true joys that I have going on.

Would love to hear some inspiration stories about passing the next year 🙂

thanks!

Don't be disheartened. I know several people who failed and had to retake it. All of them retook it and passed without issues. All but one of them I wouldn't hold it against them in the slightest and would have no problem with them taking care of my family. So odds are you will retake it, pass, and never think of this again.

Now, you should figure out why you failed. I feel for most people it's an issue of preparation. Not enough, not effective, or both.
 
I know one doc who had to take her EM boards 4 times before passing (I'm not sure if that was written or oral.) She was IM/EM. You'll pass, just study harder next time. That's really all there is to it. Keep it to yourself. If people ask, just tell them that you're waiting another year to take it. I did Rosh and PEER for my written. AAEM review course for the Oral along with Rivers and Okuda. That's really all you need.
 
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