Failed ABEM Oral Boards 2021

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lingu1a

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Similar to other "Failed Oral Boards" threads, I'm of course taken aback. I did all of Okuda (which contains a fair amount of out of date material), had a fair amount of oral boards prep in residency and practiced a lot before with others, had a strategy going in, etc. It appears it just wasn't my day. Passed the written exam fine. I'll likely do AAEMs course.

However, ABEM said another seat could be up to 2 years away...

For anyone that failed in the March 2021 group, have you received a seat assignment yet? Or any communication from ABEM, for that matter? Having this delayed to due COVID and now hanging over my head for up to another two years is honestly the worst part.

Having absolutely no feedback is also pretty terrible. Did I fail the new Structured Interview? Was I terrible at Data Acquisition? Did I miss a Critical Action? Who knows.
 
Groove said:
Did you take any review courses? I did the AAEM review course about 3 weeks before my exam and it was a life saver. I would have probably failed without it. Eerily similar and two of their cases were almost identical on my real exam. I highly recommend it.
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No, I plan on doing AAEM this time around. I’m more concerned about the timing of re-examination.
 
southerndoc said:
Most hospitals will allow you 3-5 years after graduation to obtain board certification (provided your hospital requires it). I know my health system gives 5 years after graduation to become board certified by ABEM.
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That’s the issue - It took 2 years to get this spot and ABEM is saying it might take two years to get another.

It would be helpful to know if anyone from March who failed was able to get another spot already or if it’s been radio silence from ABEM. With COVID delays, there are likely thousands of applicants who have passed the 2019 and 2020 written exams waiting for oral exam spots. If I don’t get a spot assigned before the 2k more people who pass the 2021 written, then I assume I’m behind all those people too.
 
lingu1a said:
That’s the issue - It took 2 years to get this spot and ABEM is saying it might take two years to get another.

It would be helpful to know if anyone from March who failed was able to get another spot already or if it’s been radio silence from ABEM. With COVID delays, there are likely thousands of applicants who have passed the 2019 and 2020 written exams waiting for oral exam spots. If I don’t get a spot assigned before the 2k more people who pass the 2021 written, then I assume I’m behind all those people too.
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This is ridiculous IMO. ABEM is acting like the school teachers union. You know, we have this thing called a VACCINE, that is highly effective right? Get the examiners vaccinated, put on some masks (if indoors), start in person exams and do your damn jobs!
 
Someone at ABEM probably missed a boat payment and they had to select a few candidates to pay to take it again.

Terrible, pointless exam. I'm so sorry you failed. It's not a reflection of you as a physician at all--which is why the exam even existing is infuriating.
 
bravotwozero said:
This is ridiculous IMO. ABEM is acting like the school teachers union. You know, we have this thing called a VACCINE, that is highly effective right? Get the examiners vaccinated, put on some masks (if indoors), start in person exams and do your damn jobs!
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Actually, the virtual format should allow them to do more exams, not less. I just dont understand why they are so behind. If they need examiners, they should be recruiting more examiners. The virtual format should make this much easier to get people through.
 
gamerEMdoc said:
Actually, the virtual format should allow them to do more exams, not less. I just dont understand why they are so behind. If they need examiners, they should be recruiting more examiners. The virtual format should make this much easier to get people through.
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But hiring more people is going to cut into their biannual all expenses paid five start resort vacations...
 
I do not agree that it's a useless exam. There's a format to be learned, yes, but once you know it, it becomes a test of clinical knowledge and organization. I do not think it needs to be in person though, can be virtual going forward. If anything we should be making this exam way more difficult to prevent inferior candidates from all these expansion residencies from practicing in our field.

As far as exam proctors goes, ABEM does not pay them. They are volunteers. However, you need to have 5 years experience post being boarded to qualify as an examiner. Perhaps if they lowered this requirement to, say 3 years, or offered a small stipend to proctors, they would be able to recruit more people and get more candidates examined.
 
GonnaBeADoc2222 said:
I do not agree that it's a useless exam. There's a format to be learned, yes, but once you know it, it becomes a test of clinical knowledge and organization. I do not think it needs to be in person though, can be virtual going forward. If anything we should be making this exam way more difficult to prevent inferior candidates from all these expansion residencies from practicing in our field.

As far as exam proctors goes, ABEM does not pay them. They are volunteers. However, you need to have 5 years experience post being boarded to qualify as an examiner. Perhaps if they lowered this requirement to, say 3 years, or offered a small stipend to proctors, they would be able to recruit more people and get more candidates examined.
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Yeah, pay your proctors? What a concept?!!! ABEM is sitting on a cash reserve of over $30 million, and they can't pay for proctors,...because $500k salary for employees and all expenses paid vacations?
 
Huh so does anyone know if they ended up failing more people this year with the new online format?

The board of directors refuses to pay the proctors which makes it difficult to give the exam more frequently.
 
alpinism said:
Huh so does anyone know if they ended up failing more people this year with the new online format?

The board of directors refuses to pay the proctors which makes it difficult to give the exam more frequently.
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They did. 90% pass in April, 93% pass in March per their oral boards scoring information on the ABEM website. Wasn't it previously like 97%?

As for OP, just call and ask. I know some 2020 grads who were proactive, called to get a spot, took it and already passed. Meanwhile, a 2019 grad was faithfully waiting for ABEM to assign a spot.

ABEM/Board certification is a total racket and the 2nd biggest scam, after choosing medicine as a career.
 
GeneralVeers said:
Pathetic that people volunteer their time to be proctors, while ABEM stashes away the cash and wastes it on lavish vacations. Physicians are stupid, stupid people and need to stop doing stuff for free so that others can profit.
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JAFERD_MD said:
They did. 90% pass in April, 93% pass in March per their oral boards scoring information on the ABEM website. Wasn't it previously like 97%?

As for OP, just call and ask. I know some 2020 grads who were proactive, called to get a spot, took it and already passed. Meanwhile, a 2019 grad was faithfully waiting for ABEM to assign a spot.

ABEM/Board certification is a total racket and the 2nd biggest scam, after choosing medicine as a career.
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Ok, so like...you can't have it both ways. We can't B&M about NPs having no standards and then wish away our own standards. We'd literally be handing the midlevel lobby more ammo. Imagine their headlines of "DOCTORS VOTE TO DECREASE BOARDS STANDARDS!!!! SEE?! ANYONE CAN DO THIS JOB!!!"

The test is fine. The fact that it previously had a 90+ pass rate is not. It should be made more difficult (as should the written boards). It should have a 20% fail rate. If the RRC/ACEP/SAEM going to do nothing to limit residency expansion then ABEM needs to be the final check, and limit all these people from expansion residencies from destroying our field.
 
GonnaBeADoc2222 said:
The fact that it previously had a 90+ pass rate is not. It should be made more difficult (as should the written boards). It should have a 20% fail rate. If the RRC/ACEP/SAEM going to do nothing to limit residency expansion then ABEM needs to be the final check, and limit all these people from expansion residencies from destroying our field.
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This is insanity. This 20% number is completely arbitrary and unnecessarily hostile towards physicians.

Board certification should be criterion-based: either you meet the standard, or you don't.
 
The fact that the exam had a 97% pass rate in the past was suspect. Compare this is to optho oral boards with a 72% pass rate last year.
 
Kryptocoin said:
The fact that the exam had a 97% pass rate in the past was suspect. Compare this is to optho oral boards with a 72% pass rate last year.
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You're telling me more than a quarter of ophthalmology residency graduates do not meet their board's standards? If true, that sounds like a serious indictment of either ophthalmology residency training or their test.
 
Franzd'Epinay said:
You're telling me more than a quarter of ophthalmology residency graduates do not meet their board's standards? If true, that sounds like a serious indictment of either ophthalmology residency training or their test.
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American Board of Ophthalmology Facts & Statistics | American Board of Ophthalmology

Certification Written Qualifying Examination (WQE): Year Total Candidates Passed Pass % Failed Fail % 2011 636 456 71.70 180 28.30 2010 628 ...
abop.org abop.org

It varies annually. But seems to hover btw 70s and 80s.
 
Kryptocoin said:
Neither does does a 97% pass rate. Just lends credence that it's a useless non-distinguishing test.
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I'd say make the written exam harder then. My issue with the oral board exam is the arbitrariness of the cases, and the examiners, not to mention the cost, and theatre of the whole experience. It's a stupid, useless game that doesn't reflect any reality of practicing Emergency Medicine. You pass based on how well you play the game, not medical knowledge or competence.
 
GeneralVeers said:
I'd say make the written exam harder then. My issue with the oral board exam is the arbitrariness of the cases, and the examiners, not to mention the cost, and theatre of the whole experience. It's a stupid, useless game that doesn't reflect any reality of practicing Emergency Medicine. You pass based on how well you play the game, not medical knowledge or competence.
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The cases really aren't arbitrary though. Also the "game" isn't that hard.
 
GeneralVeers said:
I'd say make the written exam harder then. My issue with the oral board exam is the arbitrariness of the cases, and the examiners, not to mention the cost, and theatre of the whole experience. It's a stupid, useless game that doesn't reflect any reality of practicing Emergency Medicine. You pass based on how well you play the game, not medical knowledge or competence.
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The cases are actually too straight forward. You are given a classic presentation of most illnesses. In real life, half my ER patients are terrible historians and barely know which meds they are on.

People fail the test because they don't know or think they don't have to play the game (overconfidence/hubris) . Did you treat that fever ? introduce yourself ?give pain meds? Acknowledge the EMT in the room? Address the family? Verbalize your ddx etc? All trivial but important things we should do in real life and on the test.
 
Kryptocoin said:
The cases are actually too straight forward. You are given a classic presentation of most illnesses. In real life, half my ER patients are terrible historians and barely know which meds they are on.

People fail the test because they don't know or think they don't have to play the game (overconfidence/hubris) . Did you treat that fever ? introduce yourself ?give pain meds? Acknowledge the EMT in the room? Address the family? Verbalize your ddx etc? All trivial but important things we should do in real life and on the test.
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We will agree to disagree. I passed, but it was the second most stupid experience I've paid a lot of money for. The number one is the Step 2 Clinical Skills exam
 
The most important part is the introduction and making sure your stabilization orders are complete like IV, supplemental oxygen and pulse ox. I now I guy/girl who has failed it multiple times and he is a really great doc and failed it this year as well. They have He has paid for a non AAEM board course and tutor and paid thousands of dollars. When over a case with them and it was obvious.


She/He forgot to say pulse ox in their orders "Iv 18 gage, 15L NC, cardiac monitor, rhythm strip and cxr" and his/her Hugo would always be green and red no blue monitor. Also getting a history before stabilizing the patient if you dont stabilize by giving orders and instead introduce yourself and ask questions you likely failed. Also not verbalizing your MDM and not telling the patient what they are doing with the management.
 
Brigade4Radiant said:
The most important part is the introduction and making sure your stabilization orders are complete like IV, supplemental oxygen and pulse ox. I now I guy/girl who has failed it multiple times and he is a really great doc and failed it this year as well. They have He has paid for a non AAEM board course and tutor and paid thousands of dollars. When over a case with them and it was obvious.


She/He forgot to say pulse ox in their orders "Iv 18 gage, 15L NC, cardiac monitor, rhythm strip and cxr" and his/her Hugo would always be green and red no blue monitor. Also getting a history before stabilizing the patient if you dont stabilize by giving orders and instead introduce yourself and ask questions you likely failed. Also not verbalizing your MDM and not telling the patient what they are doing with the management.
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If you fail this exam more than 1x, there is something majorly wrong with you. Every case in Okuda starts off with obtain all vitals, IV/O2/Monitor
 
GonnaBeADoc2222 said:
If you fail this exam more than 1x, there is something majorly wrong with you. Every case in Okuda starts off with obtain all vitals, IV/O2/Monitor
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this guy went through a course that gave them a methodical approach but didn’t state that if you don’t do it exactly this way you will fail.

Also what’s O2? Oxygen? Nasal cannula? and cardiac monitoring?

Also many people use Okuda and failthe exam doesn’t give you feedback and you can’t discuss the case in their case the tutor course the used and continual went to was crap

So if you fail it it can be easy to continue to fail it as this has happened to multiple people.
 
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Brigade4Radiant said:
Also many people
multiple people.
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If you know multiple people that flunked the oral exam, there's some residency programs that need some 'splaining to do.

People don't exactly advertise board failures, usually, but I can't recall anyone who failed it, to my recollection.
 
It seems like the petition to do away with the oral boards on a EMdocs may have backfired. We were complaining that the oral boards are useless with such a high pass rate. they said, OK no problem well fail one 1 out of 10 of you to prove that this is a real test that you need to take seriously. Also, people think that there is this massive underground group of abem Decision makers in their little suite in East Lansing headquarters. How many people do you think really have the ultimate say in How and when to administer this test? How many people are really sitting around the boardroom table deciding on the fate and time line of thousands of us for board certification? dr mallory ( abem president),dr keim (secretary) the dude with the epic moustache in the sample videos and a few other "board of directors". The organisation has inherent strength because the board certification started in their office and until the few people that really make decisions are approached and are willing to change, there is nothing that will change. And the last point to those that argue that this is differentiates us from mlp's, Our world has proven That they don't care about board certification aside for fulfilling bylaws hospital requirements for staffing EDs. Our jobs are being taken by those that are cheaper and less trained and all of the boards certifications in the world don't take away the fact that we are losing our jobs and our opportunities because of what is REALLY important to staffing groups. They should spend a 10th of what they make off of us for boards on Is advocating and advertising for the need of having the best trained clinicians to take care of the public - Because having board certification to show "we are better" Has done nothing to protect our livelihoods and has only been a money suck to keep up with and maintain
 
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tryin hard said:
It seems like the petition to do away with the oral boards on a EMdocs may have backfired. We were complaining that the oral boards are useless with such a high pass rate. they said, OK no problem well fail one 1 out of 10 of you to prove that this is a real test that you need to take seriously. Also, people think that there is this massive underground group of abem Decision makers in their little suite in East Lansing headquarters. How many people do you think really have the ultimate say in How and when to administer this test? How many people are really sitting around the boardroom table deciding on the fate and time line of thousands of us for board certification? dr mallory ( abem president),dr keim (secretary) the dude with the epic moustache in the sample videos and a few other "board of directors". The organisation has inherent strength because the board certification started in their office and until the few people that really make decisions are approached and are willing to change, there is nothing that will change. And the last point to those that argue that this is differentiates us from mlp's, Our world has proven That they don't care about board certification aside for fulfilling bylaws hospital requirements for staffing EDs. Our jobs are being taken by those that are cheaper and less trained and all of the boards certifications in the world don't take away the fact that we are losing our jobs and our opportunities because of what is REALLY important to staffing groups. They should spend a 10th of what they make off of us for boards on Is advocating and advertising for the need of having the best trained clinicians to take care of the public - Because having board
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My counter to this is that the exam is pointless. The written exam might be useful.

The oral exam has nothing to do with us as physicians. In addition to the oral exam, why not mandate 100 pushups? Or a photography contest? The format is so far removed from anything realistic it's just not useful, no matter the pass/fail ratio. Their data on it is really, really weak and mostly outdated on the part of the website justifying this nonsense.

I passed the 2021 oral exam. I feel no pride in doing so. Felt like a waste of time cash grab. I could have randomly failed like OP. I don't feel it's a reflection on me at all as a doctor whether I passed or failed this oral exam.
 
AlmostAnMD said:
My counter to this is that the exam is pointless. The written exam might be useful.

The oral exam has nothing to do with us as physicians. In addition to the oral exam, why not mandate 100 pushups? Or a photography contest? The format is so far removed from anything realistic it's just not useful, no matter the pass/fail ratio. Their data on it is really, really weak and mostly outdated on the part of the website justifying this nonsense.

I passed the 2021 oral exam. I feel no pride in doing so. Felt like a waste of time cash grab. I could have randomly failed like OP. I don't feel it's a reflection on me at all as a doctor whether I passed or failed this oral exam.
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The persistence of the oral exam continues to undermine the validity of ABEM.
 
AlmostAnMD said:
My counter to this is that the exam is pointless. The written exam might be useful.

The oral exam has nothing to do with us as physicians. In addition to the oral exam, why not mandate 100 pushups? Or a photography contest? The format is so far removed from anything realistic it's just not useful, no matter the pass/fail ratio. Their data on it is really, really weak and mostly outdated on the part of the website justifying this nonsense.

I passed the 2021 oral exam. I feel no pride in doing so. Felt like a waste of time cash grab. I could have randomly failed like OP. I don't feel it's a reflection on me at all as a doctor whether I passed or failed this oral exam.
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I passed too and agree it was pointless. i agree with you and Im just saying It's unfortunate that us trying to stand up For a valid evaluation of our abilities and stopping with the oral board nonsense may have resulted in them tightening the ropes
 
I'll preface this with stating that I passed this exam easily, however, I do have one colleague that failed, and she is a very good doctor who I would be more than happy to allow her to treat one of my family members.

For any physician oral board exam, if the average doc can't walk into the room and take the test after finishing residency and pass the exam w/o any sort of prep other than reading the rules of the test, then the test is clearly a poor marker for physician competency. You shouldn't have to pay for a $500-$1000 review course just to figure out how to take a test which is supposed to be measuring my competency as a physician. You have already graduated residency, that should be all the training that is required to prepare you for an oral board exam. I'm not sure how much merit there is in an exam that is deducting points from applicants for forgetting to say "hello" to the imaginary patient, deducting points for forgetting to tell the imaginary family member what the plan is, or forgetting to get additional information from the imaginary EMS, or failing a case because you were not aware that apparently ABEM general is the only hospital in the country that has endocrine on call, or losing points for running out of time on a triple where your 3 cases theoretically were a patient with a pulseless extremity from a Monteggia fracture who sustained it while running out of his burning apartment building who also happens to have mild CO poisoning but of course doesn't mention his apartment was on fire unless you press him, a patient with methanol poisoning, and a patient with first trimester vaginal bleeding. All this while your proctor is refusing to let you just ask for multiple non-pertinent physical exam systems at the same time to expedite this absurd dungeons & dragons game.

I just can't believe there are practicing non-ABEM affiliated EM physicians out there that are totally cool with us shelling out $1800 not including travel costs for this absurd exam that in no way reflects the practice of actual emergency medicine.
 
SomeOtherUser said:
I did all of that, right during/after ABCs IV O2 Monitor Fingerstick Allergies, EKG etc. Spoke to any family etc. Always went back to the patient to reassess and reevaluate. Closed up after dispoing patients. None of my patients had adverse events. The consultants on the exam did not help at all and just agreed with everything I said, said okay and we'll take the patient. Because there's no breakdown will never know what happened.
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What did you do? Also there is no during or after your order must be exact also what’s O2 monitoring?

the most important part is the beginning.
 
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SomeOtherUser said:
Yeah sorry I meant right after I saw the vital signs and if they were abnormal started large bore IV x 2, started oxygen 2L to NRB or more depending on what patient needed, placed the patient on monitoring, IVF if hypotensive. If the VS were normal I waited until after the ABCs to do all that stuff but regardless I always did those things. Right when the patient needed them.
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what monitoring? So cardiac and pulse oximeter? You have to play the game and do things in an exact order also verbalize abc always look at a abems website and detailed score criteria take what everyone says with a grain of salt
 
Brigade4Radiant said:
what monitoring? So cardiac and pulse oximeter? You have to play the game and do things in an exact order also verbalize abc always look at a abems website and detailed score criteria take what everyone says with a grain of salt
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Because even if you get all the medicine in the exam right, and save the patient, you fail because you didn't tell the nurse to start an IV or put the patient on monitor. Things that we never have to do and are automatic for any crashing patient in real life. What a stupid, stupid exam.
 
Apollyon said:
Yeah, ABEM General, which does have endocrine on call, but no ortho. Yeah, that's real life, there!
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When I was doing my ABEM General shifts, I had to read all my own images (apparently they don't have radiology), but they did have neonatologist that pretty much said, "sure, do whatever you want, I have no meaningful input to your pertinent and detailed question on the patient you are about to admit to me..."
 
Many people here have mentioned losing points for "not telling the family the plan" or addressing the EMT in the room or whatever. Can anyone definitively confirm with some evidence that this matters? I never "talked to the family" or did anything except dispo the patient on my orals and I passed.
 
BoardingDoc said:
Many people here have mentioned losing points for "not telling the family the plan" or addressing the EMT in the room or whatever. Can anyone definitively confirm with some evidence that this matters? I never "talked to the family" or did anything except dispo the patient on my orals and I passed.
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I think this subject has annoyed me the most - there are some pretty significantly conflicting recommendations for approaching these cases and most of what you're given is passed down during residency. Some say IV, O2, Monitor for every patient, others say don't shotgun this if they're not hypoxic. We were always taught to say "What do I hear/see/smell when I walk in the room?" but Okuda list a "Primary Survey" - does this mean I need to ask about the airway, secretions, gag reflex, breathing, circulation for every patient or is this the "What do I hear/see/smell?" Some say if you don't talk to EMS or family you're going to fail, others say they never did that and passed. Some say GU/rectal on every patient, no matter the complaint - is this really representative of what we do on a daily basis? Some resources say not to interpret labs or imagining out loud but ABEM's video example does this. In the example video he just asks "HEENT?, Abdomen?" whereas some people will say the examiners want you to ask specifics.

I watched the example ABEM has on their site so. many. times. I feel like I had good rapport with almost all the examiners, never felt like I got the "cues" some resources say you'll get from the examiner that you're doing something abnormal or running out of time. I had a plan, I practiced with multiple people, I had checkboxes to not forget all aspects of the physical, I reevaluated, I updated the family, I asked EMS to stick around. I honestly don't know what went wrong, but here I am another $1,300 poorer hoping another seat comes up sooner rather than later.
 
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I got Ohio ACEP written board review and found it inappropriately outdated as well
 
The in-person ICEP (Illinois) course was fantastic. It felt just like the real thing. It was money well-spent just for my own peace of mind (I got reimbursed from my CME funds anyways).
 
So for those of you who passed, what did you feel was the most worthwhile and effective method of practice? Going through Okuda with others? I signed up for the AAEM course but other than practicing randomly with people I don’t know what else to be doing right now. Also is the sheet they give you just an outline of a body and the big “+” that you can write orders actions exam etc?
 
panscan said:
So for those of you who passed, what did you feel was the most worthwhile and effective method of practice? Going through Okuda with others? I signed up for the AAEM course but other than practicing randomly with people I don’t know what else to be doing right now. Also is the sheet they give you just an outline of a body and the big “+” that you can write orders actions exam etc?
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I passed the April exam. I went through Okuda by myself (had done practice cases several years ago in residency) and did the AAEM course about 1 week before my exam. The sheet they provide only has the body outline.
 
i only went through the okuda book and passed by a good margin. i thought i was fine reading cases alone but i was soooo wrong. when i started acting out cases with friends and spouse i realized that was the key. it gets you used to the checkboxes of not forgetting to ask/go back to med/surg etc history for example which is easy to do if you need to stop at primary survey to stabalize a critical case. reminds you to ask allergies before any med intervention because i never forgot after someone i practiced with made the patient go into anaphylaxis cuz i forgot to ask. finding a couple good friends to spend some time really going through cases with me was key - and i did no other course. taking a formal course would probably forsure mimic the pressure of the real life test though a little better.
 
thanks all. that is very helpful. its so easy and almost comforting to just read okuda but clearly that is not the best practice.
 
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