Failed my specialty board exam.

[amestramgram]

Sorry moderators I didn't find a specific forum for this question so, please move as you see fit.

I've failed my Pediatric Cardiology board exam and failed it because -
- each question was something like a mental struggle
- I trained to be able to solve straightforward clinical scenarios, and each clinical scenario shared on the exam was a scenario much more complicated than what I was used to. According to the curve, 95% of test takers scored higher than me.

The test questions from USMLEWorld were excellent, because there were thousands of them, and they were written at a higher intellectual caliber than the real exam. That is my precise learning style.

My board provides only 75 questions a year to help me train for this exam.

Do I have any other way to gain this training? I've moved on the Adult Congenital Fellowship and I cannot directly attain this kind of mind training with complicated cases - because I don't have access. My problem is now I'm automatically excluded from taking Adult Congenital Boards until I pass Pediatric Cardiology, which is in 2 years. I literally put my life on hold for the test and still failed.

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[group_theory]

Sorry to hear about the test results. Doesn't help that the test is offer every other year.

I'll move this thread to the Pediatrics Forum where there may be some pediatric cardiologists or fellows who can help (however the number is small)

 

[SurfingDoctor]

Does PREP have a Cardiology section? They have one for other subspecialites.

Also ask attendings in your program for their study materials. People usually save questions from previous years they used to study.

 

[amestramgram]

They do have a Cardiology section but I can't seem to score greater than a 20% on them no matter how hard I try. The way they make me think is still very unnatural. It's almost like I need somebody to explain me how these folks minds work - I had no trouble with my general pediatric boards. I'm told by all my preceptors that I do quite well as a real life doctor but my test taking skills are awful.

 

[FlowLimited]

It sounds like you got tripped up by how questions were written rather than a lack of knowledge. That said, have you seen the ABP content outlines (https://www.abp.org/become-certified/subspecialty-certification/content-outlines-subspecialties)? These 100+ page PDFs are daunting, but they include every topic that could be tested on the exam. Going through it might allow you to identify areas of weakness or topics that you haven't encountered when doing practice questions.

 

[amestramgram]

And I've indeed went there, but they seem to always know which conditions are similar, or esoteric physical exam clues that are one line somewhere, and have those things on the test. It's like I'm in a competition with a senior clinician on solving complex patients, where the senior doctor is going to win out on experience. I feel like I've lost a chess match but have no clue how they won so fast. How do I train my brain to think how they think? All I need is 5000 more PREP questions, but I can't get to them. Any alternative methods to get the training?

 

[SurfingDoctor]

And I've indeed went there, but they seem to always know which conditions are similar, or esoteric physical exam clues that are one line somewhere, and have those things on the test. It's like I'm in a competition with a senior clinician on solving complex patients, where the senior doctor is going to win out on experience. I feel like I've lost a chess match but have no clue how they won so fast. How do I train my brain to think how they think? All I need is 5000 more PREP questions, but I can't get to them. Any alternative methods to get the training?

Did you speak to colleagues who passed and what their methods were?

Most test taking issues aren’t specific to knowledge but understanding how the questions are worded to reach the right answer. I didn’t take the Cardiology boards but the Critical Care boards have quite a bit of congenital heart disease, post-operative arrhythmia and lots on the Fick Equation and oxygen delivery/extraction. The latter requires a lot of practice rewriting the equations over and over. The former requires knowing the right test/treatment in the right setting.

Again, I would talk to your colleagues and actually talk to your fellowship PD. They have a very vested interest in making sure you past your boards.

 

[amestramgram]

I spoke to my fellowship faculty and they said keep your head up, try the board review course, and bring the utmost determination for it to never happen again.
My colleagues said they did practice questions. I've taken all these pieces of advice, put my life on hold to study for the test, and still failed. It's that brain training I need. Should I just go claim an ADA learning handicap and ask for double time on the examination?

I have seen super smart fellows at Harvard, I rotated there and was stunned by how much smarter they are than me. I'm in the process of asking them how they succeeded.

 

[SurfingDoctor]

I spoke to my fellowship faculty and they said keep your head up, try the board review course, and bring the utmost determination for it to never happen again.
My colleagues said they did practice questions. I've taken all these pieces of advice, put my life on hold to study for the test, and still failed. It's that brain training I need. Should I just go claim an ADA learning handicap and ask for double time on the examination?

I have seen super smart fellows at Harvard, I rotated there and was stunned by how much smarter they are than me. I'm in the process of asking them how they succeeded.

Do you have a specific disability that impairs your ability to take tests? If so, yes you should make sure the test accommodates you.

As far as smarter, even though I don’t know you, I’m not sure I believe that. I’m telling you that the tests have little to do with smarts and more to do with test taking abilities.

Case in point, the dude who was my co-fellow in training (actually I was a year ahead in starting but we graduated at the same time), nice guy... a little eccentric. He went to MIT for undergrad, Harvard for medical school. In fellowship he struggled. He could takes test and nail it, but his application of what he learned left a lot to be desired. Oh he tell you what FRC was, but his ability to troubleshoot hypoxemia was lacking, even at the end of fellowship. What I mean by the andecdote is that rarely is a failure on a test a knowledge gap but more of a test taking gap. Practice enough and you’ll get an idea of right and wrong answers. Generally speaking for most boards, knowledge will help you eliminate 50% of the answers and test taking will helpntp you the right answer of the remaining answer left.