With all due respect, Dr. Perfect, my beef is not with the difficulty of the exam, aside from the fact that it's completely fake and a lot of people don't do well with oral exams even when they know all the material. The fact of the matter is that somewhere around 20% of people fail the orals every year. These aren't *****s. These are people who've done well on step1-3 and passed the ABA written examination. 1 out of every 5 anesthesiologists you see has had to postpone potentially their retirement for a whole year and you should actually give a crap about your colleagues. I'm not even saying that I'm one who ever failed his boards but I'm sticking up for those who have.
Failed the orals
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Maybe the oral exam process is weeding out people that are good at multiple choice questions but bad at explaining their logic in a sticky situation. The ABA wants you to be a consultant level anesthesiologist. When a surgeon is screaming about something and the patient is crumping, you've got to stick to your guns and explain your line of thinking.
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Arch Guillotti
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Friend, I will assume this comment is aimed at me😀
We will have to agree to disagree on this one. If someone doesn't do well in a controlled exam while sitting in a chair across the table from 2 dudes in suits - how well are they going to do when a case is going badly and clear and precise communication is required across the drapes. Yes, this is a bit of an oversimplification but you get the point.
So what if someone has done well on a bunch of other exams? I just don't see the relevance.
Why in the world would failing the orals make you postpone your retirement for a year?😕😕😕 You can still work for goodness sakes. Most people who fail the orals will already be working at a job and your partners may not even know you failed. I would be surprised if a group fired you just because of a single failure. Any big group is going to have someone who didn't have a straight path to board-certification.
Contrary to a previous user, I think that struggling with boards does make a difference to employers/hospitals/credentialing committees/contracts/state medical boards/etc.
The oral boards are a big deal for everyone involved in terms of planning. Anything more that twice a year seems excessive to me. And as a point of order, lets say you bomb the fall exam and have to wait till the next fall to take them instead of in the spring. You have been delayed six months, not twelve.
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In addition, the exam costs a fortune to administer. Think about the cost of securing an entire hotel and then paying travel costs for all of the examiners as well as providing all of the incidentals of the exam. The examiners "volunteer" their time. They get a free trip, but it is a working trip that can be very stressful. In addition, they use part of their vacation or CME time in order to attend. It is prestigious to be an examiner, but it comes at a cost of time and money as they are away from their revenue generating jobs for an entire week. I know people who have done it.
I really don't think that the ABA could do it more than twice a year without significantly bumping the costs above the already astronomical amount it costs. By the time the people who take it in the fall find out and reregister, the spring exam is booked and planned. I suspect that they are not able to make adjustments to the number of examinees that late in the game. Of course, it is possible that they could assume a 20% historical failure rate and let those register after they get their failure notice, but I don't know the logistics. The number already taking it in any given session is very high, so they may not be able to absorb any more into a session.
I really don't think that the ABA could do it more than twice a year without significantly bumping the costs above the already astronomical amount it costs. By the time the people who take it in the fall find out and reregister, the spring exam is booked and planned. I suspect that they are not able to make adjustments to the number of examinees that late in the game. Of course, it is possible that they could assume a 20% historical failure rate and let those register after they get their failure notice, but I don't know the logistics. The number already taking it in any given session is very high, so they may not be able to absorb any more into a session.
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During the miserable month+ between the time I took my oral exam and the time I got my score, I genuinely thought there was a nontrivial chance I had not passed it.
I obsessed over a couple easy questions I blew or drew blanks on, and I had some knowledge gaps once they got off into the weeds. It never occurred to me to assert that the test was unfair though.
Some unavoidable degree of subject randomness and luck of the draw WRT which four examiners were evaluating me, sure. But any oral exam will have that problem, and they do go to great lengths to minimize it. The test is as standardized and fair as they can make it.
It appears that you're arguing that there should be NO oral exam, period, because everyone taking it is "smart," has passed USMLE (or COMLEX) 1 2 & 3 and the anesthesiology written, and has graduated from an accredited residency program - well, we've had that debate before. I won't rehash everything that I've posted there and elsewhere before, except to say that I think that board certification should not be a gimme for everyone who gets past the written, that if anything the bar for passing the written should be HIGHER, that an oral exam has an important place for a specialty such as ours, that I know a couple of good anesthesiologists who've failed the oral, and that I'm glad it's behind me.
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I've known far more marginal anesthesiologists who failed the orals than good ones who failed.
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I predict that in a few years the pass rate for the written (and probably the orals too) will go up. The ABA will soon incorporate the staged written exam. Stage one will be the basic science portion and will be given some time around the PGY-III year. Passge of that exam will be required to progress to the PGY-IV (CA-III) year. Stage two will be the clinical portion and will probably be administered when the current written exam is given. This process will weed out anyone who will not be able to pass the board exam before they graduate their residency program. Miraculously, all programs will experience a higher board pass rate for their grads. Not sure everyone will be excited by this change, but it is barreling ahead.
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I agree, you would would be wasting your time if you attempt to sue the ABA.
I can speak with authority on this topic because I failed the orals on my initial attempt .Idiot is a strong word. I would say, however that the oral ABA exam is fair. Oral exams are administered by several other specialty boards including neurosur,ENT and general surgery to name a few.
Think of the costs involved in administering oral exams. Getting a shot at the exam once a year is reasonable. It would not be wise to rush to retake the exam say within three or even six months of learning that you failed. Remember after three consecutive unsuccessful attempts at the orals you turn into a pumpkin. You want to have enough time to prepare well and unlearn bad habits. It takes several months to assess what went wrong and rectify it.
This may all turn out to be a useless discussion, you may pass your exam.
Relax for now.
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QFT
I dont' know about every specialty, but I know for certain that Gyn/OB and Ortho oral exams are only offered once per year. I highly doubt that any board provides more than one opportunity per year due to the complexity of scheduling examiners and the work load that would result.
In fact I would be thankful to the ABA that they don't do like ABOG or ABOS and require us to collect and submit all of our cases for a defined period prior to the exam so that they can go through with a fine tooth comb and pick apart every little decision that we made.
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I was a little rough in my earlier reply but I am a firm believer that the ABA oral exam is generally fair. I am sure there are outliers but I felt that the exam was tough but nothing unreasonable. ABA board-certification is no walk in the park but if a bozo like me did it, anybody can😀.
CambieMD has been there, done that and he gives wise, realistic advice.
CambieMD has been there, done that and he gives wise, realistic advice.
I thought I failed my oral exam when I took it in 2005. I was so depressed in the month waiting for it. I knew I bombed the first stem (or thought I bombed it) but in retrospect still thought I answered the questions to the best of my knowledge.
I lost 10 pounds, got gray hair growing (I was only 31), irritable with my girlfriend.
Than miraculously looked on the aba website and it read that my certificate was issued on xxx 2005. I could not even believe it.
So until the results come out, there's still hope even for those who think they failed it.
You never know how you are graded.
I lost 10 pounds, got gray hair growing (I was only 31), irritable with my girlfriend.
Than miraculously looked on the aba website and it read that my certificate was issued on xxx 2005. I could not even believe it.
So until the results come out, there's still hope even for those who think they failed it.
You never know how you are graded.
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Yeah...I just have to pray that something good happens. I definitely shined in my first exam minus one question, and he did ask a follow up question on the same subject matter which I got right. Who knows. I would say based on how I did most likely I failed. Hopefully the bottom 20% did some stupid **** that got them Failures.
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Basically what happened to me, but in 2010 and i probably GAINED 10 pounds. Wishing you the same luck we had.
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I don't think that the orals are graded on a cure. You have to have enough points to pass.
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You are obviously upset and that does not make you think clearly.
It is an exam and as such is not meant to pass everybody, it has to hold some standards, therefore there always will be some amount of people who won't pass. If you do not blame everyone and bad luck ( which happens) but analyze your mistakes and prepare accordingly ( with a possible prep course involved) you will pass the next time. The key is to know the material - if you do not know - you will not pass. Generally the exam is actually FAIR unless you've bumped into some especially malicious examiner ( which happens but is not a rule).
Good luck.
And if it was your first time - you may have passed this time and your frustration is standard reaction after this experience 🙂
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I'm not as down on the guy who hates the oral system as most here. I passed, so my reasons aren't bitterness. It's simply true that the oral is much more subjective than the written exam, and that is a significant problem.
I'm not saying the written exam is the gold standard, but the fact is the first timers who flunk the written are pretty much true bottom 10 percenters, particularly in knowledge base. That isn't as true for first time oral flunkers. Many oral flunkers are very good anesthesiologists that had a bad day, bad questions, bad examiner, bad whatever, and some oral passers got flat out lucky that they could squeak their way through just one hour with the right personality and happening to get questions that escaped their vast gaps of knowledge.
That said, the oral process does make you a much better anesthesiologist and needs continued improvement, not abandonment.
I'm not saying the written exam is the gold standard, but the fact is the first timers who flunk the written are pretty much true bottom 10 percenters, particularly in knowledge base. That isn't as true for first time oral flunkers. Many oral flunkers are very good anesthesiologists that had a bad day, bad questions, bad examiner, bad whatever, and some oral passers got flat out lucky that they could squeak their way through just one hour with the right personality and happening to get questions that escaped their vast gaps of knowledge.
That said, the oral process does make you a much better anesthesiologist and needs continued improvement, not abandonment.
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See slides 26-36-- actual scoresheet
http://www.anesthesiawiki.net/metrohealthanesthesia/MHAnes/presentations/thingsIDoForResidents.ppt
From Sapdaddy in Spring 2010 forum post on oral boards.
"there's a column on the left side with Y, M, N, I and they are answering if you are displaying the attributes of an ABA diplomate (if you should be boarded or not) for each topic yes, maybe, no, or insufficient coverage.
the column on the right is for how often you said the right things for each module: 1 consistently 2 often 3 occasionally 4 rarely.
if the examiner gives mostly Y's and M's and 1's and 2's you probably passed. if the examiner is giving N's (the 3rd bubble from the left) and 3's and 4's on that right column (the bubbles run vertically so it would be the 2 lower ones) then you probably didn't pass. if the examiner gives those 3's and 4's then they have to fill in something in the bottom right about why you sucked.
i'm telling you this, "almost" as if i'm staring at this very same bubble sheet and reading it verbatim to you"
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Seeing that grading form brought me some relief knowing that each section carries a separate grade. Wish I would have seen that earlier as I may not have been so thrown off by that one question
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I think of the sections on the oral board exam like rounds. You can lose a round but win the match. For purposes of the orals, being knocked down is similar to completely blanking on an important question.
This thread is premature. The scores will be out in a few weeks.
Complain when you find out that you actually failed the orals. I would bet that most of those who think that they failed passed.
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And there will be a few that are certain they aced it who will be completely shocked to learn their examiners were not nearly as impressed as the examinee thought they were.
Which shows what a horribly subjective test it is.
Look, you're trying to enter a Guild of sorts. It has to be exclusive by definition. In the old days it was easy - keep out the women, the minorities, etc. and etc. Now it's more subtle but they're still looking for PLU (People Like Us). So even though symphony orchestras run auditions behind a bluescreen, your ABA examiners can fail you for your sex, your age, your accent, looking down, looking up, looking like cousin Hank...and they will. Because 20% fail need to fail every year, NO MATTER HOW GOOD THEY ARE. You are not being graded for inclusion but exclusion.
But at some point in the process you realize they can't hurt you anymore, and it may be advantageous to let them know.
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I don't believe any of this.
All the ABA examiners I know are completely reasonable folks.
Examiners are randomly audited during the process and all the exam results are evaluated for major discrepancies/examiner bias.
Examinees fall into 3 categories after they finish a sesion (from the examiner perspective):
A few rock the exam and know they pass
A few bomb the exam and know they fail
Most are somewhere in the middle, most pass but some don't
I thought the exam and the process was very reasonable.
Of course I passed the first time around😀
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Welcome to the forum.
This is ridiculous. 20% don't "need" to fail each year. If you're looking for evidence of objectivity, look at the fail rates during the dark years of the specialty (late 90s early 00s IIRC).
I'd write more but typing on a phone sucks.
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Wow, why so touchy? Don't you think the process should be held to the same high standards as examinees?
There's a reason IM got rid of oral exams many years ago; let's look at the flaws and improve upon them.
There's a reason IM got rid of oral exams many years ago; let's look at the flaws and improve upon them.
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Well, if i fail, which will most likely be the case, I won't be bitter about the outcome. I definitely had a poor performance on the second exam. Was it based on my lack of knowledge. No. Was it based on clinical skills. No. I just lost focus and questions that I knew answers too and were relatively easy questions I came up short on. Explanations were brief or nonexistent. Whatever. There's nothing I can do about it now. I just hope that my performance on the first exam was adequate enough to pull me through.
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From the April 2003 newsletter
ASA said:
More than half of the candidates failed the written in 2000. That to me is pretty suggestive that the written exam has a knowledge threshold for passing; perhaps you think it is "culturally biased" because so many anesthesia programs filled with FMGs in the late 90s? You don't have to leave this forum to find people who think the written is an unnecessary, arbitrary test of clinically-irrelevant minutia - they're entitled to their opinion, but I respectfully disagree.
Oral pass rates in those years+1 were a little better, in the 70% range. I think this is evidence that the written exam is pretty good at weeding out knowledge-deficient candidates ... but not perfect. What's more, the 10% lower-than-usual oral pass rate is evidence that an oral exam is needed to catch some of the weak candidates who managed to scrape by the written.
A cynic might argue that the reason more people failed the oral those years was because there were more FMGs in anesthesia, and the racist examiners kept them out. I think that's a ridiculous accusation that needs solid evidence to make, and that a more reasonable explanation was that a lot of candidates those years were simply sub par ... and the oral exam functioned as intended by denying board certification to them.
Old thread on this subject, though that thread is more focused on the written exam. I won't repost what I wrote there; the arguments are the same. Reasonable people can (and do) disagree with me, but when it comes to fairness, I think the ABA does a good job with the absolutely necessary board certification process.
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I wish our grade was posted on this, I am tired of sweating bullets, man I pray I passed.
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I agree with most of your comments. The purpose of the written ABA exam is to test knowledge. The oral ABA exam is not designed to test knowledge. It is designed to test the application of knowledge. My score on the written exam was very high. I did not get lucky when I took the test. I knew the information and found the test to be easy.
I failed the oral exam because I was not well prepared for the exam. i had a strong knowledge base but was not prepared to discuss very basic areas of anesthesia. My examiners were courteous and seemed sympathetic to my plight. They gently asked their questions but I continued to flounder with even the simplist of questions. My knowledge was great but my commonsense application was terrible. I went to the Ho course not once but twice. I simply did not fully understand the purpose of the oral exam and that was reflected by my performance.
Examinees may fail the orals because they have a poor knowledge base but the exam is not testing your knowledge base. The fact that someone fails the orals doesn't mean that they have a poor knowledge base. Most people fail the orals because they have not adequately prepared for the exam. I spent a lot of time preparing for the orals prior to my first attempt but my preperation did not address my specific weaknesses. My answers were not complete. I always seemed like I was holding back. I was told this at the Ho course. I needed more focused practice.
I was disappointed after my second attempt at the orals. I kept getting cut off before I could finish my answers. I was much better prepared but I did not get to show that to my examiners.
The orals are very fair.If you failed the orals, you deserved to fail. The examiners want you to well. The board doesn't have to look for 20% of the examinees to "fail", enough people screw themselves up. The examiners have to be fair. They cannot be too difficult or too easy. They will not be asked back.
Everyone can pass the orals with the proper preperation and focus. The proper recipe for success varies from person to person. I tailored my own program to get me through the orals.
Cambie
p.s. It took me a day to complete this post.
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Your post was spot on. I also killed the written exam. I was just under 2 standard deviations above the mean. I felt like I killed the first exam and was being cut off on answers just like you're supposed too. Unfortunately, missed one question that threw me for a tail spin. What I've learned. You definitely have to stay focused. I did not. You also cannot let the pace of the exam throw you. I lost focus and gave in to the pace of the exam instead of slowing things down and thinking thru questions on part 2. I also didn't prepare for the pre-op section enough and anticipate obvious questions they were going to ask. Well, lets hope the first exam pulls me through otherwise I had a $2000+ practice exam
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CambieMD - short of an actual oral examiner posting here, I think yours is some of the best insight regarding the orals that anyone has to offer. Glad to see you posting. 👍
I think this is why some GOOD anesthesiologists fail the oral. I'm not sure it's why MOST anesthesiologists fail the oral.
I went to Ho's course before taking the exam, and my impression was that of the problems most of the public examinees/victims displayed, the biggest weakness was knowledge. Of course there were delivery problems, accent problems, language barrier problems, stage fright problems ... but Ho zeroed in on knowledge over and over again. Every time, during the critique after he shredded another one, he'd come back to knowledge.
I think most people fail because their so-so knowledge base was OK to get through a multiple choice exam, but wasn't good enough to bear the kind of probing a human examiner can do when weakness is sensed.
I think a few people fail because they have trouble demonstrating what they know or proving that they're safe.
I don't know exactly where I'm going with all this rambling except to say that my gut feeling is that those two groups don't overlap much, and that the 2nd group surely has a FAR higher pass rate the second time around.
I think this is why some GOOD anesthesiologists fail the oral. I'm not sure it's why MOST anesthesiologists fail the oral.
I went to Ho's course before taking the exam, and my impression was that of the problems most of the public examinees/victims displayed, the biggest weakness was knowledge. Of course there were delivery problems, accent problems, language barrier problems, stage fright problems ... but Ho zeroed in on knowledge over and over again. Every time, during the critique after he shredded another one, he'd come back to knowledge.
I think most people fail because their so-so knowledge base was OK to get through a multiple choice exam, but wasn't good enough to bear the kind of probing a human examiner can do when weakness is sensed.
I think a few people fail because they have trouble demonstrating what they know or proving that they're safe.
I don't know exactly where I'm going with all this rambling except to say that my gut feeling is that those two groups don't overlap much, and that the 2nd group surely has a FAR higher pass rate the second time around.
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👍
Nice post Cambie.
Getting cut off is a good thing and I think it can throw some people off. I think examiners know weather you know enough depth by judging your first couple of sentences. In other words, answering the questions directly and without hesitation- this takes practice and is dependent on both knowledge base and verbalizing your thoughts as a consultant of the specialty.
Oral practice exams are worth their weight in gold. They assist you in giving answers in a short concise manner without dancing around the fire for too long... if you stay in the cage for too long, you will open yourself up for a shot.
I feel as if most examinees, including myself when I took it not too long ago, need to have a structure to your answers before you even hear the question. Kinda like starting a CABG... their is a recipe that you follow and if you stick to it, you are likely not to mess up as you are walking a road that has been practiced many times. You stray from the routine/plan/mission and you open yourself to distractions. I know a number of senior/junior/retired examiners and they all look for this organization.
In the end, presentation ain't worth squat if you don't have the fundamental knowledge. That is square one.
KungPow- my experience was almost identical to yours...
The first stem went well, sure I passed it, but the second stem decimated me. The hardest part was that the examiners honed in on simple topics that I know well, but were asked very unexpectedly and in rapid fire succession. I hesitated and did not give smooth answers, and they were like sharks smelling blood in the water. This tripped me up, and I lost focus, and stumbled on things that I should not have. I definitely answered a number of questions well, but really bombed a couple of simple follow-ups. I look back and am having a hard time that I may have failed on medical student level topics.
I cannot stress enough that you must control the pace of the exam to the best of your ability. They will rattle you for sure, but try and stay focused. I did not. This is key, because being cut off mid sentence over and over is quite distracting.
If I failed, I will not be surprised at all. Hard to stomach as I did very well on all practice mock orals, and have never struggled with writtens. The oral exam is 99% about keeping a cool head. Right about now I feel like the ABA just took a great big steamer on my April and May. Talk about a bitter mix of anxiety, regret, shame, and anger.
Hang tough peeps, the chance may be slim, but we may just have squeaked by...
The first stem went well, sure I passed it, but the second stem decimated me. The hardest part was that the examiners honed in on simple topics that I know well, but were asked very unexpectedly and in rapid fire succession. I hesitated and did not give smooth answers, and they were like sharks smelling blood in the water. This tripped me up, and I lost focus, and stumbled on things that I should not have. I definitely answered a number of questions well, but really bombed a couple of simple follow-ups. I look back and am having a hard time that I may have failed on medical student level topics.
I cannot stress enough that you must control the pace of the exam to the best of your ability. They will rattle you for sure, but try and stay focused. I did not. This is key, because being cut off mid sentence over and over is quite distracting.
If I failed, I will not be surprised at all. Hard to stomach as I did very well on all practice mock orals, and have never struggled with writtens. The oral exam is 99% about keeping a cool head. Right about now I feel like the ABA just took a great big steamer on my April and May. Talk about a bitter mix of anxiety, regret, shame, and anger.
Hang tough peeps, the chance may be slim, but we may just have squeaked by...
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I just took the orals as well. The week before the test I went back to my training institution and had three practice orals all with real examiners. In addition to giving me real tests, they also explained a few things about how the exam is given, what the examiners are thinking, etc. One of the folks ( a senior examiner with 17 years of exams under his belt) told me how to fail the exam. He said there are basically three types of people who fail the exam:
1-people who don't know enough stuff. He told me that this is 90% of people who fail the orals. they just don't have the knowledge base to "get" what the question is after and appropriately respond
2-super nerds (his words) who know everything under the sun, but cannot present all they know in a concise and convincing manner (per him, 5% of failures)
3-normal people who freak out and lose their s%*t in the room and babble/cry/argue with the examiners (again per him, 5% of failures)
I think this is why most people come out thinking they failed the exam, but actually pass. You really have to screw some major things up before you fail this thing. The way this guy put it, you walk in passing, and if you are way outside what they view as "diplomate material", you fail.
As an aside, I totally flubbed this practice exam and had this guy just shaking his head at me for like 10 minutes. He gave me a "straight up fail" for that exam. Hopefully not predictive of the real thing (fingers crossed!!!).
1-people who don't know enough stuff. He told me that this is 90% of people who fail the orals. they just don't have the knowledge base to "get" what the question is after and appropriately respond
2-super nerds (his words) who know everything under the sun, but cannot present all they know in a concise and convincing manner (per him, 5% of failures)
3-normal people who freak out and lose their s%*t in the room and babble/cry/argue with the examiners (again per him, 5% of failures)
I think this is why most people come out thinking they failed the exam, but actually pass. You really have to screw some major things up before you fail this thing. The way this guy put it, you walk in passing, and if you are way outside what they view as "diplomate material", you fail.
As an aside, I totally flubbed this practice exam and had this guy just shaking his head at me for like 10 minutes. He gave me a "straight up fail" for that exam. Hopefully not predictive of the real thing (fingers crossed!!!).
It was a resident lecture that was intended to be honest, but a little entertaining, jokes thrown in there. Like, "see what i do for you residents? i go down to ft lauderdale to stay in a nice hotel for you." Some people freak out over the bubble sheets or the way that it's scored. She's trying to take away that fear so the residents remain focused when the examiners write things down on the scoresheet.
Personally, I like the "sh__ happens" slide.
expect it, because the scripts make it happen. "at some point the patient will become hypotensive" etc...
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sucks at how good KPC was at predicting this
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- Reaction score
- 35
Seriously for future examinees. If you miss any part of a question or aren't 100% sure what they said have them repeat the question. They cannot downgrade you for having them repeat the question and it will buy you some time to think about what they asked. That was my fatal mistake. Not only did I get the question wrong but I was shellshocked by the stupidity of my agreeing to that treatment plan. I walked into the second exam with a blank piece of paper with no anticipated responses for preop or intraop management and was mentally KO'D.
