Failed the orals

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KungPOWChicken

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Took the exam on Monday, and I walked out of the exam knowing pretty damn well that i failed. The first exam started off pretty well, and I felt good about how things were going, but then in the post op section I got nailed with a question that I misinterpreted and made a big clinical mistake. Didn't like the reaction from the examiner and from there on out the exam went downhill. The 2nd exam I couldn't stay focused because my brain was so caught up on what happened. Took most of the ten minutes just to read the second stem question. Well, I probably missed five questions (some of which should have been no brainers) in the second exam. One of which was a test that was clearly not indicated. I can't believe what happened. bummed out.
 
KungPOWChicken said:
Took the exam on Monday, and I walked out of the exam knowing pretty damn well that i failed. The first exam started off pretty well, and I felt good about how things were going, but then in the post op section I got nailed with a question that I misinterpreted and made a big clinical mistake. Didn't like the reaction from the examiner and from there on out the exam went downhill. The 2nd exam I couldn't stay focused because my brain was so caught up on what happened. Took most of the ten minutes just to read the second stem question. Well, I probably missed five questions (some of which should have been no brainers) in the second exam. One of which was a test that was clearly not indicated. I can't believe what happened. bummed out.
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Reaction from the examiner? They aren't really supposed to have reactions. I've never talked to anyone who thought they passed so don't get too down.
 
Virtually everyone I've ever talked to about the orals has said they walked out thinking they failed. Wait for your results before beating yourself up too much (I know this is easier said than done.)
 
Look at the bright side, you get to accumulate more skymiles.
 
One of my examiners sighed a lot and said "let's just move on" after I flubbed some stupid gimme question. I was worried. Waiting for my score was excruciating. They passed me.

Wait for your score is the only thing I can say, 'cause that's what people said to me, not that it made me feel any better.
 
Thanks for your support!!! This freakin waiting for a month is going to be absolute torture
 
not to sound arrogant but when i left san fran. I KNEW I PAssed there was NO question in my mind. There was nothing they got me on. NOTHING. WHY? I took the HO course
 
if you remember the names of who examined you that day and you have someone at your former residency who is a board examiner you may be able to get them to make a call for you and get an idea of how bad or good you did in a specific situation.
 
Ummm, everyone leaves the Orals thinking they might've flunked. Most of them pass.

Besides, if you don't pass, it has absolutely no impact on your next job. You can simply spend another $2000 and take it again.
 
Has anyone put together a study guide useful for the oral boards? Common lists, DDx, etc in word format in order to be able to spit them out in an organized fashion if asked? Would that even help?
 
jennyboo said:
Besides, if you don't pass, it has absolutely no impact on your next job.
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The Navy gives me a whole $208.33 extra each month for being board certified ... tells me what the world's largest HMO thinks of board certification. But elsewhere being BC can influence pay, partner track, employability, etc. I had a residency classmate (also with military obligations) who wanted to moonlight right out of residency, and he was told to go away and come back when you're board certified.
 
scudrunner said:
:wow::wow:

That's insane.
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Don't forget travel ... time off work. The real cost of a retake is going to be more like $2K for the exam + $1K for travel + $3-5K in lost pay for taking a 2 or 3 weekdays off. Plus the potential for lost pay raises, partner track questions. And failing any exam, no matter how arbitrary it seems to be, is never fun. There's a reason everybody sweats the damn thing.
 
pgg said:
Don't forget travel ... time off work. The real cost of a retake is going to be more like $2K for the exam + $1K for travel + $3-5K in lost pay for taking a 2 or 3 weekdays off. Plus the potential for lost pay raises, partner track questions. And failing any exam, no matter how arbitrary it seems to be, is never fun. There's a reason everybody sweats the damn thing.
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Except for hivoltage. 😎
 
pgg said:
The Navy gives me a whole $208.33 extra each month for being board certified ... tells me what the world's largest HMO thinks of board certification. But elsewhere being BC can influence pay, partner track, employability, etc. I had a residency classmate (also with military obligations) who wanted to moonlight right out of residency, and he was told to go away and come back when you're board certified.
Click to expand...

The difference of being board certified for me is 60K the first year, 90K the second year, and not having a job the third year. So, it's important.
 
bostonblaz said:
if you remember the names of who examined you that day and you have someone at your former residency who is a board examiner you may be able to get them to make a call for you and get an idea of how bad or good you did in a specific situation.
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this sounds like an incredibly bad idea
 
I didn't do any board review course and honestly I don't think you have too either. Obviously having a solid knowledge base and practicing are the keys too success. Ho talks about all this bull**** you have to say but honestly as soon as the examiner hears what they want it's next question. They cut you off midsentence. I was honestly rockin the test til I got to one stupid question about management basically a therapy that has been proven not helpful. Unfortunately I agreed to it because I misinterpreted what that was. That was it, I finished that exam fine, but between cases I was so pissed off I said that I lost all focus. My mind drew blanks on easy questions on test 2. At least 5 questions wrong.
 
KungPOWChicken said:
I didn't do any board review course and honestly I don't think you have too either. Obviously having a solid knowledge base and practicing are the keys too success. Ho talks about all this bull**** you have to say but honestly as soon as the examiner hears what they want it's next question. They cut you off midsentence. I was honestly rockin the test til I got to one stupid question about management basically a therapy that has been proven not helpful. Unfortunately I agreed to it because I misinterpreted what that was. That was it, I finished that exam fine, but between cases I was so pissed off I said that I lost all focus. My mind drew blanks on easy questions on test 2. At least 5 questions wrong.
Click to expand...

Sounds like you'll be taking them again. Don't dwell on it. You already recognized what mistakes you made, just don't make them when you take the exam again.
 
KungPow,

I didn't do any magic review Ho-Shhhhmo courses either, but like you have a strong knowledge base and level head in the OR. I just finished the exam and like you feel like i rocked certain questions and that certain questions took a nasty liquid dump on my face:scared:. I think we be OK though!!!😀 I hope I can follow up on this post in 6 weeks with confirmation though.


KungPOWChicken said:
Took the exam on Monday, and I walked out of the exam knowing pretty damn well that i failed. The first exam started off pretty well, and I felt good about how things were going, but then in the post op section I got nailed with a question that I misinterpreted and made a big clinical mistake. Didn't like the reaction from the examiner and from there on out the exam went downhill. The 2nd exam I couldn't stay focused because my brain was so caught up on what happened. Took most of the ten minutes just to read the second stem question. Well, I probably missed five questions (some of which should have been no brainers) in the second exam. One of which was a test that was clearly not indicated. I can't believe what happened. bummed out.
Click to expand...
 
KungPOWChicken said:
My mind drew blanks on easy questions on test 2. At least 5 questions wrong.
Click to expand...

Were they unequivocal kill errors? Going for a 'therapy not proven helpful' probably isn't a fatal error unless it's using leeches to bleed out the evil spirits and bad humors.

I know I missed a few questions. I also said "I don't know" a couple times. I didn't put an epidural in a septic coagulopathic patient though, or confuse lifethreatening hypoxia for "not enough sedation" during an AFOI.



Speaking of kill errors, I'm reminded of my very first mock oral a few months into my CA1 year. Staff stares at me across the table and says ... "Well, you just killed two and paralyzed one. Nice job." Fortunately I got better.


Arch Guillotti said:
to me pass = domination.
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P is all the domination anyone needs.
 
Failing the orals is very painful and stressful but it really isn't the end of the world. It may seem that way but life will go on. There are consequences to failing but it is what it is. You just dust yourself off and figure out what went wrong.

During my first attempt at the orals I was so lame that one of my examiners laughed at me. I came off like a guy from the trash haulers convention who got off on the wrong floor and walked in and took an oral exam. I was clueless.

I can laugh about it now but it was painful early on.

Hang loose until you get your scores back. Statistics are on your side. Most people pass the orals on their first attempt.

Cambie
 
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The way you feel about how you did has everything to do with your own perception and may or may not reflect how you actually did. Interestingly, I know of several colleagues who left the exam saying that they totally nailed it, only to find out a few weeks later that they failed. I also know of someone who stated that they failed for certain. They told me their case and how they answered a few of the questions. I was pretty sure they had failed too. They passed. Some people have no idea how poorly they did while others actually did pretty well but beat themselves up over a few small screw ups they wish they had given a better answer for.
Bottom line, wait for the results before you get too down on yourself.
 
bostonblaz said:
if you remember the names of who examined you that day and you have someone at your former residency who is a board examiner you may be able to get them to make a call for you and get an idea of how bad or good you did in a specific situation.
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Examiners administer 3-4 exams a day for several days. The likelihood of them remembering a specific candidate is low. In addition, the examination process is confidential and it would violate examiner rules to discuss details of the exam with the examinee or their designee.
In other words, don't bother even considering this option.
 
My exam is today and I am unable to sleep .. Totally screwed
 
There's really nothing you can do a this time. But don't stress over it (I know that's hard to say right now).

It's an exam and it's supposed to be hard.

What the majority of oral board examiners want to see is your overall thought process. There are 2-3 ways to approach certain anesthetic situations. As long as you didn't make an off hand approach, your answers may not necessarily be wrong.

I still remember my oral exam even after more than 5 years like it was yesterday. I thought I bombed the first stem also. And I wasn't focused on the second exam too.

Somehow I passed. But looking back on it (because I still have a very good memory) and weeding out all the games the oral examiners played.....as I now reflect, I answered those questions thoughtfully to the best of my knowledge and I was safe.

That's all the oral boards come down to. You need to show your overall thought process and you are proceeding in a safe manner.

Like others have stated, statistics are on your side with first time oral exam takers. The passing rate is well over 80%.
 
What kind of games do examiners play?
I'm taking it tomorrow
 
Daredevil said:
What kind of games do examiners play?
I'm taking it tomorrow
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I don't think they really play games, per se.

They'll certainly give you enough rope to hang yourself though.

If you're giving the right answer they usually cut you off before long. If you've been talking for a while and they let you, it might be a sign to shut up. I don't have any inside knowledge, just musing. A couple times during my exam I caught myself starting to confabulate and guess, and they were patiently listening to me. I closed my mouth and they moved on.
 
Daredevil said:
What kind of games do examiners play?
I'm taking it tomorrow
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Well one of my examiners was a very well known anesthesiologist. Pure evil in their questioning with me to the point of sounding condescending to me.

They made strange faces to me like they weren't satisfied with my answers. I just finally gave up and said I don't know and they moved on. Maybe saying, " I don't know" stops the bleeding so you don't dig yourself into a deeper hole.
 
I did very good in first exam, I didn't do well in the second is there a chance I might pass
 
Daredevil said:
What kind of games do examiners play?
I'm taking it tomorrow
Click to expand...

Most of them don't.

You really just need to realize their mentality and their pressures too.

They HAVE to score you, and they HAVE to try and get through a certain amount of the questions they have lined up to do it.
They want to test you, and the calmer, more experienced ones may push you on your thinking, but the rest also want to make sure they don't look like idiots by never getting past part 1 of the first stem.

You don't get invited back if your examinations never get very far or all of your examinees magically fail.

Take a breath before you answer, think it through, and spit it out in concise form.

Don't blow the gimmie questions. If your case is a clear set up for certain issues, think about them ahead of time, have your answers ready at the tip of your tongue so you can get them out and you both can move on to something else you could potentially hang yourself with (kidding).

I tell my residents the same thing when we go into a case together. There are certain aspects to the case that are gimmies. You know you're going to induce, you know you're going to intubate, you know they're gonna bleed. . . etc. Know what you're going to do for these BEFORE you even enter the room so you can focus on the other issues or unknowns when they come up.

They're generally, genuinely, not trying to trick you, but if you say something blindingly stupid, they'll likely call you on it, or hopefully just repeat it to you to give you a chance to correct it yourself.
 
Yeah I came out feeling very crappy about what I did and what I SHOULD have said.

Not a good feeling, but you ain't the only one.
 
How does one become an oral examiner? Can any old PP guy do it? Or does it have to be an academician? Just curious.
 
Seriously, I've been thinking about this frickin exam all day everyday since I took it on Monday. Let me tell you my first case I nailed the anesthetic plan. There was no arguement about it. Intraop there was a question which I answered 100% correctly because I looked it up after. I knew I nailed it and stuck to my guns, but the examiner tried to get me to second guess myself. I'm glad I didn't. **** like this rattles you though. I did well on all parts of that exam except the post-op therapy I misintepreted because it was a long winded bull**** question about a very rare complication. I would never even think of that therapy yet alone bring it up. Anyways, you could call it a kill error because it doesn't help and could worsen things. That was like a knock out blow. My mind was completely rattled after that. I knew every question they asked on the second exam but was drawing blanks from being so rattled.
 
scudrunner said:
How does one become an oral examiner? Can any old PP guy do it? Or does it have to be an academician? Just curious.
Click to expand...

You have to be invited into the group by ANOTHER examiner. All about networking.
 
scudrunner said:
How does one become an oral examiner? Can any old PP guy do it? Or does it have to be an academician? Just curious.
Click to expand...

Each year, there is a call for examiners. You can apply to be an examiner. You must have good recommendations from others. Most are academic but there are a few private practice people out there too. If you are over a certain age, 40 I believe, then you are not eligible to enter the process. They want you to have a 20 year commitment. Training good examiners is a long process, so they want someone they can get a lot of years out of if they make it in the system. In addition, you must be at least 50% clinical so that administrators and full time researchers don't give the exam.
As far as the exam, most don't try and trick you. They will occasionally give you enough rope to hang yourself, but occasionally the rope is a life line. It is up to you to figure out if it is a hangman's rope or a life line. That tells the examiner if you have a knowledge gap. If you take the rope and hang yourself with it, you fail. If you take another rope and use it as a life line, you can save yourself. For example, if a patient with an anterior mediastinal mass is dying before your eyes in the exam and you are drawing a blank on what to do after position changes and other interventions fail. They may say, "a colleague suggests cardiopulmonary bypass. Do you agree with this?" If you recognize it and discuss it, this can lead you down a correct path. If you don't recognize it, you have lost points.
 
That's exactly what happened to me. I hung myself on that rope mainly because I incorrectly interpreted a confusing question.
 
For what it's worth, a board examiner on our faculty says it's currently impossible to fail on the basis of a single section alone (preop, one of the intraops, postop, grabbag), no matter how badly you bomb it. Obviously, you'd have to do well on the rest, but there is some comfort in knowing that if you say one thing that is really stupid, you still have hope.
 
Years ago (the 80s) a well known anesthesiologist board examiner told me that the only "game" the examiners played was to never let someone get through without at least one wrong answer. Once, he had a gal from Harvard who got everything right. They couldn't stump her. Finally, he asked her something like "what is the statue that is located just outside the ether dome?"
She couldn't answer....
 
kmurp said:
Years ago (the 80s) a well known anesthesiologist board examiner told me that the only "game" the examiners played was to never let someone get through without at least one wrong answer. Once, he had a gal from Harvard who got everything right. They couldn't stump her. Finally, he asked her something like "what is the statue that is located just outside the ether dome?"
She couldn't answer....
Click to expand...

Apollo?? BORED certified!!!
 
Gern Blansten said:
For example, if a patient with an anterior mediastinal mass is dying before your eyes in the exam and you are drawing a blank on what to do after position changes and other interventions fail. They may say, "a colleague suggests cardiopulmonary bypass. Do you agree with this?" If you recognize it and discuss it, this can lead you down a correct path. If you don't recognize it, you have lost points.
Click to expand...

I've heard of this being done before, but it must be planned. Bypass machines don't just lie around the OR....actually, did a heart case where one WAS just lying around and we used it!! Anyways....

http://www.ncbi.nlm.nih.gov/pubmed/21224977

would anyone answer that question "Yes?" If so, do you think the examiner would be ok with the fact that the patient is "dying before your eyes?"
 
I couldn't sleep very well, thinking about my oral exam performance!

I probably won't until I get that letter back in a month!
 
The unfairness of the exam, aside from the fact that it's so artificial, is that it can only be taken once a year. For some people this equates to not just the stress of taking the test again and putting their life on hold for another year, but the loss in salary of tens of thousands of dollars. I can't wait for the first anesthesiologist to challenge the once per year rule and sue the ABA for lost salary. If they want a class action lawsuit, I'm sure many would be willing to attach their name to it.

As an aside, do all other specialties only allow you to take board certification exams once per year?
 
I think you would have to be an idiot for suing the ABA. If you fail it, you need to figure out why you failed and fix it rather that casting blame and pointing fingers.


Outrigger said:
The unfairness of the exam, aside from the fact that it's so artificial, is that it can only be taken once a year. For some people this equates to not just the stress of taking the test again and putting their life on hold for another year, but the loss in salary of tens of thousands of dollars. I can't wait for the first anesthesiologist to challenge the once per year rule and sue the ABA for lost salary. If they want a class action lawsuit, I'm sure many would be willing to attach their name to it.
Click to expand...
 
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