General Cardiology Boards 2023

[Egghead34]

Well that was, how should I put it…AAAAAAAAAHHHHHHhhhhhhhaaaAaaaHhhhhhhaaaaHhhAaHhh!!!

Day 1 had some bizarre stuff but overall quite doable.

But day 2, mein gott. Those EKGs. Those echo images. I must’ve overcoded everything. Please tell me someone else is feeling horrible right now.

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[Cardio_4_Life]

Absolutely ridiculous day 2.... You are not alone

 

[paki20]

Terrible exam.

Day 1 tested random factoids including some random trivia questions that I guarantee are not found in any board review book or course.

Day 2. How can you have 2 second blurry images with 3 word descriptors and 1 view on a standardized board test.

Are they looking to trick or actually test basic level competency? ABIM needs to go. This does not test actual clinical knowledge.

 

[Blaughable]

Okay that test was just dumb. I’ve never felt like a test was worse put together. Typos all over day 1. Huge sections not even tested, meanwhile pointless statistics questions. Day 2 people got angiography studies without any way of coding them. A whole EKG section without a single tracing of VT. Terrible images throughout the entire thing. I don’t know what this was testing, but it sure wasn’t how to be a cardiologist. ABIM should not be charge of this test.

 

[cv2023]

Okay that test was just dumb. I’ve never felt like a test was worse put together. Typos all over day 1. Huge sections not even tested, meanwhile pointless statistics questions. Day 2 people got angiography studies without any way of coding them. A whole EKG section without a single tracing of VT. Terrible images throughout the entire thing. I don’t know what this was testing, but it sure wasn’t how to be a cardiologist. ABIM should not be charge of this test.

"angiography studies without any way of coding them." I thought it was just me. What a colossal embarrassment for ABIM.

 

[Egghead34]

I like how they refer to TAVR as transcutaneous valves. Err, you mean percutaneous?

 

[mksa1982]

Yeah, this is how it was last year

I don’t remember medicine boards being this ridiculous. Right?

But cards boards (as well as EP boards) were f***ing ridiculous
Notice how the pass rates for cards boards have gone down too
But to whoever taking more boards after cards with the wonderful organization that is ABIM - it doesn’t get any better

 

[IC2324]

this exam is horrible! Absolutely the worst among all boards!

First day was bad but still better compared to second day! EKGs horrible quality! Many can’t tell if there is a P wave or not simply cause the quality is so dumb! Patient presentation vague and super short! Angiographies with no way to code them cause simply no one bothered from ABIM to check and add the anatomical options for at least 2 angios, like really it is insane to see something and know what it is but can’t code it cause the option is not there! Like the entire area they asking about is not there! i don’t understand the purpose of creating such a bad exam! Like what they are trying to test and how it correlates with clinical practice especially in day 2! Like even if I practice in the worst medical center/hospital in this country I won’t have to deal with such horrible tracings/images/vague short stories!

 

[shouldigomd]

I didn't mind day 1. Was more or less what I expected with the strategy of cheap ambiguous scenarios to make it "hard." Contrasted with echo boards which felt like a test of all of the tiny unimportant minutia they could string up.

Day 2 was crazy for me too though. I think I need glasses after straining so hard to read all those blurry EKGs. I didn't mind the image quality on cath / echo, I felt like I could see what I needed to see. Trying to code on the other hand.... I was so lost and frustrated.

 

[May19882014]

I called ABIM about the images that couldn't be coded. (18004412246). Email your frustration to [email protected]
I asked them to either disqualify the coding section this year( only pass/fail based on day 1) or let us retake day 2.

 

[Egghead34]

this exam is horrible! Absolutely the worst among all boards!

First day was bad but still better compared to second day! EKGs horrible quality! Many can’t tell if there is a P wave or not simply cause the quality is so dumb! Patient presentation vague and super short! Angiographies with no way to code them cause simply no one bothered from ABIM to check and add the anatomical options for at least 2 angios, like really it is insane to see something and know what it is but can’t code it cause the option is not there! Like the entire area they asking about is not there! i don’t understand the purpose of creating such a bad exam! Like what they are trying to test and how it correlates with clinical practice especially in day 2! Like even if I practice in the worst medical center/hospital in this country I won’t have to deal with such horrible tracings/images/vague short stories!

since my memory has gone blank, can you remind me what was uncodeable?

 

[paki20]

I called ABIM about the images that couldn't be coded. (18004412246). Email your frustration to [email protected]
I asked them to either disqualify the coding section this year( only pass/fail based on day 1) or let us retake day 2.

People's careers depend on these stupid exams it's really not acceptable at all

Image quality is not representative of real life

 

[May19882014]

since my memory has gone blank, can you remind me what was uncodeable?

two questions were non-coronary angiograms with coronary coding sheet. One questions was a type of ASD not on the coding sheet.

 

[shouldigomd]

two questions were non-coronary angiograms with coronary coding sheet. One questions was a type of ASD not on the coding sheet.

Wow that sucks. Mine were all angiograms.

 

[A.Real.Dreamer114]

We should all make some noise on twitter. That’s the only way they’ll listen.

 

[Full Metal IC]

Mine were all coronary angiograms. But their coding system is a mess even for that. If there's a bypass graft to a native vessel how do you code the native vessel? It's often occluded proximally. But the clinically relevant disease is in the runoff from the graft. Do you code that and ignore the proximal occlusion? Do you code both an occlusion and the distal disease separately? Is the occlusion considered the "worst" stenosis or is that to be ignored because grafts aren't used to bypass non-severe disease? Literally no one on earth seems to know. I get that it is difficult to write these exams but it is frustrating that they aren't transparent about how to actually code. Also, asking us to interpret based on a single view is a travesty and an insult to the fundamental principals of coronary angiography.

 

[IC2324]

I called ABIM about the images that couldn't be coded. (18004412246). Email your frustration to [email protected]
I asked them to either disqualify the coding section this year( only pass/fail based on day 1) or let us retake day 2.

Can you please keep us posted if they reply to you? I will also send an email

 

[blazingrockets55]

I had two non coronary cases and wasted a lot of time trying to figure out what I was missing. My guess is they’ll just call them experimental and throw them out. I’ll still send an email just to make myself feel better though.

 

[paki20]

Mine were all coronary angiograms. But their coding system is a mess even for that. If there's a bypass graft to a native vessel how do you code the native vessel? It's often occluded proximally. But the clinically relevant disease is in the runoff from the graft. Do you code that and ignore the proximal occlusion? Do you code both an occlusion and the distal disease separately? Is the occlusion considered the "worst" stenosis or is that to be ignored because grafts aren't used to bypass non-severe disease? Literally no one on earth seems to know. I get that it is difficult to write these exams but it is frustrating that they aren't transparent about how to actually code. Also, asking us to interpret based on a single view is a travesty and an insult to the fundamental principals of coronary angiography.

Yes exactly, no one knows how to properly code that and basing stenosis can be so subjective angiographically. They should make the cath films multiple choice instead of coding subjectively, people fail otherwise simple cath films just based on improper coding which is crazy. People need to start making noise on Twitter and tag ABIM.

 

[IC2324]

I think the best and only way that will solve all of this ABIM mess is when we will have our own board exams ran by our our professional societies (ACC, SCAI, HRS) as what has been proposed recently!

 

[Egghead34]

Mine were all coronary angiograms. But their coding system is a mess even for that. If there's a bypass graft to a native vessel how do you code the native vessel? It's often occluded proximally. But the clinically relevant disease is in the runoff from the graft. Do you code that and ignore the proximal occlusion? Do you code both an occlusion and the distal disease separately? Is the occlusion considered the "worst" stenosis or is that to be ignored because grafts aren't used to bypass non-severe disease? Literally no one on earth seems to know. I get that it is difficult to write these exams but it is frustrating that they aren't transparent about how to actually code. Also, asking us to interpret based on a single view is a travesty and an insult to the fundamental principals of coronary angiography.

Same. First I coded main vessel CTO. Then mild for the disease distal to the graft. Then I erased it all and just coded for the graft.

 

[Egghead34]

two questions were non-coronary angiograms with coronary coding sheet. One questions was a type of ASD not on the coding sheet.

I guess we got different exams. mine were all coronaries

 

[IC2324]

I had two non coronary cases and wasted a lot of time trying to figure out what I was missing. My guess is they’ll just call them experimental and throw them out. I’ll still send an email just to make myself feel better though.

The problem to me was not having non coronary angios, they were in fact easy non coronary cases, but I could never imagine that at the level of this exam these 2 questions are being asked and the coding sheet doesn’t even have/reflect the vessel shown let alone what is wrong / diagnosis in the vessel! This tells all the story how these boards and questions are written and what kind of quality check is taking place!

 

[May19882014]

Same. First I coded main vessel CTO. Then mild. The I erased it and just coded for the graft.

😂…I first coded cto (because contrast didn’t go all the way back)..then just coded the graft (because maybe there was competitive flow in proxi lad if you squint then it would be greater then 75; wouldn’t know without injecting left main)…either way in the real world using just that one image to conclude disease severity would be wildly wrong and lead to poor pt management; ABIM is promoting incorrect interpretation that can lead to harm.

 

[Egghead34]

😂…I first coded cto (because contrast didn’t go all the way back)..then just coded the graft (because maybe there was competitive flow in proxi lad if you squint then it would be greater then 75; wouldn’t know without injecting left main)…either way in the real world using just that one image to conclude disease severity would be wildly wrong and lead to poor pt management; ABIM is promoting incorrect interpretation that can lead to harm.

lol, yes. I had one graft case where the adjacent main vessel had a stent. But the vessel never lit up because the graft did not backfill retrograde past an OstiaL CTO. So do I code stent patent or stent occluded?

 

[shouldigomd]

I don't even know how to code a patent vessel. Do you leave it blank or code "insignificant stenosis" ....

No clue how to code for stress echo either. There are people who will fail this exam based on this crap.

 

[cardio4sure]

The imaging section was one of the most useless tests I have ever taken.
There were images of a couple of studies that obviously wasn't on the coding sheet. I think that is what most are referring to.
Several one image cath questions to code with, very far from what we were all trained to look at multiple angles to get a full picture
I only coded the grafts and not the native disease. I don't even know if that was the right way to go about it. I didn't code what I didn't see.
Overall poorly written exam.
Lots of vague ECG images without a driving theme.

 

[tn4596]

Overall impression
Ekg was the easier portion of the test, maybe bc lots of resource to practice like ecgsource and okeef.
The echo and cath portion there weren’t many resource on how to code for these, def missed a bunch of point from coding incorrectly…

 

[blazingrockets55]

Are we all going to email?

[email protected]

 

[cv2023]

People's careers depend on these stupid exams it's really not acceptable at all

Image quality is not representative of real life

This is exactly the problem. Careers are determined by these exams. It is simply appalling that these errors were not discovered prior to the exam. The ABIM's default position may be to dismiss these questions as "experimental" or exclude them altogether, but that doesn't account for the time spent during the exam (by myself, for instance) trying to make sense of these films and code them appropriately....time that could have been spent on reviewing other questions/films.

I hope that the ACC gets word of this, and brings the heat on ABIM to rectify the situation, and maybe that involves invalidating the entire imaging section, as was proposed earlier on this thread. But to simply drop these questions from the final tally, and not recognize that many of us spent precious time agonizing over the "right" answer when that answer wasn't even on the coding sheet, is also specious.

 

[cv2023]

I had two non coronary cases and wasted a lot of time trying to figure out what I was missing. My guess is they’ll just call them experimental and throw them out. I’ll still send an email just to make myself feel better though.

Yes, this exactly. I also wasted a lot of time trying to figure out what I was missing. This is why simply throwing the questions out is also grossly unfair, it doesn't account for the massive opportunity cost of trying to solve what is an unsolvable question.

 

[DrPcv]

There is something in the works for a new board. But not sure how or when. Or if hopefully wont just become another money grab.

Time for a change? Cardiology groups announce plan to develop a new medical board independent of the ABIM

"We know that the cardiovascular community is ready for an independent, self-governed entity, and we are proud to develop this new board with cardiologists and cardiology organizations at the helm," ACC President B. Hadley Wilson, MD, said in a statement.

cardiovascularbusiness.com

 

[tn4596]

There is something in the works for a new board. But not sure how or when. Or if hopefully wont just become another money grab.

Time for a change? Cardiology groups announce plan to develop a new medical board independent of the ABIM

"We know that the cardiovascular community is ready for an independent, self-governed entity, and we are proud to develop this new board with cardiologists and cardiology organizations at the helm," ACC President B. Hadley Wilson, MD, said in a statement.

cardiovascularbusiness.com

A new board and not a money grab? I think these things are mutually exclusive 😂

 

[mksa1982]

Is this a f**king joke? There’s a section on how they ensure exam fairness. WTF. Is this supposed to be satire?

Quarterly News & Notes: Fall 2023

A letter from Dr. Rajeev Jain, Ensuring ABIM’s exams fairly assess physician knowledge, New Internal Medicine assessments to launch in January, check your MOC points, ABIM to provide additional information about certification status, Diversity, Equity and Inclusion report

blog.abim.org

 

[May19882014]

 

[May19882014]

View attachment 377600

In response to my detailed message; "we can't responsed individually"

 

[May19882014]

My response to "James" from the ABIM test development to the above email.

 

[PrivateJoker]

Day 1: A significant amount of the exam had poorly written questions (and answer choices) with way too much assumption that the test taker understands what the question writer is looking for, or was testing random factoids that really have no business being on an exam because they can either be looked up if needed, or are not clinically relevant. Large and very relevant areas of cardiology that were completely untested and in their place redundant testing on Zebras. Poor quality images and EKGs.

Day 2: Poor quality EKG tracings with vague stems. Poor quality echo images and cath films with single or limited views not indicative of reality as you would rarely make clinical decisions or diagnosis based on incomplete information. Angiograms with no way of coding.

If did not pass will be waiting for new CV board establishment. Not worth the time, stress and money to sit for an exam that in my opinion does not reflect clinical competence.

 

[TAVR4life]

Day 1: A significant amount of the exam had poorly written questions (and answer choices) with way too much assumption that the test taker understands what the question writer is looking for, or was testing random factoids that really have no business being on an exam because they can either be looked up if needed, or are not clinically relevant. Large and very relevant areas of cardiology that were completely untested and in their place redundant testing on Zebras. Poor quality images and EKGs.

Day 2: Poor quality EKG tracings with vague stems. Poor quality echo images and cath films with single or limited views not indicative of reality as you would rarely make clinical decisions or diagnosis based on incomplete information. Angiograms with no way of coding.

If did not pass will be waiting for new CV board establishment. Not worth the time, stress and money to sit for an exam that in my opinion does not reflect clinical competence.

Its a horrendous exam and pass rates are some of the lowest among the boards we take despite cardiologists being cream of the crop in IM. Its clearly a flawed exam, no one knows how to code for day 2 (not even Mayo clinic board review faculty). It seems like ABIM wants a significant percentage of people to fail every year--this process should not be punitive. For a standardized board exam the goal needs to be minimum competency and thus there is no place for trick questions. For a standardized exam the image quality should be IDEAL conditions. In real world you get several other data points to make a diagnosis not 1 view of coronary angiogram with 2 second clips with 3 word descriptors. It's not how cardiology is practiced in real world, there is a gray zone when it comes to interpretation of cardiac studies so frankly it does not make sense to test day 2 the way they do.

 

[cv2023]

My response to "James" from the ABIM test development to the above email.

View attachment 377601

Well done!!

EDIT: also, I completely agree with you about voiding the second day entirely. It's pretty remarkable, really: only a couple weeks after the ACC/etc formally begin the process of taking back our boards, the ABIM shows the medical world why they are incapable of administering said board exams. You'd think the ABIM would have been on high alert to show up and deliver a solid test on game day, so to speak, and instead they have, what, three separate glaring errors on the imaging section? How did the errors slip through multiple layers of editing? And even better that is was the imaging section with the errors, it's historically been the section everyone complains about.

I mean, if there was any doubt previously about whether the ACC should take over for these bloated, incompetent fools, this week pretty much erased it all.

 

[iwannabegreat]

I hope they pass me.. the second day was ridiculous

 

[mksa1982]

Why does my experience with EP boards this year sound so similar to what happened with cards boards this year...?

 

[anoncardioguy]

So everyone in this thread feels the same way. What are we going to do about it? Anyone have mentors/big name attendings? Contact the Heme Onc guy who has been blasting ABIM on twitter?

 

[May19882014]

So everyone in this thread feels the same way. What are we going to do about it? Anyone have mentors/big name attendings? Contact the Heme Onc guy who has been blasting ABIM on twitter?

I just created a petition with the help of AI. I don't have Twitter; so anyone who does if they can share and sign.

This campaign needs you now

Disqualify Day 2 of the Cardiovascular Board Exam for Unfair Practices

chng.it

 

[May19882014]

I just created a petition with the help of AI. I don't have Twitter; so anyone who does if they can share and sign.

This campaign needs you now

Disqualify Day 2 of the Cardiovascular Board Exam for Unfair Practices

chng.it

The cardiologist before us should have done this long time ago.

 

[anoncardioguy]

Gaining traction https://x.com/aarongoodman33/status/1713629742438683063?s=46&t=lhgD8hX-W7btoz-wZQvhVg

 

[timpview]

The cardiologist before us should have done this long time ago.

Ha. As if anything changes.

And no, the ACC and those cronies aren’t going to detach themselves from abim. It’s all posturing.

 

[iwannabegreat]

Ha. As if anything changes.

And no, the ACC and those cronies aren’t going to detach themselves from abim. It’s all posturing.

I agree nth will change..they will do whatever and fail a certain people and ruin careers just for some not well written test..we as doctors go through a lot already dealing with this for the last few months has been very stressful to be honest

 

[paki20]

I agree nth will change..they will do whatever and fail a certain people and ruin careers just for some not well written test..we as doctors go through a lot already dealing with this for the last few months has been very stressful to be honest

And frankly we are not students anymore, we have families, young kids, aging parents, sick patients, very demanding careers as cardiologists, etc etc we don't have protected time to study for board exams like we did when we were students. There's literally no reason to purposefully be out to trick, ask random trivia level questions or give tricky 2 second video clips or poor quality ECGs and ask to intrepret on a standardized exam. Just test basic knowledge to ensure basic level competency it doesn't have to be an aptitude level test.

 

[iwannabegreat]

And frankly we are not students anymore, we have families, young kids, aging parents, sick patients, very demanding careers as cardiologists, etc etc we don't have protected time to study for board exams like we did when we were students. There's literally no reason to purposefully be out to trick, ask random trivia level questions or give tricky 2 second video clips or poor quality ECGs and ask to intrepret on a standardized exam. Just test basic knowledge to ensure basic level competency it doesn't have to be an aptitude level test.

I agree totally..💯