HOQ qbank

[onchopeful1]

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How did people do overall on exam blocks on HOQ prior to board exams?
I haven’t been able to study much at all and with boards next week, I’m not doing that great on random exam blocks and worried about failing.

 

[HaemOnculus]

Similar to uWorld, the HOQ bank is harder than the actual test but covers the material well. I found it a great resource.

 

[osprey099]

Similar to uWorld, the HOQ bank is harder than the actual test but covers the material well. I found it a great resource.

There's uWorld for heme onc boards??

 

[HemeOncHopeful19]

Me doing Gyn Onc practice questions

 

[bobbyknightranger]

There's uWorld for heme onc boards??

Sadly, no. If there were I would pay a very handsome sum for it. UWorld, are you listening?

 

[onchopeful1]

Any recommendations for heme boards? As in, I have two days to study for it in the next week — what’s highest yield?

 

[gutonc]

Any recommendations for heme boards? As in, I have two days to study for it in the next week — what’s highest yield?

Faking your own death to get your registration fee back when you cancel?

 

[onchopeful1]

Other than losing money, is there any downside to taking the test and seeing if I can muster a pass?
Worst case: at this point, nobody should care if I fail this, right?

 

[gutonc]

Other than losing money, is there any downside to taking the test and seeing if I can muster a pass?
Worst case: at this point, nobody should care if I fail this, right?

Other than ego, no, and I was being mostly facetious. But the heme boards are notorious for being harder than the onc and way harder than they actually need to be.

If I was me, I'd just go ahead and take it cold/blind and see what happened. If I passed, hooray!, if I failed, F it, I passed Onc and that's all I need.

 

[HemeOncHopeful19]

Other than ego, no, and I was being mostly facetious. But the heme boards are notorious for being harder than the onc and way harder than they actually need to be.

Worth nothing both tests have almost identical first time pass rates over the past 5 years (90% being the lowest) but I agree Heme questions feel more BS

 

[randomhemoncpd]

Other than losing money, is there any downside to taking the test and seeing if I can muster a pass?
Worst case: at this point, nobody should care if I fail this, right?

For you, no. It does look bad for the program though.

 

[Ubba]

Also going to be super awkward if you interact at all with faculty and junior fellows at your program after you leave. Better believe there will be a combination of pity and disdain.

 

[onchopeful1]

…. So back to the question, what are the highest yield topics I can spend two days reviewing?

 

[JoeDilly]

The ABIM site will have a percentage breakdown of each topic if you haven't looked at that yet (though, in classic heme fashion, my memory is that the outline was exceptionally vague when compared to onc's).

If you truly haven't done anything to prep, then my vote for highest yield thing would be working your way through the most recent ASH-SAP questions (if you have access). I wouldn't even know what to focus on topic-wise with only two days (and honestly not sure any answer here will be helpful for you, since it really depends on your personal strengths/weaknesses), but at least ASH-SAP would 1) hit a smattering of high yield topics across benign and malignant, and 2) give you the best estimation of the structure/length/at times annoyingly ambiguous nature of questions as they appear on the heme boards. Best of luck!

 

[FaithSaves]

Is the ASH exam harder or easier compared to the ITE?

And does anyone know if there is a % correct for passing? (like how for IM the number quoted was 65%)

 

[blackcadillacs]

Yes would be great to know from people who passed boards, how they did on HOQ first. I'm getting 50-60%s and don't know if this correlates with passing

 

[gutonc]

Yes would be great to know from people who passed boards, how they did on HOQ first. I'm getting 50-60%s and don't know if this correlates with passing

I was hitting 75-80% on HOQ, but it was my 2nd tool after using ASCO-SEP. I passed comfortably. Note that this was almost 9 years ago.

 

[ShuperNewbie]

@blackcadillacs I'm right there with you. Hitting about 50-70% on my first pass of HOQ. The questions are pretty hard (and occasionally wrong lol). We'll see if this correlates with passing in a few weeks haha.

 

[onchopeful1]

Crossing my fingers.

I feel heme ITE is unnecessarily difficult.
1) how much does knowing the pathophys of conditions or memorizing downstream mechanisms of drugs REALLY impact clinical care on a day to day basis?
2) the case presentations are also so vague — the same objective can be best on onc ITE and heme ITE and I thought the onc was more clinically based and actually evaluating your understanding… rather than test testing skills or the 2% chance of an abnormal presentation for a disease.

Hoping the board isn’t as much like that…
I wish there was a uworld equivalent for heme/onc — it’d be nice to know what kind of questions to actually expect.

UGH.

 

[onchopeful1]

If you want to feel more confident before Onc… do ASCO SEP.
FYI for anyone in the future.

 

[gutonc]

If you want to feel more confident before Onc… do ASCO SEP.
FYI for anyone in the future.

I've said it many times before (so I didn't bother in this thread), but I felt (at least back in the dark ages when I initially certified) that HOQ and ASCO-SEP were pretty much equivalent in both their good and bad and were fairly representative of the test in general.

 

[Mehena]

In my opinion, ASCO SEP is a good material, along with other resources such as the HOQ and maybe a board review course video. You can crush the ITE by studying SEP; it might boost your confidence. However, it probably defeats the purpose of the ITE. The actual exam, however, covers a broader and deeper range of onc topics. The length of the question stems might be similar, but I found the real exam harder.

I passed both tests comfortably.
For Oncology, I used the HOQ during training and had one more pass. I also used ASCO SEP and MD Anderson board review videos.
For Hematology, I used the HOQ similarly. ASH SAP questions, which I believe are more representative of the actual board exam. Any board review video will do

 

[ShuperNewbie]

Ooof

 

[gutonc]

Ooof

Which one was today? i'm going to guess heme.

 

[nuitsansetoiles]

It was onc yesterday. Kinda rough, with all those outdated questions

 

[gritsngravy]

Onc had so many outdated questions it was kind of ridiculous. Heme was probably tougher but at least up to date?

For anyone finding this thread later, I'd still endorse HOQ. Certainly the most "complete" source. As mentioned from others, ASCO SEP and ASH SAP questions are also solid.

 

[gutonc]

Onc had so many outdated questions it was kind of ridiculous. Heme was probably tougher but at least up to date?

The questions are typically 3 or so years out of current clinical practice. That was true when I took it and also of the IM boards when I took them. It's why you don't use board review stuff to review for clinic.

 

[onchopeful1]

Re: onc — true. Adjuvant sunitinib!? No way.

Heme — I have no idea? I don’t think any question bank I did prepared me for that. Transplant should be a different board. Way too much and nitty gritty details that I feel most non-transplant docs wouldn’t/shouldn’t need to know to pass a board.

 

[HemeOncHopeful19]

Re: onc — true. Adjuvant sunitinib!? No way.

Heme — I have no idea? I don’t think any question bank I did prepared me for that. Transplant should be a different board. Way too much and nitty gritty details that I feel most non-transplant docs wouldn’t/shouldn’t need to know to pass a board.

Agreed 100%.

Also loved Onc boards gave me a few “Here is a patient with metastatic whatever who just progressed on <first line therapy that hasn’t been used since before fellowship so you’ve never actually seen a patient who progressed on it>, what should they get next?” and “What’s your opinion on surgical procedure A vs surgical procedure B vs just calling IR instead?”

I also would love just for once if there would be a cord compression question where the answer choice is “call both Rad Onc and Neurosurgery and let them duke it out”

 

[onchopeful1]

I also genuinely want to know if they think it’s right to do a pneumonectomy in a “healthy” 70 something year old person with N2 disease just because the surgeon said it’s resectable?

 

[onchopeful1]

Anyone have tips for heme boards for future people? Because I don’t…

 

[gutonc]

Anyone have tips for heme boards for future people? Because I don’t…

Don't take them?

 

[nuitsansetoiles]

I also genuinely want to know if they think it’s right to do a pneumonectomy in a “healthy” 70 something year old person with N2 disease just because the surgeon said it’s resectable?

I think I said to do neoadjuvant therapy (might have been wrong). That'd be nuts in real life

The questions are typically 3 or so years out of current clinical practice. That was true when I took it and also of the IM boards when I took them. It's why you don't use board review stuff to review for clinic.

The board review stuff was way more up to date than the exam itself. Literally a breast cancer question asked about ET +/- chemo and there was no Oncotype where it was clearly indicated!

 

[onchopeful1]

I think I said to do neoadjuvant therapy (might have been wrong). That'd be nuts in real life


The board review stuff was way more up to date than the exam itself. Literally a breast cancer question asked about ET +/- chemo and there was no Oncotype where it was clearly indicated!

Damn. I didn’t remember seeing a neoadj option. Ah well.

I remember that question - what the heck!

 

[onchopeful1]

Don't take them?

If that was an option, I’d be happy to. I am NOT a hematologist and don’t ever plan to be. But I am a community doc and from what I’ve heard, some practices require both.

 

[gutonc]

If that was an option, I’d be happy to. I am NOT a hematologist and don’t ever plan to be. But I am a community doc and from what I’ve heard, some practices require both.

Nobody will care if you take/pass the exam or not. I promise. You need A board exam, not ALL the board exams.

FWIW, I'm a single-onc boarded physician working in a rural community practice where half of my caseload is boring benign heme and nobody cares.

 

[TexasMed22]

Nobody will care if you take/pass the exam or not. I promise. You need A board exam, not ALL the board exams.

FWIW, I'm a single-onc boarded physician working in a rural community practice where half of my caseload is boring benign heme and nobody cares.

Related to this, it seems like most community heme oncs spend about half their time seeing benign heme, and many of them would prefer to just do onc only. Given the huge demand for oncologists right now, why don't they just stop seeing benign heme cases? Or at least turf them to the NPs if they're so boring/easy?

 

[osprey099]

Related to this, it seems like most community heme oncs spend about half their time seeing benign heme, and many of them would prefer to just do onc only. Given the huge demand for oncologists right now, why don't they just stop seeing benign heme cases? Or at least turf them to the NPs if they're so boring/easy?

I can see how this makes sense for private practice, but for community hospital employed positions, there are tips and tricks where you can bill a new heme for at least a 99204 and maybe even a 99205. A heme typically is a lot easier and faster than a new onc. So you are billing/earning the same 99204 heme patient as you are an 99204 onc patient, but in about 1/3 of the time it takes

 

[gutonc]

I can see how this makes sense for private practice, but for community hospital employed positions, there are tips and tricks where you can bill a new heme for at least a 99204 and maybe even a 99205. A heme typically is a lot easier and faster than a new onc. So you are billing/earning the same 99204 heme patient as you are an 99204 onc patient, but in about 1/3 of the time it takes

This. I walk in, say "we're going to get some labs, my MA will be in to get you in a minute", have them come back in 3 weeks to review the labs and then either do something for them or send them back to PCP. That's a 99204 (usually based on complexity of chart review) and a 99213-99214 with very little actual work involved.

Boring pays the bills, exciting keeps you much busier than you want to be and doesn't pay as much.

 

[TexasMed22]

This. I walk in, say "we're going to get some labs, my MA will be in to get you in a minute", have them come back in 3 weeks to review the labs and then either do something for them or send them back to PCP. That's a 99204 (usually based on complexity of chart review) and a 99213-99214 with very little actual work involved.

Boring pays the bills, exciting keeps you much busier than you want to be and doesn't pay as much.

That makes sense, thanks for the info. When you say half your caseload is benign heme, does that mean half your scheduled patients are benign heme? Or that half of your total work hours are spent on benign heme?

 

[osprey099]

This. I walk in, say "we're going to get some labs, my MA will be in to get you in a minute", have them come back in 3 weeks to review the labs and then either do something for them or send them back to PCP. That's a 99204 (usually based on complexity of chart review) and a 99213-99214 with very little actual work involved.

Boring pays the bills, exciting keeps you much busier than you want to be and doesn't pay as much.

If only this applied to private practice, where the majority of income is revenue based off drug-margin rather than E/M billing...

 

[gutonc]

If only this applied to private practice, where the majority of income is revenue based off drug-margin rather than E/M billing...

There are a lot of reasons I don't work for a for-profit system. This is only one of them.

But...Aranesp and luspatercept pay a f***ton.

 

[gutonc]

That makes sense, thanks for the info. When you say half your caseload is benign heme, does that mean half your scheduled patients are benign heme? Or that half of your total work hours are spent on benign heme?

Does it matter? The new ones all get 40 minutes and the follow ups all get 20. Doesn't matter what the diagnosis is.

 

[osprey099]

There are a lot of reasons I don't work for a for-profit system. This is only one of them.

But...Aranesp and luspatercept pay a f***ton.

Care to share some of your other reasons? 😀

 

[Duke1K]

Anyone have tips for heme boards for future people? Because I don’t…

Heme boards were a bit tougher than I expected - just a tad more difficult than the ASH ITEs. Maybe it's my background, but the exam felt overrepresented in benign heme questions. Gotta know coagulation extremely well, rare bleeding disorders and associated conditions, von Willebrand, Hgb electrophoresis. Must've had 10 questions on MAHA. Need to absolutely commit lymphoma immunophenotyping to memory. Plus an unusual amount of Punnett squares, but not overrepresented in the amount of hereditary cytopenic conditions like the ASH ITEs usually are.

I thought there was relatively fewer questions about leukemia (which were all very basic anyway) and myeloma, probably because the fields are changing so rapidly. The transplant questions seemed more conceptual than clinical; likely unfair for non-transplanters. Maybe 1-2 questions only on CAR T and no questions on lymphoma/myeloma bispecifics (actually, very few questions on advanced therapies for relapsed disease generally) but this may change. There was an expected amount of unfair molecular/pathophysiology questions, which you knew or you didn't.

There were both overlong question stems (sometimes the answer doesn't require you to look at the question stem at all, and sometimes the correct answer depends on noticing a small detail) and some that were extremely succinct - in short, challenging and unbalanced.

I'm not sure any particular resource would've prepared me fully. The ASH review series is the best foundation. I only supplemented with ASH SAP questions, and by doing a lot of clinical heme. I tried HOQbank which I thought was unnecessarily detailed, focused on the wrong things, and was outright incorrect/outdated sometimes; maybe it's better for onc but I doubt it. I also did a little bit of BoardsVitals, which I quite liked, but didn't stick with it.

My advice would be to take copious notes on the ASH review series, and do a qbank - otherwise, learn consistently and thoroughly throughout fellowship. The exam may be hard if you don't have a general heme clinic or two, or you don't participate in tumor boards/conferences to learn about more esoteric presentations/newer literature. If so, you'll need to have your ASH ITE score guide how much additional studying you need. Otherwise, I wouldn't sweat it too much - just remember that many questions are experimental and ultimately thrown out.

 

[osprey099]

Heme boards were a bit tougher than I expected - just a tad more difficult than the ASH ITEs. Maybe it's my background, but the exam felt overrepresented in benign heme questions. Gotta know coagulation extremely well, rare bleeding disorders and associated conditions, von Willebrand, Hgb electrophoresis. Must've had 10 questions on MAHA. Need to absolutely commit lymphoma immunophenotyping to memory. Plus an unusual amount of Punnett squares, but not overrepresented in the amount of hereditary cytopenic conditions like the ASH ITEs usually are.

I thought there was relatively fewer questions about leukemia (which were all very basic anyway) and myeloma, probably because the fields are changing so rapidly. The transplant questions seemed more conceptual than clinical; likely unfair for non-transplanters. Maybe 1-2 questions only on CAR T and no questions on lymphoma/myeloma bispecifics (actually, very few questions on advanced therapies for relapsed disease generally) but this may change. There was an expected amount of unfair molecular/pathophysiology questions, which you knew or you didn't.

There were both overlong question stems (sometimes the answer doesn't require you to look at the question stem at all, and sometimes the correct answer depends on noticing a small detail) and some that were extremely succinct - in short, challenging and unbalanced.

I'm not sure any particular resource would've prepared me fully. The ASH review series is the best foundation. I only supplemented with ASH SAP questions, and by doing a lot of clinical heme. I tried HOQbank which I thought was unnecessarily detailed, focused on the wrong things, and was outright incorrect/outdated sometimes; maybe it's better for onc but I doubt it. I also did a little bit of BoardsVitals, which I quite liked, but didn't stick with it.

My advice would be to take copious notes on the ASH review series, and do a qbank - otherwise, learn consistently and thoroughly throughout fellowship. The exam may be hard if you don't have a general heme clinic or two, or you don't participate in tumor boards/conferences to learn about more esoteric presentations/newer literature. If so, you'll need to have your ASH ITE score guide how much additional studying you need. Otherwise, I wouldn't sweat it too much - just remember that many questions are experimental and ultimately thrown out.

One of my heme attendings said he read ASH SAP cover to cover twice, and scored in 90th percentile

 

[blackcadillacs]

Heme boards were a bit tougher than I expected - just a tad more difficult than the ASH ITEs. Maybe it's my background, but the exam felt overrepresented in benign heme questions. Gotta know coagulation extremely well, rare bleeding disorders and associated conditions, von Willebrand, Hgb electrophoresis. Must've had 10 questions on MAHA. Need to absolutely commit lymphoma immunophenotyping to memory. Plus an unusual amount of Punnett squares, but not overrepresented in the amount of hereditary cytopenic conditions like the ASH ITEs usually are.

I thought there was relatively fewer questions about leukemia (which were all very basic anyway) and myeloma, probably because the fields are changing so rapidly. The transplant questions seemed more conceptual than clinical; likely unfair for non-transplanters. Maybe 1-2 questions only on CAR T and no questions on lymphoma/myeloma bispecifics (actually, very few questions on advanced therapies for relapsed disease generally) but this may change. There was an expected amount of unfair molecular/pathophysiology questions, which you knew or you didn't.

There were both overlong question stems (sometimes the answer doesn't require you to look at the question stem at all, and sometimes the correct answer depends on noticing a small detail) and some that were extremely succinct - in short, challenging and unbalanced.

I'm not sure any particular resource would've prepared me fully. The ASH review series is the best foundation. I only supplemented with ASH SAP questions, and by doing a lot of clinical heme. I tried HOQbank which I thought was unnecessarily detailed, focused on the wrong things, and was outright incorrect/outdated sometimes; maybe it's better for onc but I doubt it. I also did a little bit of BoardsVitals, which I quite liked, but didn't stick with it.

My advice would be to take copious notes on the ASH review series, and do a qbank - otherwise, learn consistently and thoroughly throughout fellowship. The exam may be hard if you don't have a general heme clinic or two, or you don't participate in tumor boards/conferences to learn about more esoteric presentations/newer literature. If so, you'll need to have your ASH ITE score guide how much additional studying you need. Otherwise, I wouldn't sweat it too much - just remember that many questions are experimental and ultimately thrown out.

Agreed, I'd hoped that studying malignant heme for Onc boards would help for Heme boards, but there was so much more benign heme than malignant. It felt like 10 questions on von Willebrand so know this really well. Lots and lots of hemolytic anemias. Not as much thrombosis. I actually didn't feel like there were too many really esoteric questions. The malignant heme didn't feel difficult. No study tips on my end, except don't rely on malignant heme to get you through these boards

 

[Duke1K]

Agreed, I'd hoped that studying malignant heme for Onc boards would help for Heme boards, but there was so much more benign heme than malignant. It felt like 10 questions on von Willebrand so know this really well. Lots and lots of hemolytic anemias. Not as much thrombosis. I actually didn't feel like there were too many really esoteric questions. The malignant heme didn't feel difficult. No study tips on my end, except don't rely on malignant heme to get you through these boards

Did you feel like doing HOQ was worth the time for the heme boards? What about onc boards?

 

[HemeOncHopeful19]

Did you feel like doing HOQ was worth the time for the heme boards? What about onc boards?

Yes to both but I didn’t use the ASH/ASCO questions as much so couldn’t compare them.

IMO 80% of his questions are really good and it’s more up to you to ignore the 10-20% that aren’t that useful but that isn’t a hard thing to do by the time you’re a 3rd year fellow

 

[gutonc]

Yes to both but I didn’t use the ASH/ASCO questions as much so couldn’t compare them.

IMO 80% of his questions are really good and it’s more up to you to ignore the 10-20% that aren’t that useful but that isn’t a hard thing to do by the time you’re a 3rd year fellow

I think this is largely true of any of the study materials at this level. I've been involved in writing ASCO-SEP questions (and am going to be on the ITE item writing committee soon) and the guidance (and compensation) that the question writers are given are pretty minimal, and the editing can leave a bit to be desired.

The reason there's no UWorld for these sub-specialty exams is not that there's not a demand for it, but there's no money in it given the relatively small market. To make the kind of money UW does on their Step prep materials on an exam like this, they'd need to charge $10K for it, which is clearly not something that's going to get a lot of traction.