ITE 2014

Discussion in 'Anesthesiology' started by yancantcook, Feb 23, 2014.

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  1. yancantcook

    yancantcook Senior Member 10+ Year Member

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    Anyone else think the ITE this year was more of a medicine test than anything else? I get frustrated that the ABA chooses to test us constantly on esoteric details that are absolutely irrelevant in real life. Just venting some of my frustrations here.
     
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  3. G-Man82

    G-Man82 10+ Year Member

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    I felt like it was really similar to Step 1 in its basic science details ... minus the page long vignettes.
     
  4. lane

    lane Passing gas 10+ Year Member

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    that or they want to emphasize the importance of being a physician with a broad range of knowledge in all areas of perioperative medicine, including the basic sciences
     
    calcox likes this.
  5. G-Man82

    G-Man82 10+ Year Member

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    I like the idea of being a perioperative physician with a broad range of knowledge. I just feel like some of the things they asked about have not really been stressed in Residency. Outside of the ICU rotations, I haven't really been analyzing urine sodium to differentiate between cerebral salt wasting and SIADH. Often when those patients come to us for TBI, I don't have that information to begin with. It's stat to the OR.

    Honestly, I think this test just highlighted some extra stuff that I need to focus on outside of general anesthesia related circumstances. They really don't want us to forget what we learned in our Intern years.
     
  6. Libertas

    Libertas ASA Member 10+ Year Member

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    So does anybody have a sense of what % correct correlates to what scaled scores on that 50 point scale?
     
  7. FFP

    FFP Grunt/cog/body Gold Donor 7+ Year Member

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    Maybe the ABA wants you to be more than a CRNA who happens to have a medical diploma.

    I know that 20% of my knowledge will cover 80% of the cases (it's so easy to stop reading after you reach board certification), but it's that last "esoteric" 80% that makes the difference between me and a midlevel. Especially the stuff that they can't just Google. ;)

    If you watch the movie "Rush", you will see that Nikki Lauda became a world champion because he was not only a pretty good Formula 1 driver, but he understood the details about how his car worked, so he knew what to ask of his mechanics. If/when our knowledge of basic science is way ahead of the midlevels, our understanding of clinical science becomes similarly different, and our presence makes a much bigger impact in the care of the patient. Facts can be Googled, but advanced medical thinking cannot.

    As more and more smart technology penetrates in anesthesia, the difference between an anesthesiologist and a midlevel won't be experience (they might even have more, because they "specialize" in certain surgeries), skills (monkey see, monkey do) or factual knowledge (have you seen one without a smartphone?), but understanding and vision. An anesthesiologist should be to a CRNA as Sherlock Holmes was to Watson.
     
    Last edited: Feb 23, 2014
    GasAllDay and calcox like this.
  8. HollATme

    HollATme 2+ Year Member

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    FFP - What are your thoughts and recommendations when it comes to studying and this "advanced medical thinking?"
    I thought the ITE in 2013 was reasonable. The ITE yesterday was a tad over the top -- asking about the composition of the childs-pugh score is a tad esoteric if you ask me, and is something readily available on Google.

    A lot of these questions being asked are not exactly ones that would "differentiate us from a CRNA" - perhaps I'm wrong there.

    I studied from anesthesia books quite a bit last year as a CA-1, did pretty good on the ITE. This year I went through 2 full sets of question banks and portions of Hall, in addition to sporadic look throughs of keywords from openanesthesia. I felt this exam was even tougher with the minutiae being asked.
     
  9. FFP

    FFP Grunt/cog/body Gold Donor 7+ Year Member

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    I would estimate that the percentage of correct answers is double the score on the 50 point scale.
     
  10. FFP

    FFP Grunt/cog/body Gold Donor 7+ Year Member

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    I hated my written boards a few years ago, even if I scored around the 80th percentile. Many of the questions were USMLE Step 1 level, some completely irrelevant to clinical practice. I felt totally disrespected as a clinician. So I understand what you guys say.

    But... the more I practice as an attending, the more I realize how important is for me to have a broad and deep knowledge of medical science. I have to rationally argue with surgeons, with internists, with nurses, with patients. (The oral boards are much more pertinent from that standpoint.) That means knowing a lot about coexisting diseases with anesthesia implications. (Just look at the Hines-Marschall book, and that's the bare minimum.) Otherwise, I am just another body at the head of the bed.
     
  11. HollATme

    HollATme 2+ Year Member

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    To be honest, since there is so much to read - I made the anesthesiology texts my go-to. I had read so many times on here that the Coexisting Diseases book is not quite high yield for the ITE but it is good to have read for every day and oral boards related knowledge. Now that I'm done with the ITE, I may actually go and dive into that book full force and try to have it done by June/July and make key notes from each chapter and incorporate it with my exhaustive study packet I've made while going through key words and question banks so by the time CA-3 ITE rolls around I'll have just about everything I need to hopefully cover most of my bases, for that and the written exam when I graduate.

    I just feel that the key things you mention --- rationally defending your points against various healthcare providers --- would be easier if attendings did more "on the job" teaching -- the practical things not "oh let me see if I can pimp you on x,y, and z and if you know it great, i'm done for the day... and if not, it's going on your eval and will make for nice watercooler fodder with other attendings" .... if they took the time to teach practical things, like given a certain scenario what would you do? what should we be thinking about and how should one go about this process or that, or if caught in a situation how should one address things to a healthcare provider? One could regurgitate facts from a book all day long and still have things not go as well when managing a patient or when communicating with others.

    if you want a true consultant, that's what one needs to teach their residents. not "can you tell me everything about x, y, and z?" sure, it is important to have book knowledge, not downplaying that, but I think there needs to be MORE done if we really want to talk about differentiating ourselves from nurses. Plus, if what we are doing in residency isn't differentiating ourselves enough and we have to tack on random q's from day 1 of med school, then perhaps we should consider changing our paradigm that is medical education.
     
  12. FFP

    FFP Grunt/cog/body Gold Donor 7+ Year Member

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    You are right: residency education mostly sucks, because it's not about education, it's about cheap labor. And nobody tells you that, in real life, all the knowledge they test on the ITEs and written boards doesn't really matter if you can't apply and present it in an oral boards-like fashion.

    Before you get lost in the Hines-Marschall book, get really friendly with the Yao-Artusio one. Besides the fantastic knowledge base, the way they ask and answer most of the questions is the way an attending should think.
     
    Last edited: Feb 24, 2014
  13. shift_roro

    shift_roro 10+ Year Member

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    Overall felt like a fair exam, although I thought there was somewhat more emphasis on endocrine/metabolic stuff than previous years.
     
  14. Agast

    Agast 7+ Year Member

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    the river lethe
    See, I thought that was one of the easier questions, because it asked which one was NOT part of the score. And you don't need to know the Childs-Pugh criteria to understand that AST/ALT levels are unsuitable measures of hepatic function.
     
  15. HollATme

    HollATme 2+ Year Member

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    Same could be said about cerebral salt wasting vs. SIADH - not a tough question and TBH it's something that's more dealt with than the childs-pugh score. I'm not gonna argue if one should have quickly gotten that or not, it's just something that I wasn't in particular looking into while I was studying a whole lot of other stuff. At least I know it now (looked it up after the exam). Perhaps you'll do well.
     
  16. gasblaster

    gasblaster ASA Member 5+ Year Member

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    The general consensus from my coresidents was that it was more IM heavy than we were expecting. There were more endo medicine questions that there were on inhalation anesthetics, intravenous anesthetics, or regional (maybe even combined). There were also a handful of questions out of left field that weren't going to be in any textbook or question bank.

    As a CA-1 taking the new 2 part written exam, I hope this isn't a foreshadowing of our test in July.
     
    floridaboy18 likes this.
  17. FFP

    FFP Grunt/cog/body Gold Donor 7+ Year Member

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    Read about everything that is included in the Basic part of the content outline. Then nothing will come as a surprise.
     
  18. PonyUp

    PonyUp 2+ Year Member

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    I'm not trying to piss in anyone's cheerios, but as a medicine intern that hasn't even started anesthesia yet, I felt pretty good about the test. I either knew the answer, or I didn't, and moved on. It's also easy to brush off words you've never seen in your life when you know the score you get is just going to be a benchmark.

    Regarding the proportion of medicine questions: I took step 3 the last weekend in January which I believe benefited me greatly on the medicine questions. I had less than a month to change gears toward anesthesia. I finished through inhalation anesthetics in baby miller, read the takeaway points at the chapter beginnings in morgan and mikhail up to chapter 19 the day before the test, and did a couple of old ITEs on the ABA website. I opened Hall but 99% of that was way above my head. There were 30+ repeat questions from old ITEs on this exam, and that's >10% that I could simply click the right answer and move on. Really the most important thing I did was the old questions, as they targeted concepts that would be tested, regardless of whether the question stayed the same. That and memorizing the low hanging fruit equations [time left in an oxygen tank, transfusion requirement, oxygen carrying capacity etc].

    With that said, if I was a CA2 that was several years out from my last ward month, I'd probably be frustrated.
     
  19. scudrunner

    scudrunner ASAPAC Supporter 7+ Year Member

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    When are results released?
     
  20. pgg

    pgg Laugh at me, will they? SDN Moderator 10+ Year Member

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    If you pick through the archives of SDN, you'll find this question is asked pretty routinely after ITEs. There's always a lot of medicine on it. People call it minutia but maybe the definition of minutia is just "stuff you don't often think about when doing routine lap choles and cystos" ...


    I think that's it.
     
  21. bkell101

    bkell101 UDGRAD 7+ Year Member

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    Huge emphasis on medicine. I really like the parallel FFP drew to the movie Rush.

    I walked out of the exam thinking: Reading over basic medicine step2/3 notes plus read the first 10-12 chapters of miller you would get 75% correct.

    I definitely think part 1 ABA exam is going to be even more medicine/ICU principles. Glancing at my old step 2/3 notes in the weeks prior for sure....wpw, aldosterone, urine lytes, respiratory quotients, lambert eaton physical exam...all in my old notes...
     
  22. R-35

    R-35 Member 10+ Year Member

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    Probably a month, hopefully it comes back faster this year.
     
  23. Mapleson D

    Mapleson D DBCA 7+ Year Member

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    The written boards similarly have a LOT of medicine on them.
     
  24. R-35

    R-35 Member 10+ Year Member

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    Any news on scores?
     
  25. Stellar Clouds

    Stellar Clouds Lightly Seasoned Meat 2+ Year Member

    We still haven't received ours
     
  26. GassmanMD

    GassmanMD ASA Member 5+ Year Member

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    Waiting very impatiently here... I am going to adjust my study strategy for the basic exam based on my score and won't be studying till I get it.
     
  27. Depakote

    Depakote Pediatric Anesthesiologist Moderator Emeritus Lifetime Donor 10+ Year Member

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    Our program coordinator told us we wouldn't hear for 5-6 weeks (this was about 1 week ago).
     
  28. Stellar Clouds

    Stellar Clouds Lightly Seasoned Meat 2+ Year Member

    Wow, that long? I thought that it would only be a few weeks.
     
  29. GassmanMD

    GassmanMD ASA Member 5+ Year Member

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    Wow my program coordinator confirmed 5 weeks too... Maybe they are mistaken and it's 5 weeks from the test date
     
  30. PonyUp

    PonyUp 2+ Year Member

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    I asked the coordinator at the program where I took it. She stated that she would receive scores during the 2nd week of April.
     
  31. asmith1121

    asmith1121 7+ Year Member

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    It was this time last year we got our scores. Hopefully tomorrow!
     
  32. kazuma

    kazuma ASA Member 5+ Year Member

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    Scores are back. CA2 85% using only M5 board review. On questions I missed, I read the corresponding topic in big barash and big miller. I thought it was a tough exam, I went down 5% compared to my CA1 ITE.
     
  33. HollATme

    HollATme 2+ Year Member

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    Well, crap. I guess we'll find out this following week.

    Sounds like you still rocked out. I don't think I did as well as I had done last year, and I certainly didn't hit 90%tile last year.
     
  34. Dwindlin

    Dwindlin ASA Member 7+ Year Member

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    Do CA1's take a different exam than the 2's and 3's? Apparently this used to happen in Surgery and stopped this year.
     
  35. FFP

    FFP Grunt/cog/body Gold Donor 7+ Year Member

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    Not in the past. Maybe this year, with the new ABA basic exam coming.
     
  36. R-35

    R-35 Member 10+ Year Member

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    Good to hear, I guess well find out next week.
     
  37. floridaboy18

    floridaboy18 ASA Member 5+ Year Member

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    Our scores were given back today too. 80% with only doing four and a half ace books and read through baby miller and 60% of Morgan and Mikhail (didn't read sub's as I read those when I do the coorelating subspecialty). Ca-1. Average score was a 29 for ca-1s
     
  38. PonyUp

    PonyUp 2+ Year Member

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    Is there any reason to believe our programs wouldn't have our scores yet? Is there any way I can access my score online? Didn't hear anything today.
     
  39. scudrunner

    scudrunner ASAPAC Supporter 7+ Year Member

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    Skimming the tree tops
    Does the number score you get translate across years? In other words, is a 30 as an intern equal to a 30 as a ca-2? Btw, we didn't get our scores yet either.
     
  40. R-35

    R-35 Member 10+ Year Member

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    Scores are equal, percentiles are based on your class and test. So while a 40 might be 99th as a ca1 it might be less than 90th as a ca2 etc.
     
  41. scudrunner

    scudrunner ASAPAC Supporter 7+ Year Member

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    Is there a certain score that correlates with minimum passing score for the real deal?
     
    Last edited: Apr 4, 2014
  42. floridaboy18

    floridaboy18 ASA Member 5+ Year Member

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    Our program (who hasn't had anyone failed the writtens in years) always says that a 35 is usually considered the score at which you are on a solid trajectory to pass. High 30s and low 40s you could take it that day and almost certainly pass.
     
  43. kazuma

    kazuma ASA Member 5+ Year Member

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    35 raw/scaled score or 35 percentile?


    I've heard that a >30% CA3 score can lead to a passing score but it can go either way. However, it's important to not get cavalier your CA3 year if you score>30% since every CA3 across the country is usually studying hard core that last six months and you could easily fall behind the curve. I've seen an individual score >60% on the CA3 ITE and fail the written 5 months later. Conversely, I've seen a couple individuals with single digit percentile CA3 ITE scores miraculously pull it together and pass the written boards. These are some extreme examples though. A 35 raw/scaled score would put you on a solid track to pass.

    Here are some points from this year's norm table for comparison for those that are interested.

    Raw/scaled 35= CA0 99%, CA1 85%, CA2 62%, CA3 45%
    Raw/scaled 40= CA0 99%, CA1 97%, CA288%, CA3 83%

    Interestingly, this year they also gave you a percent correct score in both the "basic" and "advanced" question categories. I would imagine this score will be helpful for the current CA1 class that is gearing up for the basic exam this July. If I was a CA1 and didn't score very high in the basic category, I'd be doing hardcore studying and good Q-bank questions everyday for the next few months. The last thing you want is your residency extended 6 months.
     
  44. asmith1121

    asmith1121 7+ Year Member

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    Interestingly, this year they also gave you a percent correct score in both the "basic" and "advanced" question categories. I would imagine this score will be helpful for the current CA1 class that is gearing up for the basic exam this July. If I was a CA1 and didn't score very high in the basic category, I'd be doing hardcore studying and good Q-bank questions everyday for the next few months. The last thing you want is your residency extended 6 months.[/QUOTE]

    Scores are out?!?
     
  45. floridaboy18

    floridaboy18 ASA Member 5+ Year Member

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    35 raw which makes sense if you look at the percentile scores that correlated in the message you posted.
     
  46. HollATme

    HollATme 2+ Year Member

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    35/62%
     
  47. kvan

    kvan 7+ Year Member

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    Got my score today.....bummer. Does anyone know how a 28 scaled score translates to a percentile score?
     
  48. FFP

    FFP Grunt/cog/body Gold Donor 7+ Year Member

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    Depends on the CA year. Not so bad for a CA-1, catastrophic for a CA-3.
     
  49. kvan

    kvan 7+ Year Member

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    I am ca-2.
     
  50. FFP

    FFP Grunt/cog/body Gold Donor 7+ Year Member

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    Under 50th percentile; anyway, not good.

    You have one year to fix it. You don't want to risk failing your written board exam.
     
  51. NightNight

    NightNight ASA Member 2+ Year Member

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    When you are looking at the rank tables, who is a PGYO (medical students??) and who is CB (clinical base year/CA-O)?
     

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