ITE preparation

[titanjones]

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So what are you people using for preparation for the ITE?? I already know about hall. BUt some say read faust (sooo old!), and other say just keep reading Morgan and Mikhail..what are YOU doing to prepare?
😕😱😕

 

[Impromptu]

Stretches, so my back doesn't kill me after sitting in those smaller than normal desk/chairs, wtih foldover desktops that don't allow for 1 full sheet of paper (let alone a test and answer key), with desktops that don't lay flat because my legs are too tall.

 

[pgg]

So what are you people using for preparation for the ITE?? I already know about hall. BUt some say read faust (sooo old!), and other say just keep reading Morgan and Mikhail..what are YOU doing to prepare?
😕😱😕

I think most here would agree that if you're going to prepare for a specific test, you should spend a lot of your study time doing questions.

Hall. The old mid-1990s ITEs (available free at asahq.org). I thought Big Blue was pretty high yield.

 

[PMPMD]

ACE exams! I love these things!

 

[nycitygas]

I'm taking it for the first time, but I plan on rereading Hall baby miller which did wonders for the AKT. Not sure if I'll have time for the old ITE questions, anyone have any experience with how high yield they are?

 

[titanjones]

ACE exams! I love these things!

what is ace exams? im not familiar with this, and google is not helpful

 

[titanjones]

i guess ill buy big blue..

 

[michigangirl]

millions of threads on how to prepare for the written boards-- so all of them apply to preparing for the ITE-- just on a much smaller scale since the scores don't really matter.

Faust or Big Blue-- very high yield for all the informational topics.
Hall for questions
old ABA exams

again, don't spend too much time studying for ITEs-- they real high yield studying will come right before the real exam.

 

[Bertelman]

what is ace exams? im not familiar with this, and google is not helpful

search the ASA website.

 

[PMPMD]

ACE exams are a series of practice exams put out by the ABA. They have well-referenced explanations for the questions.

 

[amyl]

ACE exams are a series of practice exams put out by the ABA. They have well-referenced explanations for the questions.

i read a standard anesthesia book on a regular basis... lately its been longnecker. now that the ite is around the corner its big blue and hall all the way.

 

[pgg]

again, don't spend too much time studying for ITEs-- they real high yield studying will come right before the real exam.

I disagree. Partly because my program was very interested in how we all did on the ITEs, and those who underperformed were hazed (for lack of a better word). Partly because I've never regretted doing well on a test. Partly because after 3 years of smoking ITEs the actual written exam was a low stress event.

 

[ymgc]

Does this test have any importance for interns taking it? Why do programs even make us take it? any insight would be much appreciated.

 

[pgg]

Does this test have any importance for interns taking it? Why do programs even make us take it? any insight would be much appreciated.

I thought it would be kind of useful in that you see the material in a test environment one extra time. Used to be that the ITE and the actual written were the same exam, with people taking it for credit sitting 3 feet away from people taking their first ITE. In retrospect though I don't think it was worth the loss of a Saturday when I took it pre-CA1. It's kind of like having students take a mock USMLE Step 1 on their first day of medical school.

Unless you're in a categorical program where you've done some anesthesia recently, I can't imagine that your program would get upset if you scored poorly on it. If you're not coming off a CA0 year I wouldn't make the slightest effort to "prepare" for it or sweat the fact that you'll be utterly lost on 80%+ of the questions.

 

[Narcotized]

So what are you people using for preparation for the ITE??

Absolutely nothing. Focus on learning anesthesia and you won't need to study for ITE's. Test scores will reflect what you've done during the year. For day to day year-round studying you can't go worng with Eminem (Morgan and Mikhail).

 

[Arch Guillotti]

again, don't spend too much time studying for ITEs-- they real high yield studying will come right before the real exam.

This is silly, some programs won't let you moonlight unless you have a decent score on the ITE.

 

[lord_jeebus]

I think the ITE matters, at least for some people. All of my fellowship (pain) apps ask me to submit my score. Some programs are already accepting applications, so they may initially see only my CA-1 score.

There was also a resident at my program who had graduation delayed for a particularly poor ITE score.

As for getting a high score (I was able to do very well last year), I recommend Big Blue highly, Hall almost as highly, and Faust with some reservations. The retired ASA questions are still very representative of the current ITE. I've sat down with Baby Miller for the first time since the beginning of CA-1, and I think reviewing this for the ITE instead of Big Blue would also work very well. What I thought was just trivia when I first read it turns out to be very testable trivia, and it's remarkably high yield.

Of course, no review books will make up completely for not reading during the course of residency.

 

[michigangirl]

Disagree if you will. I think it's a waste of time to do actual book studying specifically for the ITE. Like Narcotized stated, focus on learning anesthesia and read for your cases, like you normally would to LEARN anesthesia-- it will show on your ITE-- if your program gives great weight to the ITE and you're in danger of getting kicked out, not getting advanced to the following year, not being able to moonlight, then so be it, study your A#s off. But my program didn't judge people based on it-- in fact, till a couple years ago, people had to take it post-call. so that says it all to me- guess this is an outlier.

This is silly, some programs won't let you moonlight unless you have a decent score on the ITE.

 

[pgg]

Disagree if you will. I think it's a waste of time to do actual book studying specifically for the ITE. Like Narcotized stated, focus on learning anesthesia and read for your cases, like you normally would to LEARN anesthesia-- it will show on your ITE

One of the things I was told as I was checking in at my residency program was that it is possible to be a "good resident" - manifested by being on time, having a good attitude, being an attentive mental sponge during cases, reading about your cases, working hard, volunteering/asking for bigger cases, honing your monkey skills, actively participating in journal clubs and PBLDs, all those things that are the hallmark of a good resident - and still fail the written exam.

About 20% of first time takers fail the ABA written exam. One in five takers are not *****s who flake on their basic case prep for three years.

It's probably enough to just learn anesthesia and be a good anesthesiologist. But a board failure is a life and income altering event. The written exam and ITE are nearly identical standardized exams, with all the quirks and minutia standardized exams have, and my personal opinion is that it's awfully bold (even arrogant) to blow off three free practice swings at the exam because you expect to be prepared after three years of being a good resident.

Train like you fight. Own the ITEs and the actual written exam will be a low stress formality.

Besides, however much it appears that your program doesn't care about your ITE score, people will notice and treat you differently if you score high. When you screw something up as a resident, it may be the difference between attendings thinking "oh he just had an off day" vs "lemme tell you what that bonehead did the other day" ...

 

[Bertelman]

Disagree if you will. I think it's a waste of time to do actual book studying specifically for the ITE.

Like Jeebus said, you will be submitting these for fellowship apps. Treat the ITE appropriately.

 

[chocomorsel]

One of the things I was told as I was checking in at my residency program was that it is possible to be a "good resident" - manifested by being on time, having a good attitude, being an attentive mental sponge during cases, reading about your cases, working hard, volunteering/asking for bigger cases, honing your monkey skills, actively participating in journal clubs and PBLDs, all those things that are the hallmark of a good resident - and still fail the written exam.

About 20% of first time takers fail the ABA written exam. One in five takers are not *****s who flake on their basic case prep for three years.

It's probably enough to just learn anesthesia and be a good anesthesiologist. But a board failure is a life and income altering event. The written exam and ITE are nearly identical standardized exams, with all the quirks and minutia standardized exams have, and my personal opinion is that it's awfully bold (even arrogant) to blow off three free practice swings at the exam because you expect to be prepared after three years of being a good resident.

Train like you fight. Own the ITEs and the actual written exam will be a low stress formality.

Besides, however much it appears that your program doesn't care about your ITE score, people will notice and treat you differently if you score high. When you screw something up as a resident, it may be the difference between attendings thinking "oh he just had an off day" vs "lemme tell you what that bonehead did the other day" ...

Agreed completely. I scored poorly and the way I'm currently being treated is a sure sign of it. It does matter even if they say it doesn't. Don't trust them. Certainly studying this time around. You do well on the exam and can get away with almost killing a patient and you do poorly, every screw up gets magnified 10X. I know this first hand. Doesn't matter how good of a resident you are otherwise. Not just speaking from personal experience. I've spoken to other residents who've confirmed this bias.

 

[Narcotized]

My personal opinion is that it's awfully bold (even arrogant) to blow off three free practice swings at the exam because you expect to be prepared after three years of being a good resident.

That's not quite an accurate representation of what I'm saying. I say absolutely make the most of those 3 free swings at the exam. But I'm saying if you learn anesthesia during the year then there will be no need to "study" for the ITE's.

I was not a particularly good college or med student. High test scores, lots of fun, lots of cramming, average grades, marginal applicant. I wasn't an outstanding over-the-top studier in residency either, but I was very consistant and put away previous habits of procrastination. I did a little everyday, and if you do that ITE's will reflect it. Your scores will raise eyebrows and you will moonlight, get the heat off of you, get fellowships, or whatever else your goal is.

You have an entire year between ITE's to know one book really well (whichever book you choose). That's not asking too much. And even the "bad test takers" out there will amazingly become good test takers if they get on a disciplined reading plan. No ITE studying necessary. I'm doubtful anybody but the most minimal of exceptions that was smart enough to get in and complete an anesthesia residency and then failed the written exam was actually a reasonably read resident during his training.

I'm not bashing anyone that failed the exam. I'm just saying if they are honest with themselves they will most likely admit they didn't read consistantly during their training. The people I know that failed didn't. In fact, most of the ones I know that didn't do jack during their training still passed if they crammed really hard at the end.

 

[Arch Guillotti]

agree, I think that there is a lot of upside to doing well on the test and there is a downside to doing poorly. I think that blowing it off is a bad idea. Cramming at the end is high yield but it sure makes life easier when you are rereading rather than reading for the first time.

One of the things I was told as I was checking in at my residency program was that it is possible to be a "good resident" - manifested by being on time, having a good attitude, being an attentive mental sponge during cases, reading about your cases, working hard, volunteering/asking for bigger cases, honing your monkey skills, actively participating in journal clubs and PBLDs, all those things that are the hallmark of a good resident - and still fail the written exam.

About 20% of first time takers fail the ABA written exam. One in five takers are not *****s who flake on their basic case prep for three years.

It's probably enough to just learn anesthesia and be a good anesthesiologist. But a board failure is a life and income altering event. The written exam and ITE are nearly identical standardized exams, with all the quirks and minutia standardized exams have, and my personal opinion is that it's awfully bold (even arrogant) to blow off three free practice swings at the exam because you expect to be prepared after three years of being a good resident.

Train like you fight. Own the ITEs and the actual written exam will be a low stress formality.

Besides, however much it appears that your program doesn't care about your ITE score, people will notice and treat you differently if you score high. When you screw something up as a resident, it may be the difference between attendings thinking "oh he just had an off day" vs "lemme tell you what that bonehead did the other day" ...

 

[Narcotized]

About 20% of first time takers fail the ABA written exam.

I suspect that is a very non-uniform number; that most programs have minimal problems with written passage, and that the problem lies mostly with malignant programs (ie, no reading time) and the small number of really really bad programs (ie, not the highest of applicant to begin with).

 

[Arch Guillotti]

I suspect that is a very non-uniform number; that most programs have minimal problems with written passage, and that the problem lies mostly with malignant programs (ie, no reading time) and the small number of really really bad programs (ie, not the highest of applicant to begin with).

Per the ABA newsletter, 92% of first timers passed part one in 2009. All repeaters had a pass rate of around 50%. The total cohort had a pass rate of about 80% it appears.

 

[nycitygas]

I wouldn't stress the ITE too much as an intern. Taking and passing your step 3 is of utmost importance (some programs will not let you advance until you have passed it). The next key thing is to spend June before you start studying for your initial AKTs. Reputations in programs are made the first few months of residency and having high scores can only help. The first 25 chapters in baby miller and the corresponding Hall questions are absolutely money.
One thing all medical students should be aware of is the amount of studying an anesthesia residency pertains. In your first six months, you'll likely take 3 AKTs and then an ITE in March. Anybody can learn how to intubate, its knowing what to do when **** hits the fan that differentiates us from other mid-level providers.

 

[Narcotized]

Per the ABA newsletter, 92% of first timers passed part one in 2009.

I know this won't be a popular opinion, but I feel 8% is too low a standard when you see how many CA-1's have passing scores after just one year and haven't even taken any subspecialties, and when you reflect on the screwups you knew that packed in a couple of months of big blue at the end and passed.

Kind of a strange system. They go from a, if you put in the time you will pass written exam, to an, almost anybody on a bad day could possibly fail oral exam.

 

[pgg]

Arch thanks for clarifying the 1st timer pass rate vs the all-comer pass rate which I erroneously posted ...

I know this won't be a popular opinion, but I feel 8% is too low a standard when you see how many CA-1's have passing scores after just one year

I sort of agree with you. The large number of CA-1 passes make me go ... but I don't think 8% fail is unreasonable.

We have reason to believe the ABA actually has a threshold standard since during the dark years of the specialty they were failing upwards of 50% of takers. They didn't just set the curve at X% and leave it at that.

 

[johncunningham]

I'm a couple of years out.

During residency there was a long standing divide between the "golden boys" and the "blacksheep". Some of that was due to personality, but a lot of it stemmed from a perception that some people were better residents than others. Admittedly a lot of that perception came from day to day work interaction in the OR but some (maybe a lot) came from inservice scores. I know for a fact (from my time as chief resident) that poor performers on the written exams were well known to all faculty members. Doing well on the exam is important. As proof... CA3's who scored a passing grade on the inservice were awarded a cash stipend that covered the actual written exam fees upon graduation. Poor performers were offered remediation and were occasionally prevented from advancing.

How do you do well? Old well worn advice:
-read every day, for every case from a real text. Not just Lange or Hall or Faust
-flip through a good review book in the weeks before the exam. you ned to refresh your memory of all the random tidbits that you don't think about on a daily basis. I liked Faust.

One last tidbit for current residents: Get real, meaningful feedback on a daily basis. Easier said than done, but really try to guide the faculty in helping you to see where you could have done better and what concepts they think you are missing. Seriously, at the end of every day try to go over a couple of key concepts. By the end of 3 years you will be golden.

John

 

[Laryngophed]

I know I'm as low on the totem pole as it gets, but why would one ever want to perform sub-optimally on an exam?

 

[michigangirl]

Couldn't have said it better-- but it looks like you and I are in the minority here Narcotized. Either way, for those of you who think we are saying "blow it off"-- we are not-- we are just saying don't go crazy studying specifically for the ITE, just learn anesthesia and it will all pay off in the end.

That's not quite an accurate representation of what I'm saying. I say absolutely make the most of those 3 free swings at the exam. But I'm saying if you learn anesthesia during the year then there will be no need to "study" for the ITE's.

I was not a particularly good college or med student. High test scores, lots of fun, lots of cramming, average grades, marginal applicant. I wasn't an outstanding over-the-top studier in residency either, but I was very consistant and put away previous habits of procrastination. I did a little everyday, and if you do that ITE's will reflect it. Your scores will raise eyebrows and you will moonlight, get the heat off of you, get fellowships, or whatever else your goal is.

You have an entire year between ITE's to know one book really well (whichever book you choose). That's not asking too much. And even the "bad test takers" out there will amazingly become good test takers if they get on a disciplined reading plan. No ITE studying necessary. I'm doubtful anybody but the most minimal of exceptions that was smart enough to get in and complete an anesthesia residency and then failed the written exam was actually a reasonably read resident during his training.

I'm not bashing anyone that failed the exam. I'm just saying if they are honest with themselves they will most likely admit they didn't read consistantly during their training. The people I know that failed didn't. In fact, most of the ones I know that didn't do jack during their training still passed if they crammed really hard at the end.

 

[Bertelman]

Couldn't have said it better-- but it looks like you and I are in the minority here Narcotized. Either way, for those of you who think we are saying "blow it off"-- we are not-- we are just saying don't go crazy studying specifically for the ITE, just learn anesthesia and it will all pay off in the end.

I think the rest of us are saying, at the very least, you should be working practice questions prior to the exam. I don't think it's a revolutionary idea to use MC questions to prepare for an exam that is..... MC questions.

That's what I would call "studying for an exam." If there are some that can pass the boards without ever cracking a practice question source, then great. That's not really representative of most anesthesia residents.

I also believe standardized exams often test minutiae that are generally irrelevant for the average practitioner on a day-to-day basis. You can bone up on every page in Miller, or you can work a few practice exams and realize these questions seem to reappear. One way seems to be more efficient for me, the other seems to be more efficient for you.

 

[phantom77]

Morgan and Mikhail is all you need. I destroyed that exam every year I took it using ONLY that book. I'm not suggesting that you never pick up another book as obviously for general knowledge development its good to read different sources, but for the sole goal of doing great on the ITE that's all you need.

 

[Salt Creep]

I know I'm as low on the totem pole as it gets, but why would one ever want to perform sub-optimally on an exam?

If you're a CA-0/1, you can demonstrate marked improvement. I didn't intentionally throw the exam the first couple times, but I didn't exactly work hard on it either.

 

[Narcotized]

Morgan and Mikhail is all you need. I destroyed that exam every year I took it using ONLY that book. I'm not suggesting that you never pick up another book as obviously for general knowledge development its good to read different sources, but for the sole goal of doing great on the ITE that's all you need.

Great advice. Pick a book like M & M. Master it over a year (One book. How many books did we have to read in a year for medical school?). Sprinkle in other sources, and I agree some questions are very helpful learning aids as well as getting used to test format.

Learn anesthesia; not "studying" for the tests. Result: smoke ITE's and writtens. Just try it before you bash it. Everyone I know that has set the goal of learning anesthesia through very modest consistant discipline has blown away tests without using big blue gimmick books and courses for last minute cram study.

 

[GoBroncos!]

when do these results come back?

 

[hippuppy]

I thought I would bump this thread since ITE scores were trickling in and we got ours this week.

I did poorly, not because I wasn't reading but more ( I think ) because I wasn't studying properly. I am certainly concerned how I will be treated now. I believe I am perceived as a good resident, at least this is how I have been treated up to this point in my CA-1 year by faculty and upper levels.

Now I have an objective measure and it isn't a good one.

Ay advice on how to improve for next year? I thought focusing on the keywords from this ITE and the AKTs, re-read M&M or focus on the new Baby Miller, do Hall and ACE/ABA questions.

Any thoughts? Anybody turn things around?

Thanks in advance.

Hip

 

[Bertelman]

I thought I would bump this thread since ITE scores were trickling in and we got ours this week.

I did poorly, not because I wasn't reading but more ( I think ) because I wasn't studying properly. I am certainly concerned how I will be treated now. I believe I am perceived as a good resident, at least this is how I have been treated up to this point in my CA-1 year by faculty and upper levels.

Now I have an objective measure and it isn't a good one.

Ay advice on how to improve for next year? I thought focusing on the keywords from this ITE and the AKTs, re-read M&M or focus on the new Baby Miller, do Hall and ACE/ABA questions.

Any thoughts? Anybody turn things around?

Thanks in advance.

Hip

How exactly where you studying before? What books were you using? Practice Questions?

 

[hippuppy]

I read most of M&M in the early months of residency prior to junior core lectures. I read up on my cases in Anesthesiologist manual of surgical procedures and disease specifics in Co-existing dz. about 1 month out I started reading Hall, which I should have started much earlier.

Perhaps focusing on baby miller, doing questions regularly and making a study document with the keywords I missed is how I am going to approach it. Unless I get good advice otherwise.

 

[HollATme]

What constitutes as poorly?

 

[hippuppy]

In my opinion, less than the 20% percentile. Depends on your goals/expectations I guess.

 

[HollATme]

In my opinion, less than the 20% percentile. Depends on your goals/expectations I guess.

How did you do as an intern? Better or under 20th percentile, as well? I scored a 28th percentile, but I'm just an intern and I understand the scale varies per class year and year to year. Last year's scaled scores seemed to correlate to a much higher percentile.

 

[Bertelman]

I read most of M&M in the early months of residency prior to junior core lectures. I read up on my cases in Anesthesiologist manual of surgical procedures and disease specifics in Co-existing dz. about 1 month out I started reading Hall, which I should have started much earlier.

Perhaps focusing on baby miller, doing questions regularly and making a study document with the keywords I missed is how I am going to approach it. Unless I get good advice otherwise.

Manual of Surgical procedures and Co-existing Dz are low-yield for ITEs. I like Co-existing, but that is focused on medical problems. Not a big fan of Surgical Procedures, but even the folks that like that book would probably say it is low-yield for standardized exam purposes. Many many pages of text without much testable material.

I'm guessing you are a CA-1. M&M is good, so I would suggest sticking with that book and choosing to read it again if you like it, or try Baby Miller. Pick one of those, and read it before your next exam.

You also need practice questions. Hall is good, so are the ACE questions. I would say you should knock them both out before you take your boards, but just pick one before your next ITE. Should be able to do Hall at least once, and read one of your texts before the next go-round.

 

[hippuppy]

I did my internship in surgery in 2006, then was a flight surgeon in the Navy for four years before returning to academics in July'11 as a new CA1 so this was my first ITE. The percentile score between CB residents (like we have at our program who actually get anesthesia in their first year) and CA-1s was greater than a 40 percentile difference. Amazing.

I will also be picking up the new Faust when it comes out in early 2013( actually preordered it on Amazon)

 

[SitraAchra]

.

 

[pgg]

There's some overlap between "studying to learn anesthesia" and "studying for a specific written exam" ...

But once you've decided that doing well on a test is important and have set aside time to specifically do test prep, it's my feeling that practice questions should be your primary source, and you should only go to texts for focused reading to understand why the right answer is right and why the wrong answers are wrong.

This is maybe not the best way to "learn anesthesia" but all exams are, to some extent, a game.


The AKTs can be gamed to some degree (especially the AKT-1 and -6) because they don't cover "everything" the way the ITE does. The company publishes a test outline. Eg, time spent preparing for the AKT-6 would be better spent looking at machine diagrams in Baby Miller than the pediatric chapters of Big Miller.

 

[PMPMD]

I used Barash, Faust, Hall and ACE questions and did very well on the ITEs.

 

[PMPMD]

Manual of Surgical procedures and Co-existing Dz are low-yield for ITEs. I like Co-existing, but that is focused on medical problems. Not a big fan of Surgical Procedures, but even the folks that like that book would probably say it is low-yield for standardized exam purposes. Many many pages of text without much testable material.

Agree. Joffe is good for real life but not ITEs. And Coexisting dzs is more of an oral boards book (I hope; will find out in < 6 months).

 

[HollATme]

I used Barash, Faust, Hall and ACE questions and did very well on the ITEs.

Barash big book or handbook?

 

[PMPMD]

Barash big book or handbook?

The big dog. The whole Paul G.

I used this for primary reading, not just board prep.