I know this topic has been posted about quite a bit in the past but I'd like to share my experience and get some advice. I took the oral boards last year and unfortunately ended up failing my first exam ever. I began studying around 4 months out and my main study schedule focused mostly on UBP and repeatedly practicing its' stems out loud with colleagues while supplementing my knowledge base in areas I felt weak using Yao & Artusio and Big Red. I also would listen to anesthesia-related podcasts/audio files while driving, at the gym, etc. I was basically living and breathing anesthesia for that entire study period. By the end of it, I had gotten through all of UBP three times and felt prepared to be able to tackle its' stems. In addition to this, I did a few practice exams with real oral board examiners at my institution. Generally, the advice I got from them was that my knowledge base was strong but that I was being ultra-conservative (which I guess I was modeling after UBP) in my answers and that I should try to answer questions how I would actually do the case in real life rather than essentially reciting the textbook approach. I'm now unsure whether or not this was good advice. Without giving away any specifics, on test day itself, my preop/intraop stem was like something out of a dream. It was a topic that I knew cold. A case I had personally done dozens of times and one that I happened to have recently reviewed. I literally could feel the stress melt away when I read it and couldn't believe my luck. My balloon was deflated, however, when the patient ended up having a "kill-sequence" type complication during induction which I treated accordingly (and would still treat the same way today in real life) but my examiner kept perseverating on a specific portion of the treatment and not moving on despite the fact that I had answered the question. I thought that maybe they wanted a better explanation so I restated my answer again and explained exactly why I am choosing the route that I did. And then...the examiner re-asked the same question again. I even quickly jotted down the question word for word on my scrap paper to make sure I wasn't having a brain fart and misunderstanding. At this point, I was confused and unsure whether or not they were trying to "help me" go down a different route or just testing to see how I function under pressure. I went with the latter and re-stated my answer again and tried to use other facts to support it. While I can't restate the specific scenario, it was such a bread-and-butter classic complication that I still really don't see what else I could have said. Finally, we moved on but it almost felt like that kind of set the tone for the rest of the stem despite not really having any more situations like that. My intraop/postop stem was a more complex patient but nothing insurmountable that I wasn't prepared for. However, the case itself was non-urgent/emergent and the patient was glaringly not optimized for surgery based on the stem. I recalled reading in Jensen something along the lines of "Many test-takers have failed for allowing their patient to go intraop at the persuasion of the examiners" and to make sure to bring up your concern even if the examiner doesn't lead that way. So before starting off with induction, I mentioned that this patient could probably be much better optimized before proceeding with this non-emergent case and then defended why I felt that way. The examiners did not seem pleased (though, that may be my read of the situation) that I was veering off course. Doing this was probably a mistake in retrospect but that line from Jensen had really stuck with me and I didn't want to fail for not mentioning something that seemed wrong to me. I guess it ended up biting me. Leaving the exam I felt that it could have gone either way. While I was extremely concerned about the above-mentioned things, much of the rest felt like it went well and I only had to say "I'm not sure" a couple of times. Devastatingly, I ended up failing. Anyway, that leaves me where I am now having to retake this exam again soon and I really don't know what else to do. I've already gone the UBP/constant practice out loud route last time and don't feel comfortable doing the exact same thing again. I feel like I need more help 'playing the game' rather than more knowledge. I would like to take a course but I am unable to decide which one is best. One that I was heavily considering seems to be heavily shilled (on these forums, especially) with its' greatest proponents clearly getting kickbacks or being involved with the course based on their post history and ingenuity of responses. Anyone that's not a spambot have any good recommendations?