Take this advice with the usual caveats as I am currently studying for orals.
# 1: Start studying early (like January)
# 2: Get a reliable group of study partners (preferably > 3 and preferably from multiple institutions)
# 3: Get yourself a reliable set of Power Point slides (should be ~ 8 total, one from each subsite) from a major institution (MDACC, MGH, and UCSF ones are all good) and work on updating them to the year you are taking oral boards
#4: Go to the Spring Refresher as many of that year's oral examiners will be presenting; alternatively, if you can't make it to the Spring Refresher then try to get as many old ones as you can (I believe you can pay for these through ASTRO)
#5: Go to at least one mock oral boards (preferably given by people who have oral boards testing experience)
#6: Practice verbalizing your answers and have "templates" for what you are going to say for commonly tested scenarios (e.g. CSI, three field breast, Gyn Brachy, Prostate Brachy); this is not a multiple choice exam where you can flag a question and come back later; it is VERY important to practice saying the correct answers out loud
#7: NCCN guidelines are the ultimate yardstick of what is considered "acceptable" treatment in the United States; I would be extremely hesitant against recommending something that was not in the NCCN
#8: In general it is better to say the way you actually treat patients (e.g. if you routinely do IMRT for anal cancer don't say I do AP/PA); they may ask you follow-up questions which can only be answered by someone who actually practices what they are proposing
With regards to Osler, I've heard polarizing opinions. Either it sucks or it was really good. If you don't have reliable study partners, have no opportunity to take mock oral boards, or started studying really late then Osler may be worth it for you.
