Oral Board Studying

[Idon'tknow??]

What material are people using to study for oral boards? Ho, etc? Are you reviewing Hall books etc for more detail?

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[sevoflurane]

What material are people using to study for oral boards? Ho, etc? Are you reviewing Hall books etc for more detail?

HO mainly. I like the structure. I also do 5-6 practice board stems a week.

 

[tucker27705]

I'm reading Miller, Longnecker etc.
Yeah, right.
Big Blue served me very well on writtens, so I am continuing with Big Red. I plan to attend one of his weekend tutorials and do some practice exams there. Also, someone gave me Ranger Red, 16 or so exams by him on CD. Put them on my ipod and listen on the way to work, they are decent.
Like I said I'm banking on the fact that Big Blue was dead on, so I think he knows what he is doing when it comes to board prep. Many friends rec'd Ho, but I didn't want a new outline to review. Big Red is very close to Big Blue so I transferred my own notes over to it on my first read through.
Considering the "spiels", need to work on some scripted answers for anticipated Q's.
good luck.
Tuck

 

[pgg]

I went to the Ho 2-day weekend course and followed it with the Mon-Tue must-know cases course. Overall was kind of disappointed. Wasn't a total waste because - if nothing else - it was about 45 hours of focused study time.

The book is pretty good. Too big to be a "review" book but I like the question & spoken answer format. The public mock orals were not real helpful, except maybe as a confidence booster. I'm reluctant to cast stones at anyone who volunteered to get grilled by Ho in front of 50 people, but they were all pretty weak and many were just astonishingly bad. Some of the things they said and did were incredible. In that sense it was reassuring (I'd like to think they mostly filled the pool from which failures come). There are some shaky candidates out there. I don't know how Ho can keep the poker face and not cringe when they say dangerously bizarre, weird stuff.

The private exams I did were good. I thought the experience of walking into a hotel room with a stem to face a stranger was helpful, and by the end I was somewhat desensitized to the weirdness of it all.

The must-know cases were OK. Basically gave 8 or 9 exams and received 8 or 9 exams to/from other students. Then Ho gave his answers to the scripted questions, sometimes with a short review of a topic. Most of the topic reviews I thought were rather low yield ... I was much more interested in how he handled ambiguous questions and uncertainty, not 20 minutes on the anesthetic implications of myasthenia gravis. You can pick your partners and I managed to avoid the really weak public examinees from the previous two days.

Overall the course re-highlighted a couple of areas where I know I'm weak, and really proved to me the importance of talking. Just in those 4 days I got much better at articulating answers, so I guess it was worthwhile. Still kind of underwhelmed ... glad the cost was covered by my hospital CME fund.


At this point I think the remainder of my prep will be 4 or 5 practice exams each week (probably my wife reading the questions to me), with some reading on the side. I had consistently solid and good feedback from my private examiners, and feel reasonably confident now, a couple months early.

And yet I know some awfully smart, capable anesthesiologists who failed their first time up. I think there's room for ANYONE to fail. I'll be glad and relieved when this damn thing is behind me.

 

[Arch Guillotti]

I agree with everything pgg said. I think that the review books pretty much say the same thing, and that you just need to pick a format that you like. I also think that the review books I am familiar with (Big Red and Ho) and WAAAY too detailed. I simply wasn't asked that level of detail on my exam. Fund of knowledge is EXTREMELY important, but I think that most of this is stuff that you learn during residency and studying for the ITE. The examiners want to know if you are capable and confident and can develop a proper anesthetic plan and execute it and what to do when there are complications.

I feel that a number of factors will serve you well for the oral exam:

Go to a good residency
Read a lot
Practice exams a lot
Be comfortable with speaking aloud
Be reasonable and not dogmatic
Be able to back up any decison you may make
Know when you need to cut your losses

In some ways the orals is a big mind game. Don't get psyched out. You can't expect to waltz in there without preparation and pass but if you put some time and effort into it most everyone comes out OK.

I went to the Ho 2-day weekend course and followed it with the Mon-Tue must-know cases course. Overall was kind of disappointed. Wasn't a total waste because - if nothing else - it was about 45 hours of focused study time.

The book is pretty good. Too big to be a "review" book but I like the question & spoken answer format. The public mock orals were not real helpful, except maybe as a confidence booster. I'm reluctant to cast stones at anyone who volunteered to get grilled by Ho in front of 50 people, but they were all pretty weak and many were just astonishingly bad. Some of the things they said and did were incredible. In that sense it was reassuring (I'd like to think they mostly filled the pool from which failures come). There are some shaky candidates out there. I don't know how Ho can keep the poker face and not cringe when they say dangerously bizarre, weird stuff.

The private exams I did were good. I thought the experience of walking into a hotel room with a stem to face a stranger was helpful, and by the end I was somewhat desensitized to the weirdness of it all.

The must-know cases were OK. Basically gave 8 or 9 exams and received 8 or 9 exams to/from other students. Then Ho gave his answers to the scripted questions, sometimes with a short review of a topic. Most of the topic reviews I thought were rather low yield ... I was much more interested in how he handled ambiguous questions and uncertainty, not 20 minutes on the anesthetic implications of myasthenia gravis. You can pick your partners and I managed to avoid the really weak public examinees from the previous two days.

Overall the course re-highlighted a couple of areas where I know I'm weak, and really proved to me the importance of talking. Just in those 4 days I got much better at articulating answers, so I guess it was worthwhile. Still kind of underwhelmed ... glad the cost was covered by my hospital CME fund.


At this point I think the remainder of my prep will be 4 or 5 practice exams each week (probably my wife reading the questions to me), with some reading on the side. I had consistently solid and good feedback from my private examiners, and feel reasonably confident now, a couple months early.

And yet I know some awfully smart, capable anesthesiologists who failed their first time up. I think there's room for ANYONE to fail. I'll be glad and relieved when this damn thing is behind me.

 

[Arch Guillotti]

I don't know how Ho can keep the poker face and not cringe when they say dangerously bizarre, weird stuff.

Because he is making an ASSLOAD of money off of them.

Seriously though, I had the same experience at the course that I took. Unfortunately, this small sample of test takers is a minute fraction of those who actually do take the test.

 

[IN2B8R]

I agree with everything pgg said. I think that the review books pretty much say the same thing, and that you just need to pick a format that you like. I also think that the review books I am familiar with (Big Red and Ho) and WAAAY too detailed. I simply wasn't asked that level of detail on my exam. Fund of knowledge is EXTREMELY important, but I think that most of this is stuff that you learn during residency and studying for the ITE. The examiners want to know if you are capable and confident and can develop a proper anesthetic plan and execute it and what to do when there are complications.

I feel that a number of factors will serve you well for the oral exam:

Go to a good residency
Read a lot
Practice exams a lot
Be comfortable with speaking aloud
Be reasonable and not dogmatic
Be able to back up any decison you may make
Know when you need to cut your losses

In some ways the orals is a big mind game. Don't get psyched out. You can't expect to waltz in there without preparation and pass but if you put some time and effort into it most everyone comes out OK.

Excellent advice. I would say, however, based on my experience when I took the orals several years back, that sometimes an examiner will ask in depth stuff--just the luck of the draw.... As you said, a good residency and lots of reading, along with a solid presentation is what gets you through this exam.

 

[Arch Guillotti]

Actually I pretty much agree with you. Anything is fair game, including minutiae. The good thing is that once they start drilling you on the minutiae, it probably means that you are doing pretty good otherwise.

Excellent advice. I would say, however, based on my experience when I took the orals several years back, that sometimes an examiner will ask in depth stuff--just the luck of the draw.... As you said, a good residency and lots of reading, along with a solid presentation is what gets you through this exam.

 

[Gaseous Clay]

Sorry, not meant to hijack this thread (or maybe I am), but any thoughts on the differences between previous Big Blue editions for the writtens? I have the 2005 version (I want to say 13th edition off the top of my head) and am wondering if it is worth trying to get a hold of the 2009 version. Thanks.

 

[Arch Guillotti]

I don't think it changes that much. The edition I studied from was the most recent and it seemed to have a fair amount of outdated info.

Sorry, not meant to hijack this thread (or maybe I am), but any thoughts on the differences between previous Big Blue editions for the writtens? I have the 2005 version (I want to say 13th edition off the top of my head) and am wondering if it is worth trying to get a hold of the 2009 version. Thanks.

 

[Sapdaddy]

anyone who writes oral board material knows what's up with the exam. at each exam there is a small group of board-certified attendings who are invited there to observe, learn, and report back to their residency program. they learn the "ins and outs" of that whole test, the way it's scored, how they pick the examiners, wha they are looking for, the questions, etc. it gets a pool of future "examiners" ready to go for training, and i'm sure that Ho and Jensen and now Gallagher can get to these people and get feedback on these exams so that they can structure their board courses.

my wife was lucky enough to be privy to this information when she got to go to one of these. although this was AFTER her being boarded, she is definitely an asset to her residents and board-eligible attendings.

 

[Lonestar]

anyone who writes oral board material knows what's up with the exam. at each exam there is a small group of board-certified attendings who are invited there to observe, learn, and report back to their residency program. they learn the "ins and outs" of that whole test, the way it's scored, how they pick the examiners, wha they are looking for, the questions, etc. it gets a pool of future "examiners" ready to go for training, and i'm sure that Ho and Jensen and now Gallagher can get to these people and get feedback on these exams so that they can structure their board courses.

my wife was lucky enough to be privy to this information when she got to go to one of these. although this was AFTER her being boarded, she is definitely an asset to her residents and board-eligible attendings.

Its all a bunch of bs. The oral board exam does not differentiate the good physicians from the bad ones. All it does is entrench the field of anesthesiology in further bureacracy. They need to scrap it all together and save the field a lot of headaches. I know of plenty of non board certified anesthesiologists that I would prefer over certain board certified physicians. The rite of passage that many physicians point to should be finishing residency and passing the writtens.

 

[Arch Guillotti]

This is a little too much of a conspiracy theory for me. Sometimes there is an third examiner in the room but they are there solely to observe (junior examiner, too many examiners, etc.) I doubt most examiners really know the intricacies of the scoring. Examiners do not know if you passed or failed after you walk out of the room. If you obviously rocked it, then it is a safe bet that you passed and bombing it probably means you flunked. Everybody else is in between.

I don't care if you have all the "answers" in the world. If you can't communicate effectively and think on your feet then you stand a good chance of having to repeat the exam.

I don't doubt for a second that Ho and those guys are able to pump info out of folks who have already taken the test. Ho admitted as much during his course.

anyone who writes oral board material knows what's up with the exam. at each exam there is a small group of board-certified attendings who are invited there to observe, learn, and report back to their residency program. they learn the "ins and outs" of that whole test, the way it's scored, how they pick the examiners, wha they are looking for, the questions, etc. it gets a pool of future "examiners" ready to go for training, and i'm sure that Ho and Jensen and now Gallagher can get to these people and get feedback on these exams so that they can structure their board courses.

my wife was lucky enough to be privy to this information when she got to go to one of these. although this was AFTER her being boarded, she is definitely an asset to her residents and board-eligible attendings.

 

[Arch Guillotti]

There is a lot of mystique surrounding the oral exam but after it is all said and done with I am kind of glad that we still have it and that it's tough.

I am sure there are plenty of nonboard certified anesthesiologists out there that are very skilled. However, board certification is the gold standard and if you can't obtain it then I think it raises a big red flag.

Its all a bunch of bs. The oral board exam does not differentiate the good physicians from the bad ones. All it does is entrench the field of anesthesiology in further bureacracy. They need to scrap it all together and save the field a lot of headaches. I know of plenty of non board certified anesthesiologists that I would prefer over certain board certified physicians. The rite of passage that many physicians point to should be finishing residency and passing the writtens.

 

[pgg]

Its all a bunch of bs. The oral board exam does not differentiate the good physicians from the bad ones.

I haven't taken it yet, but my admittedly data-deficient belief at this point is that

1) Some good, safe anesthesiologists have bad days and fail the oral exam. I've known a couple of great attendings who stumbled here, and I hope I'm not going to be one of them.

2) Relatively few really bad, unsafe anesthesiologists pass it. For this reason alone the oral is worthwhile.


Going to Ho's course was like walking into a surreal Twilight Zone of dodgy anesthesiologists. Some of those guys probably won't pass and probably shouldn't even be practicing - but they all managed to get through a residency and pass that written exam. Residency programs are notoriously tolerant of poor residents and the written exam can be gamed (plus you get 3 or 4 swings at the ITE before you even take it), so I don't think these two checkmarks are sufficient. I think the oral exam has a place.

 

[IN2B8R]

I haven't taken it yet, but my admittedly data-deficient belief at this point is that

1) Some good, safe anesthesiologists have bad days and fail the oral exam. I've known a couple of great attendings who stumbled here, and I hope I'm not going to be one of them.

2) Relatively few really bad, unsafe anesthesiologists pass it. For this reason alone the oral is worthwhile.


Going to Ho's course was like walking into a surreal Twilight Zone of dodgy anesthesiologists. Some of those guys probably won't pass and probably shouldn't even be practicing - but they all managed to get through a residency and pass that written exam. Residency programs are notoriously tolerant of poor residents and the written exam can be gamed (plus you get 3 or 4 swings at the ITE before you even take it), so I don't think these two checkmarks are sufficient. I think the oral exam has a place.

You have the right attitude, especially for someone who has not taken the exam yet. Best of luck on your exam.

 

[Sapdaddy]

This is a little too much of a conspiracy theory for me. Sometimes there is an third examiner in the room but they are there solely to observe (junior examiner, too many examiners, etc.) I doubt most examiners really know the intricacies of the scoring. Examiners do not know if you passed or failed after you walk out of the room. If you obviously rocked it, then it is a safe bet that you passed and bombing it probably means you flunked. Everybody else is in between.

I don't care if you have all the "answers" in the world. If you can't communicate effectively and think on your feet then you stand a good chance of having to repeat the exam.

I don't doubt for a second that Ho and those guys are able to pump info out of folks who have already taken the test. Ho admitted as much during his course.

i'm telling you, she took and passed oral boards in Boston in 2006 first try. then went back to a training course in ft. lauderdale in spring 2008. got all the scoop on how that test is set up.

or was it all a well-crafted plan to go on vacation without me???? none of you live in South Florida, right?

 

[rsgillmd]

Its all a bunch of bs. The oral board exam does not differentiate the good physicians from the bad ones. All it does is entrench the field of anesthesiology in further bureacracy. They need to scrap it all together and save the field a lot of headaches. I know of plenty of non board certified anesthesiologists that I would prefer over certain board certified physicians. The rite of passage that many physicians point to should be finishing residency and passing the writtens.

Lonestar, I beg to differ slightly. I agree it is full of headaches, and sometimes just seems totally random. I think the stories of good attendings who failed the first time around contribute to the hype of the exam. However, I do think it has a purpose of making sure people can communicate a plan and are not doing something totally egregious. When I do something a surgeon is not used to, most seem to appreciate me more when they see that I can explain my rationale.

Besides the headaches it causes us, the orals are probably also one of the few things also distinguishing us from mid-levels (educational and training background aside). I'm sure some motivated mid-levels can study and probably pass our written. I highly doubt many, if any, will be able to pass the oral exam.

 

[Lonestar]

Lonestar, I beg to differ slightly. I agree it is full of headaches, and sometimes just seems totally random. I think the stories of good attendings who failed the first time around contribute to the hype of the exam. However, I do think it has a purpose of making sure people can communicate a plan and are not doing something totally egregious. When I do something a surgeon is not used to, most seem to appreciate me more when they see that I can explain my rationale.

Besides the headaches it causes us, the orals are probably also one of the few things also distinguishing us from mid-levels (educational and training background aside). I'm sure some motivated mid-levels can study and probably pass our written. I highly doubt many, if any, will be able to pass the oral exam.

No, i believe what separates us from others is our dedication to medical education, long training and responsibility. Not some bs 1 hr exam that doesn't really help us become better physicians. Its all there to help some in the public feel more comfortable with us. There are already standards set in residency programs and majority do a good job at weeding out the bad apples. You are not going to go through 4 yrs of training with lack of knowledge and lack of clinical acumen. Thats all I am saying.

 

[Sapdaddy]

No, i believe what separates us from others is our dedication to medical education, long training and responsibility. Not some bs 1 hr exam that doesn't really help us become better physicians. Its all there to help some in the public feel more comfortable with us. There are already standards set in residency programs and majority do a good job at weeding out the bad apples. You are not going to go through 4 yrs of training with lack of knowledge and lack of clinical acumen. Thats all I am saying.

lots of learning takes place in preparation for that 1hr of bs. and that's how it makes you a better anesthesiologist. that's why we wrote a book for you. definitely wasn't for $, the book royalty advance probably broke down to 50 cents/hr of effort, and then we actually donated the advance $ to the hospital anesthesia education and research fund. although the chair did purchase 1 copy for every residency proram in the country. very nice of him. should be getting them out to you in a week.

 

[Bertelman]

lots of learning takes place in preparation for that 1hr of bs. and that's how it makes you a better anesthesiologist. that's why we wrote a book for you. definitely wasn't for $, the book royalty advance probably broke down to 50 cents/hr of effort, and then we actually donated the advance $ to the hospital anesthesia education and research fund. although the chair did purchase 1 copy for every residency proram in the country. very nice of him. should be getting them out to you in a week.

What is this book you speak of?

 

[Sapdaddy]

What is this book you speak of?

I don't think I can advertise per the TOS, but "since you asked" I think I can say this (especially if i plug SDN's bookstore here):

you can buy it on SDN. search "oral board" on the SDN bookstore. we put 2 years of our lives into this book and we think it's well worth the $50.
that is a picture of our beautiful daughter, Rachel, on the front cover. if you buy it, she will sign it for you at the ASA this october.

Moderators, is this post okay?

 

[Sapdaddy]

so, without a doubt i can tell you that those board course guys know how that test works. and to be fair, when she took the orals, she used Board Stiff, Yao, Big Red, went to 1 Jensen course, and did a lot of practicing, lots of mock orals, and also pulled out the "big books" at times. obviously you can pass without her book if thousands have done it before, hopefully it is one more tool in your toolbox, er bookshelf, including the above titles we can vouch for.

 

[maceo]

I agree with everything pgg said. I think that the review books pretty much say the same thing, and that you just need to pick a format that you like. I also think that the review books I am familiar with (Big Red and Ho) and WAAAY too detailed. I simply wasn't asked that level of detail on my exam. Fund of knowledge is EXTREMELY important, but I think that most of this is stuff that you learn during residency and studying for the ITE. The examiners want to know if you are capable and confident and can develop a proper anesthetic plan and execute it and what to do when there are complications.

I feel that a number of factors will serve you well for the oral exam:

Go to a good residency
Read a lot
Practice exams a lot
Be comfortable with speaking aloud
Be reasonable and not dogmatic
Be able to back up any decison you may make
Know when you need to cut your losses

In some ways the orals is a big mind game. Don't get psyched out. You can't expect to waltz in there without preparation and pass but if you put some time and effort into it most everyone comes out OK.

You have to know the material more than the ITE. The writtens just test recognition. The orals test understanding. So not only do you have to recognize things.. you ahve to understand. If you dont UNDERstand, you are NOT going to pass. So the whole time you study for the orals you have to know the basics cold, then have an UNDERSTANDING as to why you are inducing a patient a certain way or at least understand the pitfalls or the things that go bad before they happen..

 

[Sapdaddy]

Actually I pretty much agree with you. Anything is fair game, including minutiae. The good thing is that once they start drilling you on the minutiae, it probably means that you are doing pretty good otherwise.

the examiners are actually not supposed to pursue for factual minutiae. the ABA gives the examiners the questions the night before and are told to not do a lot of research on the topic. as long as you don't pull them down to discussing the minutiae by 1) showing off or 2) quoting specific articles, they aren't supposed to go there unless you go there first!

you still have to know the reasoning behind "why this and not that" so there is a lot of knowledge depth that you have to have, but don't fear the examiners pulling an obscure study out of their pocket and expecting you to have read it.

does that help with that fear?
btw, i'm so glad i don't do what you guys do (especially the internalization of all that acute stress), but then again i don't make 4 figures a shift!
good luck on orals!

sap

 

[Sergio99]

Hello,

I agree with Arch Guillotti's advice and everything else said on this thread.

In general, the board exam is fair. This comes from a guy that has experienced both outcomes: I have flunked it and I have passed it.

The problem is, you need to know the mechanics of the exam. They will grade you on how you plan an anesthetic, how you carry it on, how you deal with complications, how you relate to people. So, be on the watch for those situations and don't panic. Learn how to deal with them.

Since they have to see how you plan the whole thing, first they will give you a case scenario for you to work on with enough time to think about it. When they ask you "how would you anesthetize this patient?" You start by doing a preop evaluation with a history and physical exam including a full review of systems and then go on with your anesthetic plan. It doesn't need to be a long speech; just say that you do it. They want to see that you don't anesthetize someone without a full evaluation.

Then, because they have to see what you do with specific complications, they will throw them at you one by one. No matter what you do, things will go bad, because they need that for the exam: complications will happen in spite of all your precautions, because that is a part of the exam; it is built that way. They need to grade you on handling complications. Then, because of something you did or just out of the blue, your patient will go into cardiac arrest. Don't panic, that is part of the exam as well. They want to see not only how you do CPR, but your differential diagnoses and treatments in an orderly fashion as well. They need to grade you on that, too.

If after you explained something they say, "suppose you did such and such," or they want you to change your anesthetic plan, don't be quick to say, "it can't be done;" see if you can be flexible enough to do it and try to think aloud so they can see why you do or don't do what they asked you to do.

Then the surgeon will come up with some request that you may or may not satisfy. At that point they are grading you on interpersonal relationships. How do you handle that? Know when the request is such that you can satisfy by changing your anesthetic plan, and when the request is such that you have to deny it and stick to your guns.

Then, if you see that you did something you shouldn't have done, that you burned a bridge you shouldn't have burned, be quick to recognize it and backpedal your way; say, "I am sorry, I made a mistake, I should have done so and so." They may take advantage of your error and use it as another complication handling situation: don't panic; just handle it as best you can.

And be mindful that your main function in anesthesia is to diagnose what is going on and treat accordingly, not to have the monitor-syringe reflex bypassing your brain. Whenever possible, start by explaining what could have happened and how you figure it out, then act. If a situation they throw at you is such that you have to act immediately without loss of time, do it, but add to it "while I mentally do a quick differential diagnosis of such and such and such, etc." They don't want to see you running around like a beheaded chicken. They want you to think and act rationally. Of course, if you linger on differential diagnoses and never act, or if you start with a long-winded explanation of something that is fairly obvious, they will not like that, either.

And when they say to you, "don't tell us what the textbook says, tell us what you do in your own practice," they want to know whether what you do in your practice is what the textbook says or not. You should prove to them that you do in fact practice by the textbook. Remember that many of the people who are examining you at the boards may be the authors of chapters in those very same textbooks. They want to see that you heed their advice.

One more thing, if they don't let yo finish your answer, don't think you made a mistake. Once they figure out whether you know something or not, they are not interested in the rest of your answer. Once they were able to say "this chap knows the topic" or "he has no clue of what he is talking about", they will not want to hear any more of your answer; they are not there to hear you lecture. They have to move on because they have an outline, a list of questions and a time schedule to stick to.

 

[Sapdaddy]

nice post sergio!

 

[rsgillmd]

Sergio had a very good post. I just wanted to add a little to what he was saying: Listen to the question. It's a simple statement but if you listen to people taking exams you will see they make this mistake. I certainly made it, and learned from watching others.

If they ask, "What do you think?" then give a brief differential diagnosis (you'll probably get interuppted anyway). If they ask, "What do you want to do?" then give them your plan.

Ex: "You see your A-line go flat and V-fib on the EKG. What do you do?" A wrong answer would be, "V-fib in this could be caused by ...." Rather I would answer, "I would notify the surgeon and request that CPR be started. I would call for the code cart ...."

The single best piece of advice that I was given by my program director was: just picture yourself in the OR and do what you would do there. Her point is that we know what to do in real life, because we provide good care to patients everyday. Don't let the exam change that.

According to my PD, two things are pretty much certain: You will get a difficult airway situation, and you will be asked about ACLS in some aspect. Both were true for my exams.

I don't know how it was for the others, but I can tell you that I was quite nervous sitting outside the door, but once they started asking questions those 35 minutes literally flew by. I think having done tons of practice exams (especially in my perceived weak areas), having reviewed some textbook basics, and remembering my PD's advice all helped me pass the exam.

Good luck to those preparing for it.

 

[Sergio99]

...Listen to the question. It's a simple statement but if you listen to people taking exams you will see they make this mistake...

How true! Thank you for adding this, Rsgillmd. Pay attention to the questions.

...Ex: "You see your A-line go flat and V-fib on the EKG. What do you do?" A wrong answer would be, "V-fib in this could be caused by ...." Rather I would answer, "I would notify the surgeon and request that CPR be started. I would call for the code cart ...."

Excellent example. Here you have to act first, and then go on with your differential diagnosis, while the CPR is in progress, just like they teach you in ACLS.

...According to my PD, two things are pretty much certain: You will get a difficult airway situation, and you will be asked about ACLS in some aspect. Both were true for my exams...

Since we are at it, let's remind people that a very common case scenario is that of a patient needing ACLS or difficult airway management while under local or regional anesthesia, because that is a common cause for bad outcomes according to closed claims analysis. Either for something you did or something the surgeon did, the patient will stop breathing, or have a seizure, a cardiac arrest, a total spinal, or a massive intravascular or subarachnoid injection of local anesthetic, or all of the above, and you will have to deal with it, and when you want to intubate him, he will have a difficult airway. Actually, it behooves everybody to rehearse the algorithms for this situation, because this is not an imaginary situation: we are being told that it happens in real practice more often than one tends to think about it.

Variations on the theme would be the same situations with the patient prone or lateral, on fracture tables or Jackson tables, under the robot, in the MRI scanner, or pregnant.

 

[drpainfree]

I studied the Essential Oral Board Review from Michael Ho, and used Board Stiff Three sporadically, and did a few practice orals, passed it first time. It wasn't a tough exam, but definitely nerve-wrecking experience. I have to say though, if you were a diligent resident, study reasonably well during residency, put your effort into oral board prep, and practice speak out loud, you will pass.

BTW, if anyone wants to take over my books, drop me a message. They are both in brand-new conditions.

Best luck

 

[drpainfree]

I studied the Essential Oral Board Review from Michael Ho, and used Board Stiff Three sporadically, and did a few practice orals, passed it first time. It wasn't a tough exam, but definitely nerve-wrecking experience. I have to say though, if you were a diligent resident, study reasonably well during residency, put your effort into oral board prep, and practice speak out loud, you will pass.

BTW, if anyone wants to take over my books, drop me a message. They are both in brand-new condition.

Best luck

 

[Brave Sir Robi]

Took the oral boards a few years back and see alot of good advice on this thread. As for as the difficulty of the exam, that is different for everyone because it is dependent on so many factors....stem difficulty, examiner difficulty, topics recently studied, personal experience and practice, etc. So, don't put too much stock in any one person's experience....easy or hard.

The best advice is to give it your all. Every minute spent in study will make you a better doctor during the exam and beyond. I also believe the best way to study is to practice actual exams and read up on topics when you feel your knowledge is weak.

Clinical judgment is one of the attributes tested repeatedly throughout the exam. Practicing questions exposes you to multiple difficult clinical scenarios, giving you the opportunity to think them through thoroughly before the exam. During the exam is not the time mentally address a difficult situation for the very first time. The course i attended did a great job of reviewing many of the most challenging clinical situations you could face on the boards....many that i had not had to deal with in residency or clinical practice.

 

[supahfresh]

Anyone want to sell me their ranger red or spiels or audio red?

 

[mich81]

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[periopdoc]

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I can't imagine why.

- pod


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