Oral boards are coming... tips? Esp for halving my usual pt interview time?

[fiatslug]

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Oral boards coming up in June😱 (anyone else?). I'm reading Boarding Time, along with the Clinical Study Guide for the Oral Boards in Psychiatry. I work in a partial hospitalization setting, so most days I'm doing at least one intake, and I'm comfortable with the biopsychosocial formulation. But I take 50-65 minutes to do a thorough intake, and I'm not sure how I could possibly halve that for the oral boards!! I know I write down too much now when I'm doing an intake, and will work to stop doing that over the next couple of months--hard habit for me to break.

Any tips to streamline the interview? Obviously I'll have to be much more directive than I am in typical practice.

Other advice in general?

I'll have the opportunity to do several mock board exams with colleagues who intimidate me, so that's all good

 

[whopper]

I figure practice, presenting cases to colleagues, and thinking what to do in worst case scenarios ahead of time are the best weapons.

 

[nitemagi]

I'm probably an inappropriate respondent since my year is the first to not have to take the orals (it's built into our residency).

But, I would say find a model of the most efficient psychiatrist you know and see if they can model an interview for you. Then translating the outpt clinic breakdown (5/10/5) into this, use the first 5 minutes for open ended questions, the next 10+ for focused historical questions, redirecting as needed. How quickly are you forming a differential? Are you maintaining a good therapeutic alliance if you have to interrupt? Are your questions formulated in a way that the patient can give specific answers, and are your questions always pertinent to the differential?

 

[Manicsleep]

Here is something that I think helped me. I say think because although I thought I did well on the oral boards, I was not sure if I was going to pass or fail.

I put up 2 peices of paper on 2 chairs and drew the most boring looking faces on them. Then I presented a variety of patients to them. I also made up questions that may be asked of me and presented them. This was in addition to presenting to colleagues and attendings who gave feedback.

Record your interviews with patients and try to do this multiple times. I don't know why this isn't done more in training programs but its an excellent way to teach and learn. It forces you to be on the top of your game. The more you do it your 'game' gets better. Its actually good for more than just the test but for actual clinical skills. Its particularly good for teaching dynamic and analytic therapy.

 

[michaelrack]

according to this course http://www.beattheboards.com/, you're not supposed to practice on your own pts. A board interview is completely different from an intake interview.

 

[Majesty]

When I was in residency we practiced on patients all the time.
I even went back to my residency to practice on patients 2 weeks before my oral boards. You have to get informed consent but there is nothing wrong with it as far as I know.

We were forced to interview patients with a camera for psychotherapy in residency, every resident did it and thats how we were supervised. I actually didn't like it very much at the time, especially when certain supervisors would give me an exasperated look. It was worth it though.

The beat the boards course just wants you to pay money to take their course. I took that course and it is filled with a lot of people who are not good english speakers, have failed before or like me are very very anxious about that test. I think it has something to offer but generally it is not for the average psychiatry resident. I did not find it useful after the fact but it did alleviate my anxiety because I was doing something to prepare.

 

[michaelrack]

When I was in residency we practiced on patients all the time.
I even went back to my residency to practice on patients 2 weeks before my oral boards. You have to get informed consent but there is nothing wrong with it as far as I know.
.[/I]

practicing on pts is good, they just shouldn't be your own pts.

 

[Majesty]

I practice on every one of my patients. I thought all physicians did that.

Physicians Practice Medicine, Attorneys Practice Law...etc.

If I get something else out of it, like preparation for boards, that is considered unethical? I feel like I am missing something here. Didn't everyone do this in residency?

 

[michaelrack]

I practice on every one of my patients. I thought all physicians did that.

Physicians Practice Medicine, Attorneys Practice Law...etc.

If I get something else out of it, like preparation for boards, that is considered unethical? I feel like I am missing something here. Didn't everyone do this in residency?

nothing to do with ethics. the boards are not "real life"- a good board interview has little in common with a good clinical interview- 2 different skill sets. practicing for the boards with your own pts is like practicing figure skating with speed/racing skates

i drank the beat the boards koolaid

 

[michaelrack]

I Didn't everyone do this in residency?

in a good residency mock orals are done with another resident's/doctor's patient

 

[Majesty]

in a good residency mock orals are done with another resident's/doctor's patient

Yeah...but then you talk to them while cross covering etc. I get your point though.
Also, we recorded our selves in psychotherapy sessions (but i see how thats not really mock board style interviews).

I drank the BTB kool aid as well and I didn't like the taste. So I tell the younger kids to stick with the nutrition of what's in their own backyard....did I kill the analogy yet?

 

[Doc Samson]

Oral boards coming up in June😱 (anyone else?). I'm reading Boarding Time, along with the Clinical Study Guide for the Oral Boards in Psychiatry. I work in a partial hospitalization setting, so most days I'm doing at least one intake, and I'm comfortable with the biopsychosocial formulation. But I take 50-65 minutes to do a thorough intake, and I'm not sure how I could possibly halve that for the oral boards!! I know I write down too much now when I'm doing an intake, and will work to stop doing that over the next couple of months--hard habit for me to break.

Any tips to streamline the interview? Obviously I'll have to be much more directive than I am in typical practice.

Other advice in general?

I'll have the opportunity to do several mock board exams with colleagues who intimidate me, so that's all good

Mock boards are the key to success. Otherwise, pick up a few moonlighting shifts in a busy psych ED - 30 minutes is a LONG interview in that setting.

 

[fiatslug]

I do work in the ED every few weeks--good for brevity 👍. I'm just afraid I'm going to get through the psych hx and maybe the med hx and it'll be over!😱