Oral Boards Resources 2024 ed.

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Jan 24, 2017
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Been meaning to do this for a while. There's a lot of resources out there, even on SDN, but not really in one place. Hopefully this will help some of you out. I will try to periodically update this.
If you're reading. You fall into one of these four groups.

1. Those of you who just finished residency, and passed your advanced exam. congratulation! You're on your way to become a board certified anesthesiologist. probably can skip to the main resources section.

2. Those of you who passed both parts on the first try congratulation! You were well prepared for this!

3. Those of you who passed the second time, after a prep course or two, congratulations! Your additional inputs can help the future board certified anesthesiologists.

4. Those of us who had to repeat parts of it on multiple attempts, (SOE and/or OSCE), the experiences can be time, energy and money consuming, PTSD developing, anxiety provoking, demoralizing and even soul crushing. The nagging from the hospital; sometimes even getting ghosted from the locum companies can be rather unpleasant. Most importantly, the shame, shame, and shame, both professionally and personally; suffering alone, unable to share with other people.
The typical answers I've heard from well meaning partners, friends even prep courses.
I. Just memorize (Whatever resources)...
II. Just take a prep course
III. Just tell them what you would do in a real case
IV. Just do enough mocks, so you know what they would ask
V. Just be desensitized, so you don't feel anxious
VI. Just write down everything you think they'd ask.
These comments didn't help.

The rest of the post is for group 1 and 4.

One of my partners, who was a board examiner, kept emphasizing this is NOT a knowledge exam. "You've been tested with Step 1-3, then basic exam, advanced exam, now it's time for the applied exam." He was always adamantly opposed for me to take any prep course, because he felt they may teach me the wrong things. His pet peeves were "do a focused history and physical...". "Do you talk like that at work?", he would ask.

I still took plenty of prep-courses for various reasons, because even as an ex-board examiner, Dr. K was not able to tell me explicitly why I failed.

This is not meant to be a comprehensive review, but more as a primer for those who want to know quickly some of the things these course can offer.

Niels Jensen - Big Red (Anesthesiology Boards)
Pros -
OG of prep courses
Organized in a way that I can conceptualize and keep them organized
Focused on scripts, so you can use them if you are in a jam
Cons -
He has been doing this for a long time, wouldn't rely on him for any OSCE related material
With a memorized script. you may just dig a hole and not be able to climb out of it
Not publicly offering mocks

Michael Ho - Anesthesiology consultant (Anesthesiology Consultants)
Pros -
Very popular for the last decade
In person conference (definitely before covid, I think he also had some last year or two (?))
lots and lots of videos
"guaranteed" passing plan
Cons -
He has "favorites"
Materials really aren't organized. There were no printed "answers".
Confusing and expensive plans to buy
Mock exams scheduling can be difficult

Smarter Anesthesia (Smarter Anesthesia)
Pros -
Different approach than "traditional" prep course
Focus on what you already know, enable you to present that material in an organized and more eloquent fashion
Individualized plan by the course director
Encourage to find study buddies (rather than pay for more exams)
Cons -
Appears to be the new kid on the block, some may be skeptical (they’ve been around)
Some may not be ready to accept their approach
No (large numbers of) mock examiners.

Ultimate board prep (UBP) (Ultimate Board Prep)
Pros -
Well received by those who have used it.
Materials are carefully cited and well organized.
Established OSCE program
Cons -
Wordy answers, can be interpreted as still need to memorize
Various pricing plans
Some Mock examiners are better than others

Just Oral Boards (JOB) (Just Oral Boards)
Pros -
Great course director
Smaller in-person conferences
mock exams are more tailored to the students
Cons -
Some mock examiners, probably never had any formal instructions on teaching
still focusing on "knowledge gaps"
Very limited location for in person conference

Books/Written resources
Published for Public
Old ABA Practice Exams
Board Stiff Too/Board Stiff Three
Rapid Review Anesthesiology Oral Boards
Anesthesiology Oral Board Flush Cards
Yao & Artusio's Anesthesiology

Not Published for Public
Old ABA Practice Exams (?)
UBP Practice Exams
Big Red

My purpose for this thread is because I want to start a conversation and compile some resources for those who are about to go on this journey, or those who are still in the trenches fighting this war. I hope I can provide some insights, supports and encouragements in order to change some mindsets, improve anxiety, ultimately lead to a better result/future. Hopefully this will prevent someone to become the main character who had to take 157 mock exams in order to pass his oral exam.

Good luck everybody. May the force be with you and may the odds be in your favor.

1st update:
- Those who passed after taking a course would probably could have passed without a full prep course.
- Starting as early in training as possible
- Practice verbalize your answer out loud, with study buddies.
- UBP OSCE portion is very good
- There are no "wrong" answers, as long as you can explain your reasoning
- Old exams are money (There are a few sets floating around, the latest official one was March 2022)

(5/19/24) some wording and explanations, added 1st update section.
(5/22/24) typos and wording. Links to websites.

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I passed both parts on my first try. UBP + practice sessions with a partner is the way to go. Total prep time was 2-3 weeks while working with 3 days off immediately before my exam date. I did 2-3 stems at night over face time a few times a week, and some more on the weekend. Resources: UPB and a practicing partner.

I would recommend starting with the Grabbag portion of the UBP online resource first to refresh on your knowledge base and then start all the stems with a partner. This part you can do it on your own but try to say it out loud. This way you will have most of the topics covered and now you just need to practice verbalizing it. Use UBP answers as a reference but try to cut it down to 1-2 sentences only. Practice cutting each other off after 1-2 sentences.

The OSCE portion is worth every single penny. I went over it 2 days prior to the exam and that was it. I do not recommend doing that but it's so comprehensive and close to the real thing, it will prepare you well for that part of the exam.

I paid for the Ho course but ended up just using UBP resources by practicing with my classmates. Personally, I do not recommend the Ho course, too many forms of resources, I tried to use them but got overwhelmed pretty quickly. I find it hard to use his course working a full time job. If I had 3-4 weeks off of dedicated time maybe it would have been worthwhile.

I attended JOB weekend conference a few months prior and I highly recommend it. Dr. Tran is a great teacher and I find the conference helpful.

Your oral board prep started first day of CA1. You will need a good knowledge base to do well, you can't verbalize sound answers without knowing the facts. My residency program had us do mock orals 4-5 times during CA3 and I am grateful for that. I didn't do any extra mock orals with these prep course examiners besides the JOB conference
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I personally had a lot of anxiety leading up to the oral board for some reason. During residency, we had multiple practice sessions but was never this stressful knowing not even half of what I know now. I believe there’s a lot of resources that one can use but the most important thing is to stick to one and master it.

I personally used the UBP, rapid review book and used old retired stems. I believe that my actual exam reflected most closely the old retired stems. The way I approached this exam was that I went through the UBP multiple times. First pass was to brush up on my knowledge and from the second pass, I organized it in a way that I would bundle stems with same topic such as cardiac/vascular, OB, Peds, Neuro, special cases (pheo, carcinoid, etc), airway/ENT, general. This gives about 3-6 stems per section and I read through these bundles multiple times. This gave me good idea regarding the different types of Qs I will expect from certain stem. I also gave a practice run for my co-resident who was scheduled to take it a month earlier and wrote down certain phrases/terms he used that I liked. Lastly, I also went through old retired stems with in a bundled group (probably did about 10-15 stems) but I dissected the about 30-35 stems on my own meaning I will study the type of questions that they would ask for certain topics.

I do believe this is an applied exam and there is rarely a wrong answer (unless it’s ACLS/PALS/Neonates, MH, LAST syndrome, etc) but there’s certainly a better answer. I had a stem where pt had an unstable hemodynamic, hx of difficult airway with no previous record, and active vomiting. Many people will answer this differently. I’ve seen this type of question before so I asked around my colleagues and I had many different answers/logic behind their answer. So when this was asked on my exam, I prefaced my answer with my concerns about this patient and addressed why I would prioritize certain things over. So I think there is no definitely right or wrong answer in this type of question but if you run a wrong code in ACLS, I believe it’s an automatic failure bc you harm the pt.

Also, it’s knowledge based so you have to have a good foundation. Practice verbalizing your thought process is also key but I think this depends on your examiners. My first stem examiners (intra op/postop) were pretty aggressive and only wanted short answers and asked about what I would do rather than why I would do certain things. That stem was more like a rapid fire question/answer session where as my second stem (pre op/intra op) was focused more on why I would do certain things and this makes sense as the intra op/post op stem deals with more “events” during the case so they want to see how you would react or treat certain events.

i still vividly remember the feeling I had walking out from that building and I don’t wish anyone to repeat the process. It was such a horrible experience that I’m not planning to go anywhere near NC anymore.
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I recommend Yao Artusio's text book. I had a PDF copy of UBP and stopped after reading a quarter of the cases. I felt as though the explanations really did not mirror the test and spent too much timing with superfluous details (ie.
a paragraph+ with each answer explaining which monitors to place).

Then review the OSCE content outline and make sure you are familiar with the hands on aspects of the exam (TTE, ultrasound anatomy for blocks/POCUS). Also have a framework for breaking bad news, creating a QI project, etc.

Save your money and don't bother paying for a prep course.
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A post more for Group IV.

Some of my overall criticisms on most of these prep course, in addition to what have already been mentioned, some bad, some worse.

In my experience, most of these courses will, at some point, use "knowledge deficiencies" as your point of weakness. It's the easiest thing to attack, especially when they decided to "fail" you on a particular exam. This observation is especially true after you've taken mock exams with multiple "examiners". One would tell me that my funds of knowledge is good; the next will tell me that I need to study more. Some of the worst offenders will even use that as a reason to scare you into paying for more exams.

Not only that the most of the examiners have no formal teaching trainings, they are not able to verbalize what I've done wrong. Other than the fact that I didn't give the "correct" answer, most of them have nothing else to offer. One of the more surreal experiences is that during the explanation portion of my mock exam, the examiner who already told me that I wouldn't have passed that particular exam because I didn't know some random facts, went on to tell me that she uses succinylcholine almost indiscriminately in her own practice. My expectation of this "mock examiner" who supposedly have all that knowledge, was met with the reality of I may actually be sitting in front of a dangerous anesthesiologist.

Some of these courses will deem their materials propitiatory and not release all the information in a particular course package. If you want to know more details, then you need to buy the "white gold" package. Or you need to do more mock exams in this particular topic. They can give you the relevant citations/papers, but they are not able to summarize the article for you. By the way, they are also unable to provide you with any questions/answers in a printed format, because it's their intellectual property.

So which is it? Do I know enough, or not enough? Do these examiners actually believing what they're teaching? More importantly, do they actually practice the way they're teaching me? Which resources should I actually be reading? Why so secretive about releasing the "right" answers?

Little did I know, none of these really mattered.
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This is strictly my opinion and experience. I took Dr. Ho's course and strongly recommend it. I failed my first time last year, thinking I had all the knowledge and skill set from residency. What Ho preaches is this test is 90% knowledge and if you don't study and have a deep understanding of Anesthesia, you're likely to not trust your answers and will fail. You have to have a strong knowlege base and while real examiners may disagree with me, I'm certainly not downplaying the importance of good clinical judgement and situational adaptability. These are necessary, but it all starts with knowlege. As i learned, my knowlege was not up to standards. Examiners definitely try to trick you and convince you to chose an unsafe management strategy (even if it's a routine/easy situation) and you have to have the knowledge and confidence to chose otherwise.

I purchased the 4-Day Multi-Modal Crash course and couldn't be happier with the results. True, it is a chunk of change but I personally feel I needed the help, there is enough material offered to justify the cost and at this point (after one fail), my career was nearly on the line. Where Dr. Ho's course shines are the hundreds of hours of videos which is a goldmine of knowlege - what you need. Many or most of his videos are with candidates taking the course and you get to watch them respond to answers and see what are good and not good responses, so you can compare to how you would answer these questions. The mock exams are hit or miss with various "examiners" who may or may not have been out of the game for a long time. It can also be difficult to schedule a mutual time. Take their feedback with a grain of salt. I got a weekly email with a stem, candidate responses and Dr. Ho's responses which were great. I also did two mocks with real senior board examiners from residency and a few mocks with collegues from work. All in all, I don't think there is a better review course for this exam than Ho's. If you drink the cool aid like me, and put the work in, I feel pretty confident you'll pass this exam as I did on round two. Best of luck!