Oral boards review book recommendation (other than Okuda)

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enalli

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I've been slowly going through the Okuda book and looks like I'll be done with a month to spare before the oral boards. I wanted to go through some more cases and am trying to decide between "First Aid for the Emergency Medicine Oral Boards" and "Emergency Medicine Oral Board Review: Pearls of Wisdom." Do any of you have experience with either book? Any other book recommendations? I only ever see people mention Okuda, but I'll feel slightly less anxious if I can read through some more cases.

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Both have about 50 cases. The Pearls of Wisdom book uses an outline format of going over topics, which I'm not a huge fan of. But if you are just reading the cases, I'm sure either one will be fine. Probably overkill though anyways if you've made it through the Okuda book.
 
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Do a review course it’s worth the money. This isn’t a traditional exam so it’s best to actually study with how the exam will be since the logistics can throw you off.
 
I have a random question for those who have taken the review course or whatever: How frequently do people get penalized for overusing resources or over-working-up? I'm just starting the Okuda book and from the perspective of what I learned in residency, some of their permissible or even critical actions are not evidence-based or otherwise things we would not do in real life (eg, the aforementioned rectalize-everyone, or mandatory WBI in iron OD, or immediate fluid bolus in a non-septic-appearing young guy w/ chest pain that turned out to be mediastinitis but could've just as easily have been CHF from first glance). So I tend to miss these kinds of critical actions.

So, seems like it's best to err on the safe side of throwing in the kitchen sink, from my perspective. But have people gotten burned doing it this way?

Relatedly, does one get penalized for doing an unnecessary rectal/GU exam, as we certainly would in real life for most of these pts that have "rectal exam wnl" written in the case? One old document I found online recommended to rectalize an MI pt to "rule-out" GI bleed prior to giving tPA... I don't remember learning to do this in residency.

(Yes, we played the Oral Board Dungeons 'n' Dragons game in residency so I think I have a pretty good handle on the flow, but sometimes the critical actions my attendings made up seemed more... reasonable.)
 
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Review course not necessary - waste of time and money. Okuda all that's needed. Go through all the cases in detail and then again more passively in the few days before the exam. Passed easily.
 
Just passed. I don't think I even got through half the okuda book and it was more than enough.

Is there any justification, any whatsoever, for this exam other than collecting money?
 
I have a random question for those who have taken the review course or whatever: How frequently do people get penalized for overusing resources or over-working-up? I'm just starting the Okuda book and from the perspective of what I learned in residency, some of their permissible or even critical actions are not evidence-based or otherwise things we would not do in real life (eg, the aforementioned rectalize-everyone, or mandatory WBI in iron OD, or immediate fluid bolus in a non-septic-appearing young guy w/ chest pain that turned out to be mediastinitis but could've just as easily have been CHF from first glance). So I tend to miss these kinds of critical actions.

So, seems like it's best to err on the safe side of throwing in the kitchen sink, from my perspective. But have people gotten burned doing it this way?

Relatedly, does one get penalized for doing an unnecessary rectal/GU exam, as we certainly would in real life for most of these pts that have "rectal exam wnl" written in the case? One old document I found online recommended to rectalize an MI pt to "rule-out" GI bleed prior to giving tPA... I don't remember learning to do this in residency.

(Yes, we played the Oral Board Dungeons 'n' Dragons game in residency so I think I have a pretty good handle on the flow, but sometimes the critical actions my attendings made up seemed more... reasonable.)

Disclaimer: I have not looked into this in depth and have no insider knowledge of the exam. I have gone through the Okuda book and passed the boards. My advice is based on my general sense of how these things work and not on anything specific I've encountered in the exam.

I do remember thinking the Okuda critical actions were off on a lot of the cases, most importantly including certain things that I thought shouldn't really be critical actions. I shrugged it off and thought I'd use common sense in terms of what a critical action should be and it was fine. To be clear, I mean exam common sense, not real life common sense. So, for example, in a case of anaphylaxis, I wouldn't be surprised if observing them for 6 hours after epi administration was a critical action (exam common sense), even though in real life I wouldn't necessarily think that's super important and be ok discharging them before my shift ends, even if it ends in a couple of hours (real life common sense). The exam is not the time to be dogma busting though.

In terms of resource utilization, I would err on the side of doing stuff, rather that not doing stuff, but also using common sense. What I mean is that I don't think anyone will pick on you for ordering an additional blood test even if it's not absolutely necessary or testing for something that's a soft call, but maybe if you wanted to go above and beyond on the soft call you might be. So if you had a young person with atypical chest pain and sent a couple of troponins you'd be fine (exam common sense), even though it might be a patient you wouln't send trops on in real life. Now, if you wanted to admit this patient when it was clearly not indicated, maybe they'd penalize you for that?

At least that's how I hope this exam works. Otherwise it's even more random than it seems.
 
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