Orals boards... i don't know? Review course.... absolutely not!

[Calilove]

---

Members do not see this ad.

I just took my Anesthesia Oral Board Examination in Minneapolis... Wow! I had an "aggressive" examiner type for my first room. My second room was a calmer, more laid-back examiner. Both had "young guns" in tow.

No need to take a review course... i wasted alot of dough this way. The exam is sooooo subjective! The one thing Ive learned about anesthesia is there are too many ways to accomplish the same goal. Also, there are many ways to make the anesthetic safe vs. less safe vs. not safe, but we'll just see what happens!

Its true that we already know wayyyy more minutia than what will be tested by an oral board examiner. However, I can clearly see how anyone can be failed because there are NOOOO right/wrong answers. Its all grey-zone, with alot left up for interpretation.

Don't get me wrong, there are some things in our anesthesia practice that are absolute "NO-NOs"! But, for the most part, most of us know not to cross that line. However, I think it comes down to the fact that the ABA examiners CANNOT PASS EVERYONE.

This is what is troubling... This is why alot of our colleagues, some of them resident All-Stars; chief residents; etc... cannot pass this subjective exam.

And this is where the board review courses get it absolutely wrong! Alot of time is spent on anesthesia concepts and theories and algorithms that we already know to the extent that this exam will test them. However, not enough time is spent teaching us how to deal with that "aggressive" examiner that won't accept an answer accompanied by a sensible reason. How do you skate the line of "being flexible" but not "backing down easily when our choice is questioned"?

I don't think that studying textbooks is needed after you've passed the written exam. I'd just grab a bunch of practice oral exams and have one or two of my buddies act like the "aggressive" examiner that won't accept an answer even though its backed up with sound reasoning!

I definitely don't wanna take this exam again, but if I do; I definitely won't be shelling out 1000+$s to Ho/Jensen!

 

[pgg]

However, I can clearly see how anyone can be failed because there are NOOOO right/wrong answers.

😕 Of course there are wrong answers that will get you failed.

I definitely don't wanna take this exam again, but if I do; I definitely won't be shelling out 1000+$s to Ho/Jensen!

Which course did you take?


I have to admit I'm slightly annoyed by posts like this (there are others) that purport to have the One True Universal Solution to board prep.

 

[powermd]

😕 Of course there are wrong answers that will get you failed.



Which course did you take?


I have to admit I'm slightly annoyed by posts like this (there are others) that purport to have the One True Universal Solution to board prep.

One of the former board examiners from my residency program recalls a guy who, on repeated questioning about the issue, would not- UNDER ANY CIRCUMSTANCES, leave a totally stable post-partum mom under epidural anesthesia to walk 6 feet away to INTUBATE AND SAVE HER DYING BABY. Even with the mom begging the anesthesiologist to save the baby, the guy firmly asserted that his duty is to the mom, and the mom only.

He failed.

Guys, the bar is set lower than you think.

 

[abg]

just took the oral boards two days ago. I can't shake the feelings of failure. The whole thing keeps re-playing in my head. The first session was kinda shaky, due to my nervousness. I blanked on a "duh" question because I was thinking so hard. The examiner had to suggest the (obvious) answer to which I quickly agreed. Right then, I'm thinking "I failed...might as well just walk out, board the plane home".
I managed to pull it together for the 2nd session and was better at my responses.
Does anyone else have a similar experience?🙁
Is it normal to feel that you failed?

 

[foxtrot]

I just took my Anesthesia Oral Board Examination in Minneapolis... Wow! I had an "aggressive" examiner type for my first room. My second room was a calmer, more laid-back examiner. Both had "young guns" in tow.

No need to take a review course... i wasted alot of dough this way. The exam is sooooo subjective! The one thing Ive learned about anesthesia is there are too many ways to accomplish the same goal. Also, there are many ways to make the anesthetic safe vs. less safe vs. not safe, but we'll just see what happens!

Its true that we already know wayyyy more minutia than what will be tested by an oral board examiner. However, I can clearly see how anyone can be failed because there are NOOOO right/wrong answers. Its all grey-zone, with alot left up for interpretation.

Don't get me wrong, there are some things in our anesthesia practice that are absolute "NO-NOs"! But, for the most part, most of us know not to cross that line. However, I think it comes down to the fact that the ABA examiners CANNOT PASS EVERYONE.

This is what is troubling... This is why alot of our colleagues, some of them resident All-Stars; chief residents; etc... cannot pass this subjective exam.

And this is where the board review courses get it absolutely wrong! Alot of time is spent on anesthesia concepts and theories and algorithms that we already know to the extent that this exam will test them. However, not enough time is spent teaching us how to deal with that "aggressive" examiner that won't accept an answer accompanied by a sensible reason. How do you skate the line of "being flexible" but not "backing down easily when our choice is questioned"?

I don't think that studying textbooks is needed after you've passed the written exam. I'd just grab a bunch of practice oral exams and have one or two of my buddies act like the "aggressive" examiner that won't accept an answer even though its backed up with sound reasoning!

I definitely don't wanna take this exam again, but if I do; I definitely won't be shelling out 1000+$s to Ho/Jensen!

I agree that you don't have to take a board review class to pass but there are some people who do it for peace of mind like myself. It is knowing that I did everything I did to pass the exam. There is something about that which eases certain people's minds. It also helps to hear other people struggle so that you start thinking "what would I say if faced that question." I took Ho's course and signed up for a public exam..talk about aggressive, he would not back down. It all depends what type of learner you are, there is no one way to pass the boards. You may have not needed to take a course but there are others who disagree.

 

[raider67]

just took the oral boards two days ago. I can't shake the feelings of failure. The whole thing keeps re-playing in my head. The first session was kinda shaky, due to my nervousness. I blanked on a "duh" question because I was thinking so hard. The examiner had to suggest the (obvious) answer to which I quickly agreed. Right then, I'm thinking "I failed...might as well just walk out, board the plane home".
I managed to pull it together for the 2nd session and was better at my responses.
Does anyone else have a similar experience?🙁
Is it normal to feel that you failed?

your experience is all too familiar. First room was rough but the second went better. I feel the looming sense of failure. I really do not want to go through this again.

 

[powermd]

your experience is all too familiar. First room was rough but the second went better. I feel the looming sense of failure. I really do not want to go through this again.

Everyone misses some obvious points. I missed a developing case of sepsis, part of the ventilation algorithm for hypoxia on OLV, and a few other "can't miss" issues. Most people I know had a similar experience and they all passed. The folks who fail are the true psychos and those who can't communicate clearly in English.

 

[2ndyear]

That really really sucked. I felt prepared going into the exam, but now I feel like I failed. I know I missed some points, and I had trouble following where we were. I also know some very well spoken smart American grads who have failed, so that doesn't make me feel better. 20+% of us WILL fail every year, sometimes closer to 30%. That's a pretty big number. I know that ABA has high standards and all, but to fail that many people (2000 or so take it each year, so 500 people out of 2000 are failing?) really does not make for a great statistic. The whole process seems archaic, there has to be a better way to assess knowledge and critical thinking. Perhaps that is simulation. Like it or not, the oral is still a knowledge test. I passed the written no problem, but I found the knowledge not to be there on the oral.

 

[raider67]

I know several well spoken and fellowship trained people fail. They kept jumping around and stopping me just when I started to describe my plan. I know they will sometimes do this when they feel you know the subject but it was disconcerting.

Did anyone not get to all the grabbags at the end? I got cut off half way through the last one during the first session. I also had a fair amount of text book stuff like sevo vs DES vs iso.

This was a stressfull exam(by design) and seems very subjective. No other choice but waiting now (venting here helps)

 

[maceo]

take the michael ho course

 

[siednarb]

did those of you who took it this past fall find it very tough to wait all year for the exam? would you have rathered taken the exam in April or did having the extra time to prepare for the fall exam help in any way? Just trying to decide if I should put my name in the lottery for the spring exam or just sign up for the fall exam (also planning on taking the DO oral exam as well which is offered only once a year in the fall so thought of maybe killing 2 birds with one stone....or just going for the ABA in April and being potentially finished.

 

[pgg]

Guys, the bar is set lower than you think.

I would like to believe that, but I know very smart, good anesthesiologists who've failed.

This leads me to believe that the test may not always be straightforward, that some gamesmanship or BS artistry may be involved, and that some formal coaching might be useful.

The only thing I know for certain is that obsessive preparation is the reason I did well on ITEs and passed the written. I'm not going to just trust that the knowledge and good judgment I know I already have will be sufficient for this exam.

 

[soorg]

I took mine this past Thursday. Bombed the first room, did well on the second. It was so bad, I just wanted to leave. Worst experience ever, and I think I failed, but a bunch of my colleagues all say the same thing, and they passed. Still...

 

[hoyden]

take the michael ho course

WHICH one? He has numerous ones 😕

 

[powermd]

I would like to believe that, but I know very smart, good anesthesiologists who've failed.

This leads me to believe that the test may not always be straightforward, that some gamesmanship or BS artistry may be involved, and that some formal coaching might be useful.

The only thing I know for certain is that obsessive preparation is the reason I did well on ITEs and passed the written. I'm not going to just trust that the knowledge and good judgment I know I already have will be sufficient for this exam.

Every examiner I've worked with has said it's not about your knowledge, it's about your approach- and your ability to verbalize it in a calm and coherent way. This is a special skill that even "brilliant" people may not have. Being too smart and overthinking, and overanalyzing will probably hurt you because the examiner is left to wonder if you would do the same thing in real life- and some people DO, to the patient's detriment. It's okay to say "I don't know" or "I'm not sure", but follow it up with a plan for dealing with a situation you don't have all the answers to.

Ultimately the examiner needs to believe that if you were facing the test situation in real life, you would be be safe and meet the expected standard of care. The challenge is finding ways to quickly verbalize in an organized way all the thoughts that usually go through your mind when confronting a patient care decision. If you do this well, your examiners will likely stop you in your tracks, and force you to get to the point- this is good because that means they trust your approach. You have to get through as much of the exam as possible in a limited time too, so being quick, coherent, and concise with the "boilerplate" stuff they expect you to say is key.

My first case scenario was a nightmare from which you could derive pretty much every major issue in anesthesia (bad heart, twitchy lungs, bad airway, pacemaker, need for OLV, questionable NPO, etc). I did okay with it because I stayed focused on the issues raised by the examiners and the goal of keeping the patient safe balanced by the need to go forward with the procedure. One of the most challenging questions I got (which I suppose I can't talk about publicly) I just conceded this was a sh*tty situation where something had to give- there were no risk free options. They seemed to agree.

i didn't do a course, but I practiced with an attending, and my fellowship buddies. I read most of Mike Ho's book. It didn't really help. The practice made all the difference.

 

[Calilove]

I got "the knock" on the door, at the start of my 3rd grab bag question during my first exam. Also, I got "the knock" after about 1 question into my 3rd grab bag during the second exam.
--Does anyone EVER finish this EXAM????!!!????

 

[2ndyear]

I got the knock in both of my 3rd grab bags without time to answer. Too bad they were both chip shots that I knew well, but didn't have time...

 

[Mofeen]

Anyone from this post have a success story?