PRITE Exam Study...

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RGL01

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I'm a PGY-1. How does one study for the PRITE exam. My hospital is scheduling me to take this in October. Thanks in advance.
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Still, the sentiment in almost every program I've ever encountered is for PGY1s to just take the test and find their baseline.
More important that they are mastering the interview and MSE, doing well on their off-service rotations, and passing Step III if they haven't already.
 
PGY-I PRITE scores are a function of the quality of psychiatry training at your medical school and do not reflect anything about your current program. You would only have done one or two psych rotations at best.
After the PGY-I year, your program can start taking credit or blame. Please don’t study to the test; you will probably fail to guess much about specific content. Even if you were successful at studying to the test that would only give you a false sense of security as you confidently go on to fail the boards. It is like cheating at golf, it only hurts you. Read a text book first, then get down to articles.
 
Agree with all of the above. THAT BEING SAID:

Find out what your program expects. Talk to the PGY-2's. When I was an intern, my class went with the "don't study, get a baseline" approach. We got reamed when our scores came back and we were "the worst class ever" because we were the first ones who didn't memorize the "PRITE study guide". We made sure our interns memorized everything the next year and they got great praise for being the "best class evar." Sigh.

See what they want. They might want you to study and "do well". Or, they might want you to use it (IMO) correctly, to get a baseline.
 
I don't know. Your mortgages, your acceptance into fellowships (even though they'll never see how you did), maybe even your future spouse may depend on this. If you run for President of the US your PRITE score can become an issue.

Attendings have a gold club that they enter and only allow top scoring on the PRITE residents, where they get to eat Kobe steaks, 100 year-old red wine and make fun of the poor scorers.

Just a few days ago, I was making fun of some of the poorer scoring residents with the higher scorers in the gold club where I'm at. This is what our secret club room looks like. You have to knock on a wall 3x and say "Oli Oli Oli Oxen-Free" to get in.

140610122143-private-memberships-clubs-club-silencio-horizontal-gallery.jpg


Then at 8pm, models wearing scantily clad outfits come out and dance for us while they also serve of hookas. My favorite is the peach tobacco.

"Hahaha, I told that one resident that all the SSRIs really are the same med, just packaged under different names and he believed me. What a sucker!"

Here's a video where something very similar happens.
Embedded media from this media site is no longer available
 
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TexasPhysician said:
Some programs want to see yearly improvement on the PRITE. To do so, tanking the PGY-1 PRITE is a good start to set yourself up well.
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I have been trying to stomp this rumor out for 10 years. It is amazing how much residents will selectively latch onto such things despite clear messages to the contrary. I guess it is easy to hear what you want to hear. At orientation, we promise to never to pat a resident on the head and say “nice improvement from last year, good job”. Low is bad, and high is good. Between digitlnoize and Texasphysician, we have kind of given opposite advice. High score good, low score bad is concrete, but hard to argue with.
 
MacDonaldTriad said:
I have been trying to stomp this rumor out for 10 years. It is amazing how much residents will selectively latch onto such things despite clear messages to the contrary. I guess it is easy to hear what you want to hear. At orientation, we promise to never to pat a resident on the head and say “nice improvement from last year, good job”. Low is bad, and high is good. Between digitlnoize and Texasphysician, we have kind of given opposite advice. High score good, low score bad is concrete, but hard to argue with.
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Good luck stomping out the "rumor" when I was told by a program director.

The problem is that the PRITE was meant to be a self-assessment to help with future studying, but many programs do not treat it as such. Some programs require certain scores and will place remediation requirements for those that do not meet the set scores. Other places will want to discuss your declining score in a meeting to discuss your lack of studying. Others will restrict moonlighting below certain scores.

I think it is most worthwhile to take the exam without specific PRITE studying to determine your deficiencies. Depending on specific program policies, maybe you should study old exams for months. Getting advice for your specific program here is not near as helpful as speaking with your program to determine expectations.
 
I meant stomping out the rumor in our program.

Anyway, if you look at the sources on the answers, it is almost all K&S, or the APA text with some expert consensus stuff from the APA.

Unfortunately, looking at old tests does seem to be an effective strategy because there is some recycling or slight rewording of questions. I don’t think this is a great way to learn however and it may not help with the real boards as much as reading a text. The PRITE is made to measure strengths and weaknesses in different areas of psychiatry. It will never make a very satisfactory curriculum.
 
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This is just my opinion but I believe residents freak out about the PRITE because they have no idea how it really works and their last reference to gauging the importance of an exam is their experiences in medical school. The name of the exam is an acronym just like USMLE is.

So just like a right-wing whacko thinking that building a Muslim religious and cultural center needs to be protested and will be a center for terrorism, so too do these residents start fearing oblivion with their careers and the PRITE.

The above is not meant as a criticism. After all, it's not like residency programs tell residents to take it easy and take a chill pill when it comes to the PRITE.

Studying old PRITEs is no way to study for the board exam. The questions are not similar at all other than that they cover similar material. As most of us know by now, so much of what is on an exam depends completely on the test writer. One could have studied for professor X's exam, know X's information he told you to study cold, but then be forced to take professor Y's exam. Professor Y is teaching the same course in a different university and fail Y's exam despite one's good knowledge of the material.

So to is it with the PRITE. Study for it all you want, you may become a better test-taker on an exam that has no bearing on your future, that is poorly written, and not similar to the board exam. Or you could study for the board exam, an exam that is well-written, has more clinically useful information, and actually does have an impact on your career. Yes, there is a score correlation between the PRITE and the board exam but at least IMHO, the two exams are very diferent.

I'd recommend to residents to get USMLE Step III out of the way so you can focus more on the psychiatry board exam and to study psychiatry for real. E.g. read up textbooks, journal articles, discuss cases and articles with good attendings and other residents.
 
TexasPhysician said:
Some programs want to see yearly improvement on the PRITE. To do so, tanking the PGY-1 PRITE is a good start to set yourself up well.
Click to expand...

Programs can 'want' whatever, but seeing as how the vast majority don't offer any significant reward for excellent performance(or punishment for poor performance), most residents will continue to not put a lot of time, effort, or thought into it.

Additionally, it's an extremely poor test. If one wanted to study psychiatry topics for the purpose of being a better psychiatrist, I suppose that's admirable. But studying to do well on the prite is only somewhat loosely related to that first goal. If I were going to 'study' to be a better psych, I would never have done something so low yield as studying for the prite.
 
I don't know, guys. On the interview trail, at least three programs specifically said they had remediation procedures in place (from meeting with testting specialists to being privately tutored to review seminars) for those who did worse than a certain percentage on the PRITE, even during intern year.

TexasPhysician said:
Some programs require certain scores and will place remediation requirements for those that do not meet the set scores. Other places will want to discuss your declining score in a meeting to discuss your lack of studying. Others will restrict moonlighting below certain scores.
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This is exactly what I heard on the interview trail.
 
Mass Effect said:
I don't know, guys. On the interview trail, at least three programs specifically said they had remediation procedures in place (from meeting with testting specialists to being privately tutored to review seminars) for those who did worse than a certain percentage on the PRITE, even during intern year.
.
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well those are programs I'd probably stay away from(barring a great desire to be in that city for whatever reason). a general rule is that if someone/something puts a ton of emphasis on stupid/silly things, they themselves.......
 
vistaril said:
well those are programs I'd probably stay away from(barring a great desire to be in that city for whatever reason). a general rule is that if someone/something puts a ton of emphasis on stupid/silly things, they themselves.......
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Actually, two of these programs are among the most well-regarded programs in psychiatry. A friend of mine interviewed at another top program that had a similar policy.
 
Mass Effect said:
Actually, two of these programs are among the most well-regarded programs in psychiatry. A friend of mine interviewed at another top program that had a similar policy.
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well I would wonder what is going on then if they are worried about them scoring all that low on the prite in psychiatry......given that it's psychiatry(ie not top scorers on tests overall) and that many/most residents don't study or prepare at all, it's not very hard to avoid a low score....even for generally mediocre people. But again- point remains that if someone is concerned about how people do on such a flawed and meaningless test, well that's a separate problem imo.
 
Some programs do actually give a damn about their residents' PRITE scores. I do know that there is a ranking of programs by their PRITE scores only given to program directors about once a year.

Some PD actually give a damn about this. I wouldn't, that is unless my program were on the bottom of the barrel in terms of scores. I am not surprised some programs have "remediation programs."

I find the remediation program BS. First off, it's hard for residents to focus as much as needed on psych until USMLE is out of the way. If I were that program, I'd tell the residents to get that out of the way as soon as reasonably possible, then focus on the board exam, not the PRITE.

Second, several residents do poorly on the PRITE but do significantly well in their clinical duties. The latter is far more important.

Now if a student were doing poorly on their clinical duties and their PRITE, then maybe I'd actually do a sit-down with the resident. As much as I think the PRITE is BS, yes there is some correlation with the board exam. Just like there's a correlation with a beat up rusting piece o'crap Gremlin and a brand new Tesla. Both are cars.

i443100.jpg


Tesla_Motors2.jpg

The PRITE is just too poorly written for me to want to give that exam any credibility other than it's correlation with the board exam. That's it. I've noticed that when most residents get USMLE out of the way they do much better with their board prep. To make a resident do PRITE prep without having taken USMLE is just ridiculous. Board prep-no, but PRITE prep? Yes.
 
whopper said:
Some programs do actually give a damn about their residents' PRITE scores. I do know that there is a ranking of programs by their PRITE scores only given to program directors about once a year.
.
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There is no "ranking of programs by their PRITE score"-- we do get reports each year showing how each resident performed relative to their training level locally, nationally, and overall. I use this diagnostically to encourage those who aren't performing that well (below 50th percentile) to step it up a notch. For those doing well, it's essentially reassurance, as well as confirmation that they know something. (And now as the ACGME's NAS is bringing us the infamous Milestones, specific subscores of the PRITE might assist us in stating that a resident has or has not met a specific Medical Knowledge milestone--but we're all waiting for some feedback from the PRITE on that.)
For me, the main thing is that improvement on PRITE from year to year indicates that a resident cares enough to take their training seriously. I will say that there is definitely a correlation between PRITE scores and my subjective rating of how much effort a resident is putting forth in didactics, supervision, and personal reading. Just a little objective confirmation to my subjective impressions....
 
OK, thanks for the correction. Just that one year I was a resident, the PD mentioned how the program I was in did, so I thought it was ranked. Maybe they got each resident and averaged them out to obtain a baseline.
 
OldPsychDoc said:
There is no "ranking of programs by their PRITE score"-- we do get reports each year showing how each resident performed relative to their training level locally, nationally, and overall. I use this diagnostically to encourage those who aren't performing that well (below 50th percentile) to step it up a notch. For those doing well, it's essentially reassurance, as well as confirmation that they know something. (And now as the ACGME's NAS is bringing us the infamous Milestones, specific subscores of the PRITE might assist us in stating that a resident has or has not met a specific Medical Knowledge milestone--but we're all waiting for some feedback from the PRITE on that.)
...
Click to expand...

Are you sure? My fellowship PD once told me the exact percentile of my class in fellowship for C&A. I didn't ask either, so it would seem odd that he would make-up a statistic for no reason. Odder things have happened in life though.......
 
TexasPhysician said:
Are you sure? My fellowship PD once told me the exact percentile of my class in fellowship for C&A. I didn't ask either, so it would seem odd that he would make-up a statistic for no reason. Odder things have happened in life though.......
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Yes, you would get a class percentile score--and I suppose that technically is a ranking--but it is not the "ranking of programs by their PRITE score" that I thought whopper was kind of implying. (And we don't see a listing of programs arranged by PRITE score, ala US News...)
 
I guess the complaining about the PRITE is a natural set up. Trainees don’t like taking it, and teachers don’t like seeing poor scores on it. A lot of fairly senior people complain about MOC requirements for the same reasons. Could it be written better? Yes. Is it a completely useless irrelevant barometer of a resident’s medical knowledge that should be completely ignored because it is completely meaningless? No. It would be interesting to run a correlation between PRITE performance and complaints as to its lack of utility. I have never heard a resident who rocks the test complain about having to take it.
 
MacDonaldTriad said:
I guess the complaining about the PRITE is a natural set up. Trainees don’t like taking it, and teachers don’t like seeing poor scores on it. A lot of fairly senior people complain about MOC requirements for the same reasons. Could it be written better? Yes. Is it a completely useless irrelevant barometer of a resident’s medical knowledge that should be completely ignored because it is completely meaningless? No. It would be interesting to run a correlation between PRITE performance and complaints as to its lack of utility. I have never heard a resident who rocks the test complain about having to take it.
Click to expand...

this is a faulty argument and faulty reasoning- people who study for the test by going over old tests, prite study guides, etc are going to generally be the ones more likely to rock it(it's a test where you can pretty dramatically increase your score if you just go over 4-5 years of old tests). And those people who study for the test are obviously also likely to be the ones less likely to complain. Furthermore, those people who don't complain about the silliness of the test and study for it are also more likely to be 'do-gooders'(as the program sees it) in general.

You could get the same type of outcome if programs asked students to memorize a list of current presidents in every country in africa. The same people who would bother to do such a stupid thing(and thus do well on it) are also going to be more likely to do a lot of other goody-goody stuff. Some of this stuff does have value(being a team player on service, working late, etc) and some of it obviously doesn't(memorizing the african presidents list). Conflating these different things is faulty. Just because someone who is more likely to work hard on service is also more likely to study for prite, doesn't mean studying for prite is a good thing(just because working hard on service is)
 
vistaril said:
this is a faulty argument and faulty reasoning- people who study for the test by going over old tests, prite study guides, etc are going to generally be the ones more likely to rock it(it's a test where you can pretty dramatically increase your score if you just go over 4-5 years of old tests). And those people who study for the test are obviously also likely to be the ones less likely to complain. Furthermore, those people who don't complain about the silliness of the test and study for it are also more likely to be 'do-gooders'(as the program sees it) in general.

You could get the same type of outcome if programs asked students to memorize a list of current presidents in every country in africa. The same people who would bother to do such a stupid thing(and thus do well on it) are also going to be more likely to do a lot of other goody-goody stuff. Some of this stuff does have value(being a team player on service, working late, etc) and some of it obviously doesn't(memorizing the african presidents list). Conflating these different things is faulty. Just because someone who is more likely to work hard on service is also more likely to study for prite, doesn't mean studying for prite is a good thing(just because working hard on service is)
Click to expand...

This might be my favorite vistaril post ever. Seriously dude, well said!
 
I think I have said more than once that studying PRITE questions is not going to teach you psychiatry and is a colossal waste of time. Your argument assumes that people who rock the test do so because they “study” in this manner. If residents read books on the current geopolitical landscape of Africa, they would probably be able to name some presidents without memorizing a list.
 
MacDonaldTriad said:
I think I have said more than once that studying PRITE questions is not going to teach you psychiatry and is a colossal waste of time. Your argument assumes that people who rock the test do so because they “study” in this manner. If residents read books on the current geopolitical landscape of Africa, they would probably be able to name some presidents without memorizing a list.
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agreed, but the value(for prite purposes) of general/useful reading is so much lower than prite-specific studying.
 
Now we are in full agreement. The value of PRITE specific reading resides only in one’s gratification at cheating the test.
 
MacDonaldTriad said:
Now we are in full agreement. The value of PRITE specific reading resides only in one’s gratification at cheating the test.
Click to expand...

And in "proving" to your program that you have an "appropriate level of knowledge." About the PRITE.

Is there ANY data supporting the idea that the PRITE is a good indicator of resident knowledge or performance?

Edit: I guess I should add that I am aware that studies have shown some correlation between PRITE scores and board scores. And between USMLE scores and PRITE scores.

What I haven't seen is that it is showing anything besides an aptitude for testing. I would argue that we could take ANY standardized test and it would predict performance to a similarly correlating level as the PRITE.
 
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Relationship Between Resident-In-Training
Examination in Psychiatry and Subsequent
Certification Examination Performances


Dorthea Juul, Ph.D., Barbara S. Schneidman, M.D., M.P.H.
Sandra B. Sexson, M.D., Francisco Fernandez, M.D.
Eugene V. Beresin, M.D., Michael H. Ebert, M.D.
Daniel K. Winstead, M.D., Larry R. Faulkner, M.D.


Academic Psychiatry, 33:5, September-October 2009
 
Another problem I've noticed is this.

Where I did residency, the attendings as a whole (not specific individual ones) placed far more importance on a resident's clinical performance. While good knowledge and clinical performance go hand-in-hand, some signs of a better clinician do not.

For example good note writing, writing faster, admitting or discharging patients quicker, getting the agitated patients injected faster, attendings and nurses all attribute this to an excellent resident, but what if that resident doesn't know much outside of that?

Residents should also occasionally be able to detect very odd etiologies (e.g. antibody induced psychosis, shared delusions, be able to clearly distinguish delusional disorder from other psychotic disorders). Some can be considered good but don't have a strong knowledge base.

I'm not talking about zebras that have no clinical usefulness but zebras that occasionally happen and if missed could lead to seriously bad outcomes. Personally I found the PRITE filled with the zebra stuff that was not useful, but I did think the board exam had several useful zebras and things most residents aren't solidly taught but are very useful such as Maslov's pyramid. But getting to my original point, some attendings don't care if the resident doesn't have much knowledge so long as the day went well with that resident, and see making extra attempts to teach as an added chore.

Where I'm currently at U of Cincinnati, I'd say somewhat over 50% of the clinical attendings really care about the resident doing studious activities and will work extra for residents needing extra supervision. Where I was in residency I'd say it was less than 10%, and they scored the resident mostly on the resident's ability to make the attending's life work-free. The sad thing is at U of C, the attendings work much harder and it's a bigger pain and chore to give the extra supervision for greener residents-and this only reflects that the attendings at U of C are far superior to where I did my residency.

If a program were to have board prep, I'm all for that, but I'd be against PRITE prep because the PRITE is not a well written exam- do not memorize old PRITEs.
 
whopper said:
but I did think the board exam had several useful zebras and things most residents aren't solidly taught but are very useful such as Maslov's pyramid.
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This is the same as Maslow's hierarchy of needs? I was recently having a discussion with some people who were saying rather confidently that it doesn't really have validity and therefore isn't actually a useful model.
 
You are correct in some regards. Maslov based his pyramid more so on his clinical experience though he did base some of it on some cases where he kept allegedly long biographies of the person.

Another aspect that Maslov acknowledged is the pyramid isn't for every single person and it is highly subjective and broad.

A better, more empirically-based approach was studied by Tay and Diener.
http://academic.udayton.edu/jackbauer/Readings 595/Tay Diener 11 needs WB world copy.pdf

In short, it does show that across cultures, there is a pyramid of sorts but it's more complicated than Maslov proposed, and people could be self-actualized while still lacking some elements. Most people have their own specific and individualized idiosyncratic pyramid, but there also appear to be several common themes that do happen across cultures.

A high-functioning sociopath, for example, could be very happy with not being safe, in fact be actualized as a result of not being safe.


Personally I've found Maslov useful in the regard mentioned by Tay and Diener. You can't simply assume one follows Maslov but having conceptualized the pyramid, one can start from there and see if the patient has his own specific pyramid of needs.

Correction to a previous post, I wrote that about 10% of the attendings where I trained would've taken it upon themselves to do extra work to teach a lower-functioning resident. I'd say maybe it was more on the order of 20% While this may be of no relevance to most people I do know that some people from that program frequent this forum from time to time, and if you're from there and you're mad with my statement-it's been years since I've been there and maybe things are better, and if not, well heck, go fix this. An attending that really is only working about 2 hours out of 8 because he's making the resident do everything should be teaching more if that resident needs help.
 
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I totally agree that PRITE study is likely not the best use of one's valuable study time...but let's say you're a PGY4 resident who wants to show his program that he's not a total ***** (albeit a handsome one)...and he's rather busy with a heavy clinical load...HYPOTHETICALLY what should this bad test-taking but good natured fellow do to boost his score...and let's assume he's never studied for PRITE and fared low-to-middle-of-the-pack?
 
americanidiot said:
I totally agree that PRITE study is likely not the best use of one's valuable study time...but let's say you're a PGY4 resident who wants to show his program that he's not a total ***** (albeit a handsome one)...and he's rather busy with a heavy clinical load...HYPOTHETICALLY what should this bad test-taking but good natured fellow do to boost his score...and let's assume he's never studied for PRITE and fared low-to-middle-of-the-pack?
Click to expand...
Study PRITE? 😵
 
So things that amaze me -- we have a really long thread talking about PRITE preparation and yet pretty much nothing about board preparation. I guess residents take the PRITE 4 times and the board once (hopefully), but regardless of how you slice it, boards seem way more relevant to real life/practice than PRITEs (although I see how the two are related). It seems like the forums for other specialties have somewhat robust board exam conversations, and we've got crickets. Scratching my head ....
 
americanidiot said:
I totally agree that PRITE study is likely not the best use of one's valuable study time...but let's say you're a PGY4 resident who wants to show his program that he's not a total ***** (albeit a handsome one)...and he's rather busy with a heavy clinical load...HYPOTHETICALLY what should this bad test-taking but good natured fellow do to boost his score...and let's assume he's never studied for PRITE and fared low-to-middle-of-the-pack?
Click to expand...

Yep, old PRITEs. Hopefully you've got them around. They surprisingly repeat a decent amount of questions year to year. Still, though, why care? You're going to graduate if you made it this far without your program raising any type of hassle about your PRITE. Advice I wouldn't have listened to last year would be that your main goal in improving PRITE knowledge would be to help you with boards.
 
You can study old PRITEs. You can also dump a box of toothpicks and lay them all back in the box in a neat and ordered manner where they're all straight and on top of each other like neatly ordered carbon filaments.

You could also sprinke some tacks on the floor, then roll around in them, then jump into a bathtub filled with lemon juice.

A program will likely consider if you're board-certified and your performance in real-life as better indicators, well that is if they have half-a-brain. I've found several people to not have half-a-brain but less than that. (Not literally of course).
 
whopper said:
You can study old PRITEs. You can also dump a box of toothpicks and lay them all back in the box in a neat and ordered manner where they're all straight and on top of each other like neatly ordered carbon filaments.

You could also sprinke some tacks on the floor, then roll around in them, then jump into a bathtub filled with lemon juice.

A program will likely consider if you're board-certified and your performance in real-life as better indicators, well that is if they have half-a-brain. I've found several people to not have half-a-brain but less than that. (Not literally of course).
Click to expand...

I'll go with the tacks.
 
americanidiot said:
I totally agree that PRITE study is likely not the best use of one's valuable study time...but let's say you're a PGY4 resident who wants to show his program that he's not a total ***** (albeit a handsome one)...and he's rather busy with a heavy clinical load...HYPOTHETICALLY what should this bad test-taking but good natured fellow do to boost his score...and let's assume he's never studied for PRITE and fared low-to-middle-of-the-pack?
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PGY4? Busy? Heavy clinical load?????
🤣🤣🤣

(Whew...OK now, let me catch my breath...)
Then as Dr. Bagel says, start studying for boards, and you'll likely raise your PRITE score sufficiently.
 
Doctor Bagel said:
Yep, old PRITEs. Hopefully you've got them around. They surprisingly repeat a decent amount of questions year to year. Still, though, why care? You're going to graduate if you made it this far without your program raising any type of hassle about your PRITE. Advice I wouldn't have listened to last year would be that your main goal in improving PRITE knowledge would be to help you with boards.
Click to expand...

I think there is very little mentioned about the boards because who knows anything about them? They are still building that plane while it is flying. There have been so many changes; board prep companies have been soliciting my senior residents to write questions for gosh sakes.

“I know you haven’t actually taken the test, but do you think you could guess what it is like and write some board prep questions so we can sell them to residents and make money? We will pay you.”

Since the demise of the oral part II, they have attempted to include treatment planning skills and decision making into the computer test. The clinical vignettes have been an attempt to bridge this self-created gap, but the few graduates who have taken the test and the few attendings that have been involved find the vignettes very stilted and not very useful.

Boards or PRITE, you make a bunch of people take these things against their will and no one is likely to praise them.
 
OldPsychDoc said:
PGY4? Busy? Heavy clinical load?????
🤣🤣🤣

(Whew...OK now, let me catch my breath...)
Then as Dr. Bagel says, start studying for boards, and you'll likely raise your PRITE score sufficiently.
Click to expand...
Easy now... my old program, it was like being a 2nd year all over again with manditory electives to complete and plenty of on-service requirements that you're running alone.
 
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