RISE 2014

[Johnny Sunshine]

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Well, I just finished the AP/CP RISE exam for 2014. I am a PGY4 so I've taken the RISE a few times now. I shall be careful not to give away too much in my comments...

I found this year's AP section surprisingly difficult. I've been doing P-RISE practice questions off and on for a year or so, and have been going through 5 review/question books, yet felt like little of that helped me. I knew that molecular & genetic questions would be present, but I was still surprised at how frequent they showed up. They were fairly hard, and tended to deal with rare or odd scenarios. Overall, the AP section was a disturbing experience... 🙁

The special topics section had a notable increase in workplace/career/regulation type questions, but was otherwise as expected.

The CP section was very similar to prior years. Perhaps 20-25% of the CP section was blood bank / transfusion related, but these were mostly straightforward. Same for coagulation, hematology, chemistry, molecular, genetics, etc. The only thing that jumped out at me is a reduction in the number of microbiology "identify this organism" pictures. Instead, there were more identification questions based on a mere text description of the organisms, with perhaps a note of what plate it grew on and what the colony looked like (if bacterial). Overall, I found the CP section fair.

At the end, I left the test room feeling confused about the AP section. Every time I take the RISE, of course I find I know more than I did the previous year. But each year, the vast majority of the questions continue to discuss things I have not encountered. Things my review books don't cover, or the P-RISE practice questions don't really cover, and which certainly don't come up in actual practice.

I've had numerous attendings tell me they experienced similar confusion when they took the RISE, going so far as to say the exam is largely a waste of time, and so unlike the boards that it's almost worthless. The fact that many places take the exam as a group, or "open book", invalidates the usefulness of the exam even more. This makes it difficult to use the RISE to help prepare for the boards...and makes any actions of the residency program based upon RISE scores (corrective, promotional, etc.) very frustrating.

Still, it's apparently the most objective measure of resident progress we have. Or so people keep telling me. I'm personally not sure what to make of it.

 

[Cellpathology]

Well, I just finished the AP/CP RISE exam for 2014. I am a PGY4 so I've taken the RISE a few times now. I shall be careful not to give away too much in my comments...

I found this year's AP section surprisingly difficult. I've been doing P-RISE practice questions off and on for a year or so, and have been going through 5 review/question books, yet felt like little of that helped me. I knew that molecular & genetic questions would be present, but I was still surprised at how frequent they showed up. They were fairly hard, and tended to deal with rare or odd scenarios. Overall, the AP section was a disturbing experience... 🙁

The special topics section had a notable increase in workplace/career/regulation type questions, but was otherwise as expected.

The CP section was very similar to prior years. Perhaps 20-25% of the CP section was blood bank / transfusion related, but these were mostly straightforward. Same for coagulation, hematology, chemistry, molecular, genetics, etc. The only thing that jumped out at me is a reduction in the number of microbiology "identify this organism" pictures. Instead, there were more identification questions based on a mere text description of the organisms, with perhaps a note of what plate it grew on and what the colony looked like (if bacterial). Overall, I found the CP section fair.

At the end, I left the test room feeling confused about the AP section. Every time I take the RISE, of course I find I know more than I did the previous year. But each year, the vast majority of the questions continue to discuss things I have not encountered. Things my review books don't cover, or the P-RISE practice questions don't really cover, and which certainly don't come up in actual practice.

I've had numerous attendings tell me they experienced similar confusion when they took the RISE, going so far as to say the exam is largely a waste of time, and so unlike the boards that it's almost worthless. The fact that many places take the exam as a group, or "open book", invalidates the usefulness of the exam even more. This makes it difficult to use the RISE to help prepare for the boards...and makes any actions of the residency program based upon RISE scores (corrective, promotional, etc.) very frustrating.

Having been in your situation one year ago I will say this: The RISE vastly overemphasizes the molecular knowledge and also the miscellaneous management/personnel type questions. Molecular questions were few and far between on my AP/CP boards last year. As far as the real test goes, it will be CP that you feel like you bombed.... AP, I would argue, seemed to be a more legitimate exam. Though many say the RISE means nothing, it may mean something if you commonly score in the <10th percentile. Otherwise you will very highly likely pass the boards. (>90% pass rate, don't forget that!!)

 

[Sulfinator]

Well, I just finished the AP/CP RISE exam for 2014. I am a PGY4 so I've taken the RISE a few times now. I shall be careful not to give away too much in my comments...

I found this year's AP section surprisingly difficult. I've been doing P-RISE practice questions off and on for a year or so, and have been going through 5 review/question books, yet felt like little of that helped me. I knew that molecular & genetic questions would be present, but I was still surprised at how frequent they showed up. They were fairly hard, and tended to deal with rare or odd scenarios. Overall, the AP section was a disturbing experience... 🙁

The special topics section had a notable increase in workplace/career/regulation type questions, but was otherwise as expected.

The CP section was very similar to prior years. Perhaps 20-25% of the CP section was blood bank / transfusion related, but these were mostly straightforward. Same for coagulation, hematology, chemistry, molecular, genetics, etc. The only thing that jumped out at me is a reduction in the number of microbiology "identify this organism" pictures. Instead, there were more identification questions based on a mere text description of the organisms, with perhaps a note of what plate it grew on and what the colony looked like (if bacterial). Overall, I found the CP section fair.

At the end, I left the test room feeling confused about the AP section. Every time I take the RISE, of course I find I know more than I did the previous year. But each year, the vast majority of the questions continue to discuss things I have not encountered. Things my review books don't cover, or the P-RISE practice questions don't really cover, and which certainly don't come up in actual practice.

I've had numerous attendings tell me they experienced similar confusion when they took the RISE, going so far as to say the exam is largely a waste of time, and so unlike the boards that it's almost worthless. The fact that many places take the exam as a group, or "open book", invalidates the usefulness of the exam even more. This makes it difficult to use the RISE to help prepare for the boards...and makes any actions of the residency program based upon RISE scores (corrective, promotional, etc.) very frustrating.

Still, it's apparently the most objective measure of resident progress we have. Or so people keep telling me. I'm personally not sure what to make of it.

I just walked out of the RISE today and actually thought that the CP was tougher than the AP, though that probably reflects the fact that I my Board studying has been almost exclusively AP-oriented so far. Guess it's about time I started giving CP material some thought and attention as well.

 

[TMZ2007]

I took my boards last year. I took the RISE honestly every year and I did pretty well in PGY4 with all sections above 500 pts and >50th percentile, AP and CP. I want to echo the statement above about molecular being way overemphasized on the RISE compared to the boards. Otherwise, though, I thought the RISE was a decent enough metric for how well I personally did on the boards. I got done with both exams and thought to myself "Well, that went OK, not great, but OK enough i think" I had been studying/cramming 8 hrs/day for boards about 6 weeks before I took the RISE, so I was perhaps more prepared for the oddball stuff that ends up as test questions.

 

[Mace1370]

I'm a PGY1 and took took the RISE for the first time this year. Probably crushed it.

 

[Euchromatin]

I can also share my RISE experience. PGY-4, I started doing dedicated, "hard core" studying for boards in January and prior to the RISE I'd very thoroughly covered micro, blood bank, lab admin, coag and some heme. On the AP side, I had studied breast, lung/thoracic, derm, head and neck, endocrine, liver and medical kidney. So NOT chemistry, molecular, cytology, GI, GU, gyn, soft tissue or other AP areas. We all get the same day off service to take our RISE, which is proctored, closed book, etc.

I thought CP overall was fair. I agree there seemed to be fewer picture IDs and more descriptions in the micro section. I thought I had covered most of the high yield, basic info about antiobiotics in general and resistance/susceptibility mechanisms, patterns, testing and reporting, but there were a few questions I had to guess on in that vein (I think that is vague enough to be safe). There were also a few chemistry questions that stumped me, and I don't think I would have gotten them even if I had reviewed my Compendium and other notes more thoroughly, but overall not bad.

In special topics, I thought the hemepath and molecular sections were fine. Admittedly, I probably have a little more molecular background/interest than your average bear, so I wish there were more molecular questions on the boards - it would probably help me out. I always feel like the lab admin section is a bit of a crapshoot in that it seems hard to predict which obscure tidbits/details about regulations/accreditation they'll choose to ask about and their choice of other topics seems to range pretty far from year to year...a few years ago there were a bunch of informatics/digital pathology type questions and lately there seems to be an emphasis on human resources/personnel type stuff. I'm glad the consensus seems to be that management/admin is less emphasized on the boards.

I always hate the cytology section. I did totally fine with actual cases on my cytology rotations, but I'm not a fan of interpreting still images of one/a few cells. I found the AP section easier this year than in previous years, especially questions from the areas I had studied already. Even though I think our surg path training is really good, I feel like I learned a lot of new information about specific zebra entities, certain details that seem heavily tested and "aunt minnies" when studying for boards, which I think helped somewhat for the RISE.

 

[Pollux]

PGY4 here too. Scored 632/>99 overall in PGY3 last year (700+ in Surg Path and 600+ in all except transfusion medicine and lab admin). Our exam is closed book and proctored by program coordinator.

I took the RISE this week and here are my thoughts:

Surgical Pathology: Nothing really jumped out at me, and most of the image questions were pretty straightforward. Yes, there were some zebras (*wink wink*), but most of the time you can rule out some of the distractors to come to the correct diagnosis. I was surprised that many entities showed up more than once (some even showed up three times). There were definitely an increased number of molecular/cytogenetic related questions, but I thought most of them were fair. Definitely nothing truly cutting edge (ie. published in the last 5 years) like the FOXL2 mutation in granulosa cell tumor or STAT6 translocation in solitary fibrous tumors.

Cytology: Can't remember much of it, except I recall a lot of questions relied on "buzzwords". Yes, the cytology image questions require us to make a diagnosis based on one field; it is artificial and is not the way it works in real life. However, there's really no other easy way to test it, as virtual slides would take way too long to scan. For board review, I found ASCP's Cytopathology Review Guide a great resource for Cytology image questions. I did this question book in PGY2, and my Cytology section RISE score increased by close to 200 points that year.

Micro: I found the CP section to be harder than AP, in general. I have been doing some board reviews for a month now, and I have studied nothing but CP. I thought Micro was harder this year, as there were some random questions, many of which asked about antimicrobial resistance. I even consulted a friend who works as an infectious disease attending if he knows the answer to the antifungal resistance question (a google search showed that two of the answer choices listed may both be resistant). He didn't know either. Also, I thought there were going to be more image questions on parasite ID or fungal morphology, and was sadly disappointed. I found a few of the questions involving biochemical testing quite challenging, and had to guess on a few of them. Overall it's fair.

Chemistry: Most of the questions were straightforward, but a few of them mentioned tests that I haven't even heard of before. I guess I should expect similar things on the real CP board exam too. I'm also glad that they are pretty up to date with some of the testing guidelines.

Lab admin: I have a feeling that I totally bombed it. It was a frustrating experience, but from reading everybody else's comment here I realize I was not alone. I thought many of the regulation/workplace questions were truly random. Does anybody have any good resources to prepare for lab admin questions on the board?
Special Tech: Again a random assortment of questions. Maybe two-thirds were doable but some require knowing nitpicky details. Hopefully won't see too many of these questions on the board.

 

[BlondeDocteur]

Pollux, in addition to the Cytopathology book you mentioned, are there any other resources you'd recommend for the RISE?

PGY4 here too. Scored 632/>99 overall in PGY3 last year (700+ in Surg Path and 600+ in all except transfusion medicine and lab admin). Our exam is closed book and proctored by program coordinator.

I took the RISE this week and here are my thoughts:

Surgical Pathology: Nothing really jumped out at me, and most of the image questions were pretty straightforward. Yes, there were some zebras (*wink wink*), but most of the time you can rule out some of the distractors to come to the correct diagnosis. I was surprised that many entities showed up more than once (some even showed up three times). There were definitely an increased number of molecular/cytogenetic related questions, but I thought most of them were fair. Definitely nothing truly cutting edge (ie. published in the last 5 years) like the FOXL2 mutation in granulosa cell tumor or STAT6 translocation in solitary fibrous tumors.

Cytology: Can't remember much of it, except I recall a lot of questions relied on "buzzwords". Yes, the cytology image questions require us to make a diagnosis based on one field; it is artificial and is not the way it works in real life. However, there's really no other easy way to test it, as virtual slides would take way too long to scan. For board review, I found ASCP's Cytopathology Review Guide a great resource for Cytology image questions. I did this question book in PGY2, and my Cytology section RISE score increased by close to 200 points that year.

Micro: I found the CP section to be harder than AP, in general. I have been doing some board reviews for a month now, and I have studied nothing but CP. I thought Micro was harder this year, as there were some random questions, many of which asked about antimicrobial resistance. I even consulted a friend who works as an infectious disease attending if he knows the answer to the antifungal resistance question (a google search showed that two of the answer choices listed may both be resistant). He didn't know either. Also, I thought there were going to be more image questions on parasite ID or fungal morphology, and was sadly disappointed. I found a few of the questions involving biochemical testing quite challenging, and had to guess on a few of them. Overall it's fair.

Chemistry: Most of the questions were straightforward, but a few of them mentioned tests that I haven't even heard of before. I guess I should expect similar things on the real CP board exam too. I'm also glad that they are pretty up to date with some of the testing guidelines.

Lab admin: I have a feeling that I totally bombed it. It was a frustrating experience, but from reading everybody else's comment here I realize I was not alone. I thought many of the regulation/workplace questions were truly random. Does anybody have any good resources to prepare for lab admin questions on the board?
Special Tech: Again a random assortment of questions. Maybe two-thirds were doable but some require knowing nitpicky details. Hopefully won't see too many of these questions on the board.

 

[gbwillner]

Surgical Pathology: Nothing really jumped out at me, and most of the image questions were pretty straightforward. Yes, there were some zebras (*wink wink*), but most of the time you can rule out some of the distractors to come to the correct diagnosis. I was surprised that many entities showed up more than once (some even showed up three times)....

This will definitely repeat itself when you take the boards.

 

[Pollux]

Pollux, in addition to the Cytopathology book you mentioned, are there any other resources you'd recommend for the RISE?

I actually recommended the cytology book for general review/board review purposes. There's no need to stress out about the RISE, as most programs (as far as I know) don't put too much weight on it.

That being said, for general studying/review purposes, I would recommend the ASCP Compendium for Clinical Pathology and Osler lectures for CP (especially Blood bank and micro). For AP, I would recommend Osler and Lefkowitz.

 

[Pollux]

Micro: I found the CP section to be harder than AP, in general. I have been doing some board reviews for a month now, and I have studied nothing but CP. I thought Micro was harder this year, as there were some random questions, many of which asked about antimicrobial resistance.

Just another anecdotal evidence that perception does not always parallel the outcome. I thought CP was way harder than AP when I walked out of the exam, but ended up scoring better in CP - 99th percentile in all except TM (95th).

 

[Cyan]

Just another anecdotal evidence that perception does not always parallel the outcome. I thought CP was way harder than AP when I walked out of the exam, but ended up scoring better in CP - 99th percentile in all except TM (95th).

Nice, man. How did you do overall? Any advice on last minute board review?

 

[Pollux]

694/>99. Since there are only a few weeks left, I would stick with Osler notes and question books like Lefkowitch and Quick Compendium Companion for CP. I'll be reviewing the crammable subjects like microbiology and blood bank one last time just before my board exam date.