Time off to study after residency

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Dr. Little Foot

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I had very low quality academics in my residency. I signed up for both boards this fall (ABFAS September, ABPM October). I never had trouble with boards during school, but I was definitely not prepared for board exams at my program. I have a job offer and they told me I could start in September or October. The question: is it worth delaying my start a few weeks so I can dedicate September to full time ABFAS board prep? I did above average on my ITEs in PGY1, below average in PGY3 (basically zero prep going into the ITEs, too busy at hospital and clinic to study and didn't know ITE scores could be applied to the real exam third year). I feel good about Foot and ABPM but nervous about RRA exam.

Everyone says take a vacation before starting as attending, but that'd be tough with boards looming.
 
No. If you need that much time to study for boards you probably shouldn't be practicing at all.
I just remember Part 1 NBPME taking a good 2 months of study, and ABFAS apparently has a lower pass rate than that, so I don't want to waste $1000. Then again, I'm wasting more by not working.
 
lol what. Most people I know put in a bunch of studying for ABFAS qual
Maybe it’s changed in 15 years since I took it? So please no one take any of this seriously as I’m sure things have changed.

I never “studied” for any of them. I did some of the practice questions and the computer based questions they posted.

Couldn’t imagine I put more than like 5-10 hours in.

At that point I figured you should probably know what they are testing you on since you actually do this everyday.

Also, there is plenty of time between patients or after hours to study. We are talking about taking days/weeks off to study? Didn’t you graduate in July?

Do you think you need 2-3 months to study full time?
 
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Yeah honestly I don't know anybody who studied for ABFAS. There's nothing to study this is all stuff you should have learned during residency if you're trying to get it

But hey.... podiatry
 
Also, there is plenty of time between patients or after hours to study. We are talking about taking days/weeks off to study? Didn’t you graduate in July?

Do you think you need 2-3 months to study full time?

Yeah I've been doing some prep since graduation but I'm just getting nervous reading about fail rates. I don't necessarily need the full time to study, but I worry that adjusting to new job is going to be more intense than just supervising resident clinic. Neither task scares me alone, but at the same time? I don't want to under-prepare and end up screwing myself out of privileges for lack of board qual. You seem very confident that it's straightforward stuff that reflects what we're doing anyway, but other posters talke like it's much more difficult.
 
Yeah honestly I don't know anybody who studied for ABFAS. There's nothing to study this is all stuff you should have learned during residency if you're trying to get it

But hey.... podiatry
Yep... boards are minimum competency exams. You know what you need to.
The "study" is mostly just reviewing what you know, brushing up, learning the test format (esp CBPS for ABFAS).

That said, never hurts to read more, reinforce stuff, pick up a few things you may have forgotten.

But to neglect reading for years and then hope to "learn" and "study" in a month or two? Nope.
If your residency didn't have much academics, should've read more and/or created sessions with co-residents.

[gre or Mcat or SAT or something scored is different... obviously want the highest score possible there]
 
Everything about this feels off to me. You take ABFAS qual 3rd year. You pass it. You start your job on time.

1755286846152.png

(they're called podiatrists...)

Anyway, I'm trying to not be the kind of person who claims "young people suck", but dear lord - what is happening to the ABFAS pass rates?
1755286870307.png
 
Everything about this feels off to me. You take ABFAS qual 3rd year. You pass it. You start your job on time.

View attachment 407794
(they're called podiatrists...)

Anyway, I'm trying to not be the kind of person who claims "young people suck", but dear lord - what is happening to the ABFAS pass rates?
View attachment 407795
I would like to think it is more towards the lower standards and watering down of residencies than anything else.

I mean if there are x foot and ankle cases going on at residencies per year 20 years ago, How many are there now?

Other pods used to refer those cases to other docs who trained residents. Now those same docs are able to handle the case themselves.

That along with the combination of having 1 or 2 extra residents per year at a residency program severely impacts the program.

Even still though I guess that shouldn’t take away from academics which should be stressed more if cases are limited.

But academics are hard to find someone who is committed to lead the meeting. You need an attending who is highly motivated to it or else that planned meeting always gets cancelled.
 
Yeah I've been doing some prep since graduation but I'm just getting nervous reading about fail rates. I don't necessarily need the full time to study, but I worry that adjusting to new job is going to be more intense than just supervising resident clinic. Neither task scares me alone, but at the same time? I don't want to under-prepare and end up screwing myself out of privileges for lack of board qual. You seem very confident that it's straightforward stuff that reflects what we're doing anyway, but other posters talke like it's much more difficult.

I did my ABFAS qual while studying in my first job after residency. I got on at multiple hospitals in a large metro area without any ABFAS qual post residency. Was on hospital staff and operating before I even passed the tests. Zero hurdles. It’s hospital dependent but you can usually let your residency case logs do the heavy lifting for credentialing as long as you let them know you’re “in process” on board qualification/cert. I didn’t have ABPM either. Just part 3 boards and residency diploma w case logs and my state license.

Tbh I doubt they give a damn about the board qualification part. They just give you X amount of years to get certified after you’re on staff.

Also all the guys replying here are Uncs and took the test ages ago.

I’ve found the “recent” ABFAS qualification exam is sort of a crapshoot of a test. I knew highly academic guys who failed and others who weren’t and passed. The constant I’ve found from all the residents not only at my program but everyone I knew from other programs and such during my years in residency was the ones who passed studied a lot prior to the test. It’s too expensive to fail and the stats show that many do.
 
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I studied BW. 30 questions, 4 days a week from 3 months out. Passed exams in residency. If you space it out 15-20 a day isn’t too hard. I wiffed RRA cases first time. Passed them easily second time in the spring(I passed all sections first two years, but for some reason blanked that day). I had 0 academics in residency. I unlearned a lot of stupid **** attendings taught me.

All these guys talking about doing high powered programs then bitch about their quality of jobs… take what they say with a grain of salt. Everyone is the smartest over a keyboard.

I personally would study. I don’t think you need to delay starting a job to do so.
 
I studied BW. 30 questions, 4 days a week from 3 months out. Passed exams in residency. If you space it out 15-20 a day isn’t too hard. I wiffed RRA cases first time. Passed them easily second time in the spring(I passed all sections first two years, but for some reason blanked that day). I had 0 academics in residency. I unlearned a lot of stupid **** attendings taught me.

All these guys talking about doing high powered programs then bitch about their quality of jobs… take what they say with a grain of salt. Everyone is the smartest over a keyboard.

I personally would study. I don’t think you need to delay starting a job to do so.
💯
 
Everything about this feels off to me. You take ABFAS qual 3rd year. You pass it. You start your job on time.

View attachment 407794
(they're called podiatrists...)

Anyway, I'm trying to not be the kind of person who claims "young people suck", but dear lord - what is happening to the ABFAS pass rates?
View attachment 407795
Passed foot didactic but failed RRA didactic 2024. Passed both CBPS. The didactic portion tests a decent amount of stuff you don’t really see in residency. I did no studying, so I think studying is a good idea if you want both. Not sure you need to take off any extra time to study though.
 
Passed foot didactic but failed RRA didactic 2024. Passed both CBPS. The didactic portion tests a decent amount of stuff you don’t really see in residency. I did no studying, so I think studying is a good idea if you want both. Not sure you need to take off any extra time to study though.
The questions are a bit goofy and I think it has a lot to do with who you learned what from or what texts you’ve read. Unfortunately our field constantly has multiple people saying “this way is the best way to do that” and it’s all different ways to accomplish the same goal. It’s luck of the draw if that’s what ABFAS wants as the choice.

On a side note - has there ever been a podiatrist in the last 10 years nationwide who was the first choice the hospital consulted to treat compartment syndrome?
 
The questions are a bit goofy and I think it has a lot to do with who you learned what from or what texts you’ve read. Unfortunately our field constantly has multiple people saying “this way is the best way to do that” and it’s all different ways to accomplish the same goal. It’s luck of the draw if that’s what ABFAS wants as the choice.

On a side note - has there ever been a podiatrist in the last 10 years nationwide who was the first choice the hospital consulted to treat compartment syndrome?
I've been consulted twice during residency for compartment syndrome. Who else would they call?
 
I've been consulted twice during residency for compartment syndrome. Who else would they call?
What did you do? Did you cut?

It goes to level 1 straight to ortho trauma most of the time and even then they “wtf?” it. I know cuz I’ve been there
 
What did you do? Did you cut?

It goes to level 1 straight to ortho trauma most of the time and even then they “wtf?” it. I know cuz I’ve been there
First guy pressure was only like 23 in anterior leg so we did him the next morning with whatever other procedure he needed (don't remember, was three years ago). Second one was true compartment syndrome and we did immediate fasciotomy in OR, calc repair a few days later.

One or two other times my attending said it was compartment syndrome but I wasn't convinced, and we didn't check pressure because they were getting I&D'd anyway.

I guess this may not be normal, but at my hospital I don't think anyone outside of podiatry could tell a heel from a toenail. We have a good ortho attending who does ankles and calc fractures but doesn't have his own residents, so any ER call below the knee goes to us. Hell I've been consulted several times for fingernails (not in one of the hand states) and once for a sacral ulcer.
 
I studied. 100% of what I studied did not show up on the board exam.

You cant just sit down and study for this exam.

If there are young residents reading you need to keep up on literature throughout residency. At minimum read the ABFAS journal when it comes out. Foot and ankle international would be another one to get your hands on.
 
I had a brand new baby, got sent to another town for a rotation, and spent every minute away from my family studying. Failing an exam costs you twice because you have to pay for the exam, but you also potentially miss 1-2 days of work. For example, historically CBPS Foot and Rearfoot are on separate days.
 
I want to add to my last post. You do have to learn how to take the CBPS portion. That is something to study for. Not the content necessarily but how to play "the game".
 
I want to add to my last post. You do have to learn how to take the CBPS portion. That is something to study for. Not the content necessarily but how to play "the game".
Has anyone figured out how it's actually scored?Board Wizards admit they don't know, and I haven't found anything online. Never sure if I should click as many "correct" options as possible, or as few as necessary or what. The question stems always forget to mention what kind of insurance they have.
 
Has anyone figured out how it's actually scored?Board Wizards admit they don't know, and I haven't found anything online. Never sure if I should click as many "correct" options as possible, or as few as necessary or what. The question stems always forget to mention what kind of insurance they have.

There is a video on ABFAS website by Dr. Venson explaining this. I suggest you watch it
 
...Not sure you need to take off any extra time to study though.
This is the bottom line.
Not only is it foolish to not start getting paid and getting work experience, it's also usually not possible.
In the beginning, work to learn, not so much to earn (that'll come soon). You need to get in the work environment and learn how to deal with boss/admins, time management, pt communication, your style, practice mgmt, etc. That stuff is learned once you start real practice (this is reason #819 why fellowship is relatively dumb for most ppl).

You guys are coming out $200k, 300k, sometimes $400k+ in debt.
The interest alone on that is $1k or even over $2k per month.
(and at 7% non-bankruptable, they're happy to have you make minimum pays or defer/forbearance!)
We have too many DPMs sadly just treading water or even going backward on student loans... still owing more than they borrowed 5, 10+ years after graduation.
Even if you got a golden ticket on tuition somehow, that money can be rolling your way and compounding interest for retirement, your own office, whatever.

How long do you want to "have to" work? Age 75? 70? 65?... or 50 or 55?
I can tell you that your energy and motivation simply won't be as high as you get older.
There will be other things you want to do besides bend over to cut toenails and scrape wounds.

You have to create time to review and learn formats for these tests despite work. They're not going away. Once you pass qual, it takes time for cert case collection. Once you pass cert, you have online questions quarterly for maintain of cert. You will always have CME and hospital applications and other things you don't want to do on evenings and weekends. Learn to budget your time. These things have to be priority.

For ABFAS, for me, that meant watching less football or less hiking or not going fishing or whatever. I would basically just go to the library, read, take a gym break, go back until the library closed. Not a fun Saturday or Sunday for a few weekends, but it's important to pass.

...Also all the guys replying here are Uncs and took the test ages ago...
Maybe, maybe not.

I can say that I've passed ABFAS qual more times than any DPM.
I passed all 4 parts (2 didactic + 2 cbps) coming out of residency.
Then, they made up the "new" CBPS format, and I (and many other candidates) had to pass those two parts again.
I was from the time where re-qual was allowed, so I passed all 4 parts again... 10 total.
(note that some people have taken it more than that as they keep failing and failing like the ABPM replacement board of directors lady who was whining at the 'summitt' about failing ABFAS qual 7 times...
...but I've studied + passed it same/more - 10 parts passed and re-passed - than anyone normal... only way to do more is possibly a test developer who takes it a ton for research.)

A bit of the test changes, but it's the same anatomy and pathology and procedure concepts and just different implants (fair bit of change, mostly the same) and meds (those have actually changed very little in the 20yrs I've been studying it). They're not tricking you... but the test is hard. Board exams are like most core textbooks: they mostly testing the classic proven stuff. Boards are NOT on the cutting edge for new/unproven procedures... that's for CME meetings, some journals.

I will say with 1000% certaintly that ABFAS (or probably any test) does NOT get easier as you get further from residency and reading/academic environment. I failed one of the Abfas cbps sections on my attempt at re-qual... studied a bit more, did BoardWizards, passed it next offering. It is all stuff you've learned in school, in residency, on your own... but always need to review (and benefit from that review). Depending on residency hospital and attendings, you will probably have some pathology/procedures you didn't see much of and need to brush up on.

The blaming the residency/training is hogwash, though... all schools and residencies have the same journals, books, subscriptions available. My program was fairly good, but you still need a ton solo reading. Mine was heavy on elective bread-n-butter, adequate on RRA elecive, adequate wound/DM slop, and a bit light on trauma, no TARs. But those things are all in every book, and you get plenty of the surgical principles and OR reps. We had probably a third of our academics attending/director run (XR rounds, research)... but two thirds were set up and run by chiefs or even juniors (journal club, quizzing juniors, quizzing students, board prep). Make your own luck.
 
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Hilarious that everyone advocating not studying for ABFAS (because they went to a rockstar podiatry residency) also was complaining about "how unfair the exam was" and have failed a section of the exam.

Study for it in your last 6-8 months of residency. Take it seriously, its several thousands of dollars that you don't want to waste. It's been over 10 years since I took it so I don't have any resources that are relevant anymore.
 
Ask yourself some questions: does your job need ABFAS qualification/certification, or will it give you the case load needed to become certified?

If yes, then STUDY. You know your weaknesses - so build up and reinforce your knowledge base. Reduce the amount of bull**** variance that may occur with ABFAS scoring. McGlamry remains a good standard on which to build your base. BoardWizards is good to reinforce your knowledge base, and to learn how to do CBPS (which is it's own flavor of bull**** IMO...you should NOT need to "learn how to take a test", or learn anything beyond the subject matter being tested on). Afterwards, you can then look forward to the bull**** variance that may occur with ABFAS certification (lol). Good luck 👍

If no, then I would suggest just focus on getting ABPM and wring out as much ROI out of this profession as you can. You've heard this before. Good jobs are few and far between. Opportunities to get cases for certification get fewer with more podiatrists being introduced every year. Going rural means living rural (or at least more rural than one may be comfortable with). PP jobs won't pay you extra for the extra work you put into getting certification. With this in mind, save yourself time, money, stress - and just let your work and experience speak for itself. This may be a cynical view, but I'm basing this on what I've gone through so far - and it kind of sucks. If this isn't you, then happy for you (not really, gimme your job lol).
 
Hilarious that everyone advocating not studying for ABFAS (because they went to a rockstar podiatry residency) also was complaining about "how unfair the exam was" and have failed a section of the exam.

Study for it in your last 6-8 months of residency. Take it seriously, its several thousands of dollars that you don't want to waste. It's been over 10 years since I took it so I don't have any resources that are relevant anymore.
I studied my butt off for the exam. 100% of what I studied was worthless.

This is not a memorize and dump exam. Its an application exam. You have to understand the pathology/procedure/complication to find the best answer. This comes from years of reading, operating, literature review, etc.

Staying up to date on literature and concepts through 3rd/4th year school and thru residency will 1000 fold be more beneficial than any last minute cramming of classifications or random knowledge.

If you know your stuff the written exam is not that hard.

The CBPS I can not say the same for. CBPS is a game you have to play and is not a good test. CBPS does not test your knowledge. It tests how you can play a game. I shotgunned everything and followed adam smashers epic post and passed (Thanks @Adam Smasher ).
 
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I studied my butt off for the exam. 100% of what I studied was worthless.

This is not a memorize and dump exam. Its an application exam. You have to understand the pathology/procedure/complication to find the best answer. This comes from years of reading, operating, literature review, etc.

Staying up to date on literature and concepts through 3rd/4th year school and thru residency will 1000 fold be more beneficial than any last minute cramming of classifications or random knowledge.

If you know your stuff the written exam is not that hard.

The CBPS I can not say the same for. CBPS is a game you have to play and is not a good test. CBPS does not test your knowledge. It tests how you can play a game. I shotgunned everything and followed adam smashers epic post and passed (Thanks @Adam Smasher ).
(Poorly pixelated MRI has entered the chat)
 
The thing I wrote 8 years ago might be outdated, other than paying attention in residency is THE best study strategy and practicing the computer game is 2nd most important. Otherwise, I never really studied and I never complained either about unfairness
 
The thing I wrote 8 years ago might be outdated, other than paying attention in residency is THE best study strategy and practicing the computer game is 2nd most important. Otherwise, I never really studied and I never complained either about unfairness
I too recently took these exams the last few years and need to re-take this fall. i used your prized post like a good blueprint. A ton of it still holds up in the CBPS. However as for the didactics, as others have said is sort of a helter skelter situation.
 
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