Urogynecology/FPMRS Oral Exam/Certifying Exam Study Guide Tips and Scoring

[anonperson]

I recently took and passed the urogynecology/FPMRS oral exam (certifying exam). This applies to a relatively small subset of people but I wanted to at least write how I studied/resources used, general thoughts on the exam and the scoring system. I won't discuss any specific topics/questions from the exam.

Study Material:

Exampro offers some of the following resources that I purchased and used
-Thesis review
-Mock orals
-Case list review

I had signed up for both. I sent them my thesis and initially they had someone willing to review it who later back out claiming they did not feel knowledgeable enough to offer a review. They basically let me know this only a week or two before the deadline to submit. I did get a refund but I was unhappy with how this was handled because it put me in a tough spot.

The case list review was adequate. I think the case list review from ExamPro for the general boards was superior.

I did 3 mock orals with them, all with the same physician. She was fine. Gave some reasonable tips and it was better than nothing. I used ExamPro for my general OBGYN boards and felt that was a much better process, including the mock orals.

Overall, Exampro has limited help for people taking the urogynecology/FPMRS certifying exam in my opinion.

America's OBGYN Board Review Course
They offered the following that I purchased and used

-Thesis review
-Structured cases
-Statistics structured cases
-Statistics pre recorded lecture
-FAQs for the Oral exam (binder)

The thesis review was reasonable. I ended up using them at the last minute due to the issue with ExamPro. Overall the reviewer gave some helpful comments/critiques.

The structured cases were pretty good. There are some typos and minor issues but overall it was a helpful way to test myself.

The statistics structured cases were very well done. It is focused on MFM but the concepts are universal. There were some minor issues/errors but overall it was well done and very helpful.

The statistics pre recorded lecture wasn't too helpful. It wasn't organized well and felt like a waste of time.

The FAQs was a complete waste of money. I had mistakenly assumed it had the answers to the questions and was essentially a study guide. Nope. It's literally page after page of just questions. You have to fish for the answers. I am a busy attending working full time, why would I want to do that? Wouldn't it make more sense to charge more and just have the answers there as well so it would be a nice reference guide? A real lazy product from the company.

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My reading resources consisted of the following:

Walters and Karram textbook
Uptodate topics
AUGS/ACOG/AUA practice bulletins etc
AUGS Study Guide (This was a PDF of review course content from several years ago for the written boards (qualifying exam) It is massive and several hundred pages. I only used it for the statistics review.

I also summarized and reviewed the major urogynecological studies (TOMUS, PESSRI ValUE etc) to make sure I knew the general study design/conclusions etc.

I read through all of the Walters textbook and summarized each chapter in a Word document and created a study guide. Printed it out and had it bound at Staples. I supplemented various areas with topics from UptoDate. In addition, I made sure I knew the appropriate practice bulletins and AUA guidelines for IC, OAB, and microscopic hematuria.

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I started all of the above reading in December and took my exam in April (total of 4 months of serious study). This was all done after work and on the weekends. It was a painful 4 months.

I did my mock orals about 6 weeks before my exam so I could fix any weak areas.

My next post will review the exam itself and my general thoughts.

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[anonperson]

Test Set Up

My exam was done virtually.

ABOG sends several emails making sure you have the minimal technical specs including internet speed for the exam. They have you schedule a quick virtual visit with one of their technical consultants who also confirms some of these parameters a few weeks before the exam.

The day of the exam you log in and meet with an ABOG representative who has you show them your case list to ensure no notes and scan your room to ensure no issues/cheating.

The format of the test is the same as the general boards.
Three 1 hour sessions.
Each session has 2 physicians.
The first half is devoted to the structured cases and the second half to your case list.

They must get through the structured cases so they will move at a brisk pace.

The exam is a marathon. Having to talk that much is mentally draining so work on your stamina and ability to keep focus.

This year, due to the pandemic, they did not do a formal thesis review. It was submitted online and reviewed to see if it met criteria. If it did, then you were fine. Instead of doing a formal defense, they had structured research questions instead during the oral exam. I felt these questions were challenging. I'm not sure what would be better to be honest, a formal thesis defense vs these structured questions. My thesis in general was kind of crappy in my opinion. It did get published in a peer reviewed journal and can be found on Pubmed but it is your typical retrospective study that a fellow puts out to get something published.

The test itself went smoothly. One examiner had a small technical glitch but it seemed like it resolved quickly. I don't think one examiner heard me completely clearly but that could have been on me not talking loud enough.

Having taken my general boards in person and now this test virtually, I do prefer the virtual due to the lack of travel. I don't even care about COVID. It is a hassle to get a flight and go to Dallas. It wastes time and is cumbersome.

I am fairly confident that ABOG will eventually transition back to in person exams. They constructed a pretty elaborate testing center in Dallas so I can't imagine they will let that space go to waste.

The exam itself was fair. A few of the clinical scenarios were challenging but fair. Similarly, review of my case list was straightforward.

I will say that with the case list portion, it doesn't really matter what is on your case list because the examiner can and does sometimes choose to ask about anything. One type of example, on the office case list, the examiner can choose to review a case but ask how would you manage a condition surgically and then take you down that pathway of questions.

 

[anonperson]

Scoring

ABOG has rolled out a new scoring system. They briefly discuss it in their FAQ section on the scoring section of the certifying exam. It is supposed to account for variation in difficulty between examiners.

It took a full 6 weeks for my score to come out.

You will get an email letting you know to log in and access your score report.

Other than the formal letter indicating if you pass/fail, they actually give a separate score report. I don't recall this for my general OBGYN board exam. I thought it was interesting and appreciate the inclusion of this.

The new exam is graded on a 1-4 scale. Per ABOG, a score of 3 "represents a Competent physician who is consistently knowledgeable, can routinely provide clinically capable care."

"Although a score of 3 is Competent on the scale, ABOG takes into consideration that not all candidates will be able to achieve a competent score on all cases, and the exam cut-score is thus set lower"

They give you a histogram with the score cutoff and distribution of the scores for your test cycle.

The minimum score needed to pass appears to be ~2.6 or so. It looks like 11 people failed on my test cycle.

They further break down scores based on the structured cases and your case list in comparison to the average score as well.

It is interesting to see how you stack up against other test takers.

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Final thoughts:

I was more unsure of my results on this exam compared to my general boards. I felt comfortable with my general boards that I passed. With this exam, I was second guessing myself on a couple of things a few days after the test and wasn't certain I was going to pass.

FPMRS is a relatively limited field so you must have a good understanding of the conditions we treat, which aren't many. Knowing the risks/benefits/pertinent anatomy/major studies/complication management is key.

There is only one textbook, the Walters and Karram one, that you need to focus on. It is a fairly straightforward textbook and easy to read. Know it well and know the major studies that have been released so you can discuss them if need be (OPTIMAL, VALUE, PRIDE, ROSETTA, etc).

Pay attention to the pertinent AUGS publications. This seems obvious but if AUGS is releasing them, they are a point of emphasis. Review the AUA guidelines/algorithms for management of OAB/IC/and hematuria. The hematuria situation is a pain because there are still some differences between the AUA guidelines and the AUGS/ACOG publications.

The amount of resources are limited from the professional test taking companies and are hit or miss. The test taking resources are much more robust for the general OBGYN exam. For example, ExamPro does a good job for the general boards but isn't that great for FPMRS.

Take the test seriously to try to get it done once. The main challenge is balancing a full time job, family/personal life, and studying. As I get older, I have less stamina to sit down and study like I did when I was younger. I suspect others fall into this category as well. It is a challenge but keep pushing yourself because it is a great feeling to finally be done with this final hurdle.