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Seems like most specialties are moving away from oral exams. Any one think we still need an oral exam?
Seems like most specialties are moving away from oral exams. Any one think we still need an oral exam?
I actually think the oral was a good exam. My experience was it was not about scripts at all but often meant you had to think through real world situations using your knowledge of the literature, planning and disease processes. It felt to me more of testing how you apply your knowledge to cases rather than picking one of four choices.
The in-service is created by ACR and has never been validated. Historically it is a horrible exam. I have tried for two decades to get the ACR and ABR to look whether scores are in any way correlated but of course neither is interested as it may lay bare how bad the exam(s) are.I was told by my internists professors that the ABIM (Int Med) got rid of their oral exam in the 1970s or 1980s (can't remember exact year)
bc FMGs complained about bias (old boys club). In other words,many FMGs passed written but failed oral, so either bias or racism was
a factor. So the ABIM got rid of the oral exam.
Re Oral: I don't buy the concept life or death (surgery). Radonc is life or death too, one wrong decision, one wrong tumor volume, the pt is doomed, looking up contour guidelines does NOT warranty perfection as you guys/girls know. It is the skill set + the art of practice of medicine that matters. I think surg can safely get rid of oral.
Who is the best to judge a candidate, whether it is radonc or gensurg? It is the faculty at training program and the PD. When a resident is no good, the program knows. I have dismissed radonc residents before: we sat down and discuss his/her performance, and gave some remedial time to correct deficiencies, and after some time has passed, if not up to par...we dismiss them; rare but necessary.
Food for thought re exam in general...For years, some psychologists say final exam is not needed. Let's say you take Calculus I course, you have done test #1, test #2 (mid-term) and test #3 and do very well. What is the point of the final exam, to create stress? In other words, if you take the ABR in-service exam yearly and do well, you should be board-certified lol...
PS: Your compassion, empathy, professionalism (all the good stuff necessary to practice medicine) is NOT tested in any exam. Only the training program knows you and your behavior (whether it is good or bad)...
And more questionable programs open...Let’s not forget that the exam takes on more significance as the field becomes less competitive.
as their examiners cannot be rid of their subconscious and implicit biases to accurately and fairly score examinees.
Better than having an exam where most people pass the first time since it isn't as effective as picking out the good from the questionable residents?What is the point of an oral exam if it lets people who fail 3 to 5 times in a row still be practicing doctors? What does it mean anyway when you allow that many failures and stilll board certify the person? It means nothing. I know people who failed that many times and I would not choose to have them as my radiation oncologist. Not everyone who fails this many times is bad...but you know statistically.
I wholly and fully believe we should have a similar system. Our system allows too many incompetent doctors to be out in practice. It indirectly supports nepotism. And it would also help just a tiny bit with the job market. Why should there be competent newer doctors out there without a job when someone who graduated several years ago should not be practicing independently to begin with. And you know what? Patients don’t know the system. They don’t know to ask 1.) when did you graduate residency 2.) when did you get board certified and to calculate the discrepancy. I fully believe that people who fail the most important and applicable section of our boards 3 times in a row should be out of the game - which is a game of people’s lives.Some of the points mentioned are addressed North of the border
-In Canada they do all their exams at the end of residency. Including the oral exam (except this year since oral is cancelled). If you don't pass you can't get a full license and therefore can't practice independently. The full license in all provinces is tied to passing the LMCC exams (Canadian USMLE counterpart) and having a Royal college certificate.
-You get 3 shots at the Royal college exam. Once that's over you're out. Unless you can find a different program to take you and remediate you then you'll never be certified. I know two people who are effectively unable to work as radiation oncologists because of this (crappy job market in Canada notwithstanding).
- someone with a CV that includes a discrepancy between the year they finished residency and gotten their Royal college certificate is unlikely to get a job in a desirable locale even if they graduated from a premiere Canadian cancer center.
3). Too many garbage programs have opened in the last few years and the quality of residents getting in now and going forward will make the oral exam even more importantPeople must remember a few things
1) many specialties do not have them anymore. Even radiology got rid of them.
2) some modern countries do not have them
all of these specialties/countries put out competent physicians. We have to stop getting off on nonsense and complexity, overtesting nobody cares about or gives us respect for it. We are screwing ourselves. It does not matter to me if it is a “good exam” or not. Perhaps the radiology exam is the most relevant. Im sure same arguments were made, “we have to make sure they can read an MRI pelvis!!!” Blah blah. Guess what? The reasonable heads prevailed. It is time they do in our field.
Anybody applying should talk to as many people as possible, ask the hard questions, which programs to avoid. This is known. Otherwise, you will end up in a bottomless pit of hell, even if you pass boards, you will hate your experience and dread coming to work daily. I have always offered on here and surely many will do it as well, PM me if you want to know about something and i will try to help you.
I graduated from a mediocre program that chose to treat disease sites based on how they just wanted to...not evidence based. Had I used their contouring system for certain sites I would have failed oral boards, and I would have also mistreated my patients. I did find studying for the oral boards to be the essential aspect of the oral boards. The less aware senior residents would say "oh yeah the way such and such attending treats is perfectly fine" - mostly because they didn't have the awareness that their attending could be super wrong...hopefully these people figured out soon after leaving the residency program.
Anonymous post sent to me:
I wanted to share my experience with the oral board examination this past week. I did this post anonymously out of obvious fear of penalty in some way, but I welcome DMs through the moderators.
While the platform and format of the exam were fantastic and I greatly appreciate the ability to take the exam remotely, I was left feeling completely dejected and worthless.
Going in I felt good about my experience and preparation, only to be thrown into oddball scenarios and pinned with questions - without as much as a few moments to think of my response. I had to go onto the mednet afterward to find good answers to some of the cases that were presented. These were not the "last few fun cases" as most people tell you they are going to be, these were many times the first case presented.
After the exam, I had a complete meltdown and panic attack with the recurring thought of having to prepare and take this exam again. The rest of the night was spent fending off some really dark thoughts about my future. Fortunately, I have the best family and support team to get me through it (family I can't be with since I couldn't secure a job to be closer to them, but that's a whole separate issue).
Much of this are my own psychosocial issues and, while I am getting the help I need, I can't help but think that this is not how it should be.
I simply cannot see how that was a test of competence. It's an asinine archaic practice whose only reason for existence is that it has just existed for years. Prove me wrong.
The main reason for me sharing this it let people contemplating this field know about my experience. It has not been pleasant. Ask yourself if you want to be spending your 30s (or beyond) going through a gauntlet of exams and coming out the other end feeling like a piece of **** in some bubble**** place you didn't even know existed until you applied for the job.
As if med students needed another reason not to pursue this fieldAnonymous post sent to me:
I wanted to share my experience with the oral board examination this past week. I did this post anonymously out of obvious fear of penalty in some way, but I welcome DMs through the moderators.
While the platform and format of the exam were fantastic and I greatly appreciate the ability to take the exam remotely, I was left feeling completely dejected and worthless.
Going in I felt good about my experience and preparation, only to be thrown into oddball scenarios and pinned with questions - without as much as a few moments to think of my response. I had to go onto the mednet afterward to find good answers to some of the cases that were presented. These were not the "last few fun cases" as most people tell you they are going to be, these were many times the first case presented.
After the exam, I had a complete meltdown and panic attack with the recurring thought of having to prepare and take this exam again. The rest of the night was spent fending off some really dark thoughts about my future. Fortunately, I have the best family and support team to get me through it (family I can't be with since I couldn't secure a job to be closer to them, but that's a whole separate issue).
Much of this are my own psychosocial issues and, while I am getting the help I need, I can't help but think that this is not how it should be.
I simply cannot see how that was a test of competence. It's an asinine archaic practice whose only reason for existence is that it has just existed for years. Prove me wrong.
The main reason for me sharing this it let people contemplating this field know about my experience. It has not been pleasant. Ask yourself if you want to be spending your 30s (or beyond) going through a gauntlet of exams and coming out the other end feeling like a piece of **** in some bubble**** place you didn't even know existed until you applied for the job.
Rad Onc: You're Not Gonna Like FridayThe main reason for me sharing this it let people contemplating this field know about my experience. It has not been pleasant. Ask yourself if you want to be spending your 30s (or beyond) going through a gauntlet of exams and coming out the other end feeling like a piece of **** in some bubble**** place you didn't even know existed until you applied for the job.
Clearly, I don't know whether or not you have passed... but I will say that my year (2019), I was convinced I failed, and so were all of my friends. There was only one person with whom I spoke who felt that they had passed... but almost everyone ended up doing just fine. Part of the (awful) process of taking oral boards is studding your *** off only to feel like it was all in vain. Even if you have odd-ball cases early in the series (which I did), I get the sense that they aren't going for the minutia but are more trying to see that you have sound reasoning. A lot of the questions they ask you are not things they care about you knowing -just things to throw you off.Anonymous post sent to me:
I wanted to share my experience with the oral board examination this past week. I did this post anonymously out of obvious fear of penalty in some way, but I welcome DMs through the moderators.
While the platform and format of the exam were fantastic and I greatly appreciate the ability to take the exam remotely, I was left feeling completely dejected and worthless.
Going in I felt good about my experience and preparation, only to be thrown into oddball scenarios and pinned with questions - without as much as a few moments to think of my response. I had to go onto the mednet afterward to find good answers to some of the cases that were presented. These were not the "last few fun cases" as most people tell you they are going to be, these were many times the first case presented.
After the exam, I had a complete meltdown and panic attack with the recurring thought of having to prepare and take this exam again. The rest of the night was spent fending off some really dark thoughts about my future. Fortunately, I have the best family and support team to get me through it (family I can't be with since I couldn't secure a job to be closer to them, but that's a whole separate issue).
Much of this are my own psychosocial issues and, while I am getting the help I need, I can't help but think that this is not how it should be.
I simply cannot see how that was a test of competence. It's an asinine archaic practice whose only reason for existence is that it has just existed for years. Prove me wrong.
The main reason for me sharing this it let people contemplating this field know about my experience. It has not been pleasant. Ask yourself if you want to be spending your 30s (or beyond) going through a gauntlet of exams and coming out the other end feeling like a piece of **** in some bubble**** place you didn't even know existed until you applied for the job.
I've know of only one radiation oncologist who could tell this joke. It's really more like a story. All that work to establish the scene. . . .Rad Onc: You're Not Gonna Like Friday
A young guy goes to prison, feeling totally dejected and alone. He gets there, an older guy sees him and senses he's feeling completely nervous and depressed about the whole prison thing. "Hey young man! Don't worry, prison is not so bad. It can be good even!"
"Really?"
"Oh yeah. You like Italian food?"
"I love Italian."
"Lemme tell ya, on Monday nights we have pizza and spaghetti and eggplant parmigiana. Best food you ever ate."
"That sounds great!"
"Yeah?! And do you like baseball?"
"I love baseball!"
"Well on Tuesdays we have baseball night, we get out in the yard, pitch, catch, everybody has a great time. And do you like movies?"
"I love movies!"
"Listen to this: on Wednesdays we have movie night and popcorn! And how about cards and playing poker. You like to play poker?"
"Yep."
"All the fellas, we have poker night on Thursdays. It's a blast. Big fun."
"Gee. This actually doesn't sound bad. Maybe I'm going to like it here."
"Yeah. Don't worry 'bout it. They say prison is terrible and it's not."
"Seems so. Guess I was worried over nothing."
"And, hey, are you a homosexual?"
"No."
"Ehh... welllll... uh, you're not gonna like Friday."