"Man is least himself when he talks in his own person. Give him a mask, and he will tell you the truth." Oscar Wilde
Showing posts with label ABSITE. Show all posts
Showing posts with label ABSITE. Show all posts
Monday, September 18, 2017
A surgical resident’s legal battle with her program
My new post on Physician's Weekly is about a dispute between a resident and her surgical residency program that has escalated to court and the news media. Click here to read it.
Thursday, August 11, 2016
You failed the written boards: What to do now
I graduated this July and took the QE (written general surgery boards) on July 19th. I got my results today and I failed. Not only did I fail but my score placed me in the 5th percentile. Needless to say I'm disappointed. You hear stories about CE (oral exam) failure but never about QE failure. I never blew the ABSITE out of the water (50, 29, 20, 34, 38), but I never would have expected to perform so poorly. Rather than search for blame I'd like to form an effective strategy so that I pass the second time around.
I am sorry to hear of your misfortune. I can’t imagine how you must be feeling.
In your time as a PD did you have a resident or residents fail the QE? Several residents failed the QE. The most notable was a guy who never got below the 60th percentile on the ABSITE. To this day, I cannot understand how that happened.
What became of these people? You will be happy to learn that nearly everyone eventually passed. Patients never ask you how many times it took you to pass the boards. They don’t know about that sort of thing. As far as I know, failing the boards on the first attempt has no long term ramifications except for your program which is judged by the percentage of residents who pass the boards on their first attempt.
Any advice on how to avoid another failure? In order to help you answer the last question I will tell you that I went through SESAP 15 once. I listened to the audio as well. I stuck to high yield sources and UpToDate to supplement SESAP. I avoided reading any formal textbooks but I did read Cameron front to back during residency.
I have found that everyone learns in different ways. There is no single path to success.
One thing you said caught my attention. “I avoided reading any formal textbooks…” I think that would be a good place to start. You need to get a basic full-sized surgery textbook and read it carefully all the way through. I would advise you to take notes, make flashcards, or whatever else you think might help you to remember important points. Cameron is a great book but in my opinion it is more suited to studying for the oral boards because it is more clinically focused.
SESAP is geared more toward surgeons doing recertifying exams and is probably not worth spending time on for the QE.
Many of my residents used books of practice questions which may help, but only after you have done a lot of reading.
After you have studied your textbook and are feeling fairly comfortable, you should think about taking an intensive review course a few weeks before the exam. That may help solidify your knowledge. Taking a review course without studying beforehand probably won’t work because it is so much information over a short period of time that you will not be able to retain it all.
Study hard because the last thing you need is to fail the QE again. That would put tremendous pressure on the third attempt. You don’t want to be in that position.
I hope this helps. Good luck.
I am sorry to hear of your misfortune. I can’t imagine how you must be feeling.
In your time as a PD did you have a resident or residents fail the QE? Several residents failed the QE. The most notable was a guy who never got below the 60th percentile on the ABSITE. To this day, I cannot understand how that happened.
What became of these people? You will be happy to learn that nearly everyone eventually passed. Patients never ask you how many times it took you to pass the boards. They don’t know about that sort of thing. As far as I know, failing the boards on the first attempt has no long term ramifications except for your program which is judged by the percentage of residents who pass the boards on their first attempt.
Any advice on how to avoid another failure? In order to help you answer the last question I will tell you that I went through SESAP 15 once. I listened to the audio as well. I stuck to high yield sources and UpToDate to supplement SESAP. I avoided reading any formal textbooks but I did read Cameron front to back during residency.
I have found that everyone learns in different ways. There is no single path to success.
One thing you said caught my attention. “I avoided reading any formal textbooks…” I think that would be a good place to start. You need to get a basic full-sized surgery textbook and read it carefully all the way through. I would advise you to take notes, make flashcards, or whatever else you think might help you to remember important points. Cameron is a great book but in my opinion it is more suited to studying for the oral boards because it is more clinically focused.
SESAP is geared more toward surgeons doing recertifying exams and is probably not worth spending time on for the QE.
Many of my residents used books of practice questions which may help, but only after you have done a lot of reading.
After you have studied your textbook and are feeling fairly comfortable, you should think about taking an intensive review course a few weeks before the exam. That may help solidify your knowledge. Taking a review course without studying beforehand probably won’t work because it is so much information over a short period of time that you will not be able to retain it all.
Study hard because the last thing you need is to fail the QE again. That would put tremendous pressure on the third attempt. You don’t want to be in that position.
I hope this helps. Good luck.
Monday, February 29, 2016
The ultimate resident evaluation
It comes as no shock to me, and probably many other current and former program directors, that a recent study showed faculty overall performance evaluations of residents do not correlate with their scores on the yearly American Board of Surgery in Training Examination.
According to the JAMA Surgery paper, faculty evaluations encompassed technical skill and the six core competencies—medical knowledge, patient care, interpersonal and communication skills, professionalism, practice-based learning and improvement, and system-based practice.
The paper analyzed data for 150 residents at different levels of training over 4 years and also found that even faculty evaluations of the category medical knowledge couldn’t predict who would get a good or a bad score on the test.
It’s great to know that at the authors’ institution, the average annual evaluation scores ranged from just over 75 to 100 with means and medians both slightly above 92—like Garrison Keillor’s mythical Lake Wobegon, “where all the women are strong, all the men are good looking, and all the children are above average.”
According to the JAMA Surgery paper, faculty evaluations encompassed technical skill and the six core competencies—medical knowledge, patient care, interpersonal and communication skills, professionalism, practice-based learning and improvement, and system-based practice.
The paper analyzed data for 150 residents at different levels of training over 4 years and also found that even faculty evaluations of the category medical knowledge couldn’t predict who would get a good or a bad score on the test.
It’s great to know that at the authors’ institution, the average annual evaluation scores ranged from just over 75 to 100 with means and medians both slightly above 92—like Garrison Keillor’s mythical Lake Wobegon, “where all the women are strong, all the men are good looking, and all the children are above average.”
Friday, January 30, 2015
It's that time of year again
Hopes are high; everyone is prepared; all the talk is over. The big day is finally here.
No, it's not about the Super Bowl. It's about the American Board of Surgery In-Training Examination (ABSITE).
Every year at the end of January, all surgical residents take a five-hour, 250 question multiple-choice test. For many, it can be a watershed moment because their careers may be on the line.
I have written about the use of the ABSITE as a criterion for resident promotion. Whether you think it should be or not, it is used that way—sometimes as the only criterion. You can bet that in a few weeks, some residency programs will post notices saying they are looking for a categorical PGY-2 or 3 due to an "unexpected" vacancy for July 2015.
Another attending surgeon and I used to take in-house call the night before the examination so that all of the residents could take the test after a decent night's sleep.
Now the test may be given on different days so that the entire group does not have to take it at once.
One difficult situation I faced as a program director was when I had a good clinical resident who just could not do well on a multiple-choice examination. I had to decide whether keeping a resident who scored at the 10th percentile was worth the gamble. Scoring in the 10th percentile or less on a regular basis means that the resident has a good chance of failing the written board examination.
Of course, the very nature of percentiles is that 10% of those who take the test will finish in the 10th percentile or below. Also, the failure rate of the written board examination has hovered around 25% for many years.
The problem for programs is that the Residency Review Committee for Surgery mandates that 65% of a program's graduating residents must pass both parts of the board examination on the first attempt.
Of the many things I do not miss about practicing medicine during this turbulent era, the palpable level of anxiety surrounding the buildup to the exam and waiting for the dreaded results to come back rank high on the list.
I wish all residents who are taking the test the best of luck. I hope you were reading all along and not trying to cram a year's worth of studying into the week before the test.
May you all score above the 50th percentile.
No, it's not about the Super Bowl. It's about the American Board of Surgery In-Training Examination (ABSITE).
Every year at the end of January, all surgical residents take a five-hour, 250 question multiple-choice test. For many, it can be a watershed moment because their careers may be on the line.
I have written about the use of the ABSITE as a criterion for resident promotion. Whether you think it should be or not, it is used that way—sometimes as the only criterion. You can bet that in a few weeks, some residency programs will post notices saying they are looking for a categorical PGY-2 or 3 due to an "unexpected" vacancy for July 2015.
Another attending surgeon and I used to take in-house call the night before the examination so that all of the residents could take the test after a decent night's sleep.
Now the test may be given on different days so that the entire group does not have to take it at once.
One difficult situation I faced as a program director was when I had a good clinical resident who just could not do well on a multiple-choice examination. I had to decide whether keeping a resident who scored at the 10th percentile was worth the gamble. Scoring in the 10th percentile or less on a regular basis means that the resident has a good chance of failing the written board examination.
Of course, the very nature of percentiles is that 10% of those who take the test will finish in the 10th percentile or below. Also, the failure rate of the written board examination has hovered around 25% for many years.
The problem for programs is that the Residency Review Committee for Surgery mandates that 65% of a program's graduating residents must pass both parts of the board examination on the first attempt.
Of the many things I do not miss about practicing medicine during this turbulent era, the palpable level of anxiety surrounding the buildup to the exam and waiting for the dreaded results to come back rank high on the list.
I wish all residents who are taking the test the best of luck. I hope you were reading all along and not trying to cram a year's worth of studying into the week before the test.
May you all score above the 50th percentile.
Monday, November 17, 2014
Should resident promotion decisions be based on a written exam?
A few days ago, some surgeons on Twitter discussed the role of the American Board of Surgery In-Training Examination, a test which is given every year in January.
The test was designed to assess residents' knowledge and give them an idea of where their studying should be focused. However, many general surgery program directors (PDs) use the test results in other ways. Some impose remediation programs on residents with low scores and even base resident promotion or retention on them. Some even demand that all residents in their programs maintain scores above the 50th percentile.
The Residency Review Committee (RRC) for Surgery frowns upon these practices and states in its program requirements (Section V.A.2.e) that residents' knowledge should be monitored "by use of a formal exam such as the American Board of Surgery In Training Examination (ABSITE) or other cognitive exams. Test results should not be the sole criterion of resident knowledge, and should not be used as the sole criterion for promotion to a subsequent PG [postgraduate year] level."
The problem for program directors is that the RRC also mandates (Section V.C.2.c) that "as one measure of evaluating program effectiveness" 65% of a residency program's graduates must pass both the American Board of Surgery's Qualifying Examination (written) and Certifying Examination (oral) on their first attempts. I have said before that the "65% on the first attempt rule" does not seem evidence-based.
The test was designed to assess residents' knowledge and give them an idea of where their studying should be focused. However, many general surgery program directors (PDs) use the test results in other ways. Some impose remediation programs on residents with low scores and even base resident promotion or retention on them. Some even demand that all residents in their programs maintain scores above the 50th percentile.
The Residency Review Committee (RRC) for Surgery frowns upon these practices and states in its program requirements (Section V.A.2.e) that residents' knowledge should be monitored "by use of a formal exam such as the American Board of Surgery In Training Examination (ABSITE) or other cognitive exams. Test results should not be the sole criterion of resident knowledge, and should not be used as the sole criterion for promotion to a subsequent PG [postgraduate year] level."
The problem for program directors is that the RRC also mandates (Section V.C.2.c) that "as one measure of evaluating program effectiveness" 65% of a residency program's graduates must pass both the American Board of Surgery's Qualifying Examination (written) and Certifying Examination (oral) on their first attempts. I have said before that the "65% on the first attempt rule" does not seem evidence-based.