Radiology Board Review(RBR) » You Can Do it!

Yes You Can! By Thomas Wiley, MD

oralboards — Sat, 18 Jul 2009 20:01:23 +0000

Are you stressed out about the Board of Radiology oral board exam? Are you buried under a sea of radiology textbooks with no idea where to start your studies? Are you tired of calling your friends for answers, only to be left with more questions? You tried radiology review courses, radiology teaching files and radiology review textbooks, but you were dismayed and overwhelmed by the endless amount of radiology information and material. You are not alone. Find the right tools here to pass the american board of radiology diagnostic radiology oral board examination in Louisville with less stress!The typical radiology resident goals for the radiology oral board exam include knowing everything about every subject in radiology, getting every question right on the american board of radiology oral examination, and passing the oral board without any stress or anxiety. Most residents believe that any subject in radiology is possible on the examination, and that possible examination scenarios cannot be predicted. Therefore, all radiology subjects must be studied thoroughly. No time is devoted to stress and anxiety management. Instead, the resident devotes as much time as possible to studying radiology images and x-rays. The goal of knowing everything in radiology is noble, but ultimately impossible for most. Fortunately, the vast majority of residents will learn enough to pass anyway.

5 Keys to Success to Radiology Oral Board Exam Success

1. Learn to manage anxiety. Anxiety is very high at the radiology oral board examination. Those who learn to manage their anxiety will excel, while those who do not will stumble 2. Be Average. Since the vast majority of board exam applicants pass, you are better off striving to be average. The average candidate passes. At the end of the day, you have a better chance of passing if the examiner remembers little about you. In my opinion, the more you differ from the norm in appearance, style, or personality, the greater chance that you may fall to one side of the bell curve. 3. Learn to Follow the Hints of the Board Examiner. Examiners only lead the candidate to a conclusion for two reasons. Usually they are trying to help you come to the correct conclusion. Occasionally they may be trying to see if you will choose to do something dangerous to the patient. When the examiner is leading you, ask yourself if following the lead would be dangerous to the patient. If not, follow the lead! If it would be dangerous, express your concern over patient safety. Do not argue with the examiner. Just state your safety concerns.4. Develop a Methodical Approach to Radiologic Image Evaluation. Those who do not develop a systematic approach to image interpretation will panic when the abnormality is not quickly apparent. The resultant anxiety could be difficult to overcome. In addition, sometimes more than one abnormality is present on the image. If you only talk about the first abnormality (satisfaction of search) you may not open your eyes to the other clues available. I like to use the geographic approach from outer to inner. Some people prefer an organ based approach. Use whatever works for you, but make sure that you make this a routine habit. You will not be able to do it at the oral board exam in a panic if you have not developed this as a subconscious habit.5. Develop a Methodical Approach to Differential Diagnosis (Interpretation). Similarly, if the answer is not readily apparent, many oral board candidates will panic. Successful candidates use a methodical approach to find categories of disease which could result in the findings. The systematic approach will reduce anxiety and panic. This approach only works if it is well practiced and routine. I personally like the CITMAN mnemonic. It is short and simple. Moreover, it covers most of the types of disease processes you will see.

C-congenital
I-infection, inflammation
T-trauma
M-metabolic
A-allergic, autoimmune (remember to add vascular to this one)
N-neoplasm.

More comprehensive differential diagnosis approaches exist, but I believe simple is better.

Radiology Oral Board

oralboards — Sat, 18 Jul 2009 19:38:11 +0000

Exact ABR Statistics

The American Board of Radiology maintains statistics (stats)for pass rates for the written, physics, and oral portions of the radiology board examination on the American Board of Radiology (ABR) website at: http://theabr.org/ Realize that the radiology oral board pass rate only includes those who passed unconditionally. Those who condition the radiology oral board examination are not included in the published pass rate. The condition rate is generally high, making the fail rate quite low for first time test takers. ABR Dates

Radiology Oral Board – First Time Exam Takers

The vast majority of first time examinees pass the radiology oral board examination. Between 75% and 82% of first time test takers pass the American Board of Radiology (ABR) exam in any given year. Most people who do not pass outright condition the radiology oral board examination. 15%-19% of examinees condition the radiology oral board. A majority of people who condition the radiology board exam will pass the test when they repeat the conditioned subjects. Only 2%-7% of first time test takers fail the radiology oral board examination. Remember that this number includes people who did not even take the test because of a medical emergency, missed airline flight, family emergency, death, etc. The fact is a very small number of people fail the test. Yet the vast majority of people are petrified about failing the oral board exam. The fear leads to anxiety which is the primary reason people do poorly at the oral board exam.

Repeat Test Takers

The statistics are not as good for repeat radiology oral board exam takers. However, between 54% and 69% of repeat oral board test takers will fall into the combined pass or condition category. The failure rate for repeat test takers is between 30 and 46%. Why the difference? First, these people have already failed the radiology oral board exam once. Their anxiety level has increased substantially (Especially if anxiety caused their first failure). Second, they are likely in practice now rather than training. Their opportunity to study has on average decreased. In addition, they have probably had poor guidance on how to prepare for the oral board examination since they failed the first time. Since no one has taught them to deal with the anxiety, their chance of success is decreased. I believe the statistical difference would be eliminated if the repeaters learned to manage their anxiety and prepare for the test properly.

Stress and Anxiety

oralboards — Sat, 18 Jul 2009 19:36:40 +0000

Stress and Anxiety

You might think that the main reason that people fail the board examination is due to lack of sufficient study or case presentation. My experience is that most people spend enough time preparing these skills. In fact, most residents are extremely well prepared in these areas. The reason is that all tests to this point have been written tests, and examinees are very familiar with studying for a written type of test. The same study skills can be used to prepare for the oral board examination. What the majority of examinees fail to recognize is that stress and anxiety are much larger factors in an oral examination. Few candidates spend any time preparing to deal with anxiety and stress. I am not aware of any training programs or review courses that successfully address these issues. The fact is that most people who do not pass the board examination did not test well due to anxiety and stress. I strongly advise my students to prepare for the anxiety and stress that the examination will provoke. For each individual, the preparation may be different. If you do take the time to prepare yourself mentally for the challenge, your chance of success will be greatly enhanced. Sitting in the “hot seat” while presenting cases is a good tool for preparing for examination stress and anxiety. However, I would suggest spending some time with books, tapes, or video’s about the subject of stress and anxiety management. The small amount of time you spend on this task may slightly decrease the amount of study time for radiology, but you will be handsomely rewarded!

Resources to Reduce Exam, Test, and Oral Board Stress and Anxiety

Radiology Exam Anxiety and Stress Reduction Resources”Hot Seat” preparation for many people desensitizes the anxiety and stress response so that they can perform well in the radiology oral board exam. However, some people tend to be more anxious or nervous despite this type of preparation. Numerous resources are available to assist you with test and exam anxiety and stress reduction. If you feel like you need additional help beyond the standard “hot seat” preparation, the following links show various anxiety and stress reduction books and audio books that may help you:
The small amount of time you spend preparing for anxiety and stress management and reduction will pay big dividends on test day. What about anxiety reducing medication?I have been asked by quite a few residents about taking beta blockers or benzodiazepines for the examination. I do not recommend taking any medication prior to the examination, particularly if you do not know how it will affect your mental acuity. Remember that some anxiety and stress is essential for your mental alertness and performance on the test. You don’t want to be mentally sluggish or asleep! Your goal is to harness the anxiety for constructive purposes rather than being paralyzed with fear. With that being said, I realize that you are all doctors and capable of making your own decisions about medication.What about Coffee or Caffeine?If you are accustomed to having coffee or caffeine, I would still have some before the exam. You don’t wan to be distracted by withdrawal symptoms during the test. Remember, however, that caffeine may increase your anxiety levels though so moderation is prudent.

Dress For Success!

oralboards — Sat, 18 Jul 2009 19:33:50 +0000

Dress For Success!

What should you wear on the day of the examination? This is a question that I am often asked by residents preparing to go to Louisville. Your apparel is important. It should reflect your professional demeanor. I recommend that you dress for the exam the same as you would for an interview. Men should wear a suit or a dark color sport coat and tie. Women should also dress conservatively. I would avoid anything too revealing or brightly colored. Don’t try to make a unique fashion statement. I believe that you should try to blend in with the crowd. At the end of the day if the examiner can’t remember anything about you, you are probably going to do okay. If you are the examinee with the purple hair in a T-shirt and shorts with a large nose ring, you better really know the material to get by the extra scrutiny

Study Strategy

oralboards — Sat, 18 Jul 2009 19:32:57 +0000

Radiology Oral Board Study Strategy

Some topics are more important than others to review for the radiology oral board exam. I recommend studying much more on common entities, dangerous entities, and Aunt Minnie’s. Do not spend as much time studying benign entities or rare entities. If you miss a common or dangerous entity, you are much more likely to fail than if you miss a rare entity. I will give a simplified example. Consider one examinee on the chest section who give a very complete differential for interstitial lung disease and gets the diagnosis for lymphangiomyomatosis. He does very poorly on the differential for a patient with mulitple pulmonary nodules due to metastatic neoplasm. The second examinee does better on the multiple pulmonary nodule case, but blows the lymphangiomyomatosis case. I believe candidate 2 is more likely to pass because he did better on the more common case. Aunt Minnie’s must be studied because you can’t get the diagnosis if you can’t recognize it. Second, these cases are very easy to test! If you go through the subject lists, you can start to see which processes are important to study. For example in the chest section, you must know how to present solitary pulmonary nodule, multiple pulmonary nodules, sarcoidosis, lung cancer, and interstitial lung disease to name a few chest diseases. The is a Very Useful Review Guide for Each Subject with concise reviews of the types of cases you might see at the board examination. Review of these books and the companion Radiology Requisite series would be ideal, if you have enough time.

The american board of radiology oral board exam consists of eleven radiology sections:

1. Pulmonary (Chest) Radiology

2. Musculoskeletal (Bone) Radiology

3. Gastrointestinal (GI) Radiology

4. Genitourinary (GU) Radiology

5. Pediatric Radiology

6. Neuroradiology

7. Nuclear Medicine

8. Ultrasound

9. Breast Imaging (Mammography)

10. Vascular and Interventional Radiology

11. Virtual Cardiac Radiology

5 Keys to Success

oralboards — Sat, 18 Jul 2009 19:32:03 +0000

5 Keys to Success to Radiology Oral Board Exam Success

C-congenital
I-infection, inflammation
T-trauma
M-metabolic
A-allergic, autoimmune (remember to add vascular to this one)
N-neoplasm.

More comprehensive differential diagnosis approaches exist, but I believe simple is better.

Board Examiner Goals

oralboards — Sat, 18 Jul 2009 19:30:57 +0000

The American Board of Radiology Oral Board – Board Examiner Goals

The goal of an examiner at the radiology oral board exam is quite different from the goal of the examinee. The examiner goals fall into 5 categories:

1. Screen out dangerous radiology candidates

2. Maintain a high quality standard for radiologists in the community

3. Observe the thought process (logic) of the radiology board candidate

4. Teach key radiology points (pearls of wisdom)

5. Occasionally the examiner has a personal agenda

Very rarely is an examiner at the radiology oral board examination setting out to fail a candidate. Most are very helpful and are trying to help you pass the oral board exam. Unfortunately, most candidates assume that the examiner is an adversary. If you are mindful of the goals of the examine you can improve your chances for success!