Preparing for Oral OB/GYN Boards

Dear Senior Residents and Junior Faculty:

Congratulations! You’ve passed so many milestones already… Since starting residency, you’ve completed USMLE Step 3, survived your first 24-hour call on labor and delivery, taken multiple CREOG exams, and gotten through pimping by that attending. (And you might have even have passed your written boards already…) Just a few more milestones left, and one of them is your oral OB/GYN boards.

When should you start thinking about your oral boards?

Well, that depends a little bit on what your plans after residency are. If your post-residency training or practice plans are gynecology- or obstetrics-specific, then you might be able to use cases from your senior year of residency for some part of your case list. The rules on exactly what cases can be used are laid out in detail in each year’s Bulletin for the Oral Examination for Basic Certification in Obstetrics and Gynecology on the American Board of Obstetrics and Gynecology website. You don’t need to read it in detail before you graduate from residency, but it may make keeping track of cases from your senior year easier to know the categories they might go in and what information about each patient you might need.

In the ABOG Bulletin, check out section V (Case Lists) for the various categories for your Gynecology and Obstetrics case lists. Then check out Appendix 8: Case List Headings to see what kind of information will be needed for each type of case. If you’re not going to do obstetrics after residency, then focus on the obstetrics information so that you can keep track of information you need to build the lists while you’re still in residency. Especially if you’re not planning to practice or go to fellowship in the same hospital/medical record system, it can be very difficult to get access to the old medical records in order to put together this list after you’ve left.

Then fast-forward to within a couple months of when your case list is due. (Check out the due dates in the bulletin – don’t wait until the last minute, there’s no reason to pay a late fee; the exam is expensive enough.) There are multiple software options to build the list. You can make a word document or excel document yourself; you can download the ABOG software; or you can use another company’s software. Honestly, none of the options are awesome, but choose one and stick with it. It’s not worth the time to move from one database to another. Check with the people you know who took the exam last year and find out what the recommendations are these days for case list software.

So, now you’ve put together your list. Find several people you trust and have them read them. Make sure to start this at least 4-6 weeks before the list is due. Those individuals will have recommendations on edits and revisions. Choose the recommendations that make sense to you, make the changes, and have more people look at your list. There are formal services that will review your list, but that’s not necessary for most people. Consider having someone doing a mock oral with you with your list BEFORE you submit it. That way if something you’ve written down totally throws you off or is worded in a way that makes your management seem unusual, you can find it out before the list is finalized.

(There are some people who might try to get you to change the order of cases in your list in order to “control” the flow of the oral boards. I am not convinced that the time and effort it takes to do this is worth it, or even possible. If you have unusual complications at the beginning of the list, you will definitely want to know lots about avoiding them and working them up, but you would have known all of that anyway, right?)

Once the list is submitted, it’s time to start focusing on studying. Given that the test is given by ABOG, itshouldn’t be surprising that you should focus on the ABOG Practice Bulletins and Committee Opinions. Now that you have your list, you should have some idea of what to study. For example, if you have PPROM on your list (who doesn’t?), study that ABOG Practice Bulletins that comment on evaluation and management of PPROM. Keep an eye on the Practice Bulletins during the months between submitting your list and the month of your oral boards, and make sure to read any new ones before your examination. The other high-yield resource that I found the most useful was the list of Exxcellence pearls, available online for free.

Should you take a review course?

Well, I think that the time away from work is probably beneficial in order to have time you can dedicate to studying. Some of them have mock oral boards that they will do, but I don’t think it’s necessary to use them unless you really can’t find anyone you trust from your residency program or wherever you are working now. Be aware during the review course – you are the one taking the test, not the review course. Trust the practice bulletins and your training – if something doesn’t sound quite right, look it up yourself.

The more I learned about the structure of the test, the better prepared I felt. By this time in the process, you will be well aware that there are three portions of the test; each one will have a case list associated with it. Each section, Gynecology, Obstetrics, and Office Practice, will also have a set of cases that all examinees will complete. Each set of cases are presented to you on a computer screen and are meant to take about 30 minutes, leaving 30 minutes for them to ask you about your case list. You stay in the same room the entire time, and you have two different examiners for each section. You are free to leave to use the restroom at any time.

Test and Exam Scoring

As far as scoring goes, there are three scores for each of the three sections – Pass, Borderline, and Fail. You have to get at least one Pass, and if you get a Fail on one section, you must get Pass on the other two. I don’t recommend planning to Fail a section, but this should help your perspective on the exam, in case you feel like a section just doesn’t go the way you think it will.

The best preparation for saying “I don’t remember, but I know where I would look” or “I don’t specifically remember this patient, but my normal management of this situation would involve…” is to have practiced with as many mock examiners as possible before hand. They will help you identify the difficult cases and any management snags so you can explain them as best as possible. Choose some generalists and some specialists. The best mock oral examiners will take you down pathways where you try something that either doesn’t work or allows for something else bad to happen. You should feel uncomfortable. It will make the oral exam more tolerable.

If you can’t find someone where you did residency willing to do mock orals, there are services you can find online to do them over-the-phone. Do not put yourself in the situation of having the actual oral boards be the only time you’ve gone through the cases verbally. If you are looking for a great question bank, check us out at BoardVitals.

Good luck!

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