April 2016 Tip of the Month

Destin Black, MD, FACOG
ABC's April Review Course Lecturer

Dr. Black graduated magna cum laude with a B.S. at Wake Forest. She then completed medical school and residency at Louisiana State University. She left the comfort of her Southern roots temporarily and traveled north to Memorial Sloan-Kettering Cancer Center for her GYN Oncology fellowship. She returned to her beloved Shreveport where she is Clinical Assistant Professor at LSU. Dr. Black has extensively published, but approached ABC "to join the 'A' team" because she was so impressed with the faculty's passion for teaching.

ABOG Maintenance of Certification (MOC) Candidates

You’re working on your taxes, right? That means the first quarter is over. Are you finished with your first quarter articles? Didn’t you make a New Year’s resolution that you weren’t going to procrastinate this year? Promise yourself to get those finished before the second quarter list comes out.

For those of you in MOC Year 6, you must pass a written exam by December 15th, 2016. If you’ve never cut corners before, then our five day review courses, April 13-17, September 14-18 and November 16-20 are perfect for you. This is not the same type of review course from the past. Just as you’ve evolved and practice evidence-based medicine, our course is designed for the adult learner, is exam-focused and all lectures follow the national ACOG guidelines. Heck, you’ll walk away with loads of every day practice tips, too.

If you just can’t come to the review course, or you’re a do-it-yourselfer, then our Annual MOC Manuals summarize each of the last five years of MOC articles AND have written questions. Think of them as Cliff Notes, as they will save you oodles of time.

Finally, if you’re feeling a bit rusty or you had to repeat your primary written exam, our education specialists, Martin and Jane Jolley, specialize in standardized written exams and have created a program just for those taking their written board exam. Sign up for their Test Taking Skills Workshop being offered at our April course.

Oh, just in case you think you’re coasting after you pass your written exam, think again. You still have to read the 2016 articles. No rest for the weary!

Test Taking Tip:
The written exam is only 100 questions and you answer two books of fifty questions. Generalists get to choose their books or “selectives” for each exam. Subspecialists must take the first book based upon their designated subspecialty. They then have to choose a second book from the generalists’ selectives.
Generalist Selective Exam A & B (50 questions)
  1. Obstetrics and Gynecology and Office Practice & Women’s Health
  2. Obstetrics only
  3. Gynecology only (tends to have more Surgical GYN focus)
  4. Office Practice and Women’s Health only (primary care, office GYN & family planning focus)
 
Subspecialists: Selective Exam A (50 questions)
  1. Gynecologic Oncology
  2. Maternal Fetal Medicine
  3. Reproductive Endocrinology & Infertility
  4. Female Pelvic Medicine & Reconstructive Surgery (starting 2019)


 MODE OF PRACTICE

SELECTIVE A

SELECTIVE B

Generalist – OB&GYN

Option 1, 2, 3, or 4

Option 1, 2, 3, or 4

Generalist – GYN Only

Option 3

Option 3 or 4

Generalist – Family Planning

Option 4

Option 4

Generalist – Laborist

Option 2

Option 2

Administrator

Option 3 or 4

Option 3 or 4

MFM

MFM

Option 2

GYN Oncologist

Gynecologic Oncology

Option 3

REI

REI

Option 3 or 4

FPM

Option 3

Option 3
 
 Still not certain what’s the best strategy? Contact us for a free one-on-one consult with Dr. Das, so you can choose the strategy that’s right for you. This will give you peace of mind and confidence as you prepare for and take your exam.

 

For ABOG & AOBOG 2016 WRITTEN Exam Candidates

The AOBOG exam is THIS month and the ABOG exam is in just TWO months – YIKES! For those of you finishing your residency, the end of year stuff - projects and deadlines will really kick in next month. So this is probably your last month for hard core studying. Don’t let it slip away.

For the ABOG exam, it is your responsibility to schedule a seat with the Pearson- VUE testing center. Seats are released after March 25th, but may not be scheduled after June 3rd. Seats are limited and assigned on a “first come, first served” basis.

We strongly advise taking a BOARD review course. A weekend workshop or evening webinar simply cannot provide enough content. No matter how many questions you go through, you simply can’t answer them well if you lack the foundation. It’s like trying to build a brick wall with only the bricks and not the mortar.

We recognize that there is precious little time for you to wade through the volumes of material. That’s why our April 13-17 Review Course provides an exam focused review in accordance with the latest ACOG clinical guidelines. In 43 hours over 5 days, we will review 82 subjects, which historically covers 90% of exam topics! Our faculty is especially knowledgeable in written board exam trends and each lecture concludes with written questions.

You must be candid as to what you can/cannot accomplish on your study plan. Have you finished the MUST KNOW topics? Our Test Topics Manual is a great resource, as it lists high yield topics and suggested test questions. We recommend you shift to those topics that we don’t have time to cover at the course. These include statistics, ethics, genetics, safety and practice and liability management.

Don’t forget YOU MUST PRACTICE WITH WRITTEN questions at the end of EACH study topic. We have a number of products designed to perfectly complement your content review. Our Written Exam Webinar archives will blast you with 350+ written exam questions, based on those high yield subjects with the interactive answer discussion led by our faculty mentors. Then our Written Question Manuals provide an additional 1000+ questions and our Written Question Navigators beeline right to the subject-specific question. Since the test is computerized, ideally you should practice with tests of the same format. ABC, in collaboration with Jolley Test Prep Services, offers Computerized Diagnostic Tests.

For those who have traditionally struggled with written exams, failed the written board exam, or did not score at least 200 on your CREOG in-service exam, you cannot continue with modus operandi. It didn’t work before, so why set yourself up for the same outcome? We have found that knowledge is rarely the problem. You couldn’t have made it this far is that was the case. It’s typically a processing problem. The Jolleys have a brilliantly simply and effective PROCESS with proven success. Their Test Taking Skills Workshop is offered at our April course.

Test Taking Technique:
Make sure you carefully note the qualifiers in the stem question, such as EXCEPT, LEAST/MOST likely, BEST etc. The ABOG written board is known for their NEGATIVELY worded questions, and these are especially challenging. For example, if I say, “DON’T think of the clear turquoise water of the Caribbean.” What do you think of? Yeah, the clear, cool, sparkling, blue waters of the Caribbean, plus warm breezes, bikinis, etc. Here’s a strategy on how to not succumb to their trap. Change a negative stem to a positive one BEFORE you begin to find the best answer.
  1. Circle the negative word in the stem
  2. Omit the negative word and read the stem as a positive statement
  3. Mark each alternative with T, F, or ? (so all but one will be true)
  4. Select the false answer
Which of the following is not a component of the levator ani?
  1. Coccygeus
  2. Ileococcygeus
  3. Puborectalis
  4. Pubococcygeus
Step 1: Which of the following is NOT a component of the levator ani?
  1. Coccygeus
  2. Ileococcygeus
  3. Puborectalis
  4. Pubococcygeus
Step 2: Which of the following ARE components of the levator ani?
  1. Coccygeus
  2. Ileococcygeus
  3. Puborectalis
  4. Pubococcygeus
Step 3: Which of the following ARE components of the levator ani?
  1. Coccygeus - false
  2. Ileococcygeus - true
  3. Puborectalis - true
  4. Pubococcygeus - true

Step 4: Which of the following is NOT a component of the levator ani?

  1. COCCYGEUS
  2. Ileococcygeus
  3. Puborectalis
  4. Pubococcygeus

Now for some more questions from our Written Questions Manual

OB, Preconception Counseling #1

A 23 year old patient presents to your office for preconception counseling.  She mentions that she is a vegetarian. Which vitamin is most commonly deficient in vegetarian diets?

  1. Folate
  2. Vitamin B12
  3. Vitamin C
  4. Vitamin A

Office, Family Planning #2

Which birth control method has the highest failure rate?

  1. Sterilization
  2. Copper IUD
  3. Vasectomy
  4. OCPs
  5. Levonorgestrel IUD

Office, Medical Diseases #5

A 50 year old African-American female presents for an annual exam with a blood pressure of 145/90.  The patient returns the next week with a blood pressure of 151/88.  What is the best management choice?

  1. Recommend increasing exercise and recheck blood pressure in 3 months.
  2. Recommend checking blood pressures at home.
  3. Initiate antihypertensive therapy with losartan.
  4. Initiate antihypertensive therapy with lisinopril.
  5. Initiate antihypertensive therapy with hydrochlorothiazide

Answers to LAST month’s written questions:

FPM fecal incontinence question: Answer: D - The anorectal angle is less acute

GYN, abnormal uterine bleeding question: Answer: D - IV estrogen

REI, embryology: Answer: D - Increased serum testosterone

For ABOG 2016 ORAL Exam Candidates

The application, copy of your current medical license and application fee of $840 was due on March 15th, 2016. If you overlooked this menial, but necessary, administrative task, you can still turn it in, but of course now with a late fee of $345.  If you wait beyond April 15th, 2016 there is an even steeper late fee of $825. No applications are accepted after April 29th, 2016. Surely you already have your case list software, but if you do not, then stop everything and order it now from the ABOG website.  

Only TWO MONTHS left to complete your collection of cases. At this point, you must be up-to-date with all of your past entries. The clock is ticking. You must now enter cases no later than EVERY WEEK.

Ideally, right after you dictate your operative or delivery notes, complete the hard copy of the case list form. Once a week, enter this data into your case list software. At this point, you should have half of your office patients selected. Plan to complete all 40 categories by the end of May. Remember - you can apply only one or two patients per category.

You should now have three binders for each of the three sections - OB, GYN and Office. For each GYN patient, compile their case list sheet, H&P, operative notes, pathology reports, and discharge summaries.  For all OB patients, keep a file of the prenatal forms, delivery notes, discharge summaries and postpartum notes. For the Office patients, file the case list sheet, appropriate copies of the office visit(s) and supporting labs, imaging studies, etc.

If you have been using the ABOG case list software, chances are you are now appreciating why your predecessors grumble they would have never used it. Don’t fret – it was helpful to at least get you familiar with the process. However, if you want to take full control over the optimal construction, we recommend you customize your own software.

Rest assured, this is really pretty easy. Come to our Case List Construction Workshops.  Our flagship workshop is April 12 in Charlotte – the day before the course begins. We’ll show you how to raise your case list head and shoulders above the other candidates. For those who are OCD, order your copy of the Pass Your Oral Ob/Gyn Board Exam, 5th edition by Dr. Das. This book provides a complete step-by-step guide.

The ideal time to take your review course is in the spring, as you will be all consumed with constructing your case list from June to August. You won’t find out the month of your exam until July, so you have to assume it could be as early as November. If that’s the case, you only have two months to study. YIKES! We recommend our April 13-17 BOARD review course for an exam focused review. There is precious little time to wade through the volumes of material to figure out what to prioritize. Our faculty members have extensive speaking experience and their lectures are based on ACOG clinical guidelines – duh! the answer guide for the test. They are especially knowledgeable on the oral exam; and every lecture concludes with our signature oral exam defense tips. Ideally, complement the content covered at the review course with a workshop devoted to strategic construction of your case list.

Case List Construction Tip:
For your OB and GYN case lists, try to use as many of the applied categories as possible.  This will show more depth and breadth to your mode of practice. Carefully look at each case to ponder which category to use. For example, did you know there are 18 possible categories to list a hysterectomy?

 

For AOBOG 2016 ORAL Exam Candidates

Applications for the September 30th and October 1st, 2016 exam, along with the $3275 exam fee, are due by April 1st, 2016. However, don’t procrastinate. Since AOBOG implemented an exam cap of 45 candidates, the cap has been reached within a couple of months.

For those preparing for their April 29th and 30th exam, time is short.

Our Osteopathic Oral Exam Webinar is the only webinar in the country that is designed by an osteopathic physician. Dr. Diane Evans DO, FACOOG goes through EACH of the core topic. Since its debut in 2011, 99% of webinar participants have passed their exam! It just ended, but don’t worry, the archives are the next best thing. Each session is strategically grouped into OB, then GYN, then Oncology/Urogynecology.

The ultimate way to pull it all together for those of you preparing for the April exam, or if you’re trying to launch your prep for your fall exam is to attend our April 13-17 or September 14-18 BOARD review course, for an exam focused review. In 2015, AOBOG expanded beyond the traditional ten core topics. Now you’re accountable for a wide range of topics. Did you know our syllabus is highlighted with EACH CORE TOPIC? We also spend an evening dissecting EACH core topic and trying to predict every possible question.

Regardless, you MUST do some mock oral exams. Face-to face is best, and these are offered at the review course. However, keep that momentum going by scheduling a Telephone Mock Oral exam with one of our seasoned ABC faculty. You can also challenge yourself with our Structured Cases CDs, which are based just on the core topics.

Test Taking Technique:  
Just remember 70%. That’s all you need to pass the exam.  You do not need, nor will you likely get, 100% of the questions correct.
The questions will come at you in rapid fire. Often times the examiner will push you until you finally don’t know the answer. Don’t misinterpret this as failing the question. On the contrary, you probably passed it long before, but the examiner may simply want to explore the depth of your knowledge or at least reassure himself that you will acknowledge your limitations.
Let the last question go and focus on the question at hand. Do not let worrying about whether or not you got the last question correct distract you and thereby compromise you getting a sure pass question correct.
Remember, just 70%!

 

Chief Residents Planning A Subspecialty Fellowship

Subspecialty fellows are permitted to select 20 patients from their Chief resident year for their off specialty case list. In other words, GYN Oncologists, REI and Urogynecologists will need an OB list and MFMs need a GYN list. Start collecting those cases NOW while you still have easy access to patient records. To be on the safe side, we recommend you collect at least 30, so you can strategically select the final 20 later. For those patients, keep a file of the following: for the GYN patients, collect the H&Ps, operative notes, pathology reports, and discharge summaries. For the OB patients, keep a file of the prenatal forms, delivery notes, discharge summaries and postpartum notes. Don’t worry about the office patients at all, as you may compile this only during your fellowship

A word of caution – right now you are at your peak for general OB/GYN knowledge. Believe it or not, two years from now, your knowledge base will regress to that of an intern. Yes it’s true, if you don’t use it, you lose it. So those really cool, esoteric, bizarre, once-in-a career cases now will be a nightmare to defend later. Your greatest allies are your junior residents. If they can’t easily defend that case, cease and desist and “go fish” for another case.

Test Taking Technique:
Print out the Bulletin for the Oral Exam for Basic Certification” from abog.org. Go to Publications > Bulletin and peruse the categories. Most generalists don’t have any Oncology and Urogyn cases since they appropriately refer them. But you have the luxury top pick and chose. You want to appear well rounded and balanced. Make sure to include some bread and butter Oncology cases (uterine, ovarian, cervical cancer), Urogyn (prolapse, slings) and for heaven’s sake – at least 3 vaginal hysterectomies!  Also chose some cases on topics that you’ll totally forget about: PID, endometriosis, infertility, fibroids. Finally include some with complications – wound, GU and/or GI injury and some perioperative challenges (Thromboembolism, DM, cardiac, etc)

 

Subspecialty Fellows Planning for their 2016 ABOG General Oral Board Exam

You can now sit for your general oral boards anytime during your fellowship; however, you can only take them once while a fellow.

If you neglected to collect cases in your off specialty from your chief year, you must get back to your residency institution to gather those cases AND enter them into your software. GYN Oncologists, REI and FPMs will need an OB list and MFMs need a GYN list. If you currently have to take call for these off services, you can use those cases.

If you are retrospectively collecting cases, go with your comfort zone. Dang - how could you have forgotten so much in such a short time? Unfortunately it’s true, if you don’t use it, you lose it. Go with the bread-and-butter cases. Remember, this is your general boards. We recommend you chose those cases that reflect high-yield topics. Our Test Topics Manual and the #1 guide, Pass Your Oral Ob/Gyn Board Exam by Dr. Das will be excellent step-by-step guides.

AOBOG Osteopathic Continuous Certification (OCC) Written Exam

This exam is usually a walk in the park for generalists practicing both obstetrics & gynecology. The breakdown of the OCC exam is as follows:         

General Obstetrics                               25%
Maternal Fetal Medicine                      10%
Gynecology (office and surgery)          40%
Reproductive Endocrinology                10%
Gynecologic Oncology                         10%
Miscellaneous                                        5%
 

If you’re taking your exam at the Spring ACOOG meeting, our Written Question Manuals provide great practice for 1000+ questions and our answers and narrative explanation provide additional learning. If you already have your Prologs, our Written Question Navigators beeline you right to the subject-specific question.

 

 

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