Sunday, January 09, 2005

Psychiatry Board Exams

I am taking my psychiatry oral board exams on Saturday the 15th. This is my 3rd attempt.
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Unlike most specialties, psychiatry has both written and oral board examinations. The written examination is a multiple choice test; most psychiatrists pass it. After passing the written boards, a psychiatrist can sign up for the oral boards. During the oral boards, the psychiatrist interviews a patient, presents him to examiners, and also answers the examiners' questions. Another part of the orals is the video exam, in which the psychiatrist watches a patient being interviewed on a videotape, presents the patient to examiners, and also answers the examiners' questions. To pass the orals, a psychiatrist must pass both the live patient interview and the video exam.
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The pass rate for the orals is only 55%. The pass rate is even lower for repeat candidates.
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Each exam (written or oral) costs about $1600. So far I have spent about $6400 on exam fees alone. Adding in travel costs brings the figure up to about $9500. Adding in the cost of board review courses brings up the cost to about $14000. Adding in the money I spent passing my sleep and internal medicine boards brings my total board exam expenditures to over $25,000.
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This is my last attempt at passing the psychiatry oral boards. After flunking for the 3rd time, the whole process starts all over again. You have to turn in another application and take the written boards ($1600) before taking the orals (another $1600) again. It's just too much money.
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I am pessimistic about my chances of passing the orals; the pass rate for repeat candidates is less than 50%. I am taking another board review course this week with mock examinations, but I am not sure how much it will help. Both times I took the orals in the past, I passed the live patient interview but flunked the video exam. Most residency programs prepare you for the live patient interview, but it's hard to prepare for the video exam. Hopefully this board review course will help.
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If I flunk this time, I am giving up on psychiatry. I will need to look for a new job, probably one that is mainly sleep medicine. This blog will no longer be "The commentary of an academic internist/sleep specialist/psychiatrist" but just the commentary of an internist and sleep specialist.
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tomorrow I am heading back to my home state of California for the board review course and the oral exams. Wish me luck. Posting will be light for the next week.

29 comments:

aafan said...

Good luck! I do have friends who passed on the third attempt, so it does happen!! The video portion is so hard. It's an ambiguous interview that you have no control over (as you know). My "video patient" had medical and psych issues, and it was so vague. I had to keep saying, "well it could be this, and I'd want to know this, and it could be that, and I would ask that. And here's how I think when I hear this." Every time I was stuck, I would say something like, "I'm thinking of bio-psycho-social assessment here. For bio,I think a, b, c" and so one. I had to do practice interviews over and over, before the exam. I also did board review courses. I just about fainted when I passed. Sounds like you're doing everything. (Sorry for the unsolicited advice!)

Bora Zivkovic said...

Good Luck!


http://sciencepolitics.blogspot.com/2005/01/next-tangled-bank.html

Michael Rack, MD said...

Thank you, Shrinkette and Dr. Baker, for the advice and good wishes.

Michael Rack, MD said...

Thanks, coturnix

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Anonymous said...

I hope you passed! With that said, why give up on psychiatry if you fail? I'd just give up on the boards. The only people who seem to really care about being board certified are the board members and examiners themselves. That's it. So if you like psych, please stick with it even if you fail again. I bet you'll have no problem working very successfully, board certified or not.

Anonymous said...

psych board part II is really not formatted to test your knowledge in psychiatry. Your success is in the hands of examiners and the patient. It is not at all standardized exam.Cost is too high and above all,travel to a far off destination adds up to your confusion.

Anonymous said...

I believe the whole process is a sham and truly money making venture. I am surprised the degree to which they can get away with this type of exam that truly has little credibility outside of the board members who seem to enjoy playing it up as this very important and life traumatic event. I suspect that if you failed twice, the chances are that you will pass on the next exam since they know that many physicians will not continue this process indefinately. I wonder if this process has ever been challenges legally. Regarding the examiners, I recently failed the NYC live patient interview but passed the video vignettes. My live patient examiners seemed to not know anymore of psychiatry than myself; for instance, they were stumped on why I would not treat hypomania. Ultimately I believe it is nothing more than a Broadway presentation, wherein we dress in suits and perform for examiners to include stroking their ego. If we challenge them, if that be your style, it may have adverse consequences. I had no problem passing my Internal Medicine boards (I'm med psych trained) and that truly was a mater of content and far more nerve racking than the psych boards. Medicine use to do oral boards but d/c them in the 70s believing them to be too subjective. ABPN would do well in truly reassessing this process of testing. However, I is too much of a revenue generator to significant reform the oral boards.

Anonymous said...

someone should simply file a lawsuit. Subjective oral boards are simply a money making scheme. ABPN knows this especially in light of Nurse Practioners who have now almost identical rights in most states.

Anonymous said...

Unfortunately, the game is stacked. If you pass, in time you'll feel that you achieved something are not going to challenge the process. If you fail and challenge---you will be discredited by statements like "this person wasn't capable". When it happen (the lawsuit) it will someone who will be in the latter group and no doubt have to take a great deal of abuse. Bottom line---economics for everyone involved, we all know this.

Anonymous said...

it sounds like you did pass,congratulations.

I was wondering if you could tell me what you thought about that board review course; I can't decide if I should sign up or not.

Unknown said...

I found out yesterday that I failed the oral board for the second time. I felt very good after taking the exam and was confident I passed, what a surprise. My main emotion now is anger. I am a us grad, primary english speaker, US residency and fellowship in child psych, hav a good job and receive great reviews, but have received the "we regret to inform you but you failed" notice twice. I am not planning to take it again, why would I if I cannot think of a reason I failed.

Anonymous said...

The crooks at ABPN have made a ponzi scheme for making money by this oral board exam. This is a ridiculously inaccurate exam and tilted against minorities and international medical graduates. The crooks at ABPN enjoy the false sense of power over psychiatrists who fail as they have difficulty understanding what answer the examiner really wants to hear.
This farudulent exam must be discarded.

Anonymous said...

My examiner fell asleep during my oral exam. I challenged with their $750 appeal and it did no good. Should've saved my money. I do agree it's a big money-making scheme.

Anonymous said...

Please let me know how to pass ABPN. I am having nightmares about failing again. Those examiners look like bunch of narcissistic sadistic assholes. How to please them.
Dan

Anonymous said...

I felt good that there are lot of people in the same boat it really helped me to to get over little bit of anger and frustration. thanks for this blog.
John

Anonymous said...

If you guys are planning to sue those ass holes count me in. I don't mind spending money for good cause.

Anonymous said...

I failed the oral Psychiatry boards twice, about 20 years ago, and other than the blow to my self-esteem, I can't say it has made a huge difference, for example, in getting a job. I think that after someone passes the exam, he may buy into the idea that he really is better qualified than someone who is not board certified, and so physicians in general tend to support the importance of "membership in the club," sort of an identification with the aggressor situation. BTW, I just came across an interesting article reviewing the actual correlation of BC (any specialty) with other measures of competence, propensity to being sued, etc., and the author (who was not an MD/DO) concluded there was no correlation. Unfortunately, with the advent of managed care, the relative necessity of BC is probably here to stay.

Doctor Dan said...

Hi. I'm applying to psychiatry residencies and was wondering if the ABPN situation has improved since 2005 when all these posts were written.

Has it gotten any better?

Anonymous said...

Yes, TG, it is going to be better. You probably know by now that there will be no more oral boards, for those graduating adult psychiatry after 2009, I believe...I got screwed and have to take orals next year (Im taking written this year) as I graduated in 2009 from adult and am completing child this year (2011), they will be offered for those graduating in 2009 or earlier until 2016, is my understanding...

Anonymous said...

The Psychiatry board doesn't evaluate the knowledge of the examinee but is a money making scheme managed by certain group and at times they balck ball the candidates. A bunch of crooks.

Anonymous said...

Psychiatry Board is controlled by Jews like many other aspects of medical professions. They black ball certain groups.I don't know anyone of them having to take the test twice.

Anonymous said...

So after spending all that money you want to make that money by giving that course?if u didnt pass how can you recomend that course to others

Anonymous said...

Certain religious minority group is in charge of the board and they do discriminate. This is a money making tool. They should be sued.

Anonymous said...

do not take beat the boards - it sucks. they promise to give vignettes, and yet have not a week before the exam

Anonymous said...

The ABPN psychiatry oral boards is a scam with sick narcissistic ,xenophobic, incompetent asshole psychiatrists as the ones in charge of "failing" or "passing" . I think they are more concerned with fulfilling a quota so as NOT to pass more than 50% so they can keep their free air plane tickets and stay at lavish hotels . There is incentive for the "examiner" not to pass candidates. It is not based on competence but on making money off certain minority groups.
I dont even think that the bastard "examiners" have any contact with real live patients in their real jobs.

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Xavier said...

it is right to still have written as well as oral exams in psychiatry