The American Board of Radiology Oral Board - Typical Resident Goals and Strategy

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.  The statistics are on your side (see the radiology oral board stats page )

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 examiner, you can improve your chances for success!

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.  More on test anxiety reduction and resources.... 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 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 Radiology Case Review Series 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. Radiology Case Review Books Radiology Requisite Books

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