MCQs in otolaryngology

[Incus]

Hi there! I am a specialist Registrar (equivalent to a resident) in ENT in England. I am approaching my exit exam (the FRCS ORL-HNS) and the format of the exam has changed somehow in that they are including an mcq and an emq (extended matching questions) paper before the oral examination. I have a feeling that you guys in the states are more accustomed to mcqs and since there is no mcq bank in otolaryngology yet available for this exam in the UK you might know of any sources I can get mcqs from.
Some help would be appreciated.

Thanks

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[resxn]

I took the US Board certification exam in 2005 and I am not sure what you mean still by the MCQ's and EMQ's. Our written exam was pretty straight forward in terms of format. There were essentially short paragraph clinical descriptions with questions about management, pathology, diagnosis, etc based on the vignette. Some were ridiculously esoteric, some were blatantly obvious, but I don't know what you might mean more than that. If you offer more clarification perhaps I could help more.

 

[Incus]

I took the US Board certification exam in 2005 and I am not sure what you mean still by the MCQ's and EMQ's. Our written exam was pretty straight forward in terms of format. There were essentially short paragraph clinical descriptions with questions about management, pathology, diagnosis, etc based on the vignette. Some were ridiculously esoteric, some were blatantly obvious, but I don't know what you might mean more than that. If you offer more clarification perhaps I could help more.

Thanks for the reply.

MCQs are multiple choice questions and EMQs are extended matching questions. That simply means that there is a statement or a question with several answers (usually up to 5) and you have to decide if those answers individually are true or false. For example:

Structures derived from the second pharyngeal arch include:

1. Incus
2. Maxillary artery
3. Stylohyoid ligament
4. Stylohyoid muscle
5. Posterior third of the tongue

I am surprised you don't have mcq's in your exam. Perhaps I had the wrong impression. Thanks anyway

 

[resxn]

sorry, I'm too simple-minded to have figured that out on my own. No, the US board exam does not have ECQ's. My understanding is that they used to but those have been abandoned. The entire written test is of MCQ's only. As far as I'm aware, now being removed almost 2 years from them, it hasn't changed.

 

[Leforte]

We take a yearly exam, our inservice exam, given each March that is 300 MCQ's. This is in preparation for the written Board exam given after residency is completed. Last year I used:

1) KJ Lee - "Essential Otolaryngology"
2) R Pasha - "Otolaryngology: Head and Neck Surgery--A Clinical & Reference Guide, Second Edition"
3) MT Bowden - "Otolaryngology and Facial Plastic Surgery Board Review"
4) Cummings - "Cummings Otolaryngology: Head and Neck Surgery Review (Paperback)"

Also, take a look at the Academy's website for additional resources.

The first 2 are great for reviewing, and the last 2 for facts/questions.

If others have addition recommendations, I'd be interested in knowing, too.

 

[Incus]

We take a yearly exam, our inservice exam, given each March that is 300 MCQ's. This is in preparation for the written Board exam given after residency is completed. Last year I used:

1) KJ Lee - "Essential Otolaryngology"
2) R Pasha - "Otolaryngology: Head and Neck Surgery--A Clinical & Reference Guide, Second Edition"
3) MT Bowden - "Otolaryngology and Facial Plastic Surgery Board Review"
4) Cummings - "Cummings Otolaryngology: Head and Neck Surgery Review (Paperback)"

Also, take a look at the Academy's website for additional resources.

The first 2 are great for reviewing, and the last 2 for facts/questions.

If others have addition recommendations, I'd be interested in knowing, too.

Thank you very much indeed. That is very helpful.
Passing the MCQ paper is a matter of practice of as many MCQ's as you can find. The clinical and the viva requires a different preparation.

 

[ENTCANADA]

I'm going to be taking my American Boards in ENT at the end of March. I've been trying to find some practice multiple choice as I am told it really helps for preparation. Do you know where I could get some?

 

[TheThroat]

I'm going to be taking my American Boards in ENT at the end of March. I've been trying to find some practice multiple choice as I am told it really helps for preparation. Do you know where I could get some?

My advice is to get "Pearls of Wisdom" by MT Bowden. It is very high yield, but DOES NOT give any framework or reasoning behind its answers.

 

[aggernodi]

Not sure if any of you did this, but all I did was get the Osler lectures on CD (a bit pricy, but I thought money well spent)... listened to the entire series like 3 times and studied up on only those items that wasn't clear to me on the CD. And, for a final hurrah... took the actual Osler course right before the exam with practice orals.

It was great!

 

[ENTCANADA]

Not sure if any of you did this, but all I did was get the Osler lectures on CD (a bit pricy, but I thought money well spent)... listened to the entire series like 3 times and studied up on only those items that wasn't clear to me on the CD. And, for a final hurrah... took the actual Osler course right before the exam with practice orals.

It was great!

I've been told it is a good review and am taking it as well. I wasn't sure whether to try the practice orals but maybe I will. Apparently you can sign up for them at the course. As I mentioned in my last note, I am a bit concerned with the multiple choice, as they often take practice and can me tricky, no matter how much knowledge you have. The Canadian exam was short answer. I have all of the books previously listed, and the review books are short answer as well.

Thanks for the info. on the course!

 

[resxn]

Not sure if any of you did this, but all I did was get the Osler lectures on CD (a bit pricy, but I thought money well spent)... listened to the entire series like 3 times and studied up on only those items that wasn't clear to me on the CD. And, for a final hurrah... took the actual Osler course right before the exam with practice orals.

It was great!

I did the Osler course as well the week before the boards. I found it useful for 2 reasons.

1 - If you go to the written review, you just get a week of lectures where basically you get to eat, sleep, and drink all the garbage you need to fully review everything. Simply being away from the cares of my practice and family for those few days put my mind in ENT mode 24/7 which was the most usefuly thing. The lecturers are all pretty good as well, even if it takes some time to get used to a few of the styles.

2 - If you go to the written, you can simply sit in on the oral reviews (you have to pay to get a practice one) but doing the actual oral practice I don't think is necessary--at least for me. I think the fear of the orals far outweighs their difficulty. I found the orals to be fairly easy and definitely straight-forward (unlike the written). The part that was the most useful to me was to watch others struggle and what they did when they struggled. I used that to a) build my own confidence b) realize what not to do when you might not know the exact answer. I think I was better prepared for the orals by just watching others go through theirs. I really don't think that I would have benefitted from doing it, although I know a couple of friends that feel like they did a little bit.

 

[TheThroat]

I just got done with the Osler in Tampa (actually I am in Tampa right now). The Osler course isn't perfect, but it does allow some focus on the subject and time away from home/work.

Honestly I thought that it would be better than it was, mainly in the radiology review. Also, one of the neuro-oto lecturers was highly unorganized and fiercely opinionated. For example: when asked, "Tell us about rotary chair and optokinetics, he replied, 'You don't need to know any of that, it is irrelevant.'"

My thoughts: no course will prepare you for the minutia of the written boards. Residency will prepare you pretty well, and then look to KJ Lee, Pasha, or Pearls to polish up for before the test. The Osler may fill in some gaps, and can certainly help with the orals, giving you high yield info. Beyond that, don't think that just taking Osler will make you pass, as it has no lectures on sinus/allergy/OSA/anesthesia and many other general oto topics.

Actually, I would be pretty upset if the tab were on me ($1390 for the week, plus hotel and flight costs...over $2K), considering how poor the radiology and some of the neuro-oto lectures were. That said, I am glad that I took it (on the company tab) and got away from work. The facial plastics and H&N were particularly good.

I will caveat this by saying that if I pass, I may come back to this forum in the late spring/summer and heartily endorse the course. If i fail, well, you might hear about some oto in Arlington, TX having a nervous breakdown.

In summary, if you are really worried about passing, spend the cash to take the course. It can't hurt, and hanging out with your fellow otos is fun in a "camp" sort of way.

 

[resxn]

I'd 2nd Throat in that don't take Osler as your only or even main study technique. You gotta study your rear off, because it won't cover everything you need (i.e. minutia--and we're talking serious minutia) but it will get you in the mode that I mentioned above.

There is some bias, but I've heard that about Tampa more than Chicago even though many of the lecturers overlap.

 

[aggernodi]

I took the boards 2 years ago... Thank goodness I passed. But, this is about how much time I spent on each studying method if it helps:

1) Osler audio CDs (50%)
2) Studying stuff I didn't understand in Osler audio CDs (25%)
3) Books as described by rsxn and others (25%)

To put in a plug about Osler based on my board experiences...

I would say 10% of the questions I encountered in my boards were directly taken from Osler... word-for-word!

Another 15% of the questions were reworded questions I encountered in Osler.

Another 20% of the questions were thoroughly covered by Osler.

 

[scutum]

On the Osler website it shows that there are 6 CDs for ~ 500$. I read on another post somewhere that there are 30+ CDs.... are there different sets of Osler CDs for ENT. Is there a cheaper way to get them somewhere..discounted... One that a resident may be able to afford?

thanks

 

[Macguire318]

Has anyone heard of residents actively re-producing in-service exam questions from memory and collecting a database over the years to prepare for the exams? I recently heard that this was being done at a neighboring institution. Was surprised.

 

[resxn]

test takers sign a document promising not to record those questions under potential penalty from the board.

Having said that, I've heard similar. For my own exercise, the night after I took the written I was able to recall 214 of the questions. They never saw the light of day, however.

 

[Leforte]

I would also add that while question compiling may increase scores for the in-service, I have heard from our recent graduates that the actual Board examination is an order of magnitude (or two) harder than the inservice.

I can say, however, that having taken the in-service for several years now, I do vaguely recall questions and the subsequent answers when reading for cases.

 

[resxn]

I spoke with one of the members of the board who chairs the committee on question selection for the written part of the boards. He said that in 2005, they redid the questions to make them harder than they had been in the last 5 years. They purposely tried to raise the bar. I can vouch for the esoteric nature of some of the board questions compared to the in-service. It's a much different test to me. Maybe it's just the stress, but I think the questions were designed to be trickier on the boards than on the in-service. It's my impression that the in-service regurgitates a lot of questions from year to year. At least it seemed that way the 4 years I took them.

 

[neutropeniaboy]

I took the boards in April and passed (nice...).

My review consisted of the following:
1. Current Diagnosis and Treatment in Otolaryngology (Very helpful for general ENT, radiology, pediatrics, laryngology)
2. Osler powerpoint slides (I think about $60; helpful for plastics, congenital lesions, cleft palate)
3. Otolaryngology: A Case Study Approach (good review for preparing for the oral boards, which by the way are not difficult at all)
4. Old Inservice questions (totally unhelpful)
5. Osler lectures (got mp3s from a friend; some lectures helpful, others a waste)
6. Old boards questions from previous residents (there were some repeats, believe it or not)

My take: the written wasn't so bad. Most of the time I knew the answer right away. Probably about 25% of the time it was down to 1 or 2 answers, and after asking others for consensus, usually picked the right one. About 10% of the questions I had no F'ing clue what they were talking about and guessed. The orals were all straight forward. I approached it knowing that they do in fact give points for second place. 4 questioners and 4 cases each. I think I struggled with one plastics case (couldn't nail the pathology slide and forgot to say STSG and FTSG for recon), and I think I flunked the ENG interpretation for one question. The rest: a breeze.

I studied for about 6 weeks, typically week nights and some weekends. I also discussed this with several of my colleagues who did fellowships or were doing fellowships. We all seemed to agree that having done a fellowship helped with the orals, because we took the examiner deep. The jury was out regarding the written exam. In many cases, we sort of agreed that there were questions that had no right answer or questions with multiple right answers. Conversely, if we knew the answer immediately, it was hard to determine if we would have known it anyway....