Physics & Radbio

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Given the "robust" new information provided, any word on physics/radbio review courses that will be offered this year (other than Maryland)?
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You should see the review book ASCO provides for its fellows
 
Any thoughts on whether or not the Maryland review course is worthwhile? I'd be especially interested in feedback from residents who took the exam last year.
 
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Hey guys, just wondering if anyone has used the Osler course for radbio in the past and if so would you recommend it?

Thanks
 
radbioistheworst said:
Hey guys, just wondering if anyone has used the Osler course for radbio in the past and if so would you recommend it?

Thanks
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Rad bio is based off the Hall book, so no additional information if that is what you're looking for. It does have audio to may be explain stuff and I was able to listen to it in the car/gym etc...
 
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Mandelin Rain said:
Study Guide:
1. Entirety of Radiation Biology
2. Entirety of Molecular Biology
3. Entirety of Cellular Biology
4. Entirety of Cancer Biology
5. Entirety of Immunology

Nail those 5 simple topics and you're probably set.
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hey and don't forget to memorize how much dose people in the elevator can get... super important
 
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Now that Wallner is gone from ABR, are you all expecting a mea culpa with this year's rad bio/physics scoring/pass rate?
 
Heard it from a reliable source and was told it was openly announced in a recent ASTRO newsletter
 
bethematch said:
Heard it from a reliable source and was told it was openly announced in a recent ASTRO newsletter
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Well he gave our orals this year.
They're probably going to match the clinical board fail rate for you guys.
 
sphinx2019 said:
Well he gave our orals this year.
They're probably going to match the clinical board fail rate for you guys.
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Looking at the pass rates from last year (which the ABR spun and only gave us data for first-time takers), it's clear there was an aberration or some other outside influence other than pure chance. Was that outside influence the lower IQs of the class of 2019 or was it the ABR trying to muscle residencies somehow? I think it's pretty obvious it's the latter, and given that the exam was used as a pretense for change, to continue to validate that, I would expect lots of repeat failures on physics/rad bio this year, lots of clinical failures, and eventually cascading into oral failures, although I suspect a double digit percentage of our class will not be on track to take orals next year given the very high likelihood of more difficult physics, rad bio, and clinical exams this year. So I'd expect oral pass rates to average lower for the next 5 years or so, although probably not next year as the only ones sitting will be the geniuses that managed to get through the gauntlet of absurd qualifying exams without a repeat failure on bio or physics or a surprise failure on clinical (all of which are much more likely when you have to take 3 exams at the same time -- which the ABR very well could have done something about if they really wanted to but instead decided to go with that it's impossible because PearsonVue testing centers are a force of nature like lightning and not a company run by humans that can be negotiated with).

It's worth nothing that if you fail to sit for orals on time, that is considered a failure when it comes to analyzing stats for program accreditation. Yoo now need 60% first time pass rates to maintain accrediation on not just orals, but the qualifying exams as well. Conincidence?

When you compare our boards process to any other specialty, you can see how cruel and draconian the whole process is. You'd think the ABR would want to make certification simple (like it is for most), so that we can get into their MOC scheme sooner.

If they want to have this stupid qualifying test nonsense, then they should allow these exams to be taken at any time and generate a test automatically from a test bank of thousands of validated questions. This is how every other professional certifying body gives their exams. Not once a year in some horribly inefficient and wasteful process of generating a new test each year, which have learned is comprised of 50% of repeat questions that the more elite large programs have access to through organized recall/cheating strategies, and the other 50% of the test comprised of terrible new questions and irrelevant molecular pathway letter and number mix-and-match games that the chair of Memorial Sloan Kettering personally thinks is important.
 
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just do a bunch of raphex tests. aka recalls.
 
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I think ABR should fail another 40-50% of PGY4s this year on rad bio and physics. This will send a clear message about the rotten state of our field and tell the med students to stay away. Maybe this is what Wallner had planned all along.
 
radoncradonc said:
I think ABR should fail another 40-50% of PGY4s this year on rad bio and physics. This will send a clear message about the rotten state of our field and tell the med students to stay away. Maybe this is what Wallner had planned all along.
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Faculty I’ve spoken to keep saying oh they can’t do what they did in 2018 again. That will cause an uproar. Again, these are the people guiding med students career decisions and advising residents.
 
RadsWFA1900 said:
Faculty I’ve spoken to keep saying oh they can’t do what they did in 2018 again. That will cause an uproar. Again, these are the people guiding med students career decisions and advising residents.
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Lightning only strikes once, right?

If I were R4 after last year’s debacle I would already be studying furiously until the moment the exam started.
 
radoncradonc said:
I think ABR should fail another 40-50% of PGY4s this year on rad bio and physics. This will send a clear message about the rotten state of our field and tell the med students to stay away. Maybe this is what Wallner had planned all along.
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To do what the RRC, acgme and ASTRO couldn't... Very possible
 
medgator said:
To do what the RRC, acgme and ASTRO couldn't... Very possible
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If it means pushing a few more burnt out borderline suicidal residents over the deep end...so be it. Apparently there is no other way.
 
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radoncradonc said:
I think ABR should fail another 40-50% of PGY4s this year on rad bio and physics. This will send a clear message about the rotten state of our field and tell the med students to stay away. Maybe this is what Wallner had planned all along.
Click to expand...
Hopefully factitious. Otherwise you do not understand the personal toll this debacle has had on your colleagues. Residents in this situation haven't been able to spend time with their family or study clinical boards because Paul Wallner and Simon Powell think CDK 465-XGHE7 is a better use of time.
 
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RadOncG said:
Hopefully factitious. Otherwise you do not understand the personal toll this debacle has had on your colleagues. Residents in this situation haven't been able to spend time with their family or study clinical boards because Paul Wallner and Simon Powell think CDK 465-XGHE7 is a better use of time.
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Radiation oncology residents should not have families until they complete residency. The ABR did an analysis of residents with families vs residents without families. It will be presented by Paul at ASTRO.
 
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Heard rumours both ways along lines of “they will not do it again” to “you bet they are doubling down”. Either way, what a ginormous waste these exams are. Memorizing the proteins in all DNA repair pathways? Being able to do pointless calculations we never do in clinic?

My guess is that they are going to fail lots of people again. Look at the PW editorials and tell me he is a bit moved at all from any of his previous views. No begging from Amdur/Lee will change that. There will be people failing boards for the second to third time once again. Meanwhile they could have been studying clinical medicine and helping people in Salina Kansas. What a sad sad state of affairs this is. And we wonder why Upitt and TJ cant even fill!?
 
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thecarbonionangle said:
Heard rumours both ways along lines of “they will not do it again” to “you bet they are doubling down”. Either way, what a ginormous waste these exams are. Memorizing the proteins in all DNA repair pathways? Being able to do pointless calculations we never do in clinic?

My guess is that they are going to fail lots of people again. Look at the PW editorials and tell me he is a bit moved at all from any of his previous views. No begging from Amdur/Lee will change that. There will be people failing boards for the second to third time once again. Meanwhile they could have been studying clinical medicine and helping people in Salina Kansas. What a sad sad state of affairs this is. And we wonder why Upitt and TJ cant even fill!?
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100% true. I’ve literally never used 98% of that stuff and my patients are doing very very well and getting top level care. Hopeful that a chair that cares about the field will standup to that DO Wallner but not holding my breath. Certainly Kachnic won’t
 
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thecarbonionangle said:
Heard rumours both ways along lines of “they will not do it again” to “you bet they are doubling down”. Either way, what a ginormous waste these exams are. Memorizing the proteins in all DNA repair pathways? Being able to do pointless calculations we never do in clinic?

My guess is that they are going to fail lots of people again. Look at the PW editorials and tell me he is a bit moved at all from any of his previous views. No begging from Amdur/Lee will change that. There will be people failing boards for the second to third time once again. Meanwhile they could have been studying clinical medicine and helping people in Salina Kansas. What a sad sad state of affairs this is. And we wonder why Upitt and TJ cant even fill!?
Click to expand...

These exams might be the biggest waste of time in any field of medicine and the fact they are preventing quality residents from passing boards, getting jobs, causing unnecessary stress is embarrassing to say the least. Whenever I mention these things to residents in other fields they are dumbfounded.

I've actually heard rumors that other specialties take board exams that are relevant to their future clinical practice [gasp]
 
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We are seeing now is what is referred to as "latency of incompetence." It refers to an administration that came to the field when all you needed was a pulse. They are now in charge of many things and unfortunately have been unable to do something as simple as administer an exam to 200 people (a task that a high school teacher can easily complete). What is astounding is their attempts to explain their failures using terms like, "heterogeneity in teaching," and idiotic concepts like program size (ironic and foolish as programs maxed out at 6 when they trained) when they could have just simply said, "we screwed up." More interesting than that is the response of academics (including some residents) who are expending energy and resources to engage in a debate regarding the validity of these inane explanations. This year has truly been a learning experience for any student of human behavior-including radiation oncologists!

Good luck to all!
 
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metallica81788 said:
These exams might be the biggest waste of time in any field of medicine and the fact they are preventing quality residents from passing boards, getting jobs, causing unnecessary stress is embarrassing to say the least. Whenever I mention these things to residents in other fields they are dumbfounded.

I've actually heard rumors that other specialties take board exams that are relevant to their future clinical practice [gasp]
Click to expand...

The funny thing is the rad bio exam has been absurd for years. If you go back and look at the ASTRO study guys, it's the same clinically irrelevant molecular pathway questions.

For example, this crap:

Which of the following proteins does NOT participate in the p53 pathways involved in cell cycle regulation?
a. SMC1
b. CAK
c. p21 (CDKN1A)
d. GADD45A
e. 14-3-3-sigma

The problem is there are infinity questions like this they can ask by just taking a snapshot of some signalling pathway and asking us to memorize the name of certain proteins. Why is the name of the protein important? The protein could be named PWSUX, and it wouldn't make any difference. It's just a made up name, and questions asking you to recall made up names rather than focus on clinically relevant FUNCTION are a totally absurd waste of the exam and honestly a failure of the exam to test what it is supposed to test.

So this was always going on in the past. What changed?
I think the previous exams lined up to the study guides, the Maryland course, and Hall key points, and everyone just memorized this specific crap (plus their recalls of course) and everyone passed and immediately forgot about all the protein names and moved on.
It was just an annoying hoop to jump through.
Last year, there was no study guide, they introduced a crap ton of specific protein/pathway questions that were not asked on previous study guides that you wouldn't know about unless you worked with them in the lab, and then they set a ridiculously high passing standard.
This was completley deliberate to screw with programs pass rates to threaten accrediation and force programs to make changes the ABR wanted them to make (not their prerogative) we all know it.

What's going to happen this year? Tough to say. Either way, the results are going to be heavily biased by the extreme overstudying everyone is doing. They can make an absurd test again, and passing rates will probably go back to normal because people are studying for 30 days straight 10 hours a day prior to the exam (step 1 effort just for bio). And these bio-jokers who are exerting such influence in our field will use these rates to justify the creation of even more difficult tests in the future.

Bottom line: It's a self-perpetuating cycle. The exams will just get harder, and people will just prepare more and more and more.
Great cottage industry opportunity for someone who wants to start radbioquestions.com or something.
Pathetic that our field has allowed this. But virtually everything about our field is pathetic right now, so no surprise.
 
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I also forgot to add that someone is being paid $300,000 a year for his intelligence to organize this. That money could be used for something more useful (like ornithology) by finding someone who would organize this for free ($10k max).
 
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sphinx2019 said:
We are seeing now is what is referred to as "latency of incompetence." It refers to an administration that came to the field when all you needed was a pulse. They are now in charge of many things and unfortunately have been unable to do something as simple as administer an exam to 200 people (a task that a high school teacher can easily complete). What is astounding is their attempts to explain their failures using terms like, "heterogeneity in teaching," and idiotic concepts like program size (ironic and foolish as programs maxed out at 6 when they trained) when they could have just simply said, "we screwed up." More interesting than that is the response of academics (including some residents) who are expending energy and resources to engage in a debate regarding the validity of these inane explanations. This year has truly been a learning experience for any student of human behavior-including radiation oncologists!

Good luck to all!
Click to expand...


Funny funny and so true. The old timers who lecture people of declining resident quality joined one of the least sought after fields in medicine constantly unfilled and with IMGs now cannot even get it correct. I had classes in college about that size and an old prof and his assistant administered the test better than the so called “ABR”.

I looked at the 2019 rad bio practice ASTRO test recently out. Full of typos. A series of questions on a section say “answer and explanation are missing”. This is a complete joke. The leadership of the specialty do not give a flying F about us. They should just take a dump on our chests and get it over with. The link to the “study guides” is a useless blank syllabus with a list of books and articles.

The physics practice study guide link links to an article in a journal.
 
The fact is these tests have been useless and irrelevant for some time but people did not care until they failed enough people. It has been a failure of leadership for quite sometime. we deserve all that is coming, our field being filled with FMGs (can’t understand most path fellows on their 3rd fellowship at tumor board), unfilled programs, etc. We are already a joke in many’s eyes and will be even more of a laughing stock!
 
Any strategies for an afternoon exam? I find the eyes dimming a bit...Use the fear and the adrenaline to keep awake? :|
 
Mandelin Rain said:
"Cocaine is a helluva drug."
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Thank you MR. It'll go perfectly with my other drug of choice.

www.ncbi.nlm.nih.gov

Effects of cocaine and caffeine alone and in combination on cardiovascular performance: an experimental hemodynamic and coronary flow reserve study in a canine model - PubMed

Cocaine increased heart rate, blood pressure and dP/dt but reduced CFR. Caffeine mildly increased the hemodynamic variables but decreased CFR. Combined cocaine+caffeine attenuated the excitatory effects of cocaine significantly. A reversed drug combination i.e., caffeine+cocaine generated...
www.ncbi.nlm.nih.gov www.ncbi.nlm.nih.gov

Woof Woof.
 
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Mandelin Rain said:
"Cocaine is a helluva drug."
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Pardon the detour, but every time I hear "cocaine" I think (besides this) of a story of a man, cancer, psychiatry, radiation, and the man's use/reliance on cocaine:

Over a span of 16 years, Freud had undergone 30-some operations and several courses of radiation therapy. During much of this time, Freud was reduced to wearing a hideous, denture-like prosthesis to keep his oral and nasal cavities separated, and this device prevented him from eating and speaking normally. Following the first series of surgeries in 1923, he became deaf in his right ear and shifted his analytic couch from one wall to the other so that he could listen with his left ear. Nevertheless, he continued to see patients. In London, he had four patients in treatment, and he only disbanded his clinical practice two months before his death. During the final days, Freud requested that his bed be brought down to the study so that he could be near his books, desk, and beloved collection of antiquities.

He also was one of the first humans ever treated with hypofractionated RT for recurrent H&N cancer.
 
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At this point I'd almost prefer cannibalism to having to take this test again.
 
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If last year’s exam was as easy as the latest ASTRO study guide the pass rate would’ve been 95%

Here’s to hoping this year’s test is a reflection of the crap they want us to study. Not holding my breath though!
 
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radbioistheworst said:
If last year’s exam was as easy as the latest ASTRO study guide the pass rate would’ve been 95%

Here’s to hoping this year’s test is a reflection of the crap they want us to study. Not holding my breath though!
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Agree 100%. This year's study guide was mostly stock Hall questions. Lots of typos too.
I studied the 2017 guide last year, which was really out there, for last year's test and got burned.
I don't know what to make of this. I would presume that the editors of the study guide aren't 100% removed from what the ABR is doing. Such a dramatic change from the 2017 guide makes you wonder/hope that this year's test will be an appropriate recitation of core Hall concepts and not a repeat of the 2018 travesty/surprise cancer biology PhD qualifying exam. But fool me once...
My strategy this year is focus on the core stuff and try not to miss any easy questions as I barely failed last year. Hopefully that will be enough to get me over the hump.

I think devoting time hoping to score with the minutiae is shooting in the dark and only worthwhile if you have Hall and Joiner down cold and (if you're repeating) are totally confident in clinical and have literally nothing else to study. Any time outside of Hall and Joiner for me is being spent on last minute clinical cramming. I would honestly rather fail clinical than rad bio again. At least a repeat of clinical prep will be relevant and needed eventual prep for orals anyway. Sigh.

Good luck to everyone this week. And I mean that because there's no denying there's an element of luck to this.
 
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I would just add that I think it was the random minutia that pushed me over the hump. But hard to make sense of it.
 
LIDO said:
I would just add that I think it was the random minutia that pushed me over the hump. But hard to make sense of it.
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That's the point. That it's random.
You could randomly hit the TAQMAN assay in your deep dive, but you miss SYBR-green and the ABR decides to drop that and you've never heard of it.
You never know what random novel lab test the basic scientists on the panel are going to try and drop in and decide is core clinical competence based off of their hilariously subjective Angoff "method."
 
KHE88 said:
That's the point. That it's random.
You could randomly hit the TAQMAN assay in your deep dive, but you miss SYBR-green and the ABR decides to drop that and you've never heard of it.
You never know what random novel lab test the basic scientists on the panel are going to try and drop in.
Click to expand...
The majority of your colleagues passed and would disagree.
 
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sphinx2019 said:
The majority of your colleagues passed and would disagree.
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More time to study the random minituae when your recalls already got you 60% of the test in the bag per LK.
Takeaway for you sphinx: cheating is more efficient at programs with >6 residents.
Reality is no one cares. This couldn't have been made more clear.
 
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You know what is true about programs with fewer residents? You're less likely to have protected time for boards studying because you're more important/needed in clinic.

That's the biggest marker for how to pass. I can't imagine if I had to be in clinic for June while full time studying Physics/Rad Bio last year.
 
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xrthopeful said:
You know what is true about programs with fewer residents? You're less likely to have protected time for boards studying because you're more important/needed in clinic.

That's the biggest marker for how to pass. I can't imagine if I had to be in clinic for June while full time studying Physics/Rad Bio last year.
Click to expand...

Very true. I have heard of larger programs giving their residents up to a month (!!!) or longer out of clinic to study. Combine that with the recall databases, and the ABR's conclusion is that:

1. Residents are dumber at small programs.
2. Rad bio and physics instructors are incompetent at small programs.

The level of difficulty rad bio/physics is at, it's silly to expect residents to become competently prepared with some weekend and night studying here and there, writing notes and contouring the night before the exam, then back in clinic after it's over. How crazy it is for residents to actually be training in clinic rather than at home for months studying Taqman technique and memorizing recall questions! It's almost like Russia doping their athletes.
 
One of the things that has been somewhat overlooked in this board, is that as unfair as rad bio was last year, physics actually had an even lower pass rate. I feel like the rad bio failures were probably more over-represented on this board, maybe more vocal, but at the end both tests failed a significant amount of people, and only 50% of residents passes BOTH tests. This is a catastrophic failure of leadership in our field and I don't see us recovering from this, even if pass rates are somewhat higher this year (probably due to extreme over-studying). I don't care what the positivity butterflies say on this board. Who wants to go into a field that would even allow something like this to happen, even once?

It really is unfair how some places have a lot of time (1+ months at some places, completely away from any work!). It sucks getting home from a long day of work and sitting down and doing raphex/ astro test, reading hall. Thats the reality for a lot of people, as you're far more valued as a warm body doing scut than actually making sure you pass your boards.
 
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ST88 said:
Does anybody know if you are able to take one exam and not the other? Or do you have to take both Radiation Biology and Physics as a first time test taker. I contacted the ABR about this but haven't heard back. Thanks!
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I have no idea, but it makes zero sense not to take both even if you haven't studied for one of them.

Reasons:
1. The cost is the same regardless
2. A failure as a PGY-5 will not get you off track for orals, only a failure after PGY-5 will do that.
3. There is a chance you might pass it.
4. You will get to see what the questions look like, and up to 60% of them are recycled per LK 2018 ASTRO commentary. There's no way it can be illegal to make your own mental recalls as long as you don't share with anybody.
5. Not taking either exam counts as a failure for your program's accreditation purposes, and they're not going to like that.
6. Even if you fail it, you most likely won't have to report this to your employer for credentialing purposes. I reported it to my employer on the credentialling app, and was told to resubmit answering "No." to the question of "have you ever failed a board exam," as they told me explicitly that only certifying board exams count, not qualifying exams. The certifying exam is "the" board exam. The qualifying exams, just allow you to sit for it. And even if you report it, highly unlikely it will prevent you from getting a job.
7. Not taking it vs. failing it are going to look equally non-ideal in your job search. Nobody asked me, but some people were asked. And it wasn't a big deal.

Bottom line, is they will automatically sign you up for both as a first-time test taker. Given that they were "unable" to do something so simple as to reschedule repeat examiners for a different timeslot other than prior to the clinical written this year, you have a snowball's chance in hell getting them to create a custom exam with one portion only for you.
 
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Everything you need to know tomorrow to get the minimum passing score. Don't forget your son of sevenless and sonic hedgehog.

And you better know the difference between frizzled and disheveled protein.

Oh and survivin... that's a good one (at least it tells you what it does? inhibits apoptosis)

I wonder if other specialities just look at this and think it's all one big joke...

mmu05200.png
 
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