From the AOBS Chair - Preparing for the Oral Board Exam

The process for becoming board certified in your surgical specialty is extremely important for public safety, institutional membership and privileging, as well as, reimbursement in some circumstances. The entire process starting with the Written Qualifying Examination, including the Oral, and in some cases, Clinical Certification Examination, can be stressful.  Both the American Osteopathic Board of Surgery (AOBS) and candidates, have a lot invested in a successful outcome.  The AOBS takes its responsibility very seriously to ensure a fair, valid, and secure examination process for all.  The AOBS’ goal is that every osteopathic surgeon can become board-certified in their specialty. And towards that end, we want to share some critically important information to help make that a reality.  Here are some pointers for being prepared for taking your oral examination, which will be offered this year on Wednesday, October 11, 2017 at the Gaylord National Resort & Convention Center in Oxon Hill (National Harbor) Maryland during the American College of Osteopathic Surgeons’ Annual Clinical Assembly.

Let’s get started on prepping for the exam.  Get a good night’s sleep the night before and eat your usual breakfast the morning of the oral examination (be careful with too much coffee or other liquids; think bladder capacity).  This is a high-stakes examination by your peers so during the oral examination, professional dress is expected.  There is a security protocol in place to protect the examination and all candidates taking the test. Therefore, candidates must register, show picture identification, and sign a confidentiality statement and attestation of understanding of the appeals process.  Candidates are not allowed to carry any electronic device(s) into the examination room. It is usually best not to bring them with you at all as the AOBS will not have a secure area for storage, nor will the AOBS be responsible for any lost or stolen cell phones, laptops, backpacks, purses or wallets, etc.  
 
Be aware that there is very limited movement allowed once the examination begins, so plan your bathroom routine carefully.  If you must leave the room during the time an oral question is being administered, no additional time will be given to you to complete that question.  Five (5) breaks are provided between each oral question and the AOBS will escort you to and from the restroom.  Under no circumstances should a candidate speak to another candidate about the test contents or process.  No written materials may be brought into or out of the examination room.  Failure to follow the security measures in place by the AOBS is a breach of American Osteopathic Association (AOA) Ethics and will be reported to the AOA and will invalidate the candidate’s examination. There is an additional risk of having to appear before the Board, the Bureau of Osteopathic Specialists (BOS) or AOA before proceeding with the board certification process.  Please respect the rules and examination process and maintain the professionalism expected of a board-certified surgeon.

To maintain the integrity of the AOBS oral examination, candidates and examiners are both required to immediately declare any potential conflicts of interest before the examination begins.  It is both the candidate and examiners responsibility to recognize and report anyone they know from the same program and/or community, including colleagues, faculty trainers, friends, etc. Should a conflict of interest exist, both the candidate and examiner are asked to recuse themselves before the oral examination begins to avoid any appearance of impropriety.

Each oral question begins with a short case scenario.  It is the candidate’s role to verbalize their evaluation and management of each case. In other words, “think out loud.” You will not be prompted or coached by the examiners to answer a question.  The oral examination is not a collegial conversation or teaching experience, but rather a measure of a candidate’s performance against a standard of excellence expected from a board-certified surgeon.  Examiners may ask clarifying questions, but only to assess your knowledge and surgical management skills.  Often, but not always, an oral examiner will ask a series of specific questions related to a case presentation.  Every case is different and oral questions administered in the morning session are different than those given in the afternoon.  Cases are changed regularly over time making it improbable to “game the system” by memorizing or sharing cases with colleagues.  More importantly, that is not the expected behavior of a board-certified surgeon, and if discovered, will nullify a candidate’s examination and require disciplinary action including the potential for being barred from the process altogether.

A candidate should not ask for, nor will they be told, the correct diagnosis or treatment even after the question is completed.  No feedback of a candidate’s answer or overall performance will be given.  The examiners will be busy writing and evaluating a candidate’s case management, judgment and processing of clinical problems.  It is the examiners job to write and the candidates job to talk.  As a high-stakes oral examination, please remember, “if the candidate does not say it, the examiner cannot assess it.”  Be prepared for some occasional awkward silence at various time during your oral examination e.g. if a question is concluded early.  This silence will allow other candidates to complete the question without distraction and allows examiners to score candidate responses and prepare for the next question.  

Candidates should not be distracted by examiners writing throughout the oral examination.  Multiple examiners will be asked to assess each candidate’s use of information to diagnose surgical disorders, to properly order and interpret testing, labs, and imaging studies, and to develop treatment plans using professional judgement that rises to the level of a board-certified surgeon.  Candidates should verbalize their thought processes in a way that reflects how they normally treat patients and allows for the examiner to assess their knowledge and skill.  Examiners are tasked with recording their observations of each candidate’s knowledge and experience during each oral question using a rating form to score a candidate’s performance as: superior, good, problematic, or unacceptable.  These terms of evaluation are well-defined, written, and shared with candidates prior to the examination.  All exam items, as well as, candidates and examiners, are psychometrically evaluated by the AOBS and its psychometrician.  Passing scores are determined by mastery of content and not “graded on a curve.”

The AOBS does not accept candidate appeals based on examination content.  If a candidate wishes to appeal their examination, it is important to understand that only the administration process surrounding the oral office examination can be appealed.  An appeal request form must be submitted to a board member or the AOBS office within two (2) hours of a candidate completing the oral examination for it to be valid.  Appeals after two (2) hours will not be accepted.  Any appeal filed will automatically nullify the candidate’s examination and the exam will not be scored until the appeal is properly adjudicated. As a result, neither the AOBS or candidate will know whether the candidate passed or failed the examination until after the appeals process is completed.  Appeals can be made, usually in ascending order, to the AOBS, BOS, and AOA.

The AOBS works diligently to ensure that each candidate has an equal and fair chance to attain and maintain board certification in their surgical specialty.  Each year, more and more osteopathic surgeons are welcomed to the ranks of becoming a board-certified surgeon, with many choosing to continue to support the AOBS by becoming an item-writer, oral examiner, test proctor and/or board member.  The board is constantly improving its processes by soliciting feedback from candidates, diplomats, the ACOS and many other stakeholders to ensure a superior and defensible board certification process suitable to represent the thousands of surgeons who earn the AOBS’s highest honor and the title of board-certified osteopathic surgeon.

For more information please contact the AOBS at www.aobs.org.

Timothy M. Burandt, DO, FACOS
Chair, American Osteopathic Board of Surgery