Six months ago I wrote about the change from oral board examinations in Psychiatry to a series of clinical skills assessments to be done by members of the resident’s training program.  I had some concerns at that time about the change;  I tend to do well on oral examinations and believe that with a couple helpful bits of advice, every candidate with a reasonable fund of knowledge can do well.  I have received good feedback about the approach taken in my recordings, which is to learn the basics so darn well, through repetition day after day, that intelligent discussion comes to mind automatically– even during moments of anxiety-provoked brain freeze!

My reservation about the change from Oral Board to CSA was concern over the residents own faculty performing the examinations.  On one hand such an arrangement could provide an unfair advantage, but I am more concerned over the disadvantage from being examined by someone who perhaps has negative preconceptions from prior courses or clinical work.  The change from orals to CSA seemed to drastic;  the policy in the former was to exclude anyone who had ANY knowledge of the candidate, and the new format guarantees that most or all of the examiners will know something about the candidate!  On the other hand, having knowledge of the candidate is not completely unique. I think back to my PhD disseration, which like all dissertations was presented to my thesis committee and to the university at large.

After serving as a Clinical Skills Assessment examiner several months ago, I have a better feeling about the new system.  The format is actually identical to the format of the clinical interview portion of the old Oral Boards.  The ‘vignette’ sections were eliminated, although that may be changed going forward.  I made a couple small changes to the recordings to account for the change in format, and all of my comments in prior posts remain valid– for those of you who take the time to read them!  Bottom line, I stand by my recommendation to use the recordings during your commute, ideally for weeks or even months before the exam.  Talk back to the recordings out loud to become completely familiar with the criteria for psychiatric disorders.  Doing so will guarantee your ability to provide an intelligent differential diagnosis as you run through the critera with ease!

Best of luck in your examinations and careers,

Jeffrey T Junig MD PhD