A Review of Oral Board Reviews

Adrienne Moraff, MD
Adrienne Moraff

Preparing for the ABNS written exam is a daunting task. I wasn’t gifted with talent for standardized tests, and this was the year I needed to pass. With little guidance on board preparation courses and a program requirement to get at least 50th percentile or higher on the exam, I used the kitchen-sink approach and went to three separate board review courses. In retrospect, this was excessive, time-consuming, and very expensive. Sharing my experience will hopefully allow future examinees to use a more targeted approach based on their individual needs, while saving valuable time and money.

Chicago Review Course

The Chicago Review, spearheaded by the dedicated Leonard Kranzler of the University of Chicago, is one of the longest running neurosurgery review courses in the U.S. Course participants included neurosurgery residents taking the exam for the first or second time, foreign physicians looking to pass their American boards, and licensed neurosurgeons wanting a comprehensive practice update. The course provides value for each group. Spending 10 days in Chicago in January is far from a tropical vacation, but the 12-hour lecture days will keep participants occupied.

The course benefits from many exceptional lecturers such as Dr. Thomas Naidich, whose anatomy lectures were the course highlight, as well as eminent professors such as Dr. Edward Benzel, Dr. Ossama Al-Mefty, and Dr. Thomas Mizen, among many others. Dr. Ernesto Coscarella delivers an excellent set of 3D lectures with frequent questions to the audience and appropriate repetition of key points. Each lecture is delivered by an expert in his or her field, including neurosurgery, radiology, neuropathology, and neuro-ophthalmology. Other lectures were weaker, with fewer clinical vignettes to circle back into the clinical relevance of the material. There was at least one lecture dedicated to a proprietary surgical planning and navigation system that would have been more appropriate at an industry-sponsored course.

Another strength of the course is its emphasis on repetition, both within individual lectures and between lecturers. The course directors understand repetition is the key to adult learning and also allows participants to identify recurring themes likely to be seen on examination day.

This course was the most comprehensive of the three I attended. Every boards-testable topic was covered, along with additional material relevant for practicing surgeons needing to update their knowledge. Those needing a from-the-ground-up approach to their preparation will be hard-pressed to find a more thorough course, but the course length and steep tuition fee ($2375 for residents, $2650 for practicing surgeons) may make attending the Chicago Review impractical for many residents and surgeons. Attendance dropped precipitously after the second day of lectures, reflecting the difficulty many participants had with the very long days of didactics. Removing several lectures that did not address board review material or practice-relevant information could potentially shorten the course by at least a day, which may make it more accessible to some participants.

The Kenneth M. Earle Neuropathology and Washington Neuroradiology Review Courses

Boasting the longest history of the three courses, with 50 years of neuropathology review and 30 years of neuroradiology review, the Kenneth M. Earle Neuropathology and Washington Neuroradiology Review courses provide an in-depth series on current understanding and practice in neuropathology and neuroradiology. Due to scheduling constraints, I was only able to attend the neuropathology arm of the course. Its outstanding faculty includes Dr. Arie Perry and Dr. Greg Fuller, neuropathologists integral in the development of the WHO 2016 criteria. The faculty was able to provide a more updated discussion of molecular markers in central nervous system tumors than any of the other courses. There was emphasis placed on multidisciplinary integration in a manner unique to this course. During the neuropathology course, Dr. James Smirniotopoulos provided exceptional radiology correlations to the pathology material, tying the pathology slides to the imaging neurosurgeons will see in their patients.

The all-volunteer faculty of the course shows an unparalleled dedication to course participant education, and clear enjoyment of every moment of their time at the course. There is the traditional mix of lecture styles, but many of the lectures are lively, engaging, and occasionally laugh-out-loud funny. The case correlation sessions at the end of each day are the strongest clinical relevance offerings among all the courses, challenging participants to apply concepts and discussions from early in the day to real patient scenarios.

For neurosurgery residents preparing for board exams, the course focus may be too narrow to be useful. The level of detail provided far exceeds what is likely to be encountered on the written board exam. For neurosurgeons with particular interest in these fields or even those focused on tumor surgery, these courses are a great opportunity to improve fund of knowledge more profoundly than any of the other offerings.

Review Courses Comparison Chart

CNS SANS Board Review Course

Though much of the material has been presented for many years at the MOC SANS course, 2017 was the first year the CNS offered a dedicated ABNS board review course. The provision of this course demonstrates the CNS’ strong commitment to resident education. Running from Saturday afternoon to Sunday afternoon in Las Vegas, it is a rapid-fire foray into high-yield topics put together by dedicated faculty, many of whom are authors of the ABNS exam questions.

Lectures are fast-paced, highly interactive, and provided by a star cast of all-volunteer faculty spearheaded by Dr. Michael McDermott and Dr. Nader Pouratian. Covering the breadth and depth of the ABNS exam topics in less than 24 hours is a challenging task, but the course performs exceptionally well in this regard, including both basic science and clinical neurosurgery requirements. The material presented was more updated than that presented at the Chicago Review, which is largely reflective of the updates to the ABNS exam and the WHO 2016 CNS tumor criteria. The lecture format incorporates SANS questions throughout to highlight key points and the SANS question modules are included in course tuition.

To get the most out of this course, plan to have studied for several weeks prior to arriving. There is a good amount of review in the course, but it is designed to test your mastery of the subject matter and identify your weakest areas, not to teach you the material. The course offers the most abbreviated board preparation available, which may be an advantage for residents and physicians who are unable to get away from their programs for more than a weekend. The inclusion of all available SANS online question modules makes this the most economical board review option of the three, by far.

Conclusions

Each of these three courses are ideally suited to accomplishing different goals. All are useful in their own right and represent the hard work and dedication of many faculty members in neurosurgery, neurology, radiology, and pathology. This review of the reviews is written to give an assessment of how these courses can be best used depending on your goals. Whatever your choice of exam prep, good luck studying!

LECTURES ARE FAST-PACED, HIGHLY INTERACTIVE, AND PROVIDED BY A STAR CAST OF ALL-VOLUNTEER FACULTY SPEARHEADED BY DR. MICHAEL MCDERMOTT AND DR. NADER POURATIAN