Candidates who fail the oral exam more than once are at high risk of
failing it again, and many of these psychiatrists had received passing grades
from board-review courses.
APA wants to help candidates for certification by the American Board of
Psychiatry and Neurology prepare for their exams, especially when it's not the
candidate's first try.
Next month APA will sponsor for the second consecutive year a pilot project
to help candidates who have failed the oral examination component of the
psychiatry board certification exam more than once. The project allows
candidates the opportunity to take an oral test similar to that offered in the
board certification exam—including a live patient interview and oral
presentation—in front of “examiners” who have served as
examiners during the real thing.
Candidates taking the pilot-project test will be told whether they pass or
fail and— most importantly—if they fail, they are told why they
Deborah Hales, M.D., director of APA's Department of Education and Career
Development, said that the APA program does not include remediation
strategies. Candidates are encouraged, however, to use the information that
examiners give them to prepare for the real certification examination.
But Hales said that information can be crucial, providing a kind of“
looking glass” for candidates to polish the blemishes in their
performance when it comes time for the real thing, an ordeal that is typically
fraught with anxiety.
Of the 24 candidates who took part in the pilot project last year—all
of whom had failed the oral examination more than once—half went on to
pass the board and receive their certification.
Next month's “test” will take place on Saturday, October 29, at
the State University of New York, Downstate Medical Center in Brooklyn.
Hales told Psychiatric News that data from the American Board of
Psychiatry and Neurology indicate that the failure rate on the Part II oral
exam rate is high—as much as 50 percent. And it appears that candidates
who fail the exam more than once are at high risk of failing it multiple
times. Moreover, many of those are candidates who had received passing grades
from board-review courses. Thus, a secondary objective of the APA project is
to begin to gather data on factors that may make it likely that people will
fail the exam.
From the first pilot project it appears that a prominent reason is simple
anxiety. “Some people become so anxious that they become
disorganized,” Hales said. “They aren't able to give a coherent
The oral component consists of a half-hour interview and assessment of a
patient—a real one, not an actor—and a half-hour presentation
before an examiner during which the candidate discusses the patient's
Hales said a particularly bad omen during the exam is the candidate's
failure to establish a relationship with the patient—but, she added,
that is not typically what happens to candidates who fail repeatedly. Rather,
it is more likely to be a matter of disorganization during the
“It's a very anxiety-producing situation for almost everyone,”
She added that residency program directors are typically more than happy to
help their residents prepare for the board exam. And she noted that the
Accreditation Council for Graduate Medical Education looks at how many
residents pass the boards as one measure in the accreditation process.
The pilot-project exam costs $800, which goes to cover APA's costs. Hales
said it is an investment in the education of tomorrow's psychiatrists.
“We are always looking for ways to increase APA's value to
members,” she said. “We are concerned with the education of
psychiatrists at every level, and helping candidates overcome their
difficulties with the board exam is one way APA can be of service to
Those interested in applying for the project should contact Nancy
Delanoche by e-mail at
or phone at (703) 907-8663. The application can be downloaded at<www.psych.org/edu/res_fellows/program/pilot.cfm>.▪