Urology Oral Boards Experience: Michael Ernst, MD

As a pediatric urologist, the need to study all of adult urology again after 3½ years was a task I had been dreading ever since my graduation from residency. Initially, I planned to start studying at Thanksgiving, which then became Christmas and then New Year’s. Finally, as the early days of January rolled around, I knew I could no longer delay. In my head, all I wanted to do was push this test off for another year and deal with it then. Another year removed from residency certainly would not have helped me, and ultimately, I am very glad that I didn’t delay.

It was a strange feeling to return to the world of adult urology, trading hypospadias for hematuria and undescended testis for upper tract urothelial cancer. While it was daunting to learn new oncology guidelines with new medications, new risk groups, and new pathways, there was a warm familiarity in the immersion into the totality of urology. My weekends and evenings spent studying felt like approaching a closure that I didn’t know I needed. (Finishing residency in 2020, complete with Zoom graduations and distanced farewells, was not the way I had imagined closing such a significant life chapter.)

The hardest part of preparing for the oral boards was developing a plan and then getting started. I was very fortunate to have a fellow pediatric urology friend with whom to study. Having the consistency of a weekly scheduled meeting kept me on pace and allowed us to practice the clinical scenarios necessary for the oral boards. In addition to the accountability, I am also grateful that my partner allowed me to learn in a safe environment. Learning is inherently a vulnerable activity, especially when returning to topics of previous expertise. As a chief resident, I would have never stumbled over the workup of benign prostatic hyperplasia, but here I was trying to regain that previous proficiency.

Studying as an attending was quite different than as a resident. Not only do I have 2 small children now, but my ability to focus late at night after a full day of work has dwindled as I have aged. I spent my weekends driving around my neighborhood listening to a podcast version of the AUA guidelines while the kids napped in the back seat. I studied more for this exam than I did for the qualifying exam, part 1, partly because I felt like I had to and partly because I knew I didn’t want to have to review everything again. While I would not want to study for the oral boards again, I found it to be a very positive experience overall. I felt like a complete urologist walking into the exam with expertise in a wide variety of topics. After starting this journey 9 years prior, it was as if I had finally crossed a finish line.

Urology Oral Boards Experience: Nikki Dodge, MD

As a resident and early career attending urologist, the specter of oral boards seems to hang over everyone’s heads. I always thought this was kind of odd, given the high pass rate. Shouldn’t we not be all that worried about this? After taking the test, I completely understand why everyone makes a big deal out of it. When I got the email that results were available, my heart rate absolutely hit 200, and the feeling of relief when I saw my passing score was divine. I would rather do just about anything than take that test again!

I trained at a program that had oral boards prep baked in; we called it “imaging and pathology conference,” and it was a weekly gauntlet where 5 random residents starting at PGY-2 level would get up in front of the entire department and go through one mock oral board case each. Looking back, this was so incredibly helpful. I already had the apparatus in place to study with notes that I’d streamlined over the years, and a lot of the tougher memorization tasks were simply refreshers for me (I’ve memorized testicular cancer staging enough times that I can pretty much recite the National Comprehensive Cancer Network guidelines after a quick 30-second read of my OneNote page on the topic). I really can’t emphasize enough how this experience, while extremely stressful at the time, helped prepare me for my own exam. Not only was I relatively comfortable with the memorization/knowledge aspect, which is completely different than for written boards, but I had been in that very intimidating scenario of thinking on my feet dozens of times before. This is obviously not to say that intense practice like this is necessary to pass, but it was such a helpful part of my training and really helped ease my anxiety about the format of the exam itself.

Because of this, I probably studied a little less than average, and I passed on the prep course. I used the 2018 version of Choe’s and read through it once, taking notes as I went on things I wanted to look up or points I hadn’t come across before but felt were helpful. Of course, I also read the AUA guidelines, as well as my notes from residency, as I mentioned earlier. As a general urologist, a lot was familiar, so I focused less on what I saw every day and spent more time on peds and infertility. One of my partners was planning to take the test this year but ended up delaying, and I definitely wish that I would’ve had a study buddy to go through cases with me to prepare. I was the only person in our graduating class testing this year, so it did feel a bit isolating at times, although I had a few friends who were ahead of me in residency to commiserate with. I think studying with a buddy can really help replicate the experience and practice the thought process needed to go through the exam cases.

Urology Oral Boards Experience: Kevin Ginsburg, MD, MS

You know that Flynn Rider meme—the one where he’s about to say something unpopular so everyone draws their swords on him? Well, brace yourselves because I’m sure the next sentence will be met with resistance: I liked studying for the certifying exam.

I graduated from residency 5 years ago. I’ve been practicing since at a National Cancer Institute–designated comprehensive cancer center for the last 2 years. The overwhelming majority of my practice is cancer, but I’ll see some general urology for patients at the cancer center or while on call. I feel up to date on cutting-edge cancer care, but admittedly, I haven’t opened the Wieder chapter on metabolic stone disease or brushed up on the AUA guidelines for benign prostatic hyperplasia since I was a resident preparing for the qualifying exam. We are all too busy, juggling too much—seeing patients in the clinic, in the hospital, operating, researching, publishing, teaching the residents and medical students, preparing for grand rounds and conferences, completing administrative tasks, and serving on hospital committees. The list goes on and on, and that’s just our work lives. With a to-do list that gets longer, not shorter, each day, reading about aspects of urology that are peripheral to my practice was pretty darn low on the totem pole—that is, until the American Board of Urology forced me to do so.

Knowing that the certifying exam was looming caused me to read and brush up on topics that I wouldn’t have otherwise, and I certainly feel like I am a better urologist as a result. My advice for those preparing to take the exam in the upcoming years is to try to conceptualize the certifying exam prep as an opportunity and not just another task on your growing to-do list. Take a step back from the daily grind and review aspects of urology you don’t practice every day. You’ll find yourself a more complete and well-rounded urologist as a consequence.