Travis W. McCoy, MD
June 10, 2009
All of the following information is available on the ABOG
website, published and updated annually in the ABOG Bulletin.
At the start of your Chief year, download a copy, review the
timelines and requirements
Arrange and conduct examinations
to test the qualifications of voluntary candidates for certification and
recertification in Obstetrics and Gynecology
Issue Certificates
which may be valid only for a limited period of time, of professional
knowledge to eligible physicians who have demonstrated special
knowledge and professional qualifications relating to Obstetrics and
Gynecology
Determine whether physicians who have been issued
Certificates have continued to maintain their professional
qualifications
and to issue Certificates for Recertification, Maintenance of
Certification to those physicians who successfully demonstrate
continued maintenance of such qualifications
Test
Approve
Re-test
• ABOG Registered - Residency Graduate
– Status after application to the Board, and after they rule that you have fulfilled
the requirements to take the written examination.
• Active Candidate “Board Eligible”
– Active Candidate status achieved by passing the written examination.
– Must fulfill all requirements for admission to the oral examination and must
not have exceeded the limitations to admissibility for the orals
– Active Candidate status which has expired may be regained by repeating and
passing the Board's written examination.
• Diplomate
– An individual becomes a Diplomate of the Board when the written and oral
examinations have been satisfactorily completed and the Board's certifying
diploma has been awarded.
– Certificates have limited duration of validity (Six years).
• Expired Certificate
– Failed to complete the maintenance of certification process
– Diplomate status reinstated by successfully completing the ABOG
Maintenance of Certification process.
• Retired Diplomate
• Revoked Certificate
• Restricted
• The examination process is voluntary. The ABOG will not contact
you. You are responsible for completing applications and
submitting required materials by their deadlines
• Certification by ABOG is a dual examination process
– Written examination followed by an oral examination
• Written Exam given the last Monday in June of Chief year
• Oral Exam can follow standard timeline or accelerated process (for
some)
• There are two fees, an application fee AND an examination fee
– BOTH the written and the oral examination
– BUDGET ACCORDINGLY!!!
• Certificates have a limited valid duration for a max of 6 years
• Diplomate must undergo a Board-approved method of
maintenance of certification (MOC) in order to receive a new
certificate
Residency Fullfillment Requirements- Laid out in Bulletin
Of note:
• Program director is required to attest on behalf of the program,
to the resident's satisfactory performance, competence and
completion of the program
• Limits of leave of absence/vacation- time gone (e.g., vacation,
sick leave, maternity or paternity leave, or personal leave)
cannot exceed:
– Eight (8) weeks in any of the first three years of graduate training, or
– Six (6) weeks during the fourth graduate year, or
– a total of twenty (20) weeks over the four years of residency, then,
– If exceeded, the Residency must be extended for the duration of time
the individual was absent in excess
Standard Certification Process
• Final year of residency
– September-November -- Apply for general written examination
– June -- Take general written examination- June 29, 2009
• First year of practice (July 1, 2009 - June 30, 2010)
– No General Board activities
• Second year of practice (July 1, 2010 - June 30 2011)
– July 1, 2010 to June 30, 2011 – Collect Case list
– September 2011- Apply for general oral examination
• Third year of practice
– August 2011-- Submission of case list and Examination Fee
– Winter 2011- Take general oral examination
• If enrolled in a Fellowship in Subspecialty
• First year of fellowship (July 1-June 30)
– No Board activities
• Second year of fellowship (July 1-June 30)
– No general Board activities
• Third year of fellowship (July 1-June 30)
– No general Board activities
– September-November -- Apply for subspecialty written examination
– June – Take subspecialty written examination
• Fourth year -- First year of practice (July 1- June 30)
– July 1- June 20- Collect General Oral Case List
– Apply for the general oral examination
• Fifth year -- Second year of Practice (July 1- June 30)
– August -- Submission of case list for general oral examination
– November, December or January -- Take general oral examination
– May -- Apply for the subspecialty oral examination
– January 1-December 31—Collect Subspecialty case list
• Sixth year -- Third year of Practice (July 1- June 30)
– January -- Submission of thesis
– February -- Submission of subspecialty case list
– March or April -- Take oral subspecialty examination
• Taken the last Monday in June of Chief year
• Must apply in September of Chief Year, Budget for costs!
• Examination Fees:
• Remember, there is an application AND Examination fee for
both the Written and Oral Exams
• Written Exam- $1410
• Application fee (November 15th of Chief year)- $735
• Late fee- up to 2 wks late- $330
• Late fee- 2wks to 4wks late- $790
• Examination fee (February of Chief year)-$675
• Taken at a standard computerized testing center
• (Newburg Rd exit of I-264)
• Test results should be received by August 1st (According to
ABOG)
• Lists PASS or FAIL, and gives a numerical score
• The score has no reference and is not comparable to any other
score you are familiar with. ABOG does not report the scoring
system, thresholds or scale
• 230 questions, 3 ½ hours
• Many of the questions are “Beta” test questions and won’t be
scored. All exams different, and may not have same questions
or cover same topics
• Consists of single, best answer, multiple-choice questions
• Many (nearly all) of the questions are constructed to be
thought provoking and/or problem solving in contrast to
“recall” type questions
• They contain a continuum of answers. Specifically, all possible
answers may be plausible, but only one answer is the MOST
correct
• A lot of “the most” or “the least” questions
• The format of the test is not conducive to last minute cram
studying
• Approximately 30% of the questions are from topics
listed under each of the general headings
– Gynecology
– Obstetrics
– Office practice-preventive/primary care
• The remaining 10% of the questions are based on
cross-content topics, such as, genetics, immunology
and pharmacology
• Topics are laid out in the Bulletin, and expanded
upon in the "Educational Objectives for Resident
Education in Obstetrics and Gynecology", published
by CREOG
• Basically all of your 4 years covered in 3 ½ hours
• Don’t take it for granted
• Start studying MONTHS ahead of time. The knowledge needed
can’t be crammed
• Prolog has a good format, but time consuming
• If reviewing old tests, focus on WHY the incorrect answers are
incorrect
• On the Written, nearly all answers are correct, so you have to
take the thought process to a deeper level
• Recommend:
– “Wall exam rememberences”
– “Wall Written Exams”
• Precis likely too general
• Prolog good but time consuming.
– May be a good choice if having >3 months to study
• Given in Dallas each year, 2nd week of November, December,
and January
• Two Oral Examination Process timeframes
• Standard Oral Exam Certification Process
• Accelerated Oral Exam Process
• Start collecting case list in July of 2nd year of practice. Take the
Oral Exam in the winter of the 3rd year of practice
• Start collecting case list immediately after residency in 1st year
of practice. Take the Oral Exam in the winter of the 2nd year of
practice. (As opposed to the 3rd year in the Standard Process)
• For those in fellowship using the accelerated process, they may
collect cases in the 1st or 2nd year, and take the exam in their
2nd or 3rd year of fellowship (As opposed to taking the exam in
their 2nd year following fellowship)
• Can be done in Fellowship, but up to the individual Fellowship
Director
– Highly recommended if available!!
• Why do the Accelerated Process?
– Information fresher in your mind right out of residency
– Especially if limited focus practice
– Will likely have more time to study (Less busy practice)
– Board Certification usually required for consideration for
partnership (sooner the better)
– The length of time between successful completion of the
written examination and the oral examination may be
shortened.
• Graduating residents who pass the written examination will be
notified prior to August 1 that they have passed and are
eligible to apply for the accelerated process. The Pass
notification has a notice about applying for accelerated plan
• An active hospital practice must be established prior to Sept 1
• Must have completed residency by Aug 31
• No late applications accepted, and all deadlines and
requirements must be met to participate
• Those candidates that have just graduated from residency, may
begin collection of cases ON July 1, but must start prior to
September 1
• Application deadline ~September 15. So only about 6 weeks to
decide!
– 300 applicants accepted, lottery system if more apply
– Notified by October 1 if they are among the 300 candidates chosen
– For those not selected, application fees refunded and case collection
can stop
• Remember, there is an application AND Examination fee for
both the Written and Oral Exams
– Written Exam- $1410
• Application fee (November 15th of Chief year)- $735
– Late fee- up to 2 wks late- $330
– Late fee- 2wks to 4wks late- $790
• Examination fee (February of Chief year)-$675
• Oral Exam- $1740
– Application fee- September of year of case collection- $805
• Late fee- up to 2 wks late- $330
• Late fee- 2wks to 4wks late- $790
– Examination fee- Submit with case list, August before exam- $935
• Late fee- up to 11 days late- $330
• Travel + Hotel in Dallas (Southwest flies directly to Love Field)
$550 total
• Evaluate the mode and rationale for the clinical care of patient
management problems in obstetrics, gynecology and women’s
health
• Expected to demonstrate that they have acquired the capability to
perform, independently, major gynecologic operations, spontaneous
and operative obstetric deliveries, to manage the complications of
and to perform the essential diagnostic procedures required of a
consultant in obstetrics, gynecology and women’s health.
• The fund of knowledge required for passing the oral examination is
similar to those categories listed in regard to the Written
Examination.
• Expected to demonstrate a level of knowledge which allows them to
serve as consultants to physicians who are non-obstetrician-
gynecologists
• Passing grade on the written examination prior to applying
• Must pass the oral examination within six (6) years of passing
the written and may take the oral exam only three (3) times
• Board-approved fellowship excluded from six (6)-yr limitation
• If a candidate fails the oral examination three (3) times, or fails
to pass the oral examination within six (6) years of passing the
written examination, must repeat the written examination to
take the oral exam again
• Good moral and ethical character.
• If involved in litigation or investigation regarding practice activities,
ethical, or moral issues, the individual will not be scheduled for
examination. The Board usually will defer such a decision for one year
to gain further information.
• Unrestricted license to practice medicine. Actively engaged in
unsupervised practice of ob/gyn
• The examination completed in one-half day in Dallas, TX.
Everyone stays in the same hotel, and you are taken to the
testing center by bus
• Assigned to AM or PM session, occurring in the 2nd week of
November, December, or January. Date randomly picked by
computer
• Three hour examination; three one-hour blocks
– Obstetrics
– Gynecology
– Office Practice
• Held in small testing rooms (about exam room size), tested
alone, sitting behind a desk. Examiners sit in chairs on other
side of desk near door, computer monitor on side wall, camera
surveillance
• Three separate pairs of examiners, usually one generalist and
one specialist (MFM+Gen, REI+Gen, Onc+Gen, Gen+Gen)
– They receive your case list the night before to review
• Very formal, very to the point, very business. No information
given about the examiners or about you to the examiners.
Given list of examiners at start of exam to review any possible
conflicts of interest
• You are given a blank pad and pen and take along a clean copy
of case list (must be identical to the one given to the
examiners). No additional notes allowed on the case list
• Free to take restroom break at any time, but the clock keeps
running. Best to only go between blocks. (Consider fluid
limitations, and even using zofran/immodium!)
• Each block one hour long
– 30 minutes spent on 3-4 standardized cases, 3-4 subparts
of each case.
• Everyone that session gets the same cases. May vary
from day to day, but same ideas recur in a given year
– 30 minutes for review of case list
• May ask you about any topic brought up on your list
• Questions are about general ideas, not as much about
specific patients
• Strict time limits for all parts, buzzer goes off at the end, and
you’re stopped midsentence
• Examiners thank you, shake your hand, and walk out
• Next set of examiners immediately walk in. 2-3 minutes
between examiner sets
• Tales of pathology slides- non-existant now
• Examining team scores candidate individually and discuss each
one at the end of the day to decide on result. Scored as pass,
borderline, or fail. If conflicting scores, usually side with more
senior examiner
• Numerical score given for each section 2=Pass, 1=Borderline,
0=Fail. Must have a total score at end of the day of 4 to pass
the overall exam
• Ie. 2 Pass + 1 fail, or 1 Pass + 2 Borderline
• Results mailed out Monday of the following week
Three separate lists: OB, GYN, and Office Practice
OB and GYN must include All patients dismissed from care in
all hospitals during the case collection period
Must list all hospitalized patients, as well as all outpatient and
inpatient surgery
A Practice that consists of ambulatory care exclusively is not
considered adequate to fulfill requirements
The case lists must have sufficient numbers and sufficient
breadth and depth of clinical experience.
The case list must include a minimum of 20 inpt/outpt GYN and
20 inpt/outpt OB patients with significant problems
If, but only if, a minimum of 20 patients in GYN and OB cannot
be obtained during the collection period, the candidate may:
Submit a complete 18-month case list extending an additional 6
months prior
Submit a list of patients obtained from their senior year of residency
Case lists may not be comprised solely of cases from the senior
residency year
Case lists limited to office practice plus obstetrics or
gynecology can be submitted only by those individuals who
limit their practice to either gynecology or obstetrics
In this case, the appropriate number and types of gynecological or
obstetrical cases must be obtained from the candidate’s chief
residency year
The candidate will be examined in all three areas
Lists must be de-identified under HIPAA
(Basically can include initials only, no other identifying information)
Patients must be only those for whom the candidate has had
personal responsibility for professional management and care
The completeness and accuracy of submitted case lists are
subject to audit by the ABOG.
About 1 in 25 lists randomly audited, or on suspicion of fraud
You must bring a copy of the case list to the oral examination
for your reference, but you cannot have anything additional
written on it.
Carelessly prepared or incomplete case lists are one of the
most common reasons for failure!
Specific format for case lists
ABOG offers software free annually to collect cases in
Somewhat clumsy for daily use, but ok for final formatting
Other companies have slightly easier to use software, but
charge for it
Probably easiest to make an Excel spreadsheet for routine use
and then enter into ABOG software or format printing directly
Only approved abbreviations, are acceptable. This list is short
and these may not be the same you use, and other common
ones are not allowed
A&P Repair, Ab, AIDS, BS&O, CD, cm, D&C, D&E, DHEAS, E, FSH,
gms, HIV, HRT, IUD, Kg, PAP, PROM, PTL, SVD, T, TAH, TSH, TVH,
VBAC
List of 40 and only 40 patients from the office practice
categories
No more than two (2) patients from any one category
Cannot include any patients who appear on the hospital OB or
GYN lists.
OFFICE PRACTICE CATEGORIES
1. Preventive care/health maintenance 15. Vaginal discharge 28. Ultrasound
2. Smoking cessation & tx of obesity 16. Vulvar disease 29. Back pain
3. Sexual dysfunction 17. Breast disease 30. Respiratory tract diseases
4. Contraception 18. Eval. of urinary/rectal incont 31. Gastrointestinal diseases
5. Psychosomatic problems 19. Urinary tract infections 32. Cardiovascular diseases
6. Genetic counseling 20. STDs 33. Endocrine diseases
7. Primary/secondary amen.& hirsutism 21. Immunizations 34. Hypertension
8. Infertility 22. Pediatric gynecology 35. Dx/Mgt of dyslipidemias
9. Hyperprolactinemia 23. Sexual assault 36. Recognition / counseling of substance abuse
10. Endometriosis 24. Spousal abuse 37. Depression
11. Perimenopausal & menopausal care 25. Dysmenorrhea 38. Geriatrics
12. Office surgery 26. Premenstrual syndrome 39. Infertility evaluation & management
13. Abnormal uterine bleeding 27. Benign pelvic masses 40. Pelvic floor defects
14. Evaluation & mgt of pelvic pain
List all GYN patients managed during the case list collection
period (12 or 18 mo)
A minimum of twenty (20) gynecological patients is required,
and a candidate cannot count more than two (2) patients from
each of the categories listed below
For example, if a candidate has five (5) patients who have had Dx LSC,
they all must be reported on the case list, but only two (2) of the five
(5) will be counted as meeting the minimum requirement of twenty
(20) gynecological cases.
If, but only if, a candidate cannot acquire the necessary twenty
(20) gynecological cases in the above categories, they may use
an 18-month case list and/or select an appropriate number of
cases from their fellowship or senior residency case list
The preoperative diagnosis should appear for all major and
minor surgical procedures
The size of ovarian cysts and neoplasms must be recorded
For non-surgical conditions, the admission diagnosis should be
recorded
The treatment recorded should include all surgical procedures,
as well as primary non-surgical therapy
Surgical diagnosis refers to pathology diagnosis. For
hysterectomy specimens, the uterine weight in grams must be
recorded. In cases without tissue for histologic diagnosis, the
final clinical diagnosis should be listed.
Days in hospital is the arithmetic difference between date of
discharge and date of admission
GYNECOLOGICAL CATEGORIES
1. Abdominal hysterectomy 11. Invasive carcinoma 21. Vulvar masses
2. Laparotomy (other than tubals) 12. Carcinoma in situ 22. Vulvar ulcers
3. Vaginal hysterectomy (including LAVH) 13. Urinary incontinence 23. Adenomyosis
4. Diagnostic laparoscopy (medical management) 24. Postoperative wound complications
5. Operative laparoscopy (other than tubals) 14. Urinary and fecal incontinence 25. Postop thrombophlebitis or embolism
6. Operative hysteroscopy (operative management) 26. Postop fever for greater than 48 hours
7. Uterine myomas 15. Ectopic pregnancy 27. Rectovaginal or urinary tract fistula
8. Defects in pelvic floor 16. Operative mgt of pelvic pain 28. Abn cervical cytology and colposcopy
9. Endometriosis 17. Congenital abnormalities of the 29. Preop evaluation of coexisting conditions
10. Tubal sterilization reproductive tract (respiratory, cardiac, metabolic diseases)
18. Pelvic inflammatory disease
19. Adnexal problems except
ectopic pregnancy and PID
20. Abnormal uterine bleeding
Must list every delivery, as well as any other OB surgery or hospitalization
A minimum of twenty (20) obstetrical patients is required, cannot count
more than two (2) patients from each category
In addition, a total of the number of normal, uncomplicated obstetrical
patients managed during the same time period should appear on the
obstetrical summary sheet
These normal, uncomplicated obstetrical patients should not be listed
individually pregnancy, labor, delivery and the puerperium uncomplicated,
between 37 and 42 wks GA; vertex
membranes ruptured or were ruptured after labor began
position was occiput anterior or transverse,
labor was less than 24 hours in duration;
delivery was spontaneous or by outlet forceps, from an anterior position;
Infant had a 5-min Apgar score of >=6 and weight between 2500 & 4500 gms
placental delivery was uncomplicated
blood loss was less than 500 mL
All deliveries not fulfilling these criteria must be listed individually
OBSTETRICAL CATEGORIES
1. Breech & other malpresentations 12. CV and/or pulmonary dz complicating preg 22. Pregnancies complicated by HIV
2. Intrapartum infection (amnionitis) 13. Renal or neurological dz complicating preg 23. Primary cesarean delivery
3. Puerperal infection 14. Hematological or endocrine dz compl.preg 24. Repeat cesarean delivery
4. Third trimester bleeding 15. Infections complicating pregnancy 25. Inductions or augmentations of labor
5. Multifetal pregnancy 16. Postterm pregnancy 26. Puerperal hemorrhage
6. Cesarean hysterectomy 17. Abnormal fetal growth 27. Readmit for mat. Comp. 48 hrs 30. Coexisting malignancies
10. Hypertensive disorders of preg 20. Neonatal complication which delayed 31. Preconception evaluation, prenatal
11. Second trimester SAB neonatal discharge >48hrs and genetic diagnoses
21. Pregnancies complicated by fetal anomalies
Track ALL of your cases, especially surgical cases in your chief year
You may need them in the future!
Especially track LSC, Cysto, and Laser cases, may be needed for hospital
privileges
Get into the habit of collecting all the information needed
No need to keep H&Ps or OP notes, but include a lot of pertinent
details to remind you of the patient
Can include as much info as you want, but everything mentioned is
open to questioning
Want enough to clarify the reason you provided the type of treatment
Don’t want too much to open yourself to obscure questions
Don’t, Don’t, Don’t falsify or leave out “bad” cases
Collect and enter them as you go, don’t wait until the list is due
Especially for Office Practice!!
Keep a list of topics in your pocket, copy relevant chart notes and info
Allow time to prepare, review, and recheck!!
List has to be verified by the medical records of each hospital
Can take 1-2 weeks for verification
Review, Review, Review your list for errors
Have lists reviewed by and discuss with at least 2 other people
Helps to use those that are or have been examiners in the past
Start list reviews with “examiners” at least 1 month in advance of
due date
Gives time to make changes
After submitted in August, no changes are allowed
Make a topic list of everything on your list, know everything about
those topics
Should I take a review course?
Most say YES, by far
Too much riding on oral boards
Can only take one time per year, high cost
Which Ones are available?
Columbus Course www.perinatalresources.org
10 days, Columbus OH. $2250 + hotel (10x$134)
Once per year, Very comprehensive, many highly recommend
Intensive, 8-10hrs per day x 10 days
Shorter 5 day course in Orlando
$1750- 7 days
ExamPro www.exampro.com
Most options, courses, DVD courses, Old exam information, insider test questions,
case list review, mock exams, one on one with director
Prices vary
Dr. Wall’s www.obgynboardprep.com/- Multiple options and
sessions, $1500 course.
www.americasboardreview.com/
5 day course, $1600, Charlotte, NC
Less well known
Offers 3 courses per year, case list options, mock exams