strategies for the abai exam
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Curtain PagePreparation Strategies for the
ABAI Cert/Recert Exams
Tao Le, MD, MHSAssociate Clinical Professor
Chief, Section of Allergy & ImmunologyDepartment of MedicineUniversity of Louisville
Updated Presentation
www.slideshare.net/taolemd
Disclosures
• Editor, ACAAI Review for the Allergy and Immunology Boards
• Senior Editor, First Aid for the Boards review series (McGraw-Hill)
• Executive Editor, USMLERx.com
Disclaimers
• No affiliation with the ABAI
• ABAI makes no recommendations regarding test preparation resources or guidance
Learning Objectives
• To describe the ABAI certification and recertification examination
• To identify and select study and testing strategies for the ABAI examinations
• To identify and select appropriate study resources for the ABAI examinations
Brief History of the ABAI
• First administered in 1974
• First recertification administered 1977
• 10-yr certificates first awarded in 1989
• Offered annually starting 2005
• Certified roughly 120 allergists each year
• Roughly 85% of diplomates recertify
ABAI Exam Overview
www.abai.org
Certification MOCRecent Advances
Items 225 200 60
Time 7hrs (2 sessions) 4hrs (1 session) 6 weeks
Location test center test center ABAI Web Portal
Method computer-based computer-based computer-based
Passing Scoreabsolute minimum
absolute minimum
80% correct
Basic Science ~35% 0% 0%
Clinical Science ~65% 100% 100%
Anatomy of an MCQStem A patient who is HIV+ (peripheral blood
CD4+ count ≤ 200/µl) develops acute maxillary sinusitis.
Lead-In Which of the following organisms is most likely to be causative?
Options A. Pseudomonas aeruginosa
B. Listeria monocytogenes
C. Aspergillus fumigatus
D. Streptococcus pneumoniae
Question Structure
• Best single answer• No negatively phrased • 4 response options• Some questions have images• Trends towards:
– Short vignettes– Basic science and clinical integration– Multi-step questions – eg, clinical presentation dx
molecular defect?
Certification Exam Content
2009 2010
Basic Science 36% 38%
--Immune mechanisms 7 8
--Cells involved in immune responses
6 8
--Specific immune responses 6 9
--Laboratory tests 11 6
--Anatomy/physiology/pathology 4 4
--Research principles 2 2
Certification Exam Content
2009 2010
Clinical Science 65% 62%
--Hypersensitivity disorders 20 23
--Immunological disorders 15 13
--Pharmacology/therapeutics 14 10
--Specific diagnostic modalities 9 10
--Allergens/antigens 6 7
Certification vs. ITE
• No relationship between ABAI and AAAAI’s ITE• Similar style and construction• Similar content blueprint• Moderate correlation between ITE & Cert• Differences
– Different computer interface– ITE – 200 Q’s in 3.25 hrs– ABAI – 225 Q’s in 7 hrs
Recertification Exam Content
ABAI Clinical Items Recert(2009)
Cert (2010)
--Hypersensitivity disorders 44% 37%
--Immunological disorders 11% 21%
--Pharmacology/therapeutics
18% 16%
--Specific diagnostic modalities
14% 16%
--Allergens/antigens 12% 11%
Recert vs. Recent Advances
• Style and construction of test items are identical• Both with 100% clinical science coverage• Exams share no questions• Differences?
– Questions: 200 vs. 60 items– Content: established literature vs. clinical advances– Test situation: high stakes vs. open book/multiple attempts– Passing: 400 scaled score vs. 80%
Pass/Fail Criteria
• Norm reference standard– Until 2001– A fixed percentage always fails– Competent candidates could fail in a strong year
• Criterion reference standard– Implemented in 2003– Competency threshold predetermined– Theoretically, 100% can pass
Certification Pass Rates
Group 2011 2006-10***
Overall 88%* 81%
First-time 96%** 91%
Repeater 38% 33%
U.S. Grad 92%** 86%
IMG 63% 54%
www.abai.org
* All time high (since 1974)** 6 year high
*** Means are approximate
Recertification Pass Rates
www.abai.org
2011 99.6%
2006-10 97%
Score Report
• 3-digit scaled scores– Overall– By category– Range: 300’s – 600’s
• Overall passing threshold = 400
• Percentiles not reported
ITE Score Report
• Percent correct– Overall– By category
• Percentiles reported– Overall– By training year
Text Resources• JACI Primers – revised, online, 120 questions • ACAAI Rapid Review for the ABAI – coming this spring
– Written by fellows, recent graduates who took the ABAI– Based on the ABAI outline
• A&I MKSAP – last revised 2002• Immunology texts
– Abbas – Cellular and Molecular Immunobiology– Janeway – Immunobiology – Choose one and stick with it
• Allergy texts– Middleton’s Allergy: Principles and Practice – source for many
questions– Patterson’s Allergic Diseases – more clinically relevant; new
edition– Pediatric Allergy: Principles and Practice – new edition
Question Resources
• Past ABAI Home Study exams
• Primer practice questions
• ACAAI FIT practice questions
• A&I MKSAP questions
• ABAI review questions
Other Resources
• AAAAI/ACAAI Live Review– Good framework– Not enough for cert/recert– Basic portion
• High-yield for cert• Low-yield for recert
• Review Online -- $$$ but great for catching the details in context
Preparation Tips
• Many ways to prepare
• Review ABAI exam blueprint
• Incorporate materials from training
• Use ITE/home study exam to pinpoint areas of weakness
• Establish a study schedule and stick with it
• Alternate study methods for variety
Preparation Tips
• Focus on:– Dogma– Nuances of management– Common dz uncommon/complicated presentations– Uncommon dz common presentations
• Focus on understanding vs. memorization early• Tie basic concepts to clinical correlations• Save crammable stuff for the end
Test-taking Tips
• Know the CBT tutorial
• Know keyboard shortcuts
• Pacing should not be an issue
• OK to second guess
• Bad/ambiguous questions should be challenged
High-Yield Topic Areas• Basic immunology
– Cytokines– Chemokines– CD molecules– Immune cells– Signal transduction
• Biostatistics and research principles• Immunodeficiency• Food/inhalant allergens• Asthma/allergy meds and disease management during pregnancy• Drug AEs and interactions• Images – pollens, molds, flow-volume loops, tympanogram• Variation may be tied to the make up of the ABAI board of directors
• ABAI website – http://www.abai.org– Exam description – http://www.abai.org/exam.asp– Exam blueprint – http://www.abai.org/Outline.asp– Email – abai@abai.org
• JACI Primer – http://www.aaaai.org >> Members >> Education >> 2010 Primer
• ACAAI Board Review Corner – http://www.news-source.org/ACAAI/FIT-Archive2009.htm
Useful Links
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