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Attacking oral exam scenarios

While board scenarios do not always reflect reality, complaining will not lead to mastery


A hidden source of misery here at MCHD is the fear of the oral board scenario exams for advancement.

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When we think about what strikes fear in paramedics, pediatric arrests, precipitous deliveries and unstable bradycardias come to mind. A hidden source of misery here at MCHD is the fear of the oral board scenario exams for advancement. Yes, these are artificial scenarios and do not always reflect reality, but they are a necessary evil.

In this episode join Dr. Dickson and Dr. Patrick as they try and provide some framework for attacking and succeeding when taking oral scenario exams with tips like:

  • Do a full exam every time (back/neuro/perineum). The examiners won’t give you information that you don’t ask for
  • Don’t be afraid of tapping the brakes or even shifting to reverse. There are no extra points for going fast – pause if you need.
  • If you treat the patient, then always reassess. If you give fluids; repeat BP/HR. If you bag the patient, repeat sats.

Read next: 3 tips for firefighter/paramedics working to pass the National Registry Exam

The MCHD Paramedic Podcast was launched in early 2018 in an effort to provide easily consumable core-content EMS education and insights from prehospital care thought leaders. The Clinical Services Department of The Montgomery County Hospital District EMS service developed the podcast as a tool to better engage and disseminate continuing education to our MCHD medics as well as first responders and EMS professionals nationwide.

Dr. Casey Patrick is the assistant medical director for Montgomery County Hospital District EMS and is a practicing emergency physician in multiple community emergency departments across Greater Houston. His EMS educational focus is on innovative paramedic teaching via the MCHD Paramedic Podcast. Dr. Patrick’s prehospital clinical research involves the investigation of paramedic use of bolus dose intravenous nitroglycerin for acute pulmonary edema and the implementation of lung protective ventilation strategies for intubated EMS patients. Casey and his wife, Alyssa, work and live in Conroe, Texas, and Spokane, Washington. Together they have five children: Mia, Ainsley, Brock, Dean and Will.

Dr. Dickson graduated with honors from the University of Texas Health Science Center San Antonio in 2001 and completed emergency medicine training at Indiana University in 2004. He serves as the EMS medical director at Montgomery County Hospital District EMS and an assistant professor of emergency medicine at Baylor College of Medicine in Houston, Texas. His academic interests include systems of care in stroke and other time-sensitive emergencies, neurologic emergencies and education. He is board certified in emergency medicine in both the U.S. and Australasia, and has subspecialty board certification in EMS medicine. He has authored multiple professional articles and presented at regional, national and international conferences on emergency medicine and EMS topics.