The Israeli Surgical Oral Board Examination: Improved Objectivity Increases Knowledge Authenticity

The oral board examination in general surgery in Israel was recently revised aiming for improved objectivity and standardization. Herein, we describe the current exam model. Between 05/2018 and 11/2020, two exams per year were conducted with the current exam model. The examination consists of 12 stations, each focusing on a different field. Passing score is 80%. At the end of the examination, examiners and candidates complete a questionnaire regarding the examination's process and quality (scale 1-5). A total of 142 residents attended six oral board examinations. Mean pass rate was 76.6 ± 9.5%. Questions with overall highest pass rates were acute-care surgery (86.6 ± 4.8%), foregut surgery (84.6 ± 7.6%), and colorectal surgery (84 ± 8.1%). Questions with the highest fail rates were surgical oncology (31.7 ± 13.3%) and abdominal-wall surgery (28.8 ± 16.9%). Examiners' feedback scored highest the following: standardization of the exam (4.45 ± 0.63) and whether the presented cases reflect the daily work of an attending surgeon (4.35 ± 0.87). Candidates' feedback scored highest the following: did the examiners treat you in an appropriate manner (4.08 ± 1.17). In conclusion, oral exams are challenging and bear limitations, but properly constructed exams allow good evaluation of the trainees' thinking process and decision-making skills, without compromising exam's integrity and standardization.