About the Exams

BOARD EXAM FOR PULMONARY DISEASES
Board Exam for Pulmonary Diseases consists of two sections, which are the written (theoretical) section and the practical section.

The purpose of the exam:
To assess the extent to which a candidate adopts and implements scientific methods when solving clinical and epidemiological problems. To ensure that the candidate keeps his/her knowledge of the relevant branch/field up-to-date, and engages in educational and informative activities in this area if necessary. To include new developments in the field/subject into the physician’s practice. To promote good physician practices. To contribute to the solidarity between colleagues, and also to the improvement of transparency/accountability and common standards.

The objectives and of the exam questions:
The test will assess the candidate’s knowledge regarding the interpretation of anamnesis and physical examination findings; the proper guiding and orientation of patients; the proper management of a clinical situation or condition; the prescription of the necessary treatments; the resolving of emergencies; adherence to diagnosis and treatment guides; and the effective provision of the necessary medical and interventional treatments.

 
WRITTEN EXAM
Consists of 100 multiple-choice questions, each with one correct answer. Nearly 75% of the questions are based on cases. The questions are all prepared in accordance with the multiple-choice format. The exam committee performs the necessary corrections following a sequential evaluation, and thus selects and includes the suitable questions into exam. The duration of the exam is 150 minutes. The competence limit (i.e. passing score) is calculated bu assuming an acceptable level of performance in all exam questions.

Identifying the competence limit/passing score for the exam:
For questions with 5 choices and one correct answer:

Example Question: In basic life support, which one of the accident victim’s vital signs should first be controlled?

The right answer in this question is “C”. When we assume that a health personnel who received a Basic Life Support training and certificate would first eliminate all choices other than “C” (i.e. eliminate a total of four choices), we obtain:
In this case, the Acceptable Level of Performance Index is = 1 / (5 – 4) = 1
The possibilities for each question are as follows:

Each one of the 100 questions that will be asked during the exam will be evaluated by three faculty members who provide residency education, and the mean acceptable level of performance index will be determined for each question.
When these are summed, it will be possible to determine the number of questions that candidate must answer correctly in order to pass the exam. Naturally; the harder the question, the smaller its index value. Thus, in an exam with too many difficult questions, the passing score will accordingly be lower.

THE PRACTICAL EXAM
Examinees who successfully complete and pass the test exam will be allowed the take the practical exam. In the past, candidates who successfully completed the test exam were allowed to take the practice exam directly.
The practical exam is an Objective Structured Clinical Examination (OSCE). It is applied at 10 different stations for an average of 8-10 minutes in the applied skills laboratories of Medical Education Departments.
The questions are prepared by the members of the exam commission of Board Exam for Pulmonary Diseases. During the implementation of the exam, the specialists of the relevant applied skill laboratories will be present during the exam along with the members of the exam commission.

As shown below, a Table of Specifications is formed before the exam. The scores of the questions, the passing score for each question, and the observers at each station are all described in this table. The answer key is prepared in advance by the exam commission. As the candidates are assigned numbers during the exam (instead of being identified by name), the commission members cannot associate the papers/exams they are reading with a particular candidate.

TABLE OF SPECIFICATIONS (Exam Matrix)

Evaluation
A pre-prepared key is used for the evaluation of the exam results. In addition, the names of the candidates are not known by those evaluating the exams (blind study design). All of the candidates are consecutively evaluated at the same station; and once a station is completed by all candidates, they move to the next station, where they are similarly evaluated.

As decided by the specialist panels performed before the exam; the candidates are expected to display a minimum performance of 60% (that is, a score of 69.6 over 116) in order to receive a certificate from the Board. According to the competency limits determined before the exam; the candidates are required to receive 6 out of 10 score for the intubation skill at the relevant station; to receive 9 out of 18 at stations 1 and 2, which assess radiology knowledge (e.g. lung radiographies and BT); and to receive a total of 42 points out of 72 from the case-related questions in stations 4, 5, 6, 7, 8 and 9. These mentioned scores are the minimum passing scores for the relevant questions. Thus, the exam has minimum passing scores/limits for radiology, intubation and patient management. Candidates who are not able to pass these minimum scores at the stations will not be able to receive a certificate from the board, regardless of their exam score. Thus, the candidates are informed beforehand that, should they fail in achieving the minimum scores in question, their scores will not even be calculated, and they will automatically fail the exam.

In the exam, all of the candidates were able to pass the intubation and radiology stations. However, 5 candidates were unable to achieve the minimum score for patient management, and thus failed the exam. As it was announced prior to the exam; candidates who fail the exam will receive a document showing their exam results, while candidates who were unable to provide adequate answers to the questions regarding the 8 cases at the patient management stations will receive letters describing that their score was not calculated. When successful candidates receive their Board Documents, the exam results for these candidates can be provided in detail for each assessment target; or, alternatively, it may be provided only as a total performance percentage.

For example, the results for candidate A5:
Radiology performance: candidate’s total score at station 1 and station 2 (9+3=12) / (station 1 max. score [12] + station 2 max. score [6]) X 100 = 67%
Similarly, the candidate’s results may be provided as follow:
Bronchoscopy: (6 / 6) X 100=100%
Intubation (station 10): 100%
PFT (station 3): 100%
Patient Management: (candidate’s total score at these stations) 51 / (station 4,5,7,8,9’s total score)72 X 100= 71%
Total performance: 77%

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