Preparing for the ASAM Certification Exam

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Preparing for the ASAM Certification Exam

• John Standridge, M.D., C.M.D., F.A.A.F.P.,
• Medical Director, Counsel for Alcohol and Drug
  Abuse Services
• Professor, Department of Family Medicine
• Program Director, Geriatric Medicine Residency
• University of Tennessee College of Medicine
  Chattanooga

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General principles

• Study in the manner that works for you
• Visual learner
• Auditory learner
• Repetition
• Study groups
• What has worked in the past? You would not be to
  this point if you were not a successful
  high-functioning individual

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General principles

• Focus
• Quiet environment
• Highlight text
• Not everything
• Look for potential test questions
• Do not medicate
• Do not go off medications

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General principles

• Diet -- Have a light meal before the examination.
  Avoid a large, heavy meal it might make you
  drowsy.
• Detoxify
• Mediterranean diet
• Exercise
• Allow yourself ample time to digest the material
  twice -- A well-planned and extensive review
  will prepare you for this examination better than
  intensive "cramming."
• Do not rely on your practice experience

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General principles

• The  Physician must pass a day-long written
  examination covering knowledge of the basic
  sciences as well as the clinical science of
  addiction and its subspecialties.
• Take advantage of the ASAM Review Course.
• At this ASAM Review Course you receive sample
  questions, a syllabus, and lectures that review
  subjects including epidemiology, alcohol,
  opioids, cocaine, and other topics that you will
  see on the exam.

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What to expect on the ASAM Exam

• Test Subjects
• Categories Biochemistry-4.1Pharmacology-26.2P
  athophysiology-6.3Etiology-1.4 Diagnosis-
  19.0Treatment-11.6Complications--14.6
  Medical Ethics-0.1 Nomenclature-0.1Medicologi
  cal Issues-2.3Epidemiology and Prevention-6.3

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What to expect on the ASAM Exam

• Test Subjects
• Substances Alcohol-22.6 Sedatives-
  11.6Stimulants-14.3Cannabis-3.6Nicotine-2.5
  Other Drugs-23.4Poly Substance-1.7Opioids-17.
  9
• Note Other drugs include hallucinogens,
  inhalants, PCP, annabolic steroids,
  antichloinergics, methanol, and ethylene glycol.
• Complications may be medical or psychiatric.

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Preparing for the ASAM Exam

• Get a good night's sleep before the examination
  avoid the use of stimulants or sleeping pills
• Arrive on time at the beginning of each testing
  session.
• Bring a government-issued photo identification
  (drivers license, passport, ect.), and your
  Acceptance letter.

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Preparing for the ASAM Exam

• EXAM DAY SCHEDULE
• COMPLIMENTARY BREAKFAST AND MANDATORY
  REGISTRATION630 am Complimentary continental
  breakfast and coffee will be available.700 am -
  730 am Mandatory RegistrationMORNING
  EXAMINATION SESSION730 am - 800 am
  Distribution of materials and instructions800
  am - 1130 am Part I of the Exam (Answer Booklet
  A)LUNCH 11 30 am - 1230 pm (on your
  own)AFTERNOON EXAM SESSION 1230 pm - 100 pm
  Sign in, distribution of materials and
  instructions100 pm - 430 pm Part II of the
  Exam (Answer Booklet B)

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During the ASAM Exam

• Bring a watch and put it in a convenient
  location.
• Pace yourself you will have an average of 0.9
  minutes per question.
• Do not spend a long time on one item. If you are
  unsure of an answer, mark what you believe to be
  the correct answer on your answer sheet you may
  wish to circle the item in the test book and
  return to reconsider it later if you have extra
  time.
• Set up check points during the examination to
  determine how well you are pacing yourself.

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Sample questions

• A Standard order for Meperidine 75 mg every four
  hours is inappropriate because
•  A. Effective analgesia lasts only 2.5 to 3
  hours.
• B. If a person receiving a monoamine oxidase
  inhibitor, severe toxicity can occur.
• C.That dose is equivalent only to 5 to 7.5 mg of
  Morphine.
• D. In the presence of impaired renal function
  toxicity may occur.
• E. All of the above

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Sample questions

• 2. Propoxyphene (Darvon)
• A. Is a non-opioid analgesic
• B. Is not associated with a potential for
  physical dependence.
• C. Is non-addictive.
• D. Is an ester of methadone.
• E. Is as effective as Percocet (oxycodone) in
  relieving pain.

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Theres plenty of time . . . .

• Each of those questions was 0.9 minutes (54
  seconds)

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Test-taking strategies

• If you do not have a clue to the correct answer
  for a particular item, skip it, and return to it
  later.
• When you return to the item if you still have no
  clue, remember that no one knows all the answers.
  
• Try to approach the item logically.
• Use Structural cues if and only if you have no
  better way to select an option.
• The most general alternative is often the correct
  one.
• The longest alternative is often the correct one.

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Test-taking strategies

• Look for grammatical agreement between the stem
  and the answer.
• Logical reasoning strategies association of
  ideas or information in the stem with ideas in
  the alternatives.
• The correct alternative may contain the same
  meaning or the same words as the stem-word
  association.

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Test-taking strategies

• Specific determiners associated with incorrect
  statements.
• Always ---necessary ---never ---merely
• Must ----none ---impossible ---none
• Only ---all

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Test-taking strategies

• Specific determiners associated with correct
  statements.
• often ---seldom ---generally ----may
• perhaps ----usually

Note that in most professionally prepared
certification examinations, the editors will be
careful to eliminate obvious structural clues, so
don't spend too much time on this approach.
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Test-taking strategies

• The object is to select an answer fairly quickly
  and move on without getting hung up on a single
  term.
• Recheck your answers. Be sure that no item has
  been left blank. Change answers only if you have
  a good reason.
• Approach the test as a positive challenge.
• Keep organized.

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The Nifty Nine guidelines

• Try to approach the exam with the attitude that
  you are intellectually interested in the subject
  content of the examination.
• Manage your time so that you have time to
  complete the exam.
• Fill in your answers item by item.
• Don't let a temporary memory block panic you --
  skip the item and return to it later.

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The Nifty Nine guidelines

• 5. If you don't have clue to the correct answer
  for a particular item, skip it, and return to it
  later. When you return to the item if you still
  have no clue, remember that no one knows all the
  answers and approach the item logically.
• 6. Eliminate any options that are not reasonable.

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The Nifty Nine guidelines

• 7. Use your clinical reasoning to select a
  strategy that might enhance your guess
• the strategy is up to you,
• the object is to select an answer fairly quickly
  and move on without getting upset about any
  individual item.
• Recheck your answers
• but, only change answers if you have a good
  reason
• when rechecking your answers be sure that no
  items are left blank.

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The Nifty Nine guidelines

• 9. With single answer multiple choice items use
  structural cues if and only if you have no better
  way to select among the remaining options.
• Grammatical consistency between stem and options
  (Choose the grammatically correct answer)
• One option longer or more qualified than others
  (Choose long one).
• Specific determiners like never and always
  (eliminate options with these).
• None of the above (rarely the correct answer).
• All of the above (Often the correct answer).