My recommendation for success? Read Big Red early and daily. Work hard with Ranger Red and Spiels to turn it into a "talking test" - just as you say. Go to a tutorial early to locate weaknesses, brush up and then do not miss the final weekend tutorial. (I'm sounding like an advertisement for your course, but it is true.) Oh yes, don't forget about a lot of praying. It never hurt anyone. Also, through all this, remember priorities like wife, children, and enjoying life.

I still believe this test is too subjective and one needs a little luck (or to be blessed) to get the right examiners and the right questions. But what I've mentioned above is doing all humanly possible to prepare. I didn't know if I passed or not when I left, but I knew I had done the best I could and had two fair exams and that is all I could have hoped for.

Keep up the good work and thank you for all you have done for me.

Sincerely, RB, M.D.

Thank you for my field promotion. I worked hard, engaged the enemy (who was sly and cunning) and dominated him. Toward the end of the engagement a sneak flank attack wounded me. It was not mortal. I stood my ground, on the battlefield, prepared by my rigorous Ranger Training. It was this training that allowed me to withstand the last desperate attack, when the knock on the door occurred.

So this Christmas, instead of remorse, I am experiencing elation! Thanks and please tell the troops in the field that the promotion was worth the effort and even the fear engendered by the exam.

Dr. G-New York Platoon

At that point I had two options, I could forfeit the exam and take it next year when I was feeling better and more prepared, or take my chances and give it a try this year. It was then that a friend recommended your review course to me. I did not have Big Red at the time and thought that it would be too late to start reading a new central source.

I went to your course and requested the maximum number of practice exams. Not realizing that I could opt to refuse a public exam, I signed up for one as well. I did pretty well during the private mock orals but when I had the public exam, I totally BLANKED! The pressure was intense. I was so disappointed in my performance. But from my performance during the private exams, I thought that with more intense reviewing in the remaining weeks, there was a chance I could conquer this exam.

I went to Scottsdale with 4 liters of IV fluid and medication. My first two examiners were what many may consider "aggressive." But, compared to the pressure I experienced in front of the group of fellow Rangers at your course, this was nothing. None of their attempts at intimidation were any surprise to me because of my experience at your course. I never thought I would say this but, "Thank goodness I signed up for a public mock oral with you." The pressure just doesn't compare. The second pair of examiners was not aggressive at all and we had a blast verbal sparring.

Other advantages I had after taking your course, were that I was able to observe how well others performed during their mock orals and I could gear my performance to theirs. I was also very pleased at the topics covered during your course. It helps me to realize even more what would be stressed on the boards.

So, despite my health problems, I passed and I attribute much of my success to the knowledge I gained during your course. Knowledge that I could not have learned from any text (not even from Big Red) or from private practice mock oral exams. Thanks a million! I'll pass the word along to future warriors.

Sincerely, Ranger M, MD

Niels, thank you for your help. I passed! It was not a pleasant experience, and I feel sorry for those who have to repeat it.

My first room went very well, our battle plan went perfectly. For the first 5 minutes, I softened their positions with an artillery barrage and controlled critical moments from the start. Then at just the right time I called in mechanized reserves and overran the opposing forces with little resistance. I finished the room triumphantly--by interpreting a tricky blood gas and not being pressured to treat before interpreting (just as we practiced). When I asked for the electrolytes to check for an anion gap, the exam ended.

Unfortunately, in the second room, my artillery was destroyed quickly by an air assault. Then I was constantly pinned down by sniper fire. Before I could call in my reserves, I was counter- attacked by overwhelming forces. I dug in deep and tried to hang on. Finally, I was evacuated by a merciful knock on the door. I was beaten up badly. I never made a critical error or took a killing shot but I was wounded and bleeding from more than one place.

I was depressed for 3 days thinking that at best I had a 50/50 shot. My results were 4 days late in arriving, which further added to my anxiety. Now that it is over and I'm home I can say that without your Big Red and the Ranger course I would have failed the second room . . . Thanks to the hard work we did, and the many prayers from my family, I was able to stay calm, avoid killing errors and "endure to the end."

Corporal LC, MD

"The Fight of My Life"
Dear Niels,
I passed my Oral Boards and would like to thank you for your help. I read Big Red three times and attended 2 of your courses. I believe that your system of preparation was instrumental in my passing. In one of my rooms I had an examiner who was every bit as aggressive and obnoxious as you were during the tutorials. Although you had told us that these types of examiners exist, many people had told me that the Board had "weeded" them out. And so, I was a little bit surprised when one of my examiners was extremely aggressive and hostile. However, I found that I was quite desensitized to the hostility because of the practice at the tutorials, and he did not throw me off track. I believe I might have become quite angry and defensive had it not been for the preparations at the tutorials. Scripting the exam with Big Red and Spiels was equally important in my preparation. Although I did not not know the answer to every single question, I did know most of the answers and I was able to hit several "home runs". I think that made a big difference.

Niels, I really can't put into words adequately how truly happy I am . . . This stupid exam does bad things to good people. Ranger J.

As you know I have been in private practice for twelve years. I thought that Board certification would be something I could never achieve. When I failed the Oral exam for the third time, I had no clue as to why I could not successfully complete this exam. With your help, study material, and mock orals when I took this exam this time I knew that I had been prepared for the challenge.

My first exam was a case for coronary artery bypass surgery. I have not done a bypass case since I left residency. I was still confident because of my preparation. The second exam was a patient with myasthenia gravis for a hysterectomy. Again because of preparation, I was confident in my ability to discuss the case. To top it off, they knocked on my door five minutes too early. I was walking down the hallway leaving the exam area when I was stopped and told I had to go back to the exam room.

This forty-two year old Ranger can now proceed with a newfound sense of self-respect. Tell the Rangers never to give up. Through hard work, dedication and with God's help we can do all things. Ranger N

I came to the Chicago course two months prior to the exam without much preparation. During the first public mock exam with you I was wounded quite severely...wounded but not slain. But my goal for the first course was realized - I got scared and got serious. Using Big Red and the PREP Spiels, I became a study machine and managed to get through the primary source two and a half times before the Terminal Tutorial in Scottsdale. I still did not feel adequately prepared. This must have been evident by my horribly sullen and ashen countenance as I sat among so many nervous but well prepared Rangers. Your opening remarks of encouragement spoke volumes to my very soul, specifically, to cast aside the myriad of tumultuous, detracting, counter-productive emotions and remain disciplined to the end. I did not want to "perform" the mock oral exam before the group and I greatly appreciate the respect you exhibited for my trepidation. I was even more appreciative of you giving me a private exam even though I did not specifically request it. That act made you considerably more genuine in my eyes as a true mentor because I am by nature somewhat of a cynic who realizes there is monetary reward for your efforts to prepare us for the biggest exam of our professional lives.

When the course ended Sunday afternoon, I spent the next four days alone. I prepared for battle by continued perseverance in study...practicing those splendid Spiels in front of the mirror. I also celebrated my 36th birthday two days before the test. I actually forgot it was my birthday until three cards made their way through to me in my self-imposed preparatory solitude. My wife, kids, and my mom sent those wellsprings of encouragement. Sacrificing so much time in those last two months of study was a terrible trial, but even so, the priorities of life were clearly re-affirmed. Food, family, health, and close friends have remained the most precious and valuable resources to me. I stood the cards on the fireplace mantle of the condominium where I was staying. They were placed with care right between the two Ranger certificates I earned at your courses (which I rubbed simultaneously with both hands on a daily basis).

So, I passed the test on my first attempt. I camouflaged the Spiels and launched them at every opportunity. I ended statements decisively. I looked the examiner in the eye even when I struggled for an answer so they would know I was a good guy they should allow into their club. I bought time to think by politely requesting the examiners to repeat their questions when they would jump to new topics. And I used my hands effectively to communicate my points. During each session, I even used my "wait a minute, let's make sure I'm on the same page with you" slow-down routine to re-gain control of the pace of the exam. About halfway through the first session, I remember thinking-- I have already won this battle. The second exam did not go as well with the poker-faced Dr. Prough (head honcho at U of Texas, Galveston) and I certainly did not feel as confident when it ended. Alas, even with all the doubt, the second guessing over the next week as I played the exam and my answers over and over in my head...tormented by thinking I would probably be back again next year, still...I PASSED.

I am not as proud as I thought I would be, rather, I feel incredibly humbled. I owe so much to many whom have contributed to my life. Niels, you were instrumental in my success and I wish to express my most sincere thanks. For any Rangers who may not have come away triumphant may I offer this quote, "There is no failure except in no longer trying. There is no defeat except from within, no really insurmountable barrier save our own inherent weakness of purpose." May I also offer a new theme to you for continued encouragement of the troops during battle. Equanimity! (cool unflappability). You may already be familiar with Sir William Osler's address but I enclose a copy for you anyway. May God bless you and your family as you encourage necessary focus and provide purpose of will to the many Rangers who will do battle with the "old men" who love war.

In Humble Gratitude,
DG, MD.

Your course was an integral part to my finally passing the Oral on the third try. Each day during the four-day course right before the orals, I listened to the public mocks and wrote out a list of things I needed to quickly review that evening. By doing that I was able to "smooth out" some of the rougher areas of my presentation. Of course, scripting and practice orals were the backbone to my success. As you advised, I finally won by turning it into a "talking test".

Another thing that helped me to pass was how I viewed the examiners. I viewed them as one of the surgeons that I couldn't stand. Every hospital has at least one who is argumentative and annoying. I just pretended that it was he who I was defending my position against. This made me less fearful, maybe even more combative. To me, this was not farfetched. After all, I was fighting for my life and livelihood.

Thanks for everything. As I think back upon the war we waged during Oral and Written Boards and now go home, I am convinced your words of encouragement and coaching at the courses helped me more than anything else.

Niels, "This Ranger is going home."

You are right about this Board examination process being a war. As you said, "...the undertakers are still winning it...the old men talk of the need for it...the generals talk of the glory...but the soldiers just want to go home."

I understood what you meant by this. When my cousin Danny came home from Vietnam in 1968 we went to the airport to greet him. I was twelve years old. I remember when we saw him we all ran up to him, hugged up, and couldn't stop crying. Not a word had to be said. When my cousin Robert was dispatched to the Gulf War with the 82nd Airborne Division a horrible feeling came over me. When we heard that cousin Robert was on his way home to the States safe and sound, I cried tears of joy.

Niels, I write this last letter to you from the front with much emotion...Victory is ours! This soldier is going home...

As I leave the Ranger force: May God bless all my fellow Rangers--past, present, and future. I hope they will always remember the six words uttered Winston Churchill, by which I try to live my life: "Never, never, never. never, give up!"

Ranger TM, Chicago Platoon

"How Can Every System Possibly Function Adequately" on the day of the Oral examination? I'll tell you, scripting. I read (memorized) Big Red at least 5 times and practiced out loud and then practiced some more.

By the way, ME and PD (both of them took your class with me) also aced the oral examination!!)

Thanks again,
Ranger JC M.D.
Consultant in Anesthesiology
Certified by the American Board of Anesthesiology

P.S. Do you know what is better than knowing that you aced the Oral examination? It is knowing that I am a better anesthesiologist because of what I learned.