Tips for passing the CHT!

I did it. 

I have imagined this moment for a long while. I finally passed the CHT!!! I say finally because the wait to hear your results is torturous and frankly it sucked! But, I guess in the end it was worth waiting for because it was positive. I wanted to write this post as a way of ending this chapter but also to impart any kind of advice I can to people in the same position. If I had to do it all of again (thank goodness, no), I would definitely do things a little differently with the unmatched value of hindsight. Here are some of my recommendations that I have learned the hard way through first hand experience. Please note that all of the following is just my opinion based on this experience.

1. Get yourself a study group, online or off, whatever works in your area or for your schedule. I placed an 'ad' if you can call it that on the HTCC website saying that I was interested in forming a study group for the May 2012 exam either online or in person. People contacted me from that ad and our little Skype group was born. We had 4 people but honestly I think you can have as little or as many as you want (although I would caution against a larger group - say 5/6+) as long as the members are accountable and reliable. If you have one other person that you can rely on and who can rely on you, then maybe that's all you need. In addition, the more people you have, the more conflicting schedules you run into but if you can work around that, then that's fine.  A larger group brings people from different backgrounds together (try and mix up the group to be PTs and OTs) which can be advantageous.

We used to meet once a week for the 3 months leading up to the exam week. Because there were 4 of us we split up chapters of this book to summarise and 'present' to the group during our skype sessions. We calculated that if we covered 2 chapters a week with the time we had we would have a few weeks before the exam for review. To be perfectly honest, just by summarising my chapters, I didn't feel I retained a whole lot of information. I gained the information through discussion and reviewing my summaries and testing myself. Towards the end it became a lot like paraphrasing. BUT, the weekly meets kept me accountable and in touch with everyone and they did help in discussing some concepts. Looking back, I do think that time may have been better used but it did serve some purpose. 

2. Attend a review course to connect with other candidates and to acquire information from a different source. The course I recommend is the one provided by ASHT which is held bi-annually, usually in April and October before the May and November exams. I only heard about this course 2 months before my test date and I anticipated that everyone at the course would be taking the exam that May. Not so. A lot of people were undecided about when they were taking the exam; planning on taking it November; or using the course as a general review of Hand Therapy and not taking the exam at all. I actually think taking the course a long time before you take the exam (i.e. take the course in May but plan on taking the exam in November) is very smart. The course gives you a review (it is not long enough to teach you everything, which is emphasized throughout the weekend) so it allows you to see what you know and where you need more work and it allows you to connect with other people and possible find study partners. The manual they provide is mostly the slide presentations of the speakers but it contains some great tidbits and must-know information. I highly recommend going for the full three days (not just the weekend) as the first day is anatomy review and definitely makes the course more worthwhile. Another reason to separate taking the review course from the exam is that I found going to the course so close to my exam date, freaked me out! I came home after the weekend with my mind spinning in a million different directions of what I needed to review and felt I didn't know, whereas had I taken the review course last November it would have kick started my studying and given me some kind of direction. 

3. Plan in advance that you are taking the exam but bare in mind that it seems to be the few months before you take it that really allow you to retain information. I have spoken to a lot of therapists studying for the CHT that start reviewing 6 months and longer for the exam. The consensus appears, however, that whilst you start reading your heavy textbooks months to years in advance, you don't really internalise that information until closer to the time. This point is really relevant to me because I didn't decide or know that I was going to take the exam until the end of January 2012 (exam date May 2012) and I'm sure for most people that would be far too short to start studying. I had special circumstances in that I had just moved from another state and was awaiting my license for my new state and thus was unable to work. [As a disclaimer, I studied internationally so it took a very long time to get my license sorted out (longer than 6 months) which is not normal!] For a long time (and right up until my results), I felt very insecure about the fact that I had left it pretty late to start preparing (3 1/2 months) whereas people in my study group had been studying for a lot longer. Obviously not being able to work I had a lot more time on my hands which is why I decided to go for it. However, if you are able to decide 6 months or 12 months before that you are planning on taking it, you can get all your ducks in a row and not stress yourself out about running out of time. Also everyone is different in terms of their working and home situation and you want to be able to give yourself a break if, for example, you have to attend a wedding or you have kids and can't study intensely every weekend. So long story, but if you plan in advance you can start collecting resources and gradually ease into it baring in mind that you'll need to crank it up as D-day approaches.  

4. Do not become overwhelmed with the resources out there. HTCC lists a monstrous list of resources from which you can study. It is physically impossible to read and retain all the knowledge in all those books, journals and DVDs. In addition, and I find this hard to believe, remember that this exam is supposed to test entry-level competence in Hand Therapy. Entry. So with that in mind, how can you possibly become familiar with every last ergonomics or kinesiology textbook out there. It's good to know these specialist books exist but just because it's on the list does not mean that you have to go and get them. Personally I feel I spent far too much money on excess resource materials that I ran out of time to even look at. Stick to the basics: 

• A good anatomy atlas (I recommend any Netter's - you can't go wrong - I have an old one that someone gave me when I was a first year student - anatomy doesn't change, but if you don't have one it's probably a worthwhile investment).
• The latest edition of Rehab of the Hand (currently and for the next few years it'll be the 6th) by Skirven et al (I used the 5th edition which honestly I think is fine and was given to me so I didn't have to buy it, but for future exams, use the 6th and definitely nothing earlier than the 5th).
• Look into getting the Purple Book actually known as Hand Rehabilitation: A Quick Reference Guide because there is a newer edition coming out in January 2013 and the current 2nd edition is almost $500 on amazon! I think the original price a few years ago was $60! So if by the time you are looking to prepare for the exam, the newer edition has not come out see if you can borrow the book, or buy it second hand (someone who has taken and passed the exam does not really need this book on a daily basis) or look for deals through their website on handtherapy.com - you can get your book heavily discounted when you purchase the exam questions package (they are the same people!).
• Purchase test questions. I used questions from this site and this one. I am a firm believer in simulating the environment as much as possible and the best way to do this is to get your hands on as many test questions as you can especially as HTCC does not officially release or endorse any test questions.
• Attend the ASHT review course if time and money permits (you can save costs by becoming a member or ASHT and by sharing a hotel room if you know someone else going, I also used miles and got my flight virtually free and resisted renting a car). If you're really organised you can see about 6 months in advance where the next course will be held and try to go to one closer to you. They are usually held in Philadelphia, Baltimore, Chicago or St Louis but venues alternate so you may not get the venue you want at the time you want.
• If you feel particularly inept in a particular topic (e.g. shoulders, splinting or kinesio-taping) you can look into books that specialise in that area for a better understanding but for the most part it should all be in the Rehab of the Hand.

I spent a lot more money than is warranted on the above list and as I said with hindsight and in my opinion (no one else's) this is all you need provided you are very familiar with these materials. If you have the luxury of using up CEU money, look into courses where you feel you need more focus. As OTs we often feel a little out of our depth with shoulders, for example, but this is a big area within our profession as hand therapists so I encourage everyone to learn more about areas other than the hand and wrist for this exam. 

5. Decide ahead of time whether you are going to tell people you are taking the exam. Some people relish the pressure and the challenge of their whole world knowing, others cringe at the thought. It is often times unavoidable to keep it a complete secret but if you have a game plan from the beginning you are more likely to stick it. I tried not to tell anyone that didn't absolutely have to know but because I didn't have a job whilst studying, when people asked me what I was doing with myself, I felt like I had to account for my time and justify it as it was by no means a holiday! Most people outside of the OT world will not know what this exam is or the stresses that come with it and I have found because there is 6-8 week wait from when you actually take the exam to when you hear your results, most people beyond your inner circle forget that you even took it! You'll be reminding them when you pass! :)  

I am so nervous..

I haven't posted anything for months because of the guilt. The guilt happened whenever I thought about doing something non-study related in place of actual studying. Today, as I am no longer studying, and therefore cannot feel directly guilty about blogging, I thought I would post about the 6-8 week wait. It.is.killing.me! This is the waiting period between taking the test and actually getting one's results. Although I have been keeping busy since taking the test, the results are always at the back of my mind. Did I do enough? Do I deserve to pass (I know, crazy right? what does that really have to do with it?)? The answers I changed right at the end from right answers to wrong ones (within this context: this is the worst feeling ever), how many were they and were they one too many? Please, please, please, let me pass (again bargaining or begging to whom I'm not sure, isn't really going to help either). And now the results are due to come out next week. So close, yet still I am in the safe "ignorance-is-bliss" cocoon where if people ask me how I did, I can say I honestly don't know. I am scared for next week. I am terrified. Maybe writing about it and admitting these feelings will make me feel better or make someone else feel better. Either way, it feels good to blog again.

What did I say about those Yellow Books?!

For those of you who don't know, those yellow books are Hunter, Mackin and Callahan's Rehabilitation of the Hand and Upper Extremity, 5th Edition. They are a two-volume set of about 2000 pages of teeny, tiny surgeon, medical, therapist jargon and literature and I resisted (well it wasn't that hard..) reading them until now. You see my strategy was always to use them as reference... i.e. look something up when I needed to know more. But, at the back of my mind, I had this gnawing feeling that my guilt (at not reading them) and my insecurities (of being "the only one" not reading them) were going to get the best of me and make me cave sooner or later. Sooner is better than later in this instance because I'm the kind of person that has to finish a project once I start. I have to finish a book even if I am hating it/it's just not for me and thus taking forever to read it. I can't leave the bed unmade in the mornings. I have to pack away my clothes. You get the idea! And so, it was slowly dawning on me that if I was ever to start reading these books, I had better start, like yesterday, because they are monstrous and can literally kill you if dropped on your head, and I would never finish reading them in the so-called 3 weeks I had allocated. 

So now my whole "strategy", whatever that means, has changed.. Well more like increased a million-fold. I am doing everything I was doing before and now reading these books which amounts to probably about 200 pages a week for the two chapters that the study group is preparing. So this week is elbow and shoulder week. I am doing the summary for the elbow but I also have to prepare for the shoulder. This means reading both sections (note how I did not say chapters as there are multiple for each topic) which is roughly about 200 pages of aforementioned teeny jargon and concentrating on what I'm reading; reviewing the three different types of summaries I have mentally committed myself too (why? see what I mean about the obsessive personality?!) and trying to do 25 random MCQs a day. Plus, again at the back of mind (wow there is a lot going on back there!), I am thinking that although I have started reading the Hunter books asof one week ago, I have not read the beginning of the books or really the middle and I have skipped out basically the whole of volume 1 so when I am I going to make up that time? ahhhhhhhhhhhhhhhhh See why I need this blog? I need to vent!

The next challenge of this week is to try and get into a routine. By routine I mean studying for 6hrs a day. You would think when there are 24hrs in a day, one could get a lot done. Um, nope. Biggest procrastinator/faffer, put it here! Despite popular belief, I do have a mini-life, and by that I mean I have an apartment which needs to be cleaned, a husband, who needs his clothes to be cleaned and a little puppy who makes me clean more! And so orchestrating two 3hr study sessions can be challenging, mostly because I can't concentrate for that long but also because I need to be more disciplined and stop surfing (the web). I'm even hesitant to blog because I feel guilty about it! But I am going to try and change that: busy people get more done. Fact. So starting today I am going to get more done. By writing this post, I already get to cross off a To-Do on my list which, again, makes my obsessive-compulsive personality smile. 

And so to continue on my turned leaf, I bid you farewell to complete the next thing on my list: cook dinner at home at least once a week. (I know, I know, I live in New York.. it rubs off after a while.. ok 3 months)

Bye!!

I don't even know what day we're on now..

So my theoretical commitment of posting, if not every day, then regularly say three times a week has failed miserably. I would like to think that I have been too busy studying to have been blogging, and whilst I have been studying, it's probably not a fair assessment to say that I have been too busy. It's all about making time. Perhaps I have just been emotionally too busy and as such found the thought of blogging, a guilty one, when I should be playing catch-up. I'm feeling a little intimidated to be honest because so many people that I know of, started studying for this exam WAY in advance - 9 months - a year? and me.. just 3 months really until the exam! OK so I don't have a job but it's still scary. How will I catch up to them? Would it have been better to start 9 months ago? Not sure I can retain info for that long.. 

My strategy has changed a little since my last post. I have kind of abandoned the cardboard which I thought might happen and ordered a ton of books! I went onto exploringhandtherapy.com and ordered what they recommended for the CHT exam as well as all of their practice tests. The whole exercise was very pricey but especially for the practice tests, I think the money will be worth it. Not sure how I feel about the DVDs. The are very detailed and comprehensive but there a lot of spelling and grammar mistakes and typos and I wish academic information that cost a lot of money was presented with minimal errors. I guess for the detail-orientated A-type personality in me, typos rub me up the wrong way. Note to self: NEVER have mistakes on this blog - I'll be flayed alive! In this blog's defense, though, I'm not charging anyone to read it and I am not professing it's professional integrity! Anyway! Enough complaining - there are more important things to discuss.

I also finally received the study guide from ASHT with which I am very happy. It's basically a summary/study guide of everything you need to know in the exam without any pictures or diagrams - i.e. a lot of text! It's portable enough though that you can take it with you to refresh things and from what I can see, the text is very comprehensive. At the back of the book their are questions regarding each chapter which are nice for testing yourself. The guys from ASHT also emailed me the answer memo which is great (the answers aren't in the book) and so I can see which ones I got right and what I still need to work on. 

Then I have been using the purple book to top it all off! (I feel like I am discussing a skincare routine 1. cleanser 2. toner 3.. etc etc). The purple book (it doesn't seem like anyone really knows it's name but click on the link if you want to find it on Amazon for a ridiculous price! It must be going out of print or something because it is not an inordinately large book!) is structured with a Q and Multiple-choice-A format and is actually authored by the people that own exploringhandtherapy.com. It is also kind of considered the 'must-have' 'Bible' book for passing the CHT because the questions (in my understanding) are very similar to those in the test in terms of layout and material covered. My only thing with this book, while very comprehensive, is that the Q&A format makes it hard to learn the information before being able to answer the questions..

And then... drum roll please... I found myself a study group! An online, skype-chat via keyboard-only group, but a group nonetheless. I definitely have these three other individuals to thank for pressuring me into starting to study and to keep going as we have deliverables every other week. Because there are 4 of us, we each summarise a chapter from the purple book every 2 weeks. 'Summarising' the chapters is actually more about turning the answer into a paragraph and trying to organise the information as I don't think anyone feels confident enough to actually leave/summarise anything out. So far we have 'met' twice and I think the group is going well although I do feel more in-depth studying is needed. For me at least, I definitely need more revision. 

So today I allowed myself to finally blog because I have completed the chapters I needed to revise and summarise this week for Sunday and it's Thursday so I am feeling semi-on top of things and thought blogging would be cathartic before I start a new chapter and try and play catch up. I haven't even attempted the yellow books yet... But that's a post for 'a-whole-nother' day!

But actually the best thing I did this week was buy this:

It's called an "Our Pet's Smarter Toys IQ Treat Ball" and it has been keeping my 5-month old Dachshund puppy occupied for the entire length of this post. Score!

Hope you guys are all doing great! I would love to hear how your studying is progressing and any tips or ideas you have, everyone knows, we need to pool resources to show this exam who's boss! 

Bye for now.

Day 2/3: Getting Motivated

So technically this is Day 2 of "studying" but Day 3 since I vowed to actually start studying. I am trying a new approach to get motivated... diagrams. Instead of reading the text books over and over (and I'm not even sure if I have all the textbooks), my sister came up with the idea to try and put everything I/we need to know on one page. OK so anyone taking this exam will know that being able to put everything on one page is probably unlikely to happen but it did spark an interesting idea. I need to revise all my anatomy so why not draw a giant upper limb and use it to prompt everything I need to cover. I'm not sure if this is going to work but the idea did get me out of my "lack of studying, feeling guilty about this" slump and into doing something a little creative. 

First we went to Target and bought some huge pieces of cardboard/postboard and some cool coloured Sharpie pens. Then I attached all the pieces of cardboard (3 in total) horizontally to one another with sticky tape so that my arm could be GIANT. I then scoured the internet for diagrammatic drawings of the upper limb. I found a good-enough-one anteriorly but I still needed a posterior one: cue Netter's Atlas of Human Anatomy. I am no artist or illustrator but I just needed a basic outline of the upper limb in order to cue everything that needed to go on there. My plan is to gradually build it up, reviewing as I go, with muscles, nerves, joints and arteries and veins and then use each section to document key injuries, conditions, deformities, assessments, treatments or whatever I have space for. I think this way may make it easier to remember certain things because I will be able to visualise where they are on the page and not just try and parrot learn them. We'll see, not sure how successful this will all turn out to be. 

Thoughts? 

 

Ta Da! Creepy huh?!

Certified Hand Therapist.

So it's been a while since I last posted on this blog because I had kind of said my piece about the NBCOT. Now however, I have more to say, and this time it's about becoming a Certified Hand Therapist (eek! I am scared!). I think I have enough direct hand therapy hours to qualify to take the May exam. If not well I guess, I should delay this blog until November! Either way, I think I am going to start studying, the question is where? There is so much to learn and the only way I think I can do it all is with a little structure, sanity and support. I guess that is what this blog is all about. I want to make learning for this exam fun and interactive. Whilst trawling the internet, I didn't find any blogs directly addressing the CHT. I think this may be because a) they are too well hidden and who clicks beyond Google's initial search results anyway? b) there are only just over 5000 CHTs in the world so they are in the minority and c) studying for the CHT, working, having a life, takes a lot of time and probably time for blogging is a low priority. So I decided to start my own blog dedicated to the CHT exam which is a nice progression from taking the NBCOT a few years back. 

It's Day 1 of blogging today and Day 1 of planning my study timetable so I thought I would get off to a good start and think about my approach. Which textbooks will I use? Do I have them or have access to them? Am I going to read through everything and do questions or summarise or draw and act out scenes from Netter's (Atlas of Anatomy)? Do I need cardboard or lots of blank pieces of paper? What about a study group? Online, in person? I'm not sure yet. So far I have ordered a study guide from ASHT - the American Society of Hand Therapy but they tell me it'll still take 2 weeks and that's a lot of time I could be studying. In the meantime, I know I need to know my anatomy of the upper limb backwards, I need to know the stages of tissue healing intimately and if the study guide still hasn't arrived, I need can go through all the common and uncommon assessments or tests. Never mind diagnoses, treatment, splinting, ethics, ergonomics.. ahhhhhhh!

Anyone else out there in the same boat? I'll keep you posted.

Time Line from thinking about the NBCOT to actually getting a job

As an international OT passing the NBCOT is only the tip of the iceberg. Once you pass the NBCOT you still need to get your Visa Credential Verification Certificate (VCVC) which is valid for 5 years and is essential if you are applying for a visa to work in the US. You also need to register with the specific State that you are planning to work in. Then you need to find a job and an employer that is prepared to sponsor your visa. Then you need to apply for you visa from immigration, hope that you get it and then wait until you can start working. Typically you apply for your visa in April of a specific year and it comes into effect in October of that year. It's not an automatic process. There is a 6 month delay between application and actually being allowed to start work. Sigh. Here is a sample time line from thinking of going to the States to work as an OT and actually starting work. 

Still want to do it? Good luck. Hope we can help.

Qualifying To Take The NBCOT

In a perfect world, most of you will not need to go through this step - the pre-amble before you are allowed to register to take the NBCOT. 

If you graduated after 2007 and do not hold a Masters in OT - I'm sorry the road ends here...

1. If you graduated after 2007 and do not hold a Masters in OT from WFOT (World Federation of Occupational Therapy) recognised institution, you will not be able to take the NBCOT exam. If you are still looking to move to the States and work as an OT you will either have to acquire a Masters in your home country or some where world recognised (check this with the university you are applying to) or you could try and apply for a Masters in OT within the US. Having to do a Masters will set you back a few years and if you are looking to apply for financial aid as an international student be prepared to apply to schools at least 1-2 years in advance. You really have to be committed to working in the States as an OT to go down this route.

If you graduated before 2007 with a Bachelors or hold a Masters in OT - fun and games ahead!

2. If you graduated before 2007 with a Bachelors or hold a Masters in OT from a WFOT university then you should be eligible to take the NBCOT. However you may have to prove that your education is at the standard of American graduates who have completed their Masters in OT. As you go through the OTED (Occupational Therapy Education Determination) process you will find many hoops that you need to jump through. This is in an arduous process that I had to go through before I could register to take the exam. It also costs $500 to have this part of the application process approved - this is an expensive process - make sure you really want to do this before you get stuck in!

One of the longer steps is completing a document that states all the courses and subjects that American OT schools provide for their students and placing your equivalent course and course code next to it. So for example, usually at some point in your OT career you completed a psychology course. The form will say Neuropsychology methods, and you'll have to match that by listing a course that contains those elements. Then you will say how you were tested in the course - oral exam, case study, written papers etc. You continue with this for about 40 pages. It it also important that you get it right the first time and write out the course names for NBCOT. I listed the course codes (which is what the instructions said) on my application and they returned it saying that I had to write out the full name of the courses. I spent a lot of time writing 'Occupational Therapy Methods and Foundations 2' and the like. Get it right the first time! 

To further strengthen your proof, you need to get your university to send as detailed as possible course descriptions from their official course curricula. It's no use, you just writing course names next to the US equivalent. Sending transcripts will also help to show that you completed the requirements for each course. As I am a South African trained OT, I don't imagine that there are a lot of OTs from the same country as me trying to apply to take the NBCOT - I know of one, they are very skeptical of other countries and their training so it is important to give them as much information as possible - too much if you can - to show that you are at the same level as new graduates who take the exam. 

Concurrently, you may need to take an English language test to prove that you can speak, understand and read and write in English. Countries that are recognised as first language speakers of the English language do not need to take this test (the TOEFL). So if you are from Canada, Ireland, the United Kingdom, Australia or New Zealand you do not need to take the TOEFL. Others like myself who are not from any of the listed countries but who speak English at home, were educated in English and work in an English speaking environment are still required to take the TOEFL and spend an additional $150. Those are 4 and a half hours of my life that I'll never get back. Also bare in mind that the TOEFL is only valid for 2 years so make sure you don't do it too early and then have to do it again.

It is always a good idea to check the NBCOT website to make sure that you are up-to-date with all their requirements. I took the NBCOT exam in October 2009 and began this process in December 2008. Things may have changed but I am pretty sure that the jist is all there. The website has a specific path for internationally-trained OTs to follow so it shouldn't be too hard to navigate. However, in hindsight, I wish that there had been more info about the process online so that I knew what I was getting myself in for.

So now you've taken you English test, submitted your course curricula, transcripts, degree certificates, NBCOT forms and paid exorbitant amounts on your credit card.. now what? Now, you wait and hope to your lucky stars that they except all your paperwork in due time and allow you to take the exam. It's one roller coaster after the next.