Conquered that NBCOT.. onto the CHT

What did I say about those Yellow Books?!

2012-02-20T19:10:00.000-06:00

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..

2012-02-09T18:02:00.001-06:00

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

2012-01-07T21:25:00.000-06:00

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.

2012-01-05T09:29:00.000-06:00

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

2010-08-10T04:07:00.000-05:00

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

2010-08-10T03:36:00.000-05:00

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.

Finding the right study guides

2010-05-20T18:13:00.001-05:00

This is the question on everyone's mind! Personally, I bought study guides that in retrospect I didn't really need. Please learn from my mistakes and don't waste your money! For me, I always find it motivating and helpful to study using past questions and exam papers and as this exam is all about technique (rather than regurgitation of info), the ability to analyse what the questions are asking is very very important and the key to being successful in this exam.

1. The Official NBCOT Study Guide

This is an absolute must as it questions from NBCOT directly. You can borrow a copy from a friend and you can also order the guides in a group to bring down the cost per guide. If you get nothing else, this is one the to have. What I found really useful, was that at the back of the book, there are references for all the questions so especially if you don't get a questions right you can go and research where the question came from. It also can provide a starting point to study. You may also want to take the test before you start studying and a few weeks later when you are ready to take the exam (provided you have forgotten the questions) and compare your scores. Hopefully it'll be a confidence booster.

2. 2009 National Occupational Therapy Certification Exam Review and Study Guide by Rita Fleming-Castaldy

This is the book that gets everybody buzzing. When you first lay eyes on it, you think it has come down from heaven to save you because it seems to be all the years of OT study crammed into one book. You think to yourself, "wow, if only I had had this book during university, it could have been all I needed!". This, my friends, is not true, and while the 'Rita' book is a great book with many many topics and a CD-rom with practice questions, it is still a study GUIDE and not the be all and end all of OT prep. I think where many people fall down is in the reliance of this book and thinking that this is enough. Perhaps if you memorised every fact you would get through, but if you don't understand the foundations, you'll probably still struggle. Another critique comes with the practice exams. There are 3 on the CD-Rom with 200 questions on each. They are challenging questions which is good to get your brain ticking but they are not the same as the NBCOT questions and you need to know the 'Rita' book pretty well in order to answer them. Many people say that the questions in this book are much harder than those on the NBCOT exam, and whilst I agree that they are tough, I wouldn't necessarily say that the official NBCOT questions are easier, just different. Bottom line, this book is not a substitute for basic concepts and in my opinion will not get you through the exam just on its own, unless you know your foundations of OT really well.

3. Occupational Therapy Examination Review Guide by Johnson

I really recommend this book. I enjoyed working through it. The questions are quite easy, compared with some of the NBCOT ones but they cover a lot of the information needed for the exam. This book is great self-esteem booster as you can do well through using the same logic and analysis needed for the actual exam. Again, do a test (there are 4 in the book with 200 questions each) before starting to study a section and then a few weeks later and compare your scores. Johnson has also created exams divided by topics as well as all mixed with details rationales for the choice of each answer and references to explore concepts in more detail.

4. Castle Worldwide Practice Tests
As you start to near the end of your studies, keep the practice exams available from Castle Worldwide in mind. You won't receive the answers for these questions because they are quite similar to actual questions on the exam. This is frustrating but also motivational as you may end up doing more research and studying by trying to find the answers. You can buy the exams in a big pack or individually and they are valid for a year from date of purpose. This means you can buy the exam and wait until up to a year to take it. Once you take it though, you can't do it again unless you buy it again so keep that in mind. This is a great way to get into the testing frame of mind and prepare yourself for the exam and the score that you get is highly correlated to the score you may receive on your actual exam.

Essential Textbooks for NBCOT

2010-05-20T10:58:00.000-05:00

In our research we found that the common study guides for NBCOT are helpful with the exam. In my opinion, however, I strongly feel that the difference between a pass or a fail is in the foundational information that one needs to learn. I recommend studying from a well-trusted and recognised name in all the necessary areas: physical dysfunction, paediatrics, mental health, community and possibly legislation (especially if you are unfamiliar with the US health system).

The following are textbooks representing each area where possible. If you are looking to buy a book, getting the latest or second to latest edition is probably the best as the exam has been recently updated (in 2009) and so the topics covered are from newer editions. If you have an older edition, you don't need to buy a new one. If you really feel like you are missing out, you can try and borrow a later edition from the library. This can be such a costly process (especially if you are international or taking the exam repeatedly) that is unnecessary to buy new editions of the same textbook.

1. Physical Dysfunction
Williard and Spackman's Occupational Therapy by Crepeau, Cohn and Schell
Many of the questions the physical dysfunction questions are referenced from Williard and Spackman and so it is good to be able to look up questions in this book and get expanded text on the topics.

Occupational Therapy for Physical Dysfunction by Radomski and Trombly
Again many of the questions for physical dysfunction are referenced from Radomski and Trombly. If you have both books, that's awesome. If not, having one or the other is good enough. Again you can always try and borrow the book from a friend or take it out of the library.

Pedretti's Occupational Therapy: Practice Skills for Physical Dysfunction
I didn't have access to Pedretti's when I was studying but I know it's a good resource and it did come up in the occasional question. Again, I think if you have one of the three Phys. Dysfunction books or even better, two, you won't need all three, and most likely won't have time to go through them all.

2. Paediatrics
Occupational Therapy for Children by Case Smith
I borrowed this book from a friend - a much earlier edition - and I found it very helpful regarding the IEP (Individualised Education Plan) and the feeding responsibilities required of an OT. It comprehensively covers everything a new (and advanced) OT needs to know about paeds in the States. This is a good resource to use.

3. Mental Health
Psychosocial Occupational Therapy: A Clinical Practice by Cara and MacRae
This book is great for getting back to basics on all things mental health and specific OT interventions and approaches. It also outlines all the medication and side-effects which is really useful especially if you are unfamiliar with this field or you didn't study it intensely at university. I highly recommend this book for mental health. I wish I had had it during my studies.

4. Community
Developing Occupation-Centered Programs for the Community
This is the only book that I actually bought because it wasn't available to me locally. But that's just me. It was helpful with the tricky program questions on the exam but I don't think it's actually necessary to buy if you can borrow it. I'm still glad that I had it though for the exam because it put my mind at ease that I had a good solid resource for this section.

Introduction

2010-05-20T10:19:00.000-05:00

So to start off, let us introduce ourselves. We are two OTs who are internationally trained (in South Africa and Australia) and for various reasons, mostly involving men, we found ourselves needing to take the NBCOT. Up until last year I had never heard of the NBCOT, as such, and was only vaguely aware that in order to work in the US as an occupational therapist, one needed to take a board exam. When the time came to make the decision to move, the NBCOT loomed and after many months of stress, lots of money and energy invested and many Skype conversations, both of us passed the NBCOT comfortably. Chatting to the internet savvy OT community really helped us to conquer any perceptions we had about the exam and to actually study through Skype, email and forums/blogs. As we have both recently taken the exam (Sep and Oct 2009 respectively) we are very familiar with the process and can offer additional advice if you are an international OT wanting to take the exam. We can also explore which resources are really necessary to buy and which you can live without. Then, we can try and advise the best job search strategy especially if you are outside of the US and need a visa and job before you arrive. We hope that this becomes an interactive forum where legitimate, honest discussion and advice is imparted.