As most know, the American Board of Anesthesiology (ABA) has announced changes to Board certification in anesthesiology. Specifically, it has released a revised content domain governing the "Basic" examination during residency to be followed by the "Advanced" part 1 Written examination to be taken upon completion of residency. Once this is done successfully, passing the "Applied" Oral examination completes the triad of examinations required to become a certified diplomat of the ABA. The "Basic" is being phased in. Even though the key word content domain is already being used to write the exam, currently only one third of residents must pass this "Basic" exam to graduate from their training programs. However, by July, 2015 all residents will have to successfully pass the "Basic" (formerly ITE exam) to successfully graduate from residency. Approximately a month after completion of residency, graduates will then take the "Advanced" part 1 Written examination. After months of analysis and research looking at both content domains can be made.

First, the recent ITE reports from the February, 2014 exam clearly suggest that both the new "Basic" and "Advanced" part 1 content domain(s) are already being used to write both examinations; in effect the "Basic" examination has already supplanted the former "In-Training Examination" (ITE) in terms of tested content. Furthermore, scores of performance upon the "Advanced" content domain are also reported to and evaluated by residency programs for purposes of both resident and training program evaluation. This is clear by examination of the recent "Basic"/ITE grading report which reports results of "Basic" and "Advanced" exam performance.

Second, after extensively evaluating the ABA key words for both exams it strongly appears that a majority of key words apply to BOTH content domains. For the past many months, I've spent considerable time evaluating and categorizing key words for both the "Basic" and "Advanced" part 1 examinations. I've done this both to correlate them to my teaching tools to create greater immediacy in learning, and also to evaluate and correct new areas of possible weakness. This is always necessary as one thing which makes these exams difficult is they change and evolve. This is also precisely the power of Big Blue, my other home study materials, and the courses as we don't stay static, either, moving and adapting to the exams.

After extensive evaluation of the new "Basic" and "Advanced" part 1 Written content domains, the good news is that we are in very good shape; 25 years of relentless focus has paid off; we are currently dialed in upon the exam. For example, the field reports I've received about the "Basic"/ITE exam last February, an exam which tested both the "Basic" and "Advanced" content domains, suggest we continue to be very much on target.

Again, while we must continue to be vigilant, steadfast, and hard working, a clear but fair conclusion is possible, and namely that we already focusing very well upon exam content through key words, old questions, remembered questions, and the 170 "Lock'nLoad" GAP topics released by the Board to the training programs.

Beyond having the landscape mostly covered, as we do, you should know that my extensive analysis shows clear and distinct overlap in key words and phrases recently released for the "Basic" and "Advanced" part 1 Written examinations. Yes, there are differences, some important, but the similarities are also great. So often, time after time, case after case, slightly different words, word combinations, or phrases are used to connote virtually the exact same ideas and concepts in both content domains. We can fairly conclude, therefore, exactly what one would predict and namely that the Board desires a progression in learning and understanding in areas it regards as vital to safe patient care.

To me as a coach for 25 years in the area of Board review, this conclusion clearly calls for keeping Big Blue as one, integrated text intended to meet both exams. This having been said, some good arguments can be made for dividing Big Blue, too.

The overlap in key words coupled with fact that almost immediately after passing the "Basic" exam one must then begin preparations the "Advanced" part 1 exam required for ABA certification, suggests that Big Blue should remain as one integrated, key word correlated text. As one resident said, "Please don't make me jump to an entirely new Big Blue for the "Advanced" exam after I pass the "Basic," as it will be very stressful to learn a whole new body of information which I have the capability to learn along the way to passing the "Basic" examination.

This is also my view, but I suspect you, the collective group of people using Big Blue, may require me to divide Big Blue into "Basic" and "Advanced" versions. Obviously if this were to occur, if you insisted upon it, if the market calls for it, I must meet that need, even though I would do so with some reluctance. (Obviously, I would then offer a discount for a subsequent purchase of "Advanced" Big Blue.) However, I have to meet the needs I am called upon by you to meet.

I hope this is not the case, the dividing of Big Blue into "Basic" and "Advanced" versions, because I feel it is unnecessary and even is some respects contrary to our purposes, but if the "Basic" turns out to be a difficult examination I know from personal experience how many will refuse to have anything to do with "the next step" until a present step, passing the "Basic" exam, is successfully taken. Much will depend then, upon the difficulty of the "Basic" as to what people decide they need to pass it.

In either event, key word analysis for both exams clearly suggests that Big Blue for both exams will remain the #1 focused source, not because I declare it to be, but rather because it is the only source available with 25 years of ongoing, relentless key word, old question, remembered information, and GAP area focus. These are the only ways to fairly focus upon exam content and I've devoted my professional life through my books, audio files, courses, and teaching to providing the focus one needs to win at this critical juncture.

With respect to courses, again, analysis of key words as well as basic coaching principles calls for keeping the courses together as one. The coaching principle so important is: "Get the player exposed to the highest level of competition EARLY, as soon as possible, to enable him or her to ultimately play at that level." Adhering to this principle personally in my own life has given me the best chance for success. Seeing others do so, time after time, has validated the concept.

However, again, my sense after talking to many residents is that their concern about "just the Basic" examination may be sufficient to mandate a separate course for the "Basic" examination and especially if the examination proves difficult.

Therefore, for 2015 and until we know more, if there is sufficient interest, specifically 20-25 people necessary to have a "Basic" only course based only upon "Basic" key words and key concepts, I have ample materials, massive firepower to put on an outstanding course and help you meet and beat the threat of the "Basic" examination.

After having said this, I'll schedule such courses over the same time period as "Advanced" part 1 course so if the requisite number of people do not sign up, those that do will still a course to fall back upon which is in many respects even more desirable and superior, for the reasons offered, namely the "Basic"-"Advanced" part 1 written course.

Up to now, we have not had other instructors outside of me teach these question-answer courses, and if in fact we have two simultaneous courses it will obviously be necessary to have at least one more instructor. I have two fine people who have worked with me for the Oral examination for the past twenty years. These are major league pitchers, major league teachers, and I will begin training them now for this possible scenario—the event that sufficient interest exists for a "Basic" only, separate course. Again, those signing up for courses would then have to understand that if the numbers are not sufficient for a separate course, if there are not 20-25 people committed to a "Basic" only course, they will then be move into the standard, time tested "Basic"-"Advanced" part 1 Written course.

Parenthetically, MOCA only courses have not had sufficient numbers so MOCA attendees are currently with part 1 Written attendees. This happens to work out very nicely and successfully because the MOCA content domain is clearly a subset of the "Advanced" part 1 Written content domain. There is a parallel situation, truly, and that is there is much overlap in the content domain(s) as pointed out and this argues for one course.

Therefore, the asterisk will mark tentative dates and courses where two sessions will be held, and otherwise a divided course will not be held over that date.

Notice that asterisks appear only at dates, times, and places when I believe we will have the very best chance to get the 20-25 residents necessary for a "Basic" only course. Why 20-25 as a critical number? While it is arbitrary, personal experience after all these years suggests anything much less than this has core momentum sustainability problems (the time, trouble, and expense of travel) as well as the high costs of under-utilized meeting space; to have a four day meeting with just a handful of people is cost and time inefficient.

These are my thoughts at this time, please email me soon with your own.

We already have a great program and every single day with relentless effort it gets better through our 25 year focus upon key words, old questions, remembered questions, and the "Lock 'n Load" Gap topics.

I know I help you be successful, it's always an honor to do so, so "Onward to Victory!"

Thanks and best personal regards, Niels F. Jensen.