Advanced Perioperative Transesophageal Echocardiography Exam (PTEeXAM) Experience

This morning I completed the National Board of Echocardiography (NBE) – Advanced Perioperative Transesophageal Echocardiography examination (PTEeXAM). To achieve Advanced PTE board certification, one must pass the PTEeXAM, have an unrestricted physician license to practice medicine, and must either have come from a fellowship pathway (in my case, adult cardiothoracic anesthesiology) or practice experience pathway. The exam itself costs $1,000 and is offered only once a year… so no pressure to pass! 😉

The exam itself has 200 multiple-choice questions divided into five 40-question blocks with 54 minutes allotted for each section. There’s also a 15-minute tutorial and a 15-minute break. Add that all together, and that’s potentially five hours of testing. This is similar to my critical care ultrasound examination earlier this year.

Although I can’t talk about specific exam material, I can say that I felt very prepared for this exam after my fellowship training, reviewing PTEMasters and keeping up with reading from echocardiography textbooks like Mathew’s or Perrino’s throughout the year. I finished each section in 25-30 minutes and, as per my usual test-taking strategy, just “powered through” the exam without taking a break.

Regarding test-taking strategies, it’s important to always look at the omniplane angle to understand anatomy, relationships, and potential pathologies. This strategy saved me countless times during the exam when I was unclear about what structure was in the view. Furthermore, if there’s no omniplane angle, consider that the imaging modality may NOT be TEE (e.g., epiaortic imaging).

It’ll be 10 weeks till I receive the results. Bleh. Oh well, if you have any questions, please feel free to drop me a comment below! 🙂

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    • I went back and looked at my score report from 2019. The NBE gives a few numbers on the score report: minimum passing scale score (509), my scaled score, and my percent correct score. In addition, they broke things down by the content area (e.g., cardiac anatomy and pathology) providing your percent correct score versus the total group mean percent score (and standard deviation).

      This is an excerpt from the performance interpretation guidelines:

      “Minimum Passing Score: The National Board of Echocardiography, Inc. has set a passing standard for the examination. The standard was set after careful deliberation and study that included a question-by-question evaluation of the complete examination. The passing standard represents the minimum required level of proficiency and is associated with a minimum passing score (MPS). The MPS is shown in your Score Performance Report with your pass/fail decision. To pass the examination, your score must be equal to or greater than the minimum passing score.”

  1. Hi Rishi,

    What ONE book would you recommend reading? Trying to decide between Matthews/Perrino/Otto. So far i have only glanced at Otto and it seems like its not focused on TEE vs TTE. Thanks!

  2. Hi Rishi,
    I appreciate your post. I will be taking the exam Oct. 1st. I have gone through PTE Masters and am wondering what you would fine most useful to review over the next week… the High Yield Advanced lectures or the practice exams on the PTE website?

  3. Rishi,

    I just read your take on the PTExam. Thanks. It just seems like a ton of material. I have less than a year to cram it in while practicing anesthesia, i.e. I’m not a fellow. Good luck to me.

    You are SO organized. I love it!

    Laura McNeill


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