The Registered in Musculoskeletal Sonography (RMSK) exam is a difficult physician level registry exam. Below is information based on my experience with this board exam, where I rank each section of the exam from 1-5 while considering other board exams I have taken in the past:
1-well below average
2 -below average
3-average
4-above average
5-well above average
I am a physical therapist and have taken board exams to become a PT (licensure exams) and the orthopedic certified specialist exam (OCS). Keep this in mind with my grading; a radiologist would likely consider the "novelty" of the exam to be well below average, as an example, whereas as a PT it was above average.
Material Volume
I would rank the material volume of the RMSK as 2 (below average), though this is without considering background knowledge (which is ranked later in this blog post). There is not as much to know compared to a board preparation test to become certified as a physical therapist or as an orthopedic certified specialist. Most prep courses could easily be completed in a week if you just sat and watched through them (though I do not recommend that!). I think there are other factors that contribute to the exam's difficulty which will be discussed below.
Novelty of Exam Material
Overall I would rank this as a 4. As a PT musculoskeletal ultrasound is a mostly unique skill, and I had to put a lot of time into studying for this exam and practicing scans (on myself and on pathological patients) to get good at it. The only reason this was not rated as a 5 is because we have extensive musculoskeletal anatomy in PT school which made learning probe placement pretty easy.
I took almost two years to prep for this examination in total. I had some hands on training but much more time was spent on online board preparation material, accumulating the required exams to sit for the test, reading PubMed articles about scanning techniques/pathology, and making/reviewing flashcards.
Complexity of Questions
I would rank this as a 2. Most questions were pretty straightforward, and I was able to finish the exam with plenty of time to go back and review my answers. This is a sign of a good exam in my opinion, as I felt it tested my knowledge rather than being a intelligence test. I either knew the answers or I didn't. As a comparison, I felt the OCS had such complicated questions that it was as much an intelligence as it was a knowledge test. The one thing that threw me off a bit was the hotspot questions; I had taken two commercially available practice exams and the APCA's RMSK practice test and I didn't feel they really prepared me for that. I still passed with plenty of room to spare but think I could have done better with more practice with these.
Background Knowledge Required
I would rank this as 5 (well above average). If you weren't a professional in a field with extensive musculoskeletal background training I think this exam would be extremely difficult.
Length of Exam
This seemed pretty average and felt similar to the licensure exam for PT. A total of 4 hours is provided which is pretty standard for these types of exams. The OCS was the same amount of questions but took the full four hours (whereas I had over an hour of spare time after the RMSK). I'd rank this as 3.
Overall Difficulty
The average of the above sections is 3.2 (average). Keep in mind that board preparation exams are difficult in general so do not let this lull you into thinking this will be easy; about 27-50% of people who take this fail depending on the year. Your background and learning style may affect how difficult this test feels. Make sure to take time to learn as much as you can prior to taking this test, and I recommend multiple sources. I used Gulf Coast Ultrasound, the AIUM website, and MSK Masters. Be sure to check out the APCA's practice exam, though it is only 30 questions and cannot be taken multiple times (unless you want to pay for it multiple times). My grading may change in the future as I tack on more board exams.
Good luck! If you are wanting to practice the exam and improve your chance of passing be sure to check out my 201 question practice exam with hotspot questions made exclusively for the RMSK here.
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