How to Prepare the Three Personal Cases for the TACC Oral Exam

The foundational boundary

Keep three different records separate from the beginning

Selection matrix

Choose three cases that reveal judgment

TACC encourages interesting or technically complicated cases, but “interesting” should not be reduced to rare anatomy or a dramatic complication. A useful case allows the candidate to demonstrate recipient and donor selection, immunologic reasoning, technical planning, adaptation, complication management, longitudinal ownership, or ethical judgment.

The three cases should collectively create breadth. A set of nearly identical uncomplicated transplants may be harder to use as a demonstration of independent judgment, while three catastrophic cases may obscure routine selection and operative competence. Choose cases that you know deeply and can discuss honestly.

One source of truth

Build a private educational dossier for each case

• Case label uses only a nonidentifying educational code such as “Kidney Case A.”
• Recipient indication, severity, alternatives, contraindication assessment, and transplant benefit are summarized without exact dates or identifiers.
• Donor type, organ quality, anatomy, immunologic and infectious risk, preservation, and acceptance rationale are clear.
• The operative plan includes preparation, exposure, control, graft work, reconstruction, reperfusion, completion assessment, and deviations.
• The postoperative timeline uses relative intervals such as postoperative day ranges rather than exact calendar dates.
• Complications include recognition, differential, tests, intervention, response, escalation, outcome, and learning.
• Immunosuppression, prophylaxis, pathology, microbiology, recurrence, adherence, and longitudinal plan are included only to the extent relevant and de-identified.
• Every major decision has a principal alternative and a finding that would change the plan.
• The case has at least five examiner branches that materially alter management.
• The dossier has passed a contradiction audit and a separate privacy audit.

How to survive follow-up

Create a decision ledger instead of memorizing prose

Technical command

Know the actual operation well enough to teach it

1. 01

   Preparation

   What recipient and donor features changed the plan? What access, blood, monitoring, immunosuppression, and equipment were required?

2. 02

   Exposure and control

   What anatomy, adhesions, portal hypertension, vascular disease, prior transplant, or donor variation mattered?

3. 03

   Graft preparation

   What back-table findings, injuries, reconstructions, preservation concerns, or orientation decisions were present?

4. 04

   Reconstruction

   What was the sequence, technique, ischemic-time implication, and reason for each major anastomosis or reconstruction?

5. 05

   Intraoperative change

   What unexpected finding occurred, how was it recognized, and how did it change the plan?

6. 06

   Completion

   How were flow, perfusion, hemostasis, drainage, integrity, and organ-specific function assessed?

7. 07

   Bailout

   What would you have done if flow, anatomy, hemodynamics, closure, or graft viability were unacceptable?

Ownership

Build a complication map that avoids hindsight distortion

For each complication, separate what was predictable before the event, what first sign was available, what the working differential was at each time point, what action was taken, how the patient responded, and when escalation became necessary. This prevents the candidate from narrating the course as though the final diagnosis was obvious from the beginning.

Examiner flexibility

Prepare at least five meaningful branches per case

No PHI

Perform a dual donor-and-recipient privacy audit

Transplant cases can identify more than one person and can contain unusual combinations of organ, center, OPO, timing, geography, donor circumstance, recipient history, and outcome. Removing names alone is not enough. The educational summary must minimize indirect identification and metadata as well as direct identifiers.

• No names, initials, birth dates, addresses, phone numbers, email addresses, record numbers, account numbers, or exact ages that create unusual identifiability.
• No exact admission, donation, procurement, transplant, complication, discharge, or follow-up dates; use relative timing.
• No OPTN, UNOS, donor, recipient, match, organ, allocation, or wait-list identifiers.
• No OPO, transplant center, referring institution, clinician, town, employer, or unique geographic identifier.
• No official TACC forms, surgical logs, case submissions, correspondence, peer-review records, or credentialing materials.
• No copied notes, operative reports, pathology reports, microbiology reports, billing exports, screenshots, patient messages, or consent forms.
• No identifiable photographs, facial images, labels, accession numbers, DICOM headers, device serial numbers, or hidden file metadata.
• No uniquely identifying donor-recipient relationship or newsworthy circumstance unless generalized beyond re-identification risk.
• Only the minimum facts needed to rehearse the educational decision are retained.

From recall to adaptability

Use a four-pass personal-case rehearsal

Before the exam

Complete the final personal-case readiness checklist

• I can explain in one sentence why each case was selected.
• I can state the indication, donor/graft rationale, immunologic context, operation, major complication, outcome, and lesson without notes.
• I can describe every critical technical step and a realistic bailout.
• I know what information was available at each decision point and avoid hindsight distortion.
• I can answer at least five meaningful changed-variable questions for each case.
• The three cases collectively demonstrate breadth rather than repeating the same clinical problem.
• My answers are consistent across repeated mocks and examiner styles.
• The official log, official case submissions, and clinical records remain entirely outside SurgiTest.
• Any SurgiTest case is a new, fully de-identified educational summary with no donor or recipient PHI.
• I have verified the official TACC submission requirements and deadlines directly in current correspondence.