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Knowing Things (Preparing for the ITE)

August 07, 2022
by Mark David Siegel

Hi everyone,

Good internists know things. Yes, you can and should look up what you don’t know, but you can’t look up everything. In clinic, you need to know which moles need a biopsy and which headaches need a CT. In the hospital, you need to recognize VT, respiratory failure, and anion gaps. You need to know when to call a code. And when you do look things up, knowing things points you to the right questions.

Most categorical residents are about to take the In-Training Exam, aka the “ITE.” The ITE is low stakes, affecting neither promotion nor graduation. Its purpose is to assess what you know and how well we’re teaching. The average resident in our program scores in the 70th percentile, but the range is wide, from about the 10th to the 100th percentile. For interns, scores generally reflect what you learned in medical school. For everyone else, scores track continued learning. For PGY3s, scores predict how you’ll do next year on the Boards. For those PGY3s excused this year, last year’s score should hold up, assuming you’re still studying.

Scores return in October. In addition to your overall percentile, you’ll get a breakdown by specialty and topics to help focus your studying. Almost everyone will discover areas to work on, especially topics encountered less frequently, for example in the outpatient subspecialties.

The best way to prepare for the ITE is to read and take practice questions. I recommend MKSAP, which you can purchase with your education funds. MKSAP is well-written, concise, and realistic. Its questions closely parallel those on the ITE and Boards. Since I’m working on my Maintenance of Certification, I try to answer five MKSAP questions per day.

Every resident can excel on the ITE, and most of you will. If you do get a disappointing score, your APD will work with you on a learning plan, which usually includes a deep dive into your test results, creating a study calendar, and sometimes a referral to Dr. Jack Contessa, a talented education specialist in the GME office. Our success rate with this approach is nearly 100%.

One final note: don’t study just for the test. By itself, the ITE has no intrinsic value; there are no prizes for high scores. Instead, study to know things- to become a good internist and take great care of your patients.

Enjoy your Sunday, everyone. After a long bike ride, I’ll be driving down to New Jersey to visit my mom.


PS On Wednesday, I’m flying to Europe for a week-and-a-half vacation with the family. I hope to send pictures from Italy, Slovenia, and Croatia.


Submitted by Mark David Siegel on August 07, 2022