We got our board results last week: 96% passed. Not perfect, but not too shabby either. So what’s the secret to our success? And how do we get to 100%?
Starting with the obvious, we did well because our graduates are smart. They completed a rigorous residency, they held themselves to high standards, and they studied hard.
There are many ways to prepare, but most successful plans include the following:
- Start early: Study throughout residency. As much as possible, read every day. Try to finish most of your studying by the end of your PGY3 year, using July and early August to review. You don’t want to cram for the test while starting a new job or fellowship.
- Read about your patients: Know the evidence. Why do we use dual anti-platelet therapy? What are the recommended antibiotics for community acquired pneumonia? When should we start dialysis? The literature describes the nuances that support your work. Read.
- Invest in study materials: I love MKSAP. It’s well-written, it has tons of questions, and it targets the right material. Other great resources include NEJM Knowledge +, First Aid (edited by a former Yale resident, Tao Le), and UWorld.
- Stay up to date: New topics are fair game, so you can’t rely solely on materials you already have. Consider signing up for online resources like NEJM Journal Watch and JAMA Alerts. You can also sign up for alerts from the major journals, which provide links to new publications. Even if you don’t have time to read full length articles, you can review abstracts, perspectives, and editorials. You can also download apps that collate the literature; Read by QxMD is a great example.
- Know your strengths and vulnerabilities: You’ve each gotten a detailed score report from your In-Training Exam (ITE). Use the report to target areas needing attention.
- Read broadly: There’s more to internal medicine than the diseases we see in the hospital and primary care clinic, but it’s all on the test. You need to read about diseases you may not see, particularly those managed in outpatient settings. Examples include hypersensitivity pneumonitis, celiac disease, scleroderma, and thyroiditis.
- Use effective study habits: As Jack Contessa has taught us, we build memory by reinforcing what we learn over time. If you read about a subject, tackle questions on that subject several days later, not just right away. Months later, come back to reinforce what you’ve learned, so the memories don’t fade away.
- Do lots of study questions: Answering questions builds memory and corrects misconceptions. If you get a question right, great! If you get a question wrong, also great! You’ve just learned something! Don’t fool yourself- lucky guesses don’t count; pretend you got the question wrong. Always read the explanations accompanying the answers.
- Enjoy: It’s tedious to study just to do well on a test, but that’s not the point- if you’re just studying for the test, you’ll forget everything. Adopt a learning mindset so the information sticks. The material you’re reading about is interesting and important. Study to take great care of your patients.
Now, to set your mind at ease: You do have to prepare to pass the Boards, but every one of you can pass. If you’ve been scoring above the 50th percentile on the ITE, you’re almost certainly going to pass. Keep doing what you’re doing and follow the advice above. If you’ve scored below the 50th percentile, particularly if you’re way below, it’s time to take stock. If you adopt an effective study plan you’ll do fine.
A final word about uncommon but important issues. First, it’s okay to postpone the test for a year if you don’t have the time or ability to prepare. If you have a big life event coming up, it may make sense to postpone. Second, if an issue arises at the time of the test, for example an acute illness or family emergency, you may want to postpone. Finally, if you need special accommodations (e.g., for dyslexia), ask for them.
You can all ace the Boards. This morning, if you haven’t already done so, consider mapping out a personal plan. If you have questions or need assistance, just give anyone in program leadership a call.
Good luck and enjoy your Sunday! I’m going to take advantage of the sun and climb East Rock,