Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

A physician aces his USMLE and ABIM board exams. Here are his tips for success.

Farokh Jamalyaria, MD
Education
February 21, 2016
372 Shares
Share
Tweet
Share

In this article, I’ll discuss a medicine-specific strategy that many of my physician colleagues and I have used over the years to learn dense, complicated information quickly and effectively, and to do well on board exams.

These are the two most important tenets of studying for a medical board examination:

1. Find the highest-yield information and memorize it cold.  With active methods such as mnemonics, teaching others, lecturing “to the wall,” writing notes out from memory, writing your own multiple-choice questions, etc. — before moving on to information that’s less likely to be tested.

2. Identify the highest-yield question banks — the ones that best resemble the exam — and test yourself frequently while studying.  Look up every unfamiliar answer choice (even the wrong ones) following each question.  Try to buy or obtain practice exams that closely resemble the actual test and take them after every few weeks of studying to gauge your progress. (You hit two birds with one stone by mastering question banks because board exams supposedly test your mastery of the subset of knowledge that’s most important to your clinical practice.  Whether or not board exams actually test this subset is a controversial topic that we won’t discuss here.)

Do both steps in parallel, not in sequence.  The better you execute these steps, the higher your score on a medical board examination.

Example #1: USMLE Step 1

I attended Baylor College of Medicine (BCM) in the late 2000s.  BCM’s average Step 1 score, compared with other medical schools, was rumored to be among the top few in the nation (a quick search failed to verify this, though).  And it has continued to rise.  There were several indirect reasons for our high scores.  We studied for and took Step 1 after we had completed several key clinical rotations.  Also, BCM seemed to have a bias for admitting good test-takers (our average MCAT score was unusually high).  There were probably other indirect reasons, too.

However, these advantages aside, it remains the case that some study strategies are more effective than others.  The following was a popular Step 1 study strategy at our school in the late 2000s:

Total study time: no longer than 8 to 10 hours daily for eight weeks or less.  Many of us took weekends off.  Treat studying like a job: Get up at the same time, start studying at the same time, and finish studying at the same time each day.  Stop studying a couple days before the exam to “recharge” before you take it.

1. Memorize First Aid for the USMLE Step 1 cold.  This book was dense and painful to study.  But it was pure gold when it came to getting a high score on Step 1.  Some of us memorized it by reading through it 4 to 5 times, each time more quickly than the last (e.g., three weeks for the 1st pass, two weeks for the 2nd pass, one week for the 3rd pass, etc.).  The pharmacology section was most critical.  First Aid required a lot of supplemental studying:

Rapid Review or Lippincott Biochemistry. I used RR Biochemistry as a reference, looking up any concepts I didn’t fully understand in the relevant section of First Aid and expanding that section with my own notes.

BRS or Rapid Review Pathology: read it twice.

BRS Physiology: read it twice, taking notes in First Aid.

BRS Behavioral Science: for those who didn’t take a psychiatry rotation before studying for Step 1.

Dr. Edward Goljan’s pathology audio lectures: Best to take notes on these lectures while listening to them during the first month of studying.

Goljan’s High-Yield Review (~100 pages): best studied the week before the exam.

High-Yield Neuroanatomy: I remember really enjoying this book during med school, but I don’t recall how much I studied it for Step 1.

High-Yield Biostatistics: read it very quickly, taking notes in First Aid.

Skim the images in Robbins & Cotran Pathologic Basis of Disease.

2a. Kaplan Qbank or USMLEWorld.  With better explanations, diagrams, and a lower price point, USMLEWorld eventually became the “gold standard” question bank.  I don’t know if this is still the case.

2b. NBME practice exams.  These exams felt very different from Step 1, but word on the street was that one’s score supposedly correlated well with one’s actual Step 1 score.  Form #3 was considered most representative.

I first learned about the above strategy from an upperclassman who went into emergency medicine.  Later, one of my classmates who did very well on Step 1 told me that he used the same strategy.

In my own case, things didn’t unfold so neatly:  I read First Aid five times, took notes in First Aid while reading relevant parts of Rapid Review Biochemistry, then read BRS Physiology once and skimmed BRS Pathology and High-Yield Biostatistics quickly.  Also, and this scares me in retrospect, I only completed 36 percent of the Kaplan Qbank.

However, I took two NBME practice exams a few weeks apart during the second month of studying and did very well on them, predicting the great score that I got on the actual Step 1.  I think that in my particular case, knowing First Aid backward and forward was the key to doing well.

I shared this strategy with a friend who carried it out perfectly, then studied supplemental material — both question banks, other review books — and got an even higher score than I did.  We shared the strategy with other friends.  They all did well, too.  I told our preclinical directors about it.  The study strategy for Steps 2 and 3 is analogous.

Of course, other methods were also effective.  I’ve heard that at Caribbean medical schools, students are drilled with endless multiple-choice questions and mock Step exams for months, becoming expert at taking the test.

There’s more than one way to eat a pomegranate.  And the game has changed since 2008.  Spaced repetition software is more popular now than it was back then.  There are medicine-specific, computer-based spaced-repetition systems like Firecracker that weren’t around when I was in medical school.  Optimal learning strategies are better-understood.  Every generation of students is savvier about learning and has better learning tools available to them.

Example #2: American Board of Internal Medicine

My internal medicine residency program had a very high ABIM pass rate.  Again, they preferred to accept medical students with high Step scores (the thought–whether or not it’s correct–was that this predicts internal medicine board pass rates).

However, there were other critical things about our program that set us up for easily passing the ABIM:

1. Continuous, active learning of high-yield material. Residents don’t have much time to study.  While seeing patients, we tested ourselves and learned actively by constantly questioning our treatment strategies.  We constantly looked up important points, asked ourselves why we were ordering, say, enoxaparin for one patient and not for another, or an echocardiogram for one patient with a certain condition and not for another with the same condition, etc.

2. Studying high-yield information and practicing with a high-yield question bank. We had already studied in-line with residency training, but for the ABIM, we had to round out our knowledge, which was done by studying the latest version of the ACP’s Medical Knowledge Self-Assessment Program (MKSAP), which our program director purchased for each of us.  MKSAP is a series of review books for every subject in internal medicine.  It’s also a large question bank.  The wisdom passed down to us from prior generations was that knowing the question bank was enough to do well on the exam, and that knowing all of MKSAP by heart was sufficient for getting a high score.

(Once again, there was more than one way to study. Some residents preferred other review series.)

Example #3: American Board of Internal Medicine — Rheumatology

Rheumatology is, in some ways, a difficult branch of medicine to study.  Many of the diseases we encounter (or must be able to recognize and treat but might never encounter) are at the case report level and could show up on, say, the popular television show, House, MD.

The consensus is that the highest-yield review book is Rheumatology Secrets.  The Rheumatology Image Library is also a critically high-yield source of information.  It takes, at least, two weeks of part-time studying to get through this image bank the first time.

In rheumatology, the question banks to study are the CARE modules.  Use spaced repetition to learn (at least) the most recent five years’ worth of CARE questions completely, looking up anything you don’t understand.

Following the advice of fellows who graduated before us and of young attendings who had recently taken the exam, I read Rheumatology Secrets twice, studied five years’ worth of CARE questions in the months leading up to the exam, went through the image library twice the month before the exam, and did very well on my rheumatology boards.

I hope these tips are helpful for your upcoming board exams.

Farokh Jamalyaria rheumatologist who blogs at Physician-Artist.

Image credit: Shutterstock.com

Prev

The questionable competency of today's medical and surgical residents

February 21, 2016 Kevin 3
…
Next

A Generation X physician embraces the millennial doctor perspective

February 21, 2016 Kevin 9
…

Tagged as: Medical school, Residency

Post navigation

< Previous Post
The questionable competency of today's medical and surgical residents
Next Post >
A Generation X physician embraces the millennial doctor perspective

More by Farokh Jamalyaria, MD

  • a desk with keyboard and ipad with the kevinmd logo

    What is a serious diagnosis?

    Farokh Jamalyaria, MD
  • a desk with keyboard and ipad with the kevinmd logo

    The spookiness about sudden death

    Farokh Jamalyaria, MD
  • a desk with keyboard and ipad with the kevinmd logo

    We should all be anonymous Samaritans

    Farokh Jamalyaria, MD

Related Posts

  • Board reviews: How institutions can help students and residents pass their exams

    Sheryl Ramer
  • A physician’s addiction to social media

    Amanda Xi, MD
  • USMLE Step 1 tips that may surprise you

    Jason Ryan, MD
  • How to study smarter for USMLE Step 1: 5 tips for success

    Jason Ryan, MD
  • Want to crush USMLE Step 1? Here are some evidence-based study tips.

    David Griffin, MD
  • How a physician keynote can highlight your conference

    Kevin Pho, MD

More in Education

  • Master the ABIM Certification exam with effective strategies: insider tips for success

    Farzana Hoque, MD
  • The pros and cons of taking a gap year during medical school

    Med School Insiders
  • Breaking the silence: the truth about mental health challenges among medical students and why medical schools must take action

    Erin Waldrop
  • Breaking the stigma: Encouraging mental health help-seeking in medical trainees

    Anonymous
  • I’m not so different from Lionel Messi – and neither are you

    Lauren Tien
  • 6 ways ChatGPT can help you succeed in medical school

    Drew Bergman
  • Most Popular

  • Past Week

    • A physician’s typical day, as envisioned by a non-clinician health care MBA: a satire

      Jennifer Lycette, MD | Physician
    • Is chaos in health care leading us towards socialized medicine? How physician burnout is a catalyst.

      Howard Smith, MD | Physician
    • Revealing America’s expansion: the dark truth of Native American suffering and unjustified abuses

      Anonymous | Physician
    • The rising threat of lung cancer in Asian American female nonsmokers

      Alice S. Y. Lee, MD | Conditions
    • From Moscow Mule to the opioid crisis: Unveiling the tragic legacy and urgent solutions

      Osmund Agbo, MD | Meds
    • The tragic story of Mr. G: a painful journey towards understanding suicide

      William Lynes, MD | Physician
  • Past 6 Months

    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • An inspiring tribute to an exceptional radiologist who made a lasting impact

      Kim Downey, PT | Conditions
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • Proactive risk management: a game-changer in preventing physician burnout

      Howard Smith, MD | Physician
  • Recent Posts

    • Empathy and awareness: Unveiling the hidden dangers of food allergies [PODCAST]

      The Podcast by KevinMD | Podcast
    • The alarming epidemic of physician burnout and how we can combat it

      Tomi Mitchell, MD | Physician
    • A retired physician’s battle with moral injury

      Hayward Zwerling, MD | Physician
    • Unveiling the secrets to effective resuscitation and overcoming obstacles

      Deepak Gupta, MD | Physician
    • Georgia’s new law promoting truth and transparency in health care credentials

      Carmen Kavali, MD | Policy
    • Physician employment contracts: the key to fighting burnout and improving working conditions [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 1 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • FDA Panel Endorses mAb to Prevent RSV in Infants
  • Novel LAA Closure Device 'Promising'
  • Acute GvHD Risk After Allo-HCT Higher With Some Antibiotics vs Others
  • TTFields Therapy Yields OS Improvement in Second-Line NSCLC
  • Mental Health Provider Disclosed Personal Patient Info in Google Reviews

Meeting Coverage

  • Novel LAA Closure Device 'Promising'
  • TTFields Therapy Yields OS Improvement in Second-Line NSCLC
  • Upper Airway Stimulation Device for OSA Holds Up in Real-World Analysis
  • Morning Naps in Elderly People May Reflect Dementia Risk
  • Extra Follow-Up Confirms Benefit of Nivolumab in Muscle-Invasive Bladder Cancer
  • Most Popular

  • Past Week

    • A physician’s typical day, as envisioned by a non-clinician health care MBA: a satire

      Jennifer Lycette, MD | Physician
    • Is chaos in health care leading us towards socialized medicine? How physician burnout is a catalyst.

      Howard Smith, MD | Physician
    • Revealing America’s expansion: the dark truth of Native American suffering and unjustified abuses

      Anonymous | Physician
    • The rising threat of lung cancer in Asian American female nonsmokers

      Alice S. Y. Lee, MD | Conditions
    • From Moscow Mule to the opioid crisis: Unveiling the tragic legacy and urgent solutions

      Osmund Agbo, MD | Meds
    • The tragic story of Mr. G: a painful journey towards understanding suicide

      William Lynes, MD | Physician
  • Past 6 Months

    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • An inspiring tribute to an exceptional radiologist who made a lasting impact

      Kim Downey, PT | Conditions
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • Proactive risk management: a game-changer in preventing physician burnout

      Howard Smith, MD | Physician
  • Recent Posts

    • Empathy and awareness: Unveiling the hidden dangers of food allergies [PODCAST]

      The Podcast by KevinMD | Podcast
    • The alarming epidemic of physician burnout and how we can combat it

      Tomi Mitchell, MD | Physician
    • A retired physician’s battle with moral injury

      Hayward Zwerling, MD | Physician
    • Unveiling the secrets to effective resuscitation and overcoming obstacles

      Deepak Gupta, MD | Physician
    • Georgia’s new law promoting truth and transparency in health care credentials

      Carmen Kavali, MD | Policy
    • Physician employment contracts: the key to fighting burnout and improving working conditions [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

A physician aces his USMLE and ABIM board exams. Here are his tips for success.
1 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...