i agree with this sentiment completely. Having studied and taken a few boards (I also sit for Pediatrics) a few times (certified/recertified) over the years, i've learned that you shouldn't expect to see similar questions from your study materials and questions you see on boards (though, there were a few). But,what you should expect is that the studying/reviewing process does give you enough knowledge base to "extrapolate" and "synthesize" the information so you can make educated guesses, and guess correctly. I can honestly say i didn't really "know" the answer to most of the questions on recent board. I was making a lot of educated guesses! For example, if you know which conditions would give you an anion gap acidosis, then you can select the one that does NOT give you a gap acidosis--if that's what the question is asking. so anyway, because you won't see exact or very similar questions from study materials to actual board questions, it's nerve racking when you walk out of test center. But, study consistently, faithfully and consolidate the information in your brain! It is really about repetition, repetition, repetition!
Well said! I've always wondered how test-makers come up with novel questions about material that essentially remains unchanged over many years (not counting updates in guidelines, new drug treatments, etc.)
I suppose one way they do this is to provide less and less information in each question (I saw many "one-liner" questions!) or give a very long case presentation that includes features of many similar diseases and provide only one or two details embedded in that case to enable one to confidently rule-in and/or rule-out each answer choice.
I was never a stellar test-taker but I did learn a few things from my peers who've crushed these national-level exams.
1. They absolutely knew the material COLD, inside-out, backwards-forwards, total conceptual mastery.
This enabled them to successfully narrow down answer choices to that single best ONE--whereas I'd struggle to choose among at least two or more answer choices that all looked correct and subsequently choosing the distractor answer vs. the correct one. Again, as "IMB1836" noted, those who can make "educated guesses" often have a strong knowledge base and can manipulate this knowledge base to answer more questions correctly.
I found that focusing on my weakest areas first and then reviewing them frequently until exam time likely enabled me to pass this ABIM exam on the first try. No doubt, I had some knowledge gaps and it took some focused review to address them.
I'm often impressed by those who have an innate skill of being able to "ace" these standardized tests with much less time-intensive study. I think this has a lot to do with the way their minds process the material as it is acquired. New concepts are likely captured and integrated and re-visited so that any new test question is handled correctly and with greater ease.
Nevertheless, I'm sure this is a skill that can be developed by doing TONS of questions in a thoughtful way (i.e. going over all answers and challenging oneself and being honest with oneself about whether or not one knew the concept or simply guessed successfully.)
2. They attacked the material from multiple angles and sources.
Many posts on this forum list at least three (or more) sources that one ought to master in order to pass the ABIM exam.
We've all seen folks use MKSAP, MedStudy (Core Curriculum and/or DVD program and/or Flash Card Illness Scripts), BB, Awesome Review, First Aid, multiple question banks (MKSAP, MedStudy, UWorld, etc.), and other resources.
As we always say, "use what works best for you."
In general, I think that using many sources--at least for this exam--gives one a different take on the same subjects and may increase one's chances of passing. Again, I would only suggest adding multiple sources as long as one MASTERS at least one or two of them. (Hence the adage, know one or two sources very well...) This way one can build upon an already strong conceptual foundation and deep understanding rather than be spread thin.
3. They are GREAT teachers. My PD always advised to "teach what you learn." That way, knowledge gets ingrained in your brain. Having a dedicated study partner is KEY!
4. They are supremely confident in their ability to CRUSH any exam. It's as if they THINK like the test-makers. This is a great skill to develop. I'm still working on it...
5. They help others who struggle. I am grateful for all the tips that others have shared on this forum. No doubt these will be extremely handy when I sit for the specialty boards and IM re-certs in years to come.
Keep striving and thriving!