PASSED!!
Third time is the charm.
This has been a humbling experience. The best advice, which has already been said here, is “Respect the test”. I did not take the test seriously the first time and failed. The second time, I did not learn my lesson and did nothing new to improve my chances and failed. This time, I made a plan, started early and used multiple resources. Here is what I studied for my three attempts:
First attempt: took it right after residency.
- Basically blew it off. I had scored high in all the steps, was considered a very good resident, came from a highly-regarded program and scored around 50th percentile on the in-training exams. So I felt that with an 85% or so pass rate and over 95% first-time pass rate from my program, there was no way I was going to fail. I did about two-thirds of the MKSAP questions, scoring around 65%. I then perused board basics the weekend before my test. FAILED!
Second attempt: took it summer after the first year of fellowship.
- After I failed the first time, I told myself I was going to start studying early but really did not find the time to study because of a busy fellowship. I also procrastinated and before I knew, it was 4 weeks to my exam. I took a 2-week vacation to study – went through about 80% of MKSAP questions, again scoring about 70%. I had also bought the Medstudy books but did not get a chance to read them. I started board basics 2 about one week before the test and read through it once but it was really cramming and I did not retain much. FAILED!
Third time: 2014
I decided to get serious. I knew that if I blew it again, I would have to sit out one year and then would not be able to take my subspecialty board exam for two years which will make it difficult for me to find a job when I graduate next year. I came to SDN, read this thread and similar ones and took some of the tips.
This time, I started EARLY, meaning around January. I read Board Basics 3 three times. I also took the online Pass Machine course, taking notes as I listened to the lectures. I also used MKSAP audio companion – listened to the recordings whenever I was driving in my car and whenever I was working out at the gym. This actually helped me keep my workouts on schedule because I could study and workout at the same time. For questions, I went through all of MKSAP questions, scoring 70% on the first try. I read all the explanations including the ones I got right. I then did it a second time, scoring about 85%. The third time, I only did the questions I got wrong, making sure I had 100% at the end. To supplement the MKSAP questions, I used Knowmedge, reading the explanations for all the questions. It is not representative of the actual exam and some of the questions are very hard but it was very helpful to cement some of the knowledge. Two weeks before the exam, all I did was Board Basics 3.
I definitely felt better about the exam this 3rd time. The first and second times, it felt as if each question had two correct answers that I had to choose between. This last time, I saw a best answer for most questions. PASSED!!!
Glad it’s finally over. Now I can move on with my life. I still am of the opinion that the test does not put enough emphasis on things we commonly encounter in the day-to-day practice of internal medicine, and instead putting too much focus on uncommon diseases and even some esoteric minutiae. But it is what it is and if you put in the work, chances are high that you will pass.
So in summary, my tips will be:
For knowledge base – Board Basics 3 (a must). If you have time, then go through Medstudy if you like studying in outline form or MKSAP books (if I had to do it over again, I would have started reading MKSAP books during second year of residency to shore up my knowledge base. If you are an audio-visual learner like myself, PASS machine online videos and MKSP audios are good.
For questions – Do all MKSAP questions, multiple times and go over the explanation of the answers. Supplement with a second question bank - Knowmedge, USMLE world etc.
Start early, have a plan and stick to it, and again, Respect the exam!
Good luck to those taking it next year, and for those that failed, you can do it next time!
Johnny B Goode
Internal Medicine: Certified
Meeting Maintenance of Certification Requirements: Yes
INITIAL CERTIFICATION
Internal Medicine: 2014