How to prepare for and pass American Board of Pediatrics (ABP) exam

Prepping for the American Board of Pediatrics (ABP) Exam: A General Pediatrician’s Perspective

Zebra diagnoses everywhere!

You know that mythical zebra in your differential diagnosis, the one rarely seen in practice but commonly encountered in testing environments? Well, they are abundant on the ABP exam. Judging from the question content, one might assume that the majority of children seen by pediatricians have rare genetic syndromes: Beckwith Wiedemann syndrome, Klippel-Trenaunay syndrome, Diamond Blackfan syndrome, Hurler’s syndrome…I could go on and on. Much to the contrary, as a general pediatrician, the bulk of my time is spent on well child exams and urgent visits for otherwise healthy children. But the ABP loves a zebra, so you should too, or at least while you are studying for boards.

The American Board of Pediatrics (ABP) exam by the numbers

The exam consists of 330-350 questions. The questions are divided over 4 exam sections, each 1 hour and 45 minutes long. If you do the math you end up with about 75 seconds per question. Yes, you read that right, 75 seconds!! There is not a lot of time to mull over the question. There is no penalty for guessing, so if you don’t know an answer take your most educated guess and move on. You can always flag the question for review and come back to it if you end up with time at the end of the section. In between the sections you also get 2 – 15 minute breaks and 1 – 60 minute lunch break. All the breaks are optional, but what person can make it through 7 hours of testing without at least 1 bathroom break?!? Definitely not me. I made a point to leave the testing room during each break period, stretching my legs, using the bathroom, and grabbing some water. I didn’t end up using the whole 60 minute lunch break. By that halfway point, I was in the zone and wanted to get back and finish the test, the end was in sight!

The ABP publishes a content outline on their website:
Pediatrics Blueprint
Click on the above image to zoom in.

Warning, this is a lengthy, detailed document. At first glance this seems like an overwhelming summary that could never possibly be mastered, but I think it’s at least worth looking at. I used it during my board review course and would quickly consult the content specs to see what sorts of things the ABP expected us to know about a certain topic. You could easily use these with your review text and briefly glance at the content specs before starting your studying for the day.

Notes, Flashcards, and Review Courses

Speaking of review texts, pick one and stick to it, working through each section and focusing on areas where you feel less comfortable. I made my own notes as I went through the review text and created flash cards for high yield content. I had flash cards for all the syndromes and developmental milestones and would go over these frequently to ingrain them in my brain.

I was fortunate that my institution offered a highly regarded board review course. This type of review is not for everyone, but I felt that it helped solidify many of the topics I had been studying and complemented my individual study time well. I spent 6 days in the UCLA Board Prep course in the grand ball room of the Marriot in Marina del Rey. The weather outside was amazing, high 70s, the sun sparkling along the water’s edge. Inside the board review the air conditioning was on high, I shivered with a hoodie on to protect my head from the cold drafts above. The cold did however keep my mind sharp as we went through an exhausting amount of material. The long days in board review were like a mini boot camp, preparing me for the extensive testing day.

Don’t forget about Pedialink

You have access to 3 years of online PREP questions through Pedialink, which is created by the American Academy of Pediatrics (AAP). This is a great resource for practicing exam questions, but keep in mind that these questions are written by the AAP, not the ABP. The questions, and the answer explanations, are very detailed. Make sure you understand the right answer and its corresponding explanation. Do not get too bogged down with the explanations for the wrong answer choices. The questions on the actual exam are somewhat different, containing less detail and requiring you to go with your gut instinct in many instances instead of being able to use exact details to eliminate all but one answer choice.

Worth a thousand words, pictures are in dozens of questions

The ABP loves questions with pictures. The questions require you to recognize a physical exam finding such as a rash or dysmorphic feature and correlate with a particular diagnosis before going on to answer a question about work up, management, or pathophysiology. The ABP likes to recycle pictures. You should review Zitelli’s Atlas of Pediatric Physical Diagnosis while studying, and make sure to look through quickly again a couple nights before the test to refresh your memory.

Zitelli and Davis Atlas Pediatric

Studying Zitelli’s images are high yield for the exam.

With some preparation, you will be ready for the ABP exam! Give yourself some time to relax a little, hang out with friends, and exercise during board preparation. Keep your body and mind healthy. Good luck!

Nicole Hetzer is an Assistant Clinical Professor at the David Geffen School of Medicine at UCLA. She is a General Pediatrician practicing in Porter Ranch, California.

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