Prepping for the ABIM Exam: an Internist’s Candid Perspective (Part I)

If you are reading this, then congratulations. You have finished, or are about to finish, internal medicine residency.


To get to this point, you have successfully passed the MCAT, USMLE Step 1, USMLE Step 2 CK, USMLE Step 2 CS, and USMLE Step 3. You have poured blood and sweat into years of perpetual q3 or q4 call, surviving page-bombs by nurses, holding life-and-death conferences with overwhelmed family members, boosting the confidence of doe-eyed medical students and interns, and managing the inflated egos of attendings.


We go through all of this for the privilege of taking care of patients, to make a palpable difference in the lives of people who have entrusted their physical and emotional well-being to us. It’s certainly a heady task to take on. But before we can call ourselves truly independent, one last exam looms on the horizon: the American Board of Internal Medicine (ABIM) certification exam.


On the hierarchy of medical exams, the difficulty of the ABIM exam lies somewhere in the middle, below the MCAT and USMLE Step 1, but above USMLE Steps 2 and 3. And importantly, it is strictly pass-fail: either you get enough questions right and become board-certified, or you don’t and must retake the exam the following year. The percentile break-downs are for the egoists among us.


You’d think that a pass-fail test would endow test-takers with a sense of confidence. But if my colleagues from medical school and residency are any indication, then the ABIM test forces the re-emergence of the psychotic college pre-meds dormant in each of us. Sometimes panic ensues.


Yet I’m here to tell you that at the end of the day, the vast majority of you will pass that the test, and become the newest members of a most exclusive guild: board-certified internal medicine physicians.


Based on an anecdotal sample of my peers who took the exam in 2012, there are numerous ways to prepare for the exam. The most fastidious among us began studying in February, carving out an hour each evening to do a handful of questions. On the opposite end, a colleague, going through a series of personal crises involving a love interest, didn’t study at all. I, and most of my friends, fell somewhere in the middle. About 3 or 4 weeks before the exam, we went into “test-mode.” Taking time off from work and personal commitments—and from life in general—we holed up at libraries and coffee shops, passing the days cramming in facts and doing practice questions.


Next week: Specific strategies and resources for tackling the ABIM exam.


You can find Part II of Dr.Feng’s prepping for the ABIM board exam and other posts by Dr.Feng on the Knowmedge Blog. You can find also additional topics and questions directly from the Knowmedge Internal Medicine ABIM Board Exam Review Questions QVault. _____________________________________________________________________

Charles Feng is an internal medicine physician at Kaiser Permanente. He will be starting an allergy / immunology fellowship at UC Davis in the summer.

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