Prepping for the ABIM Exam: an Internist’s Candid Perspective (Part II)
For full disclosure, I am a decidedly average test taker. My test-taking career peaked on my SATs in high school, and my percentile ranks on subsequent standardized tests have gone down in inverse relation with my ascent in the medical hierarchy. By the time I got to residency, I was, much to the chagrin of my residency program director, satisfied with being an Average Joe.
My program director was an old school guy you’d picture from one of those stuffy prestigious places like Hopkins or MGH. Every hospital has somebody like him on their internal medicine staff. He’s got a mad-scientist shock of white hair, Benjamin Franklin bifocals, a serious demeanor, and quotes the New England Journal of Medicine as easily as a priest quotes the Bible. At our hospital, he was renowned for his diagnostic acumen and warm bedside manner—not surprisingly, the rest of the physicians at the hospital send their families to him.
Most unfortunately, he was also my clinic attending, which meant that once or twice a week, I spent an afternoon with him getting pimped and learning all of the physical exam skills I neglected to pick up in med school.
Well, you can imagine how the conversation went after he reviewed my in-service training results as an intern. That year, I scored a 26th percentile on general internal medicine—the same subject my program director/clinic attending spent 6 to 12 hours every week personally grilling me on. This was definitely not an auspicious beginning to a career in medicine.
But there’s a silver lining to this tale of woe. You see, with experience, energy, and a healthy dose of fear, my scores on the in-training exam rose with each year of training (much to the program director’s relief). It was still nothing my mom would brag about, but internal medicine residency coupled with a month of furious studying allowed me to ultimately pass the ABIM test with my head held high and my dignity intact.
I tell you this not to talk about myself, but to relay to you that, with some dedicated effort, you, too, can pass the ABIM exam.
As is usually the case, I went on an Amazon book-buying binge in early July, 6 weeks before my exam date in mid-August. However, this was money that could’ve been spent on more useful things—like a suite of nifty Apple products—because ultimately, even with a month of prep time, I only had time to do questions out of MKSAP 15 and review concepts from Boards Basics 2, an ABIM “Board Review Digest” published by the American College of Physicians that’s akin to First Aid.
Even after the rigors of internal medicine training, the prospect of reviewing all the organ systems in one month is a daunting task. After all, according to the ACP, we should be experts in cardiology, dermatology, gastroenterology and hepatology, hematology and oncology, general internal medicine, neurology, infectious disease, rheumatology, nephrology, pulmonary and critical care medicine, and endocrinology and metabolism. Indeed, I don’t think I can even speak the preceding sentence without losing my breath.
I started with dermatology, the shortest and therefore (in my mind) easiest section. I tackled cardiology second, given that it was one of my weaker subjects, and from there systematically proceeded through the rest of the question books one by one….
You can find Part III 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.