Develop a “Game Plan” for Board Review

It’s easy to become overwhelmed while preparing for boards! However, having a “Game Plan” that provides structure and direction to guide your review process can help you stay on track and reduce your test anxiety. Use these four basic steps to kickstart your review.

1.  Get to Know the Exam.  Visit the website of the professional organization giving the board examination to learn all you can about the exam (e.g., application process, deadlines, cost, documents needed, rules, types of questions, scoring, online tutorial, date/location of the exam, and test blueprint).  Use the test blueprint (i.e., number or % of questions per topic) to focus your study.  Spend the majority of your review time on the topics that have the highest percentage of questions (highest yield).

2.  Assess & Re-Assess Your Abilities.  First, assess your level of knowledge and skills by reviewing your past performance on your last one or two board examinations (e.g., USMLE, COMLEX, or In-Training Exam) to identify which areas you scored low. Remember that personality traits–habitual patterns of thought, emotion, and behavior–including learning “style” or preferences, strongly influence how you study, how you process information, and how you make decisions. Second, get a general idea of your readiness by taking a multiple choice exam of 250-300 questions organized randomly. Identify your knowledge gaps and compare these to the highest yield items on the test blueprint. Focus your preparation on taking a large pool of quality multiple choice questions (MCQs). Assess your progress daily. When you identify gaps in your knowledge, use review guides rather than textbooks, because the high-density content of textbooks can slow you down. If you need more information than the review book contains, then refer to the textbook.

3.  Improve Your Knowledge & Skills. Test-wiseness (preparation skills) and test-taking skills (strategies used during the exam) are key to increasing your scores. Board exams are designed to cover an entire domain and require a deeper understanding of principles and concepts (higher-level thinking).  You will need to go beyond reading, memorizing, and answering MCQs by recognizing memorized facts and concepts to be able to solve problems, evaluate a situation, make a judgment, or synthesize new ideas. Study techniques, such as elaboration (adding details to aid understanding) and forming associations (creating meaningful links between newly acquired information and existing knowledge) aid recall.Read MCQs correctly by reading the interrogatory (question to be answered–usually the last sentence) first, then reading the stem (case narrative). Finally, try to guess what the best answer is BEFORE you reveal the answer.  Change the questions to make them different or more challenging. Change the interrogatory to make one of the other answer options a better answer.  Edit the options to make a wrong answer the right answer.  In this way, you challenge yourself to take a single question and create many other possible questions. Finally, identify your knowledge gaps and use study guides (not textbooks) to review material.

4. Use a Structured Review Process.  Develop a study plan that schedules a regular time to study–this is the most important thing to do to prepare for boards!  Study is more effective spread over a longer period of time. Don’t schedule more than you can actually accomplish. Be specific in your calendar entries–you will be more likely to actually follow through. Be flexible by scheduling one day per week that is a non-review day to do errands and pleasurable activities.

Review your schedule at least once each week and revise as needed. Break the boards into the subspecialties. Then, break those into smaller subcategories. Divide your study week so that you put in at least two hours per night, three nights per week. Schedule the topics you will study and review during these “appointment slots”, and add 20% to the time you think it will take to cover a subcategory. Include learning at home, reading during slow times at the office or while on call.

Schedule a time each week to read generalist medical journals relevant to your practice. Include clinical practice cases to enhance your study. Schedule “Review Cycles”–each day review the weak topics from the previous day, on weekends spend 3-4 hours to consolidate your learning from the previous week, and for the last 3-5 days prior to the exam, devote time to overall review, do NOT cover new information!

These four basic steps will help you develop your “Game Plan” and bring order to what can often become a chaotic whirlwind of frenetic activity while preparing for boards. While this process takes time and effort, it’s well worth it. In short, begin with the end in mind, plan for the worst, develop a realistic study plan, and prioritize your study time.