Board Failure is Devastating

You may be one of the thousands who recently received their board results. If you were unsuccessful, you’re probably wondering how to regroup and move ahead. If you find yourself in this situation, you are not alone! Each year, thousands of physicians–across all medical specialties–fail their boards.

Failing to pass specialty boards is disappointing, demeaning, and personally and professionally devastating. For many, it means vacations aborted, less time spent with family and friends, and thousands of dollars spent on board review resources. But, the biggest frustration is the realization that you remain an “outsider” of your medical specialty community.


Board Prep Options to Consider

Most physicians regroup by attending a review course and/or subscribing to additional online question banks. Unfortunately, research shows that review courses offer little help because of their breakneck speed of delivery, and using additional question banks may not make a significant difference.

However, another option is available–coaching. If you played sports in school, you understand that the coach’s role is to provide technical support and training to the athletes and motivate the team.

Academic coaches function similarly to athletic coaches. They can (1) provide tips and techniques to help make your learning more meaningful and memorable, (2) suggest resources to make your learning more effective and efficient, and (3) monitor your progress and offer methods for improvement.

Seven Steps to Help You Regroup

Before you decide what your next step will be, here are seven ideas to consider:

  1. Take a mini-break. Press Pause. Don’t beat yourself up! Avoid freaking out–you’re not a failure! Give yourself time to unplug. Workout at the gym. Catch up on one or two critical tasks that may have been put aside while you were studying. Clear your head. Get a fresh perspective on your goal. Give yourself a few days or a week or two to gain perspective.
  2. Review your board results in detail. Identify the topics where you scored less than the median of passing candidates. If you failed your boards previously, compare your results across content domains. Then, review the exam blueprint, and take special note of topics that represent 5 percent or more of the exam. Focus your board preparation on these BIG topics–even if you passed them. Study the highest yield topics (i.e., those most frequently tested on your exam), earlier rather than later. Don’t spend a lot of time on topics representing less than 5 percent of the exam–they can take a long time to master.
  3. Create a timeline for re-taking your boards and create a study schedule. Ideally, you will want to begin studying at least one year prior to your boards. Work backwards from the date of the exam. Divide the number of topics that you need to review by the number of months that you have before the exam. Consider what time is best for you to study and how much time you can devote to studying–be realistic. Schedule your study time on your digital devices using an alert as a reminder. Include in your timeline some free time or gym time as well as vacation time. It’s critical that you devote two to four weeks to full-time study just prior to the exam–make arrangements for this at the outset. If you are unable to devote full-time to board prep, consider working part-time for awhile. Find a method for keeping you accountable to your study schedule–set deadlines and create rewards.
  4. Take another look at your board resources. What helped you the most? the least? Did you use multiple online question banks and rotate between them periodically? Did the online questions match the level of difficulty of your board questions? Did you use one primary review book to clarify and reinforce your learning? Don’t try to use too many books–stick to one primary review book and know it well. Did you review the material enough times? If you are re-taking your boards, you should aim to review your primary study resources at least four to five times in a high quality way.
  5. Reflect on your study methods. Did you use a multi-modal approach in your studying to reinforce material in several ways? Actively engage with the content (e.g., complete multiple-choice questions, watch key videos, write notes and review them periodically, highlight notes, create flash cards or mind maps, listen to audio recordings (even your own recordings of learning points) during commutes, generate questions, revisit information regularly, recite from memory what you learned, compare patient cases with the material you are studying). Depending on the amount of time you have, add at least three to four timed Practice Tests of 300-350 practice questions to monitor your progress. Get in the habit of timing yourself–do at least five timed questions each day to maintain your momentum once your scores have reached your goal. To retain material, devote time to studying and recalling what you have learned.
  6. Sharpen your test-taking skills. Approach each question in a consistent manner. Read questions carefully, determine what the question is asking. Rephrase the question in your own words and ask yourself what you already know about it. Review the answers carefully, and again, question yourself as to what you know about each response. If you are planning on doing questions only, plan on completing 2500 practice questions prior to the exam. This assumes that for each question you do not know well or get incorrect, that you go back and review the answer, explanation and review material to ensure that you understand the topic. Revisit information you have studied > 6 hours after you review it and ideally after a good night’s sleep (again, at least 6 hours).
  7. Create an effective learning environment. Where you study is just as important as the study methods you use. Remove clutter. Organize your board prep resources in one place, preferably a bookcase. Find a good desk (or table) and a comfortable (preferably ergonomic) chair. Use a desk lamp to ensure adequate lighting. Personalize your study space by adding posters, signs, and/or photos that motivate you. Create a learning space that simulates the testing environment. If you are easily distracted by TV or have small children at home, consider using a study cubicle or a private study room at a local library. For convenience, consider using a briefcase on wheels to hold your essential board prep material (laptop, primary review book, pens, highlighters, 3-ring notebook with tabs for each content area) to take with you to work or the library.

Board Failure Can Have a Silver Lining

Interestingly, failing medical boards will not materially hurt your career. Sometimes, there is a silver lining to failing an exam. As Dr. Jack Krasuski, a psychiatrist, says, “the silver lining is that you are more than passing or failing an exam. Physicians are all high-performers. Most have no history of failure, and when they fail a board exam, it can undermine their self concept.” Watch his video “What To Do If You Fail Your Board Exam.”

If you’re like most physicians preparing for boards, you’re short on time and need to be as efficient and effective as possible. You’ll want Dr. Carr’s free study guide. Inside, you’ll find 71 insightful tips to help you pass your boards successfully. You’ll receive ideas and strategies to make your study time more enjoyable and better focused.
____________________

Linda L. Carr, Ph.D., Founder/Principal at Coaching for Medical Specialty Boards, is a medical educator and learning specialist who coaches physicians preparing for specialty boards through virtual, one-on-one coaching. Visit www.DrLindaCarr.org to learn more about her program and download her FREE Study Guide.