01 Cheng Test Taking Tips 2011

Pearls for the ABIM
Examinations
Hugo Q. Cheng, MD
Department of Medicine
University of California, San Francisco
Examination Overview
One day exam at PearsonVUE or
Prometric test center
Exam divided into modules (60 questions)
2 hours to complete each module
2 minutes per question
Certification: 4 modules = 240 questions

Recertification: 3 modules = 180
questions
Certification Exam Pass Rate

Pass rates have improved for first time
test-takers:
early 90s
< 70%
2010
87%
Bad News for repeat takers: Low pass rate
2003
Recertification Exam Pass Rate
First time pass rate for recertification

exam: 88% (between 1996-2010)
Good News for repeat takers: 96% of testtakers will ultimately pass after 3 attempts
42%
The Passing Score

Determined by ABIM in advance
Not graded on a curve

The Board defines the marginal candidate
Estimates % of marginal candidates
answering each individual question correctly
Passing score derived from estimates
Your score is combined from all modules
Answer ~ two-thirds of questions correctly
Studying Strategies
Recommended for Everyone:
Start studying early

Make a study schedule
Focus on your weak areas first
Use a review text or guide
Take the tutorial:
http://www.abim.org/exam/prepare.aspx
Resources for Study
SEP Modules: similar content, but harder

MKSAP 14 or 15: harder than real test
MKSAP Board Basics
Review books from Mayo, Hopkins, Cleveland
MedStudy
Avoid journal articles, standard textbooks
Individual Learning Styles:

Attend a course
Small study groups
Shameless
Plug
Types of Questions
First Aid for the Internal

Medicine Boards
Written and edited by

UCSF faculty & fellows
High Yield Facts
Whats on the Test?
All multiple choice, single best answer

Almost all case-based, clinically oriented
What is diagnosis, Next step in dx or rx
Few ask for straight fact recall
Some experimental questions
Take the tutorial:
http://www.abim.org/exam/prepare.aspx
High Yield Areas
Subject Matter:
75% on core internal medicine specialties
25% on neurology, psych, derm, etc.
Half are cross-content topics (geriatrics, critical care,
ethics, prevention, etc.)
75% of cases occur in outpatient setting
Exam Blueprints:
www.abim.org/pdf/blueprint/im_cert.pdf
www.abim.org/pdf/blueprint/im_moc.pdf
Uncommon features of common diseases

Common features of uncommon diseases
Associations (geography, ethnicity, occupation, etc.)
Formulas (gaps and gradients)
Simple statistics (sensitivity, specificity, PPV, NPV)
Adverse effects of medications, iatrogenic disease
Whats Not on the Test?
How to Approach the Test
Areas that change rapidly:
HIV therapeutics (choosing anti-retrovirals)

New drugs
Anything less than 2-3 years old
Details that are usually looked up:
Drug doses, cancer staging
Pace yourself (spend < 2 minutes / question)

Dont rush -- read carefully
Answer easy questions first
Spend time on questions you know
something about, not where youre clueless
Change answers if more than a gut feeling
Controversies (not ready for primetime):
Answer Every Question
Virtual colonoscopy, new biomarkers for CV dz

Mammography between 40-49
How to Approach a Question

1. Read the question first
Scrutinize Pictures
Carefully examine photos (e.g., radiographs,
ECGs, physical findings):
2. Then read the case

Theyre kind of small
(bring reading glasses)
There for a reason
May be normal
Findings wont be subtle
3. Try to guess the answer before looking

at the choices
4. Read the choices carefully, cross out
ones youve eliminated
The Best Answer
When You Are Clueless
More than one answer may appear correct
Dont Panic!
Obvious answer is usually correct

Prioritize: what do you do next?
Be wary of absolutes: must, always, never
Evidence-based
Cost-effective, safest, least invasive
Standard care dont be creative
Might be an experimental question

Re-read the question carefully
Dont pick an answer youve never heard of
Dont waste time on a tough question best
guess, flag it, and move on!
Answer every question
Final Advice
Dont freak out!

Get a good nights sleep
Wear comfortable clothes
If exam is out of town, get a hotel room
Make sure you know driving directions
Dont discuss the exam
Have fun and try to learn somethingreally

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Pearls for the ABIM

Certification: 4 modules = 240 questions

Certification Exam Pass Rate

Recertification Exam Pass Rate

First time pass rate for recertification

The Passing Score

Not graded on a curve

Answer ~ two-thirds of questions correctly

Start studying early

Resources for Study

SEP Modules: similar content, but harder

Individual Learning Styles:

First Aid for the Internal

Written and edited by

High Yield Facts

Whats on the Test?

All multiple choice, single best answer

High Yield Areas

Uncommon features of common diseases

Whats Not on the Test?

How to Approach the Test

Areas that change rapidly:

HIV therapeutics (choosing anti-retrovirals)

Details that are usually looked up:

Drug doses, cancer staging

Pace yourself (spend < 2 minutes / question)

Controversies (not ready for primetime):

Answer Every Question

Virtual colonoscopy, new biomarkers for CV dz

How to Approach a Question

2. Then read the case

3. Try to guess the answer before looking

The Best Answer

When You Are Clueless

More than one answer may appear correct

Obvious answer is usually correct

Might be an experimental question

Dont freak out!

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