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7/13/10

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

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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 2 out of 3 of questions correctly


Certification Exam Pass Rate"


Pass rates have improved for first time
test-takers:
early 90s
< 70%
2009
88%
Bad News for repeat takers: Low pass rate
"

"2003"

"42%

Recertification Exam Pass Rate

First time pass rate for recertification exam:


88% (between 1996-2009)

Good News for repeat takers: 96% of testtakers will ultimately pass after 3 attempts

7/13/10

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

Individual Learning Styles:


Attend a course
Small study groups

Resources for Study


SEP Modules: similar content, but harder
MKSAP 14 or 15: harder than real test
MKSAP Prep for the Boards 2 (500 questions)
? out of print

MKSAP Board Basics


Review books from Mayo, Hopkins, Cleveland
Avoid journal articles, standard textbooks

Shameless
Plug
First Aid for the Internal
Medicine Boards

Written and edited by


UCSF faculty & fellows

High Yield Facts

7/13/10

Types of Questions

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

Whats on the Test?


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

High Yield Areas

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

7/13/10

Whats Not on 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:


Specific drug doses, cancer staging

Controversies (not ready for primetime):


Virtual colonoscopy, coronary calcium
Mammography between 40-49

How to Approach the Test

Pace yourself (spend < 2 minutes / question)


Dont rush -- read carefully
Go through the questions sequentially
Answer easy questions first
Spend time on questions you know
something about, not where youre clueless
Change answers if more than a gut feeling

Answer Every Question!

How to Approach a Question


1. Read the question first
2. Then read the case
3. Try to guess the answer before looking
at the choices
4. Read the choices carefully, cross out
ones youve eliminated

7/13/10

Scrutinize Pictures
Carefully examine photos (e.g., radiographs,
ECGs, physical findings):
Theyre kind of small
(bring reading glasses)
There for a reason
May be normal
Findings wont be subtle

The Best Answer


More than one answer may appear correct

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

When You Are Clueless


Dont Panic!

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

7/13/10

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 during breaks
Have fun and try to learn somethingreally

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