Studying for the Internal Medicine Boards?
Who’s Idea was this?
Studying for the ABIM Certification exam is a difficult task. But there are easy ways to pass the Internal Medicine Board Exam. Probably the best approach is question review. This gives you an idea of the tricks inherently placed in exams of this nature. Most physicians take the question review approach to preparation, but its slow, boring, and tedious. A sufficient number of questions in each dicipline need to be reviewed, and this can take hours of time that most physicians simply don’t have.
With decreasing reimbursement, increasing malpractice, and mounting demands by pharmacies, home health personnel, insurance companies, and durable medical supply companies (none of whom want to pay anything for our services), we have found ourselves with diminishing returns and growing demands. Yet we must be ultimately responsible (the person to sue) despite our shrinking ability to choose medications, services, length of stays, appropriateness of interventions, and more.
We are asked to “approve” these things that are decided in board rooms and lawyers offices, rather than in the privacy of an exam room. And these decision makers also demand “board certification.” What started out as a voluntary endeavor for smart doctors who somehow lacked patients, it has morphed into an added requirement. . . an extra step after college, and medical school, and residency. Like the Emperors New Clothes, doctors now espouse the merits of board certification because its accepted so universally by those who don’t have to take the exam. Imagine if we physicians decided that passing the Bar Exam once was now not enough to continue the practice of law? How quickly would that idea be squelched? But like sheep in a herd, we press on with our mounting expectations with little more than an occasional ‘nay.’
Many successful board certified physicians will say “read MKSAP” or “read Harrison’s,” but really that approach is not very helpful as an efficient tactic. While its a great way to improve the actual practice of medicine, it’s not the best use of your time in preparing for the board exam. If you were going to read Cecil’s and or the MKSAP anyway, by all means, do it. Your practice will be rewarded, but the ABIM, might be a different story. Straight forward medicine is not their goal. Everyone passing is not their goal. In their world, their has to be a hierarchy where some physicians don’t fit in. The ‘weeding’ that occurred in college pre-med classes, medical school anatomy, internship scut work, and initial certification wasn’t sufficient to drive the money machine that is needed to keep the industry alive. The mufti-million dollar world that medical “Board Certification” has become would collapse if physicians simply stopped listening to non-physicians when it comes to the practice of medicine.
Well. . . we’re on a mission now to simply pass the test before they come up with additional requirements and fees for us to invest in. The answer?? Sticking together, and using technology to our advantage.
As time has passed since residency, and technology has advanced to IPads and smart phones, and more. . . to take the old approach of ‘doing questions’ is antiquated, and ignores tools that can be used to take an efficient approach to board certification and re-certification.
Use different, and more interactive approaches to studying. Use electronic flash cards or clinical presentations that can quiz you during the course of a work day. Take your study material with you in your smart phone.
Don’t miss these questions. . .
One of the most frustrating aspects of the Internal Medicine Boards is missing an “easy” question. In this case an easy question is one that:
- You know the question is going to be on the exam.
- It is easy to miss if you don’t review it before the exam.
With only 180 question, missing one is huge. . . missing an easy one is unacceptable. One of the best examples is the Bayesian 4 Square
The table above show a way to remember the formulas, and not the actual formula.
POSITIVE PREDICTIVE VALUE = TP / TP + FP (remember the positive go across the top)
NEGATIVE PREDICTIVE VALUE = TN / TN + FN (remember the negative go across the bottom)
PREVALENCE = TP + FN / ALL ( TF+FP+TN+FN) (the people with the disease / everyone)
Flash Card Clinical Presentations present classic scenarios that “always” appear on Board exams.
Disclaimer: Integrative Clinical Resources, Inc. is not affiliated with or endorsed by any official testing organization. All organizational and test names are trademarks of their respective owners.