ABIM Internal Medicine Boards - Exam Tips

American Board of Internal Medicine (ABIM) certification exam is a high stress test given to graduates from Internal medicine residency programs. The Internal medicine recertification exam is given to physicians already in clinical practice, who have been ABIM board certified in the past. This article gives tips on preparing, studying and taking the Internal medicine boards. Although written specifically for ABIM Internal medicine boards, these tips are also useful for Family Practice, Pediatrics, OBGYN, Surgery and other board exams. 

Click here for information on the American board of Internal Medicine exam, application, board review courses and study material.     

• When & How to study for ABIM exam: During your medical residency, schedule time to study for the ABIM Internal medicine boards. The third year (PGY 3) of your residency should be your main time of preparation. Reading alone is usually a bad strategy and often depressing. You may not be able to retain much of the ABIM material that you reviewed alone either. Try to form a study group with other PGY 3 residents who will be taking the same ABIM Internal medicine boards. This will boost every ones morale and give a common sense of purpose. Set a mutually agreeable time for the discussions. The best time to study in a group is over the weekend when none of you have residency obligations. Spending three or four hours every weekend (once a week) is enough to stay focused. Understand what you are studying and the reasons for it. Keep asking yourself the question “why?” and “why not?”

• Study groups: It is crucial that you keep your study group small and stay focused on your ABIM Internal medicine board exam goals. An ideal number would be three or four residents. More than four residents would be counter-productive. Try to have a schedule and read ahead of the planned discussion. By preparing ahead, you will save time, cover more topics and retain more from the discussion.  The study group will work best if all participants follow the same board review material. However, different ABIM board review material could also work to your advantage. A good plan is to discuss your ABIM Internal medicine board review study material (Medstudy / Mayo clinic review etc) for the first two hours and then solve multiple choice questions (MKSAP) for the next two hours. Solving multiple-choice questions in groups and discussing each option in detail is vital in developing your thought process and sharpening your clinical decision making skills. You will realize the usefulness of the study group and thank your colleagues when you sit for the actual ABIM Internal medicine boards. 

• What to study for ABIM exam: Decide on the ABIM Internal medicine board review material you wish to study from. We have reviewed some commonly used material in this website. The important thing is to choose what works best for you. Choose one ABIM board review textbook and stick to it. It is far more advantageous to revise the same material several times than reading several different materials and getting confused. You must concentrate on solving MKSAP or Medstudy questions at least 50 % of your preparation time.

• Create and devote time to prepare for your ABIM boards. Remember, medical residency is the best time to prepare for the boards. Once your residency is completed, you are thrown out into the real world. If you are starting a fellowship, you will not find much time to study. If you are starting a job as a new physician, your first month will be busy learning the intricate details of medical practice and the paperwork that comes with it. You will most likely, end up designating ten days for study just prior to the exams and as we all know that never works out. So once again, residency is the best time to study. You will not find that kind of quality time after your residency.

• Prepare a schedule to study for ABIM Internal medicine board exams and hang it in a prominent place. You will make several changes to this over time. Plan to revise the ABIM Internal medicine board review material that you have chosen several times (minimum twice). Stay focused throughout the third year of your residency. By middle of the third year, your ABIM Internal medicine board review preparation must be at its peak. If you have not yet formed a study group, now is your last chance.

• Solve questions similar to ABIM exam content: Don’t try to read the ABIM Internal medicine board review material from “cover to cover”. You will not retain much. The best way to prepare is to solve questions, then read the explanation and then look up additional information related to each of the choices (options). This really improves your understanding of the question, familiarizes you with the “teaching principle” and the “testing objective” of that question (which may be repeated in the actual ABIM Internal medicine board exam), and gives you an opportunity to learn about all the other choices and how they differ from the correct answer. Ideally you should be solving MKSAP questions in your second year of residency (PGY 2). If this is not the case, you must definitely begin doing the MKSAP questions by the start of your third year of residency (PGY 3).

• Pictures & Images: Pictures of skin disorders, X-rays and other images given in board questions are generally easy ones to score points. Looking at the image first, before reading the question, usually helps spot the abnormality. Reading the ABIM question’s stem after that will help you put the pieces of the puzzle in place.

• ABIM answering strategies: When reading long multiple choice questions, it may be useful to first read the actual “lead line” of the ABIM Internal medicine board exam question. Once you understand what the question is asking, you can stay focused and look for clues in the long stem of the ABIM exam question. This strategy will also save you time. Several residents have found this strategy useful. As you read through the question, you may also find it useful to underline the key facts and abnormal findings. Once you have gone through the choices, it will be easy to look at the underlined abnormalities and try to “connect the dots”.

• Zebras: Use exam “techniques” to your advantage. Look for target words in ABIM Internal medicine board exam questions. These are referred to as “zebras”. For example in an ABIM exam question, if you see the word “anosmia”, think Kallmann’s syndrome. If you see the phrase “scar on left abdomen”, think splenectomy and look for encapsulated organisms causing sepsis. If the patient is from the Ohio or Mississippi river valleys, think histoplasmosis (CXR calcifications).

• ABIM exam day: Do not study the day before the ABIM Internal medicine boards or in-between the ABIM exam sessions. Discussing the ABIM exam questions with other residents may upset you and adversely affect your performance in the next session. Remember, “What is done, is done”. So don’t cry over spilt milk. Rather, stay focused and conserve your energy for the next ABIM board exam session.