Preparation for the In-Training Examination
Dennis L. Hufford, CDR, MC, USN
Faculty Development Fellowship
Madigan Army Medical Center
(edited for web page 03 JUL 99)
1. To understand why this exam is given
2. To understand what your exam score can and cannot reveal about you
3. To familiarize you with the structure of the test.
4. To provide practical advice on test preparation and completion.
5. To provide tips on guessing.
I. The exam: Produced and graded by the American Board of Family
1. Curriculum Development Tool for Residencies
2. Identification of individual or group knowledge base deficiencies
3. Identify individuals at risk of failing the ABFP Board Exam
The exam measures:
1. Your ability to take a standardized board-style exam.
2. The approximate quality of your last 1-2 years of training.
3. How you, your year group, and your residency compare w/ nation
The test CANNOT measure:
1. How good a doctor you are.
2. Your fitness to graduate.
II. Structure of the exam:
Time: ½ day, two "books", covering major training disciplines. (40% Int. Med., 12% each Peds, Surg, & Psych, Ob/Gyn 10%, Geriatrics and Community Med 5% each.)
Types of questions:
Book 1: 2-3 hours, 120-150 Conventional stem questions w/ 4-5 responses (single answer), 20-30 stem questions w/ 4-5 T/F responses (BEWARE: they take longer!).
Book 2: Clinical Set Problems: 1-1 ½ hours, 10-12 detailed case scenarios each followed by 8-15 T/F questions.
NO PENALTY for guessing. Unanswered questions are graded as WRONG.
Questions are at least two years old. (Many are MUCH older!!)
You may write in the test book.
A. Study?? I suggest: old board exams, preventive medicine algorithms, immunization schedules and contraindications, drug safety in pregnancy and lactation, and KNOWN areas of weakness.
B. The night before: Get some sleep! Donít study. Relax. Avoid alcohol and medications that you don't take regularly.
C. Test morning: Eat a moderate breakfast. Caffeine? (per your norm). Wear layered, comfortable clothes.
D. When handed the exam: Listen carefully to proctors instructions. (Donít mess up your answer sheet!) Understand how proctor is keeping time (blackboard time never fully accurate!)
E. Scan test booklet first, plan for where you should be in one hour, etc.
IV. As test progresses:
A. Check time about every 30 minutes or so.
B. When stumped, GUESS and MOVE ON. Mark question in TEST book for review if you have time at end.
C. Periodically verify that your answers are in sync w/ answer sheet.
V. Guessing Tips:
Prime Directive: DO NOT LET THESE RULES TALK YOU OUT OF AN ANSWER YOU KNOW IS CORRECT!
But, if all knowledge fails:
1. Eliminate obviously wrong answers. (improves guessing odds)
2. Be vigilant for catch words: NOT, ALWAYS, ALL, ALL BUT, NEVER, LEAST LIKELY, MOST LIKELY, ALL OF THE FOLLOWING EXCEPT.
3. Scrutinize similar answers carefully:
-if they state opposing conditions, one of them is the right answer.
-if they merely restate the same condition, they are BOTH WRONG.
-if both are identical except for one fact (usually a number), one is right.
4. For numerical answers, choose midrange value, consistent with most of other choices
(Avoid extremes and outliers)
5. Avoid value laden, emotional or visceral responses.
6. In long questions, consider reading answers first.
7. Ask yourself: "What did the test-writer and editors consider important in this question? (Whatís the teaching point? There usually is one.)
8. Break long, confusing questions into manageable parts.
9. Stick to mainstream principles, avoid basing answers on your last anecdotal case.
10. Questions appearing early may help with later ones, and vice versa.
11. The longest answer is often the right answer.
12. For drug choices, the brand name sometimes gives you a hint.
13. If youíve never heard of an answer (ex. procedure), chances are, itís made up!