How to Score Well on the Boards?

Author: V. Dimov, M.D., Assistant Professor of Medicine and Pediatrics at University of Chicago
Reviewer: S. Randhawa, M.D., Assistant Professor at NSU

Some residents have boards scores as high as the 99th percentile, others are so lucky. It is not easy to guess who the top and the bottom scorers are. Does it make you a better doctor if you have great scores? According to some studies, probably yes.

But if you have low scores, not everything is lost. You can actually learn how to score well on the board exams. One of our medical residents was stuck in the 30th percentile until she started practicing with 15 MCQ (multiple choice questions) every evening. On the next in-service examination, she scored well above the average.

Practice makes perfect

The best approach to score well on the MCQ exams is to do 2 things:

1. Read a concise book to understand the basics, e.g. Oxford Handbook of Clinical Medicine rather than huge volumes like Harrison's or Cecil's. Use the handbook plus a collection of medical images like the Braunwald's Atlas of Internal Medicine (available after a free registration at Medicine is a visual science, and seeing often equals remembering.

2. Practice with a lot of MCQ. In a word of mouth, one needs to solve 5,000 questions for each step of UMSLE in order to pass. If you want to do well, you need to answer 10,000 MCQ, and if you do 15,000 -- well, somebody will score at the 99th percentile and it might just be you.

Remember the following useful strategy, when you practice with MCQ:

- read the 1st line (age? background?)
- read the last line (what are they asking me?)
- read the answers

Then read the stem (if you have time), with the answers in mind. Do not waste your time reading the long stem first, you will go "over-budget" (over-time), and by the time you reach the end, you will have forgotten what the question was about. Then you have to start again but the next question is coming, and the clock never stops ticking.

In short, the formula "first line, last line, answers" works for many test takers. Try this strategy and see if it works for you. Practice makes perfect.

A simpler approach is to read the last line and the answers. By doing this, you will know what the question is about, e.g. "what are they asking me?" Then read the stem looking for a hint to find the correct answer.

Pace yourself when you practice with MCQ. You need to know how long it takes you to answer each question.

Write down the answers on a blank sheet of paper, and after you are done with the practice session, always calculate 2 variables: the percent of correct answers and the seconds you spend on each question.

For example, if you did 120 MCQ and you answered correctly 75, your score is 62%. Good!

Then, calculate the time. It took you 82 minutes to answer 120 questions, 82 minutes are 4,920 seconds. This means you spent 41 seconds per question. Google can calculate that for you.

Write those 2 numbers on the side of your answer sheet: "62 %, 42 s/Q". Monitor your progress over time.

For those who like mnemonics, the best free resource is probably Medical The web site is very comprehensive, organized by topic and fully searchable. It is the first result when your search for "medical mnemonics" on Google. I made up about 1,000 mnemonics when I was studying for USMLE and posted some of them at

Mini Oxford handbook of clinical medicine By Murray Longmore, Ian Wilkinson, Supraj R. Rajagopalan from Google Books:

First Aid for the USMLE step 1 (also step 2 and 3) - searchable on Google Books

Related reading

"The New Way Doctors Learn" - The concept of "spaced repetition" is more than 15 years old, not so new. It works.

9 evidence-based study tips
To Really Learn, Quit Studying and Take a Test - Test-taking works better than repeated studying - NYTimes

ABIM Sample Exam Questions

If you score more than 65-70% correct, you will most likely do fine. If less than 50% of your answers are correct, you should be worried -- read the test taking strategies above, and do more and more and more... questions.

ACP - Taking the boards? Try these strategies for success

ACP - Board Review Strategies

What Does the ABIM Examination Cover?

MKSAP can be helpful although some prefer Medstudy.

Useful ABIM exam data from prior years

ABIM Internal Medicine boards - 10 Tips

Graham’s Guide to Boards Prep.

30,000 Medical Images, Tables and Figures from Leading Textbooks are Online

Mnemonics. sBMJ, 2005.

How to Study. Clinical Cases and Images - Blog, 2007.

How to Study for a Big Exam. Kendra Campbell, 12/2007.

Daytime Nap May Boost Memory. WebMD, 02/2008.

Tips for Taking the USMLE. Over!My!Med!Body! 02/2008.

How to prepare for the cardiology boards., 06/2008.

5 Tips To Beat a Standardized Test. LifeHacker, 09/2008.

Getting Ready Mentally for the USMLE Exam. USMLERx Blog, 01/2009.

9 evidence-based study tips

Medical Mnemonics
ABIM Maintenance of Certification (MOC) internal medicine exam tips. KevinMD, 2011.

Learning by Spaced Repetition. Life in the Fast Lane, 2011.

How to Be a Better Test-Taker - NYTimes has some tips for you, 2012.

Drink Water to Improve Test Scores and

"Ace Medical School Exams by Maximizing Study Time" - Albert Einstein College of Medicine blog

Published: 02/12/2004
Updated: 08/21/2012

1 comment:

  1. Thank you so much for the tips, they sure will be valuable for those preparing for the boards (including me!)