When should you start studying for the Internal Medicine Boards?

The easy answer is that it is never too early to start. However, how you are studying will change depending on your stage in residency and how you have performed on standardized tests in the past.

PGY1: Learning the Medicine in Intern Year

The focus of your intern year is learning how to be a phenomenal doctor for your patients: conducting a thorough history and physical, working in interdisciplinary teams, thinking about a broad differential diagnosis, accurately documenting your treatment plan, and providing compassionate care.

It might seem incredibly daunting to add on the task of studying for your internal medicine boards too. But it is possible to both learn about your patients and the content of the advanced boards at the same time.

How to Study for the ABIM Exam During Intern Year:

1. Start slowly working through MKSAP questions.

Aim to do just 3 MKSAP questions per day, and you will finish all of the question bank during your intern year. Try to do questions that line up with your rotations to make the content stick (e.g. cardiology questions during your cardiology rotation).

2. Read the MKSAP books.

If you are someone who learns by reading, try to read 1 topic in the MKSAP books per day. You will never get through all of it (especially not in intern year), but it can provide a broad background on conditions you are seeing during the day.

Example: If you admit a patient with hematemesis, read about the evaluation of upper GI bleeding that evening to anchor your learning to a specific patient.

3. Multitasking is essential.

Given your time constraints, learn to multitask. Listen to a medical education podcast while exercising or commuting. Some great options include The Curbsiders, Clinical Problem Solvers, CardioNerds, and Core IM. Review their show notes after listening to reinforce the information.

4. Start a study notebook.

For those who learn by writing, start a notebook (virtual or physical) with notes on various topics that you update with information from lectures (i.e. noon conferences, journal clubs, etc.), reading, and MKSAP question answers.

PGY2 – Reinforcing the ABIM Material During Residency

In your second year, you are learning to think more broadly about patient management, while also learning how to lead a team. This is a great time to try to redo the MKSAP questions to reinforce the material now that you have been exposed to larger number of patients and pathologies. Other techniques to incorporate this year include:

1. Use your notebook of notes to create short chalk talks for your interns and medical students. There is no greater way to learn a topic than by teaching it to someone else. Challenge yourself to choose topics that you find difficult (e.g. acid-base problems), and you will suddenly find yourself feeling more comfortable with that field in the future.
2. Most programs have PGY2s take the in-service exam (and some programs have their residents take it every year). Use the educational objectives that you got wrong on the test to guide a deeper dive in the MKSAP books. Force yourself to take notes on those topics and find the right answer to the questions.

PGY3 – Solidifying your Knowledge and Preparing for the ABIM Exam

Amidst fellowship or job applications, your third year is the time to develop a detailed study schedule to prepare to take the boards in the summer following residency.

If you are someone who struggled with USMLE exams, you may want to start intensive studying at the beginning of PGY3.

If you are someone who has done well on USMLE and in-service exams, you can start intensive studying in the spring.

1. Aim to get through MKSAP questions at least once, if not twice, before your boards. If you feel like you need more practice with test taking skills and questions, you may want to consider doing the UWorld question bank as well.
2. If you think you might need more in depth content review, sign up for a boards review course. Many residency programs offer online courses to review the content. This can be a great resource, especially in the spring prior to your boards exam.

If at any point in this process, you feel like you need more guidance or individualized tutoring/mentoring, please reach out to Med School Tutors. We have multiple advanced boards tutors available to help guide you through the process of learning in residency, planning your fellowship and career path, and succeeding on the advanced boards.

MKSAP vs. UWorld for ABIM Exam Prep