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Updated: Feb 19, 2018

Studying doesn't end when residency starts. Starting with your first in-training exam and Step 3 to your specialty board exam, you have plenty of work left to do. Not to mention that now you're not just studying for a test, you're studying to save a life!

When I first started residency, I had no idea what was expected of me in terms of studying and academics. I heard so many rumors about different programs, from in-training exams to oral boards, and I quickly realized I knew nothing about education in residency. Here is a brief overview of what I have gathered so far about learning and testing in residency.

Disclaimer: This is from my experience in a pediatrics program. Every program is unique and has different expectations.


In-Training Exam (ITE): A national exam that, for pediatric residents, is given every July. My program uses it as a benchmark for our pediatric board exam performance. Some programs take it more seriously while others never look at it.

USMLE Step 3/COMLEX Level 3: The final (!) test from the National Board of Medical Examiners that is required before you sit for your specialty board exam. Most programs require you to take it during your first year, but others give you more flexibility. This means that, yes, you have to study for a board exam during intern year without any guarantee of a study block or time off to prepare!

Content Specifications (Specs): A blueprint of everything you could possibly need to know for your board exam, in outline form, of course.

American Board of Pediatrics (ABP): The national organization that runs our pediatrics board-certifying exam. The test is given annually in October for newly graduated residents.

Here are links to other specialty board exams:

Surgery/American Board of Surgery (ABS)

Ob/Gyn/American Board of Obstetrics and Gynecology (ABO+G)

Family Medicine/American Board of Family Medicine (ABFM)

Internal Medicine/ American Board of Internal Medicine (ABIM)

Emergency Medicine/American Board of Emergency Medicine (ABEM)

Studying Overview by PGY-Year

Intern Year: The large focus of intern year is learning how to be a doctor: how to talk to patients, write an H&P, write an order for Tylenol, communicate with nurses, etc. The best advice for interns is to read about your patients for 10 minutes when you get home. Find a section in a textbook or a concise review article and refresh your memory on the 5 causes of bloody diarrhea and how to treat them. Once you know your schedule for the year, decide on a Step 3 date and just go with it. Get a question bank and try to start about a month before. Any longer and you’ll probably burn out.

Second Year: By now you’ve mastered ordering Tylenol and can afford to spend more time reading during the day. You’ll also likely have more elective time and can focus intensely on specific subjects for a month at a time. My co-residents and I bought a group discount for MedStudy, a pediatrics board review program that has 5 textbooks broken down by system. Most of us attempt to read a chapter for each elective rotation, for example, the cardio chapter during cardio elective. My favorite thing to do during these months is break down the 30 page chapter into 1-2 pages per day. This was a foolproof way for me to get through a chapter during an elective.

Third Year: The talk of the town has suddenly turned to BOARDS. All of your elective blocks, study blocks, and research blocks are heavily emphasizing board-related content. Each program has a different approach to helping you prepare for the boards; some programs have a board-prep program with protected study time, others allow you to make your own study block. The bottom line is that you need to look at the content specs and create a study plan so that you can hit every subject before October! More on this next year when I actually have to do it…

As you can see, it’s all about planning and keeping the big picture in mind. If you have a sense of what is expected of you during each year, you can stay on track for boards while learning the real-life medicine that you need to care for your patients.

Feel free to contact me for more details about studying during residency!

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