Welcome to Inside the Boards

I’m like you. I found the boards intimidating. So much, my whole life, the eternal destination of my soul (okay maybe not everything), riding on doing well on this stupid test. Yet I wasn’t the one holding the steering wheel. As I was preparing for Step 1, I felt like the question writers were the ones steering the ship of my career. And whoever their captain was, his tangential and random thought processes seemed a lot like Jack Sparrow. I was about to be moored on an island full of out of work MDs. If the question writers were in control–had the upper hand–where was I left? Maybe it was my memory of doing so-so on the ACT and the MCAT that had me shaking.  I was scared the USMLE was going to be the same way: a lot of frustration, worry, stress and hard work for a marginal score that would leave me struggling to reach the next step in my career. For sure, there’s no rest for the weary in medicine.

I wanted this time with Step 1 to be different. So I did like most medical students: I worried and worked, I was stressed and became frustrated. I purchased a library of preparation materials only to realize that just because you know a lot of stuff doesn’t mean you’re going tocrush the boards, let alone feel confident walking into the testing center. Like the bipolar patient, who works all night on her novel, which will be the consummation of all writing heretofore put to the page (a historical note that everyone knows is a dead give away for mania on the boards), I lived, ate, and breathed test preparation those eight weeks before Step 1. It’s amazing the similarities between the floridly psychotic and the medical student in “boards” mode: they say things like “the writers are trying to trick me to sabotage my life” (delusions), they retreat to a quiet corner or room not to emerge for weeks, they ignore basic hygiene and health (negative symptoms), they assume a fixed posture at a desk with seemingly no awareness of the world outside of them (catatonia). Think about it, you know I’m right and you know who you are.

Test day came. I survived, but barely. I left the testing center with a sinking feeling, certain that I had failed.At least there’s still philosophy, I thought (more about that later). As sure as test day came, it also went. The score was released. The mouse hovered over the hyperlink. But I couldn’t do it. So, like most other medical students, I covered my eyes and had someone else pull the trigger, fully expecting the bullet of reality to hit my career right between the eyes. It was a 232. Wow. Not a 280. But not failing either. My goal was a 230. And I met it.

As my excitement wore off, so did the ice of pessimism that had formed over my hope for future career opportunities. Maybe doing well on standardized tests was possible. I took this thought and my little hope-sickle too, applied to one of the board review question banks, and then landed a gig as a question writer.

As I thought back to what had helped me meet my Step 1 goal, it clicked: I actually uncovered the path to scoring well on the boards (as well as shelf exams, residency standardized tests etc.). I had opened the door that kept good scores locked from the students who were seeking them. What was my secret? My discovery? The truth is that it’s not really a secret. It’s not really magic. Scoring well on the boards is not even really that hard. Seriously. I’m not kidding, but please keep reading because I know at this point you are cursing me. “oh great,” you’re thinking, “Another ‘do well on the boards’ gimmick. I don’t need that *&%^&, I gotta go study). Just hear me out. Next time I’ll tell you what I found: how I learned to work smarter, not harder by focusing not just on the “what,” but also the “how” in regard to board preparation.

And thanks for reading. If you enjoyed this please tell your friends and feel free to leave a comment or ask a question.